bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in Total Cardiac Output and Oxygen Extraction During Exercise in Patients Supported With an HVAD Left Ventricular Assist Device
Authors: Schmidt Thomas , Bjarnason‐Wehrens Birna , Mommertz Stephanie , Hannig Meike , Schulte‐Eistrup Sebastian , Willemsen Detlev , Reiss Nils 
Published: February 2018

AbstractFollowing implantation of a left ventricular assist device (LVAD), acceptable functional performance is now being achieved; however, peak VO2 and peak work load (watts) remain considerably limited. Maximum physical capacity is essentially dependent on generated cardiac output (CO) and arteriovenous oxygen difference (avDO2). We investigated the changes in CO and avDO2 during exercise in LVAD patients with an HVAD pump (HeartWare Inc., Framingham, MA, USA). Approximately 6 weeks after implantation, 20 patients (100% male, 60.8 ± 7.3 years old, BMI 25.7 ± 3.3) underwent a six‐minute walk test (6MWT), a cardiopulmonary exercise test (CPET), and noninvasive hemodynamic measurement. The mean six‐minute walking distance (6MWD) was 403 m (68% of predicted), and mean peak VO2 was 10.9 mL/kg/min (39% of predicted). Mean total CO improved from 3.8 L at rest to 7.0 L at maximum exercise. The mean avDO2 increased from 7.4 mL/dL (44% of oxygen content) at rest to 13.2 mL/dL (75% of oxygen content) at maximum exercise. There was a significant increase in both total CO (P < 0.01) and avDO2 (P < 0.05) between rest and sub‐maximum exercise. As exercise levels increased, however, no further significant changes were achieved. Long‐term studies, especially in combination with exercise programs, would be desirable in order to observe the development of these parameters.
Recurrent rearrangements of the PLAG1 and HMGA2 genes in lacrimal gland pleomorphic adenoma and carcinoma ex pleomorphic adenoma
Authors: Andreasen Simon , von Holstein Sarah L. , Homøe Preben , Heegaard Steffen 
Published: February 2018

AbstractPurposeLacrimal gland tumours constitute a wide spectrum of neoplastic lesions that are histologically similar to tumours of the salivary gland. In the salivary gland, pleomorphic adenoma (PA) is frequently characterized by recurrent chromosomal rearrangements of the PLAG1 and HMGA2 genes, a genetic feature retained in carcinoma ex pleomorphic adenoma (ca‐ex‐PA) that makes it possible to distinguish ca‐ex‐PA from de novo carcinomas. However, whether PLAG1 and HMGA2 gene rearrangements are found in lacrimal gland PA and ca‐ex‐PA is not known.MethodsTwenty‐one lacrimal gland PAs and four ca‐ex‐PAs were retrospectively reviewed and subjected to break‐apart fluorescence in situ hybridization (FISH) for rearrangements of the PLAG1 gene. Cases without PLAG1 abnormalities were subjected to HMGA2 break‐apart FISH. Immunohistochemical staining for PLAG1 and HMGA2 protein was performed and correlated with gene status.ResultsSixteen of 21 PAs showed rearrangement of PLAG1 and were all positive for PLAG1 protein. Two of the remaining five PAs showed rearrangement of HMGA2 and were the only cases positive for HMGA2 with immunohistochemistry. The three FISH‐negative PAs expressed PLAG1 protein. All four ca‐ex‐PAs showed rearrangement of PLAG1 and expressed PLAG1 protein. None of the de novo carcinomas showed rearrangement of either of the two genes or expression of the two proteins.ConclusionRearrangement of PLAG1 and HMGA2 and expression of the corresponding proteins are frequent and specific findings in lacrimal gland PA and ca‐ex‐PA. The mechanism for PLAG1 overexpression in FISH‐negative PAs is yet to be clarified.
Adverse events linked with the use of chimeric and humanized anti‐CD20 antibodies in children with idiopathic nephrotic syndrome
Authors: Bonanni Alice , Calatroni Marta , D'Alessandro Matteo , Signa Sara , Bertelli Enrica , Cioni Michela , Di Marco Eddi , Biassoni Roberto , Caridi Gianluca , Ingrasciotta Giulia , Bertelli Roberta , Di Donato Armando , Bruschi Maurizio , Canepa Alberto , Piaggio Giorgio , Ravani Pietro , Ghiggeri Gian Marco 
Published: February 2018

AimsAnti‐CD20 antibodies are increasingly being used to treat idiopathic nephrotic syndrome (INS) in children. While they may allow steroid and calcineurin inhibitor withdrawal, repeated infusions of anti‐CD20 antibodies are often required to maintain remission. Data on their potential toxicity in INS are needed, to consider repeated infusions.MethodsWe investigated the side effects associated with the use of rituximab (a chimeric antibody; 130 patients) and ofatumumab (a humanized antibody; 37 patients) in children with INS (steroid‐dependent and steroid/calcineurin inhibitor‐dependent disease) treated at a national referral centre over a 9‐year period (400 treatments; follow‐up 1–9 years).ResultsInfusion reactions were mainly absent in children with steroid‐dependent disease. Rash, dyspnoea, fever, cough and itchy throat (5% and 18% following rituximab and ofatumumab infusion, respectively) were resolved by using premedication with salbutamol. Other short‐term reactions (up to 3 months), including arthritis (2%) and lung injury (1%), were more common with rituximab. Infections were observed 3–9 months following infusion, were similarly common in the two groups and resolved with targeted therapies [antibiotic, fluconazole, immunoglobulins (Igs), etc.]. The number of circulating CD19/20 cells fell to 0 at month 1 and were reconstituted at month 3; circulating IgG antibodies remained within the normal range for 1 year. Tetanus and hepatitis B virus immunization was not modified by either treatment; Epstein–Barr virus and John Cunningham virus activation markers were occasionally observed.ConclusionOverall, the toxicity of anti‐CD20 monoclonal antibodies was limited to post‐infusion side effects in children with more complex disease. The relatively safe profile of anti‐CD20 antibodies supports their use as steroid‐sparing agents in children with INS.
Care associated with stillbirth for the most disadvantaged women: A multi‐method study of care in England
Authors: Redshaw Maggie , Henderson Jane 
Published: February 2018

AbstractBackgroundMost research on women experiencing stillbirth relies on online user group surveys or qualitative interviews. The objective of this study was to investigate the experience of women who are at a higher risk of stillbirth, living in areas of greatest deprivation, and are commonly not well represented.MethodsThis study used birth and death registrations in 2012‐2013 to identify a sample of mothers whose babies had died as a result of stillbirth. These women were sent a survey 6‐9 months after the stillbirth. We undertook descriptive analysis of quantitative data and used binary logistic regression with the Index of Multiple Deprivation as a measure of disadvantage. We used thematic analysis to describe free text responses.ResultsThe survey response rate was 30% (N = 473). Ethnic minority, younger age, and single parenthood were associated with disadvantage. Women residents in the most deprived areas perceived care more negatively: during labor they were significantly less likely to be spoken to by medical staff so they could understand (73% compared with 90%, adjusted odds ratio [aOR] 0.33 [95% confidence interval {CI} 0.18‐0.65]), or treated with respect by midwives (79% compared with 90%, aOR 0.41 [95% CI 0.22‐0.77]). The qualitative themes identified were: “Difficulty in accessing care,” “More could have been done,” “Ineffective communication,” and “Cared for and not cared for” which support the quantitative findings.ConclusionWomen living in the most deprived areas reported poorer experiences of care compared with more advantaged women. All women need compassionate and sensitive care around the time of a stillbirth.
Home birth integration into the health care systems of eleven international jurisdictions
Authors: Comeau Amanda , Hutton Eileen K. , Simioni Julia , Anvari Ella , Bowen Megan , Kruegar Samantha , Darling Elizabeth K. 
Published: February 2018

AbstractBackgroundThe purpose of this study was to develop assessment criteria that could be used to examine the level of integration of home birth within larger health care systems in developed countries across 11 international jurisdictions.MethodsAn expert panel developed criteria and a definition to assess home birth integration within health care systems. We selected jurisdictions based on the publications that were eligible for inclusion in our systematic review and meta‐analysis on planned place of birth. We sent the authors of the included publications a questionnaire about home birth practitioners and practices in their respective health care system at the time of their studies. We searched published peer‐reviewed, non–peer‐reviewed, and gray literature, and the websites of professional bodies to document information about home birth integration in each jurisdiction based on our criteria. Where information was lacking, we contacted experts in the field from the relevant jurisdiction.ResultsHome birth is well integrated into the health care system in British Columbia (Canada), England, Iceland, the Netherlands, New Zealand, Ontario (Canada), and Washington State (USA). Home birth is less well integrated into the health care system in Australia, Japan, Norway, and Sweden.ConclusionsThis paper is the first to propose criteria for the evaluation of home birth integration within larger maternity care systems. Application of these criteria across 11 international jurisdictions indicates differences in the recognition and training of home birth practitioners, in access to hospital facilities, and in the supplies and equipment available at home births, which give rise to variation in the level of integration across different settings. Standardized criteria for the evaluation of systems integration are essential for interpreting planned home birth outcomes that emerge from contextual differences.
Ibrutinib alone or with dexamethasone for relapsed or relapsed and refractory multiple myeloma: phase 2 trial results
Authors: Richardson Paul G. , Bensinger William I. , Huff Carol Ann , Costello Caitlin L. , Lendvai Nikoletta , Berdeja Jesus G. , Anderson Larry D. , Siegel David S. , Lebovic Daniel , Jagannath Sundar , Laubach Jacob P. , Stockerl‐Goldstein Keith E. , Kwei Long , Clow Fong , Elias Laurence , Salman Zeena , Graef Thorsten , Bilotti Elizabeth , Vij Ravi 
Published: February 2018

SummaryNovel therapies with unique new targets are needed for patients who are relapsed/refractory to current treatments for multiple myeloma. Ibrutinib is a first‐in‐class, once‐daily, oral covalent inhibitor of Bruton tyrosine kinase, which is overexpressed in the myeloma stem cell population. This study examined various doses of ibrutinib ± low‐dose dexamethasone in patients who received ≥2 prior lines of therapy, including an immunomodulatory agent. Daily ibrutinib ± weekly dexamethasone 40 mg was assessed in 4 cohorts using a Simon 2‐stage design. The primary objective was clinical benefit rate (CBR; ≥minimal response); secondary objectives included safety. Patients (n = 92) received a median of 4 prior regimens. Ibrutinib + dexamethasone produced the highest CBR (28%) in Cohort 4 (840 mg + dexamethasone; n = 43), with median duration of 9·2 months (range, 3·0–14·7). Progression‐free survival was 4·6 months (range, 0·4–17·3). Grade 3–4 haematological adverse events included anaemia (16%), thrombocytopenia (11%), and neutropenia (2%); grade 3–4 non‐haematological adverse events included pneumonia (7%), syncope (3%) and urinary tract infection (3%). Ibrutinib + dexamethasone produced notable responses in this heavily pre‐treated population. The encouraging efficacy, coupled with the favourable safety and tolerability profile of ibrutinib, supports its further evaluation as part of combination treatment.
Early movement restriction leads to enduring disorders in muscle and locomotion
Authors: Delcour Maxime , Massicotte Vicky S. , Russier Michaël , Bras Hélène , Peyronnet Julie , Canu Marie‐Hélène , Cayetanot Florence , Barbe Mary F. , Coq Jacques‐Olivier 
Published: February 2018

AbstractMotor control and body representation in the central nervous system (CNS) as well as musculoskeletal architecture and physiology are shaped during development by sensorimotor experience and feedback, but the emergence of locomotor disorders during maturation and their persistence over time remain a matter of debate in the absence of brain damage. By using transient immobilization of the hind limbs, we investigated the enduring impact of postnatal sensorimotor restriction (SMR) on gait and posture on treadmill, age‐related changes in locomotion, musculoskeletal histopathology and Hoffmann reflex in adult rats without brain damage. SMR degrades most gait parameters and induces overextended knees and ankles, leading to digitigrade locomotion that resembles equinus. Based on variations in gait parameters, SMR appears to alter age‐dependent plasticity of treadmill locomotion. SMR also leads to small but significantly decreased tibial bone length, chondromalacia, degenerative changes in the knee joint, gastrocnemius myofiber atrophy and muscle hyperreflexia, suggestive of spasticity. We showed that reduced and atypical patterns of motor outputs, and somatosensory inputs and feedback to the immature CNS, even in the absence of perinatal brain damage, play a pivotal role in the emergence of movement disorders and musculoskeletal pathologies, and in their persistence over time. Understanding how atypical sensorimotor development likely contributes to these degradations may guide effective rehabilitation treatments in children with either acquired (ie, with brain damage) or developmental (ie, without brain injury) motor disabilities.
Improving disease knowledge in 6‐ to 10‐year‐olds with sickle cell disease: A quasi‐experimental study
Authors: Morrison‐Levy N. , Knight‐Madden J. , Royal‐Thomas T. , King L. , Asnani M. 
Published: February 2018

AbstractBackgroundIncreasing knowledge and understanding of disease is known to improve outcomes in persons living with a chronic illness. In this paper, we aim to compare the disease knowledge of children with sickle cell disease (SCD), age 6–10 years, who received an intervention (an educational colouring book on SCD) geared towards improving disease knowledge, to those who did not received the colouring book.MethodsA quasi‐experimental study was conducted where disease knowledge was determined in 56 children who had received the colouring book and compared to 60 children who did not receive this intervention.ResultsThe mean knowledge score was significantly higher in the intervention group (mean difference = 2.65; 95% CI [1.43, 3.86]), as well as in older children and in those in higher grades but there was no difference between sexes. In a multiple regression model (adjusted R2: 0.39; p value < .001), knowledge score was significantly higher in those who received the intervention (β: 2.62; 95% CI [1.48, 3.76]) while adjusting for age, gender, persons living at home, and the father's employment status.ConclusionThe study highlights that a simple, inexpensive (cost: US$1/book) child‐friendly intervention can significantly improve knowledge about SCD even in young children. It also underlines various social factors that are associated with children's understanding of their disease.
IL-27: a double agent in the IL-6 family
Authors: Jones G W , Hill D G , Cardus A , Jones S A 
Published: February 2018

SummaryThe cytokine interleukin (IL)-6 is a major therapeutic target for the treatment of various inflammatory and autoimmune diseases. While IL-6 receives considerable attention in studies of innate and adaptive immunity, the IL-6-related family member IL-27 is recognized increasingly for its effects on cellular proliferation, differentiation and leucocyte effector functions. Both cytokines activate responses in myeloid and stromal tissue cells, where they direct the transition from innate to adaptive immunity. However, they are identified frequently as lymphokines that control responses in T cells and B cells. In this regard, IL-27 often opposes the action of IL-6. Here, we will review the role of IL-6 and IL-27 in inflammation, with a particular focus on inflammatory arthritis, and discuss their importance in the diagnosis, stratification and treatment of autoimmune disease.
Random walk grey wolf optimizer for constrained engineering optimization problems
Authors: Gupta Shubham , Deep Kusum 
Published: February 2018

AbstractSwarm intelligence is one of the most promising area of numerical optimization to solve real‐world optimization problems. Grey wolf optimizer (GWO), which is based on leadership hierarchy of grey wolves, is one of the relatively new algorithm in the field of swarm intelligence–based algorithms. In order to solve constrained real‐world optimization problems, in this paper, a constrained version of GWO has been proposed by incorporating a simple constraint handling technique in GWO, and then an attempt is made to improve the ability of the leaders in original GWO by proposing random walk GWO (RW‐GWO) by pointing out some drawbacks in their process of searching prey. (To the best of the knowledge of the authors, a constrained version of GWO has not been developed yet. The unconstrained version of RW‐GWO has been proposed in the authors' earlier work.) The efficiency of both these proposed algorithms have been tested on the Institute of Electrical and Electronics Engineers Congress on Evolutionary Computation 2006 benchmark problems and on 3 engineering application problems to observe their comparative performance. It is concluded from the results that the proposed improved version of GWO, namely, RW‐GWO, has better potential to solve these constraint problems compared to GWO very efficiently as a constrained optimizer.
Asthma and its related socioeconomic factors: The Shiraz Adult Respiratory Disease Study 2015
Authors: Masoompour Seyed Masoom , Mahdaviazad Hamideh , Ghayumi Seiyed Mohammad Ali 
Published: February 2018

AbstractObjectiveThis study aimed to explore the association between the prevalence of asthma and the socioeconomic factors using data from the Shiraz Adult Respiratory Disease Study, 2015(SARDS).MethodsThe SARDS was conducted from June to October 2015 among adult subjects of the general population of Shiraz, Iran. Current asthma was defined as the presence of at least 1 of the following factors in the preceding 12 months: (1) being awakened by an attack of shortness of breath, coughing, or chest tightness without any identifiable cause; (2) having an asthma attack; (3) currently using medication for asthma; or (4) having wheezing or whistling in the chest not associated with a cold or the flu. Information on individual socioeconomic status was derived from self‐reported education level, occupation, income, and residence location. A value of P < .05 was considered statistically significant.ResultsA total of 4582 respondents aged 20‐60 years were included in the analysis. The overall prevalence of adult asthma was 7.8%. The prevalence of asthma was higher significantly among female and subjects with higher body mass index, allergic rhinitis, smokers, jobless, and individuals who live in suburban areas. In the adjusted logistic regression model, being jobless (odds ratio [OR], 2.256; 95% confidence interval [CI], 1.123‐4.535) and living in a suburban area (OR, 1.735; 95% CI, 1.058‐2.845) were the most significant socioeconomic predictive factors for adult current asthma.ConclusionsIt can be concluded that lower socioeconomic status is associated with higher adult current asthma prevalence. Target interventions are necessary to reduce disparities in healthcare systems.
Intraoperative transesophageal echocardiographic predictors of recurrent left ventricular outflow tract obstruction in children undergoing subaortic stenosis resection
Authors: Nawaytou Hythem M. , Mercer‐Rosa Laura , Channing Alexandra , Cohen Meryl S. 
Published: February 2018

BackgroundIntraoperative transesophageal echocardiography (iTEE) is used to assess for residual left ventricular outflow tract obstruction (LVOTO) after surgical resection of subaortic membrane causing subaortic stenosis (sub‐AS). We aimed to identify the iTEE features associated with recurrence of LVOTO.MethodsWe conducted a retrospective study of children undergoing sub‐AS resection from June 2006 to June 2014. Doppler assessment of the flow velocity and the anatomical features of the left ventricular outflow tract were analyzed from stored echocardiograms. Recurrent LVOTO was defined as an increase in the mean pressure gradient across the left ventricular outflow tract of > 15 mm Hg on the most recent follow‐up echocardiogram from the mean pressure gradient on the predischarge echocardiogram or as doubling of the mean pressure gradient to a value ≥20 mm Hg.ResultsThirty‐five patients were included, with median age at surgery was 8.1 years (range: 0.7–29 years) and median follow‐up was 47 months (2–91 months). Ten patients (29%) had recurrent LVOTO, which was associated with a shorter distance between the narrowest diameter of the outflow tract and the aortic valve on iTEE [median 0.59 cm (range 0.39–0.74) vs 0.98 cm (0.75–1.5), P = .03]. No patients with more than mild residual LVOTO on iTEE regressed to mild or no LVOTO on follow‐up echocardiograms.ConclusionsLVOTO recurrence after sub‐AS resection is common, and residual LVOTO remains the same or increases over time. Proximity of the LVOTO to the aortic valve is a risk factor for recurrent LVOTO. These findings may be useful in counseling patients and to guide the frequency of postoperative follow‐up.
Consequences of relying on statistical significance: Some illustrations
Authors: Van Calster Ben , Steyerberg Ewout W. , Collins Gary S. , Smits Tim 
Published: February 2018

AbstractBackgroundDespite regular criticisms of null hypothesis significance testing (NHST), a focus on testing persists, sometimes in the belief to get published and sometimes encouraged by journal reviewers. This paper aims to demonstrate known key limitations of NHST using simple nontechnical illustrations.DesignThe first illustration is based on simulated data of 20 000 studies that compare two groups for an outcome event. The true effect size (difference in event rates) and sample size (20‐100 per group) were varied. The second illustration used real data from a meta‐analysis on alpha‐blockers for the treatment of ureteric stones.ResultsThe simulations demonstrated the large between‐study variability in P‐values (range between <.0001 and 1 for most simulation conditions). A focus on statistically significant effects (P < .05), notably in small to moderate samples, led to strongly overestimated effect sizes (up to 240%) and many false‐positive conclusions, that is statistically significant effects that were, in fact, true null effects. Effect sizes also exerted strong between‐study variability, but confidence intervals accounted for this: the interval width decreased with larger sample size, and the percentage of intervals that contained the true effect size was accurate across simulation conditions. Reducing alpha level, as recently suggested, reduced false‐positive conclusions but strongly increased the overestimation of significant effects (up to 320%).ConclusionsResearchers and journals should abandon statistical significance as a pivotal element in most scientific publications. Confidence intervals around effect sizes are more informative, but should not merely be reported to comply with journal requirements.