bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is vision-related quality of life impaired in patients with preperimetric glaucoma?
Authors: Daga Fábio B , Gracitelli Carolina P B , Diniz-Filho Alberto , Medeiros Felipe A 
Published: July 2018

Background/aimsTo investigate whether subjects with preperimetric glaucoma exhibit decline in patient-reported vision-related quality of life (QoL) compared with healthy individuals.MethodsThis cross-sectional study included 45 patients with preperimetric glaucoma, 102 patients with perimetric glaucoma and 81 healthy controls. Perimetric glaucoma was defined by the presence of repeatable abnormal standard automated perimetry tests and corresponding optic nerve damage in at least one eye. Preperimetric glaucoma was defined based on the presence of retinal nerve fibre layer (RNFL) loss as detected by spectral-domain optical coherence tomography in the absence of visual field loss. Patient-reported QoL was measured by the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25).ResultsPatients with preperimetric glaucoma had significantly thinner average RNFL in the better eye compared with controls (79.9±9.2 µm vs 97.8±8.6 µm; p<0.001). There was no significant difference in Rasch-calibrated NEI VFQ-25 scores between the preperimetric and control groups (72.8±16.8 vs 73.7±20.2, respectively; p=0.964). The average NEI VFQ-25 score in the perimetric glaucoma group was 58.9±18.6 and was significantly different than the average score in the preperimetric glaucoma and healthy groups (p<0.001 for both comparisons).ConclusionContrary to patients with perimetric damage, preperimetric glaucoma does not seem to be associated with loss in QoL. Prevention of disability from glaucoma may benefit from early diagnosis during a ‘window of opportunity’ given by detecting structural loss before visual field damage.
Patient-reported outcome (PRO) measure-based algorithm for clinical decision support in epilepsy outpatient follow-up: a test–retest reliability study
Authors: Schougaard Liv Marit Valen , de Thurah Annette , Christiansen David Høyrup , Sidenius Per , Hjollund Niels Henrik 
Published: July 2018

ObjectivesPatient-reported outcome (PRO) measures have been used in epilepsy outpatient clinics in Denmark since 2011. The patients’ self-reported PRO data are used by clinicians as a decision aid to support whether a patient needs contact with the outpatient clinic or not based on a PRO algorithm. Validity and reliability are fundamental to any PRO measurement used at the individual level in clinical practice. The aim of this study was to evaluate the test–retest reliability of the PRO algorithm used in epilepsy outpatient clinics and to analyse whether the method of administration (web and paper) would influence the result.Design and settingTest–retest reliability study conducted in three epilepsy outpatient clinics in Central Denmark Region, Denmark.ParticipantsA total of 554 epilepsy outpatients aged 15 years or more were included from August 2016 to April 2017. The participants completed questionnaires at two time points and were randomly divided into four test–retest groups: web–web, paper–paper, web–paper and paper–web. In total, 166 patients completed web–web, 112 paper–paper, 239 web–paper and 37 paper–web.ResultsWeighted kappa with squared weight was 0.67 (95% CI 0.60 to 0.74) for the pooled PRO algorithm, and perfect agreement was observed in 82% (95% CI 78% to 85%) of the cases. There was a tendency towards higher test–retest reliability and agreement estimates within same method of administration (web–web or paper–paper) compared with a mixture of methods (web–paper and paper–web).ConclusionsThe PRO algorithm used for clinical decision support in epilepsy outpatient clinics showed moderate to substantial test–retest reliability. Different methods of administration produced similar results, but an influence of change in administration method cannot be ruled out.
Deciding on behalf of others: a population survey on procedural preferences for surrogate decision-making
Authors: Frey Renato , Herzog Stefan M , Hertwig Ralph 
Published: July 2018

ObjectivesTo assess people’s procedural preferences for making medical surrogate decisions, from the perspectives of both a potential surrogate and an incapacitated patient.DesignComputer-assisted telephone interviews. Respondents were randomly assigned either the role of an incapacitated patient or that of a potential surrogate for an incapacitated family member. They were asked to rate six approaches to making a surrogate decision: patient-designated surrogate, discussion among family members, majority vote of family members’ individual judgements, legally assigned surrogate, population-based treatment indicator and delegating the decision to a physician.SettingGermany and German-speaking and French-speaking parts of Switzerland.Participants2010 respondents were quota sampled from a panel (representative for the German and German-speaking and French-speaking Swiss populations, respectively, in terms of age, sex and regions).Main outcome measuresEndorsement of each approach (rated on a scale from 1 to 10). Degree to which preferences overlap between the perspective of potential surrogates and potential patients.ResultsRespondents’ endorsement of the six different approaches varied markedly (from Mdn=9.3 to Mdn=2.6). Yet the preferences of respondents taking the perspective of incapacitated patients corresponded closely with those of respondents taking the perspective of a potential surrogate (absolute differences ranging from 0.1 to 1.3). The preferred approaches were a patient-designated surrogate (Mdn=9.3) and all family members making a collective decision by means of group discussion (Mdn=9.3). The two least-preferred approaches were relying on a statistical prediction rule (Mdn=3.0) and delegating the decision to a physician (Mdn=2.6).ConclusionsAlthough respondents taking the perspective of an incapacitated patient preferred a patient-designated surrogate, few people have designated such a surrogate in practice. Policy-makers may thus consider implementing active choice, that is, identifying institutional settings in which many people can be reached (eg, when obtaining a driver’s licence) and requesting them to complete advance directives and to designate a specific surrogate. Moreover, potential patients and surrogates alike highly valued shared surrogate decisions among family members. Policy-makers may consider acknowledging this possibility explicitly in future legislation, and caregivers and physicians may consider promoting shared surrogate decisions in practice.
Initiating intramuscular depot medroxyprogesterone acetate 24–48 hours after mifepristone administration does not affect success of early medical abortion
Authors: Lang Christina , Chen Zhong Eric , Johnstone Anne , Cameron Sharon 
Published: July 2018

ObjectivesThe primary objective of this study was to determine whether intramuscular depot medroxyprogesterone acetate (IM DMPA) given at the time of misoprostol administration, 24–48 hours after mifepristone, affects the rate of continuing pregnancy. In addition, the study explored factors predictive of continuing pregnancy.DesignCase-control study based on database review of women who underwent early medical abortion (EMA) over a 4-year period.SettingSingle abortion service in Scotland.Participants5122 women who underwent an EMA within the timeframe of this study.Main outcome measuresContinuing pregnancies among women receiving IM DMPA were compared with those choosing other hormonal methods of contraception, non-hormonal contraception or no contraception at the time of misoprostol administration. Logistic regression was performed to assess the effects of demographic characteristics, gestation at presentation and method of contraception provided, on outcome of pregnancy.ResultsA total of 4838 women with complete data were included, of which there were 20 continuing pregnancies (0.4%); 284 women were excluded due to missing data. There was no increased risk of a continuing pregnancy among women who initiated IM DMPA at the time of misoprostol administration (24–48 hours after mifepristone) compared with women who initiated no hormonal contraception at this time (RR 0.48; 95% CI 0.06 to 3.81). Gestation ≥8 weeks and previous terminations were factors associated with increased likelihood of continuing pregnancy.ConclusionsWomen choosing IM DMPA after EMA can be reassured that IM DMPA can be safely initiated at the time of misoprostol administration 24–48 hours after mifepristone without an increase in the risk of a continuing pregnancy. Both increasing gestation and previous termination were factors associated with an increased likelihood of continuing pregnancy following an EMA.
Regional thalamic MRI as a marker of widespread cortical pathology and progressive frontotemporal involvement in amyotrophic lateral sclerosis
Authors: Tu Sicong , Menke Ricarda A L , Talbot Kevin , Kiernan Matthew C , Turner Martin R 
Published: July 2018

BackgroundThe thalamus is a major neural hub, with selective connections to virtually all cortical regions of the brain. The multisystem neurodegenerative syndrome amyotrophic lateral sclerosis (ALS) has pathogenic overlap with frontotemporal dementia, and objective in vivo markers of extra-motor pathological spread are lacking. To better consider the role of the thalamus in neurodegeneration, the present study assessed the integrity of the thalamus and its connectivity to major cortical regions of the brain in a longitudinal manner.MethodsDiffusion-based MRI tractography was used to parcellate the thalamus into distinct regions based on structural thalamo-cortical connectivity in 20 patients with ALS, half of whom were scanned at two time points, and 31 matched controls scanned on a single occasion.ResultsAt baseline, widespread diffusivity alterations in motor- and extramotor-associated thalamic parcellations were detectable. Longitudinal decline selectively affected thalamic regions associated with frontal and temporal lobe connectivity. Diffusivity measures were significantly correlated with clinical measures of disease burden. Progression of functional disability, as indicated by change on the ALS functional rating scale, was associated with longitudinal change in mean diffusivity of the right frontal lobe thalamic parcellation (r=0.59, p=0.05).ConclusionsRegional thalamic connectivity changes mirror the progressive frontotemporal cortical involvement associated with the motor functional decline in ALS. Longitudinal MRI thalamic parcellation has potential as a non-invasive surrogate marker of cortical dysfunction in ALS.
Ensuring respect for persons in COMPASS: a cluster randomised pragmatic clinical trial
Authors: Andrews Joseph E , Moore J Brian , Weinberg Richard B , Sissine Mysha , Gesell Sabina , Halladay Jacquie , Rosamond Wayne , Bushnell Cheryl , Jones Sara , Means Paula , King Nancy M P , Omoyeni Diana , Duncan Pamela W 
Published: July 2018

Cluster randomised clinical trials present unique challenges in meeting ethical obligations to those who are treated at a randomised site. Obtaining informed consent for research within the context of clinical care is one such challenge. In order to solve this problem it is important that an informed consent process be effective and efficient, and that it does not impede the research or the healthcare. The innovative approach to informed consent employed in the COMPASS study demonstrates the feasibility of upholding ethical standards without imposing undue burden on clinical workflows, staff members or patients who may participate in the research by virtue of their presence in a cluster randomised facility. The COMPASS study included 40 randomised sites and compared the effectiveness of a postacute stroke intervention with standard care. Each site provided either the comprehensive postacute stroke intervention or standard care according to the randomisation assignment. Working together, the study team, institutional review board and members of the community designed an ethically appropriate and operationally reasonable consent process which was carried out successfully at all randomised sites. This achievement is noteworthy because it demonstrates how to effectively conduct appropriate informed consent in cluster randomised trials, and because it provides a model that can easily be adapted for other pragmatic studies. With this innovative approach to informed consent, patients have access to the information they need about research occurring where they are seeking care, and medical researchers can conduct their studies without ethical concerns or unreasonable logistical impediments.Trial registration numberNCT02588664, recruiting. This article covers the development of consent process that is currentlty being employed in the study.
Effect of supplementation of sodium stearoyl-2-lactylate as fat emulsifier in low-density diet on growth performance, backfat thickness, lean muscle percentage, and meat quality in finishing pigs
Authors: Yun H.M. , Yun K.S. , Upadhaya S.D. , Kim I.H. 
Published: July 2018

This study was conducted to evaluate the effect of supplementation of sodium stearoyl-2-lactylate as fat emulsifier in low-density diet on the growth performance and meat quality of finishing pigs. A total of 84 mixed-sex finishing pigs [(Landrace × Yorkshire) × Duroc] at 112 d of age with an average body weight (BW) of 60 ± 0.75 kg (two gilts and two barrows per pen; seven pens per treatment) were used in a 56 d experiment. Pigs were randomly allotted to one of three treatments based on BW and stratified based on sex. The following three treatments were used (1) control basal diet (T1), (2) low-energy diet (T2), and (3) T2 + 0.1% sodium stearoyl-2-lactylate emulsifier (T3). The supplementation of sodium stearoyl-2-lactylate as fat emulsifier in energy-reduced diet did not have significant effects on growth performance compared with energy-reduced diet without emulsifier, although it slightly increased final BW by 1.45%, average daily gain by 3.3%, gain to feed ratio by 3.77%, and reduced average daily feed intake by 0.64%. The supplementation of emulsifier in energy-reduced diet did not have any adverse effect (P > 0.05) on meat quality attributes, as well as backfat thickness and lean muscle percentage (LMP), compared with energy-reduced diet without emulsifier or basal diet. In conclusion, the supplementation of emulsifier at 0.1% level in low-energy diet did not have significant effects on growth performance, backfat thickness, LMP, and meat quality attributes in finishing pigs.
Supertropical quadratic forms II: Tropical trigonometry and applications
Authors: Izhakian Zur , Knebusch Manfred , Rowen Louis 
Published: July 2018

This paper is a sequel of [Z. Izhakian, M. Knebusch and L. Rowen, Supertropical semirings and supervaluations, J. Pure Appl. Algebra 220(1) (2016) 61–93], where we introduced quadratic forms on a module [Formula: see text] over a supertropical semiring [Formula: see text] and analyzed the set of bilinear companions of a quadratic form [Formula: see text] in case the module [Formula: see text] is free, with fairly complete results if [Formula: see text] is a supersemifield. Given such a companion [Formula: see text], we now classify the pairs of vectors in [Formula: see text] in terms of [Formula: see text] This amounts to a kind of tropical trigonometry with a sharp distinction between the cases for which a sort of Cauchy–Schwarz (CS) inequality holds or fails. This distinction is governed by the so-called CS-ratio [Formula: see text] of a pair of anisotropic vectors [Formula: see text] in [Formula: see text]. We apply this to study the supertropicalizations (cf. [Z. Izhakian, M. Knebusch and L. Rowen, Supertropical semirings and supervaluations, J. Pure Appl. Algebra 220(1) (2016) 61–93]) of a quadratic form on a free module [Formula: see text] over a field in the simplest cases of interest where [Formula: see text].In the last part of the paper, we introduce a suitable equivalence relation on [Formula: see text], whose classes we call rays. (It is coarser than usual projective equivalence.) For anisotropic [Formula: see text] the CS-ratio [Formula: see text] depends only on the rays of [Formula: see text] and [Formula: see text]. We develop essential basics for a kind of convex geometry on the ray-space of [Formula: see text], where the CS-ratios play a major role.
Improvement in upright and supine lung mechanics with bariatric surgery affects bronchodilator responsiveness and sleep quality
Authors: Peters Ubong , Dechman Gail , Hernandez Paul , Bhatawadekar Swati , Ellsmere James , Maksym Geoffrey 
Published: July 2018

Obesity and weight loss have complex effects on respiratory physiology, but these have been insufficiently studied, particularly at early time points following weight loss surgery and in the supine position. We evaluated 15 female participants with severe obesity before and 5 wk and 6 mo after bariatric surgery using the Pittsburgh Sleep Quality Index (PSQI), spirometry, plethysmography, and oscillometry to measure respiratory system mechanics. Oscillometry and spirometry were conducted in the upright and supine position and before and after bronchodilation with 200 µg of salbutamol. At 5 wk postsurgery, weight loss was 11.9 kg (SD 2.7) with no effect on spirometric outcomes and a slight effect on oscillometric outcomes. However, at 6 mo weight loss was 21.4 kg (SD 7.1) with a 14.1% (SD 6.1) and 17.8 (5.4)% reduction in upright and supine respiratory system resistance (Rrs),6, respectively. Respiratory system elastance also decreased by 25.7% (SD 9.4) and 20.2 (SD 7.2)% in the upright and supine positions. No changes were observed in spirometry, but sleep quality improved from PSQI of 8.4 (SD 3.5) to 4.1 (SD 2.9). Bronchodilator responsiveness was low at baseline but increased significantly after surgery, and this response was comparable to the improvement in Rrs produced by weight loss. Modeling the impedance spectra with a two-compartment model demonstrated that improvements in lung mechanics with weight loss begin in the upper or central compartment of the lungs and progress to include the peripheral compartment. Respiratory mechanics are impaired in individuals with severe obesity and is associated with poor sleep quality, but these improved substantially with weight loss. Our data provide new evidence that individuals with severe obesity may have poor sleep quality because of abnormal respiratory mechanics that weight loss improves.NEW & NOTEWORTHY This is the first study to quantify the degree of weight loss-induced improvements in respiratory system mechanics in both upright and supine positions, and its association with bronchodilator responsiveness and sleep quality at multiple time points. Weight loss induced large improvements in upright and supine respiratory system mechanics with corresponding improvements in bronchodilator responsiveness and sleep quality. Using mathematical modeling, we demonstrate that these improvements begin in the central airways and progress to include the lung periphery.
Next-Generation Sequencing Identifies a Highly Accurate miRNA Panel That Distinguishes Well-Differentiated Thyroid Cancer from Benign Thyroid Nodules
Authors: Mazeh Haggi , Deutch Tova , Karas Adi , Bogardus Kimberly A. , Mizrahi Ido , Gur-Wahnon Devorah , Ben-Dov Iddo Z. 
Published: July 2018

Abstract
Background: Fine needle aspiration biopsy (FNAB) is the gold-standard procedure for diagnosing malignant thyroid nodules. Indeterminate cytology is identified in 10% to 40% of cases, and molecular testing may guide management in this setting. Current commercial options are expensive, and are either sensitive or specific. The aim of this study was to utilize next-generation sequencing (NGS) technology to identify informative diversities in the miRNA expression profile of benign versus malignant thyroid nodules.
Methods: Ex vivo FNAB samples were obtained from thyroid specimens of patients who underwent thyroidectomy at a referral center. miRNA levels were determined using NGS and multiplexing technologies. Statistical analyses identified differences between normal and malignant samples and miRNA expression profiles that associate with malignancy were established. The accuracy of the miRNA signature in predicting histologic malignancy was validated using a group of patient specimens with indeterminate cytology results.
Results: A total of 274 samples were obtained from 102 patients undergoing thyroidectomy. Of these samples, 71% were benign and 29% were malignant. Nineteen miRNAs were identified as statistically different between benign and malignant samples and were used to classify 35 additional nodules with indeterminate cytology (validation). The miRNA panel's sensitivity, specificity, negative and positive predictive values, and overall accuracy were 91%, 100%, 87%, 100%, and 94%, respectively.
Conclusions: Using NGS technology, we identified a panel of 19 miRNAs that may be utilized to distinguish benign from malignant thyroid nodules with indeterminate cytology.
Impact: Our panel may classify indeterminate thyroid nodules at higher accuracy than commercially available molecular tests. Cancer Epidemiol Biomarkers Prev; 27(8); 858–63. ©2018 AACR.
Sex Differences in Using Systemic Inflammatory Markers to Prognosticate Patients with Head and Neck Squamous Cell Carcinoma
Authors: Lin Ching Ying , Kwon Hyunwoo , Rangel Rivera Guillermo O. , Li Xue , Chung Dongjun , Li Zihai 
Published: July 2018

AbstractBackground: Remarkable discrepancy exists in outcomes between men and women for multiple malignancies. We sought to expose sex differences in using platelet count and neutrophil-to-lymphocyte ratio (NLR) to predict overall survival for select cancer types with focus on head and neck squamous cell carcinoma (HNSCC).Methods: Peripheral blood samples from 9,365 patients seen in a tertiary teaching hospital with nine different primary tumors were retrospectively examined. HNSCC RNA-sequencing data from The Cancer Genome Atlas were analyzed by two computational means [Cell-type Identification By Estimating Relative Subsets Of RNA Transcripts (CIBERSORT) and Estimation of Stromal and Immune cells in Malignant Tumor tissues using Expression data (ESTIMATE)] to extend our observations to the tumor microenvironment.Results: For HNSCC, platelet count was more predictive of overall survival for males [log-rank test: HR = 1.809; 95% confidence interval (CI), 1.461–2.239 vs. HR = 1.287; 95% CI, 0.8901–1.861], whereas NLR was more predictive for females (HR = 2.627; 95% CI, 1.716–4.02 vs. HR = 1.261; 95% CI, 0.998–1.593). For females, lymphocyte count was more associated with survival than neutrophil count (multivariate Cox regression: P = 0.0015 vs. P = 0.7476). Both CIBERSORT (P = 0.0061) and ESTIMATE (P = 0.022) revealed greater immune infiltration in females. High tumor infiltration by T lymphocytes was more strikingly associated with survival in females (HR = 0.20, P = 0.0281) than in males (HR = 0.49, P = 0.0147).Conclusions: This is the first study to comprehensively demonstrate sex bias in the clinical utility of platelet, granulocyte, and lymphocyte counts as biomarkers to prognosticate HNSCC patients.Impact: This work emphasizes the necessity to consider sex in appraising inflammatory markers for cancer risk stratification. Cancer Epidemiol Biomarkers Prev; 27(10); 1176–85. ©2018 AACR.