bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness and cost of radiofrequency ablation and stereotactic body radiotherapy for treatment of early‐stage hepatocellular carcinoma: An analysis of SEER‐medicare
Authors: Parikh Neehar D , Marshall Vincent D , Green Michael , Lawrence Theodore S , Razumilava Nataliya , Owen Dawn , Singal Amit G , Feng Mary 
Published: June 2018

AbstractIntroductionFor early‐stage hepatocellular carcinoma (HCC) patients, ablative strategies are potentially curative treatment options. Stereotactic body radiotherapy (SBRT) has emerged as a promising ablative therapy, although its comparison with radiofrequency ablation (RFA) remains confined to a single institution retrospective review. We sought to characterize the comparative outcomes and cost between the two treatment strategies.MethodsWe conducted a secondary analysis of the Surveillance, Epidemiology, and End Results (SEER)‐Medicare linked database (2004–2011) and identified adult patients with stage I or II HCC and treated with RFA or SBRT as the initial treatment within 6 months of diagnosis. Survival analysis was conducted using Kaplan–Meier curves and multivariate Cox proportional hazard analysis. Factors associated with overall survival and 90‐day hospital admission post‐treatment were identified using propensity score (PS) adjusted multivariate analysis. We performed costs analysis and calculated incremental cost‐effectiveness ratios (ICER).ResultsFour hundred and forty patients were identified, 408 treated with RFA and 32 SBRT. In the overall cohort, 90‐day hospitalization and 1‐year mortality were similar between groups but RFA patients had better overall survival (P < 0.001). Multivariate analysis showed advanced age, higher stage, decompensated cirrhosis, and treatment with SBRT (HR 1.80; 95%CI: 1.15–2.82) was associated with worse survival, but in the PS adjusted analysis, survival and costs were similar between the two groups.ConclusionIn a national cohort of early stage HCC patients, treatment with RFA vs SBRT resulted in no significant difference in survival, 90‐day hospitalization, or costs. These data highlight the need for a randomized clinical trial comparing these two modalities.
Debugging diversity – a pan‐continental exploration of the potential of terrestrial blood‐feeding leeches as a vertebrate monitoring tool
Authors: Schnell Ida Bærholm , Bohmann Kristine , Schultze Sebastian E. , Richter Stine R. , Murray Dáithí C. , Sinding Mikkel‐Holger S. , Bass David , Cadle John E. , Campbell Mason J. , Dolch Rainer , Edwards David P. , Gray Thomas N. E. , Hansen Teis , Hoa Anh Nguyen Quang , Noer Christina Lehmkuhl , Heise‐Pavlov Sigrid , Sander Pedersen Adam F. , Ramamonjisoa Juliot Carl , Siddall Mark E. , Tilker Andrew , Traeholt Carl , Wilkinson Nicholas , Woodcock Paul , Yu Douglas W. , Bertelsen Mads Frost , Bunce Michael , Gilbert M. Thomas P. 
Published: June 2018

AbstractThe use of environmental DNA (eDNA) has become an applicable noninvasive tool with which to obtain information about biodiversity. A subdiscipline of eDNA is iDNA (invertebrate‐derived DNA), where genetic material ingested by invertebrates is used to characterize the biodiversity of the species that served as hosts. While promising, these techniques are still in their infancy, as they have only been explored on limited numbers of samples from only a single or a few different locations. In this study, we investigate the suitability of iDNA extracted from more than 3,000 haematophagous terrestrial leeches as a tool for detecting a wide range of terrestrial vertebrates across five different geographical regions on three different continents. These regions cover almost the full geographical range of haematophagous terrestrial leeches, thus representing all parts of the world where this method might apply. We identify host taxa through metabarcoding coupled with high‐throughput sequencing on Illumina and IonTorrent sequencing platforms to decrease economic costs and workload and thereby make the approach attractive for practitioners in conservation management. We identified hosts in four different taxonomic vertebrate classes: mammals, birds, reptiles and amphibians, belonging to at least 42 different taxonomic families. We find that vertebrate blood ingested by haematophagous terrestrial leeches throughout their distribution is a viable source of DNA with which to examine a wide range of vertebrates. Thus, this study provides encouraging support for the potential of haematophagous terrestrial leeches as a tool for detecting and monitoring terrestrial vertebrate biodiversity.
Effect of a gonadotropin‐releasing hormone analog for ovarian function preservation after intravenous cyclophosphamide therapy in systemic lupus erythematosus patients: a retrospective inception cohort study
Authors: Koga Tomohiro , Umeda Masataka , Endo Yushiro , Ishida Midori , Fujita Yuya , Tsuji Sosuke , Takatani Ayuko , Shimizu Toshimasa , Sumiyoshi Remi , Igawa Takashi , Fukui Shoichi , Nishino Ayako , Kawashiri Shin‐ya , Iwamoto Naoki , Ichinose Kunihiro , Tamai Mami , Nakamura Hideki , Origuchi Tomoki , Murakami Naoko , Kitajima Michio , Kawakami Atsushi 
Published: June 2018

AbstractObjectiveTo determine the effect of leuprolide acetate, a synthetic gonadotropin‐releasing hormone analog (GnRH‐a) on ovarian function preservation in systemic lupus erythematosus (SLE) patients treated with cyclophosphamide (CYC) in clinical practice.MethodsWe enrolled 30 premenopausal female SLE patients who fulfilled the 1997 American College of Rheumatology revised criteria and were treated with intravenous CYC (IVCY) in 2008–2017. We used Kaplan–Meier survival estimates to compare the GnRH‐a‐treated patients and those not treated with GnRH‐a as controls. We performed Cox regression analyses to identify factors associated with premature ovarian failure (POF), incidences of cardiovascular events, strokes and osteoporosis after IVCY therapy.ResultsAfter a mean follow‐up of 41 months, POF developed in one of the 16 GnRH‐a‐treated patients (6%) versus seven of the 14 controls (50%). Significantly improved cumulative ovarian protection over time was observed in the GnRH‐a‐treated group (P = 0.030). The hazard model analysis showed that treatment with GnRH‐a during IVCY therapy is an independent factor associated with POF after IVCY therapy (adjusted hazards ratio = 0.12, 95% CI 0.01–0.67, P = 0.013) but not incidences of cardiovascular events, strokes or osteoporosis.ConclusionThe combined use of GnRH‐a with IVCY therapy was associated with a significant reduction of POF among premenopausal women with SLE, suggesting that the addition of GnRH‐a can be a strategy to prevent POF among premenopausal women with SLE after IVCY therapy.
Patients’ concerns regarding biological agents in rheumatology
Authors: Pehlivan Yavuz , Orucoglu Nurdan , Pehlivan Seda , Kimyon Gezmis , Zengin Orhan , Kucuk Adem , Sahin Ali , Tomas Nazmiye , Oksuz Mustafa Ferhat , Kisacik Bunyamin , Akar Servet , Onat Ahmet Mesut , Dalkilic Ediz 
Published: June 2018

AbstractObjectiveThe potential side effects of biological agents may increase the anxiety levels of patients and influence not only their desire to use these therapies but also their concordance to treatment. This study aimed to determine the level and prevalence of drug‐related concern in patients treated with biological agents and to acquire additional information regarding the related causes.Materials and MethodsA total of 1134 patients who were using biological agents for at least 3 months with a diagnosis of rheumatic diseases were enrolled. General anxiety levels were evaluated using the State‐Trait Anxiety Inventory (STAI).ResultsThe most common cause for drug‐related concerns was the potential side effects of the drugs (59.5%). Among the potential side effects, cancer risk was the most common cause for concern (40.1%), followed by the risk of tuberculosis activation (30.7%). Anxiety levels were higher in patients who experienced side effects than in other patients, and this difference was statistically significant (P < 0.05). STAI trait and state scores were moderately correlated with anxiety levels related to the drug (P < 0.001).ConclusionAnxiety related to biological agents may significantly affect the patients’ anxiety levels. Awareness regarding the patients’ concerns and expectations related to the drug is important to ensure drug adherence and concordance to treatment.
Differences in quality of life determinants according to the presence of fibromyalgia in middle‐aged female patients with systemic lupus erythematosus: a multicenter, cross‐sectional, single‐ethnicity cohort
Authors: Moon Su‐Jin , Kang Kwi Young , Kwok Seung‐Ki , Ju Ji Hyeon , Hong Yeon‐Sik , Park Sung‐Hwan , Jeon Chan Hong , Choi Sang Tae , Song Jung‐Soo , Min Jun‐Ki 
Published: June 2018

AbstractObjectiveThe purpose of this study was to identify whether determinants of health‐related quality of life (HRQoL) in middle‐aged female patients with systemic lupus erythematosus (SLE) differed according to the presence or absence of fibromyalgia.MethodsOne hundred and fifty‐two patients with SLE and 139 healthy controls (HCs) completed the Medical Outcomes Study 36‐Item Short Form (SF‐36) and EuroQol EQ‐5D questionnaires about HRQoL. Disease activity and cumulative disease damage were assessed with standard indices. Sleep quality was assessed using the Korean version of the Pittsburgh Sleep Quality Index (K‐PSQI).ResultThe mean EQ‐5D and physical and mental components of SF‐36 were lower in SLE patients with fibromyalgia (n = 41) than in those without fibromyalgia (n = 111) and HCs. The scores in all eight domains of the SF‐36 were lower in SLE patients with fibromyalgia than in patients without fibromyalgia and HCs. Poor sleep (defined as a K‐PSQI > 5) was reported by 85% of SLE patients with fibromyalgia, by 51% of patients without fibromyalgia, and by 33% of HCs. Multivariate logistic regression analysis showed that lower educational level, cumulative organ damage severity and poor sleep quality were independent determinants of HRQoL in SLE patients with fibromyalgia, whereas disease activity, sleep quality and depressive mood were independent determinants of HRQoL in those without fibromyalgia.ConclusionPoor sleep quality is the common independent risk factor for poor HRQoL in both middle‐aged SLE patients with fibromyalgia and without fibromyalgia. Sleep quality improvement may improve HRQoL in female SLE patients, even in those without fibromyalgia.
Induction therapy for membranous lupus nephritis: a systematic review and network meta‐analysis
Authors: Tang Kuo‐Tung , Tseng Chien‐Hua , Hsieh Tsu‐Yi , Chen Der‐Yuan 
Published: June 2018

AbstractAimMembranous lupus glomerulonephritis (MLN) is associated with morbidities such as thromboembolism, peripheral edema and/or hyperlipidemia. However, treatment of MLN remains elusive.MethodsWe performed systematic searches on MEDLINE, EMBASE and Cochrane Library database up to November, 2017. Eligible studies included randomized trials or cohort studies which evaluated different immunosuppressants in adult patients with pathologically proved MLN. No language restrictions were applied. Endpoints included complete remission (CR) as the primary outcome, and CR plus partial remission (PR) and proteinuria‐reducing effect as secondary outcomes. Frequentist estimation of a network meta‐analysis (NMA) random‐effect model was performed.ResultsEight studies (206 patients) were included with a total of six immunosuppressants as an induction therapy for MLN. NMA results showed that both mycophenolate mofetil (MMF) and calcineurin inhibitors (CNI) are effective in the induction of CR and CR plus PR when compared with corticosteroids (CS) alone, but MMF and CNI are also associated with higher infection rates when compared with CS.ConclusionOur NMA demonstrated that both MMF and CNI are more effective than CS for induction therapy in MLN patients. However, there are limitations due to intra‐ and inter‐study variability.
Clinical effectiveness of influenza vaccination in patients with rheumatoid arthritis
Authors: Chen Chun‐Ming , Chen Hsuan‐Ju , Chen Wei‐shan , Lin Che‐Chen , Hsu Chih‐Cheng , Hsu Yueh‐Han 
Published: June 2018

AbstractObjectiveTo determine the clinical effectiveness of influenza vaccination in patients with rheumatoid arthritis (RA).MethodsThe present study was conducted by using the Taiwan National Health Insurance Research Database. In this retrospective nationwide study, we included 3748 RA patients who received influenza vaccinations in 2008, 2009 and 2010, and 3748 matched RA patients who did not receive influenza vaccinations. We followed the patients from 4 weeks after influenza vaccination to the end of the influenza season in each year. After adjustment for potential confounding factors, including disease‐modifying anti‐rheumatic drugs, we used the Cox proportional hazards regression model to analyze the clinical effectiveness of influenza vaccination.ResultsThe influenza vaccination rate in RA patients was 14.8% in 2008, 19.8% in 2009 and 9.50% in 2010. Receiving influenza vaccine was associated with reduced risk of hospitalization for septicemia, bacteremia or viremia (hazards ratio [HR] = 0.65, 95% CI = 0.45–0.94), and lower risk of mortality (HR = 0.62, 95% CI = 0.39–0.97). The effectiveness was particularly significant in elderly patients.ConclusionsRA patients receiving influenza vaccine have significantly lower morbidity and mortality, particularly in elderly patients. Further studies are needed to explore effective policies to increase the vaccination rate in elderly RA patients.
GLUT9 influences uric acid concentration in patients with Lesch‐Nyhan disease
Authors: Torres Rosa J. , Puig Juan G. 
Published: June 2018

AbstractBackgroundPatients with deficient hypoxanthine‐guanine phosphoribosyltransferase (HPRT) activity present hyperuricemia and/or hyperuricosuria, with a variable degree of neurological manifestations. Hyperuricemia in HPRT deficiency is due to uric acid overproduction and is frequently treated with allopurinol. Renal uric acid excretion is sharply increased in these patients. In recent years, several renal tubular urate transporter single nucleotide polymorphisms (SNPs), including those of the GLUT9, ABCG2 and URAT1 genes, have been described that influence the renal handling of uric acid and modulate serum urate levels. In the present study, we analyzed whether GLUT9, ABCG2 and URAT1 gene SNPs are able to influence uric acid levels and allopurinol response in patients with HPRT deficiency.MethodsThree SNPs, URAT1 rs11231825, GLUT9 rs16890979 and ABCG2 rs2231142, previously associated in our population with hyperuricemia and gout, were analyzed in 27 patients with HPRT deficiency treated with allopurinol for at least 5 years.ResultsPatients with HPRT deficiency having allele A of rs16890979 in the GLUT9 gene present with a lower serum urate concentration at diagnosis, before allopurinol treatment is instituted, and need lower allopurinol doses to maintain serum urate levels between 268 and 446 μmol/L (4.5 and 7.5 mg/dL). No relationship between rs2231142 in the ABCG2 gene or rs11231825 in the URAT1 gene and serum urate levels or allopurinol response was found in our patients with HPRT deficiency.ConclusionsGLUT9 SNPs influence the renal handling of uric acid and modulate serum urate levels and the response to treatment in patients with uric acid overproduction due to HPRT deficiency.
Axillary lymph node metastasis detection by magnetic resonance imaging in patients with breast cancer: A meta‐analysis
Authors: Zhou Peng , Wei Yongqing , Chen Guoyue , Guo Lei , Yan Deyue , Wang Ying 
Published: June 2018

BackgroundThe study was conducted to evaluate the diagnostic performance of magnetic resonance imaging (MRI) for the detection of axillary lymph node metastasis in patients with breast cancer.MethodsPubMed, Medline, Web of Science, Cochrane Embase, Chinese Biomedical Literature, and China National Knowledge Infrastructure databases were searched for open published studies relevant to the use of MRI for the detection of axillary lymph node metastasis in breast cancer patients. The pooled diagnostic sensitivity, specificity, and the symmetric receiver operating characteristic (SROC) curve was calculated by combining the individual data extracted from 26 included studies.ResultsThe pooled diagnostic sensitivity and specificity of MRI to detect axillary lymph node metastasis in patients with breast cancer were 0.77 (95% confidence interval [CI] 0.75–0.80) and 0.90 (95% CI 0.89–0.91), respectively. The pooled positive and negative likelihood ratios were 7.67 (95% CI 5.09–11.53) and 0.23 (95% CI 0.17–0.32), respectively, by random effect method. The area under the SROC curve was 0.93 for MRI to detect axillary lymph node metastasis in breast cancer patients.ConclusionWith high sensitivity, specificity, and area under the curve, MRI is an effective method to differentiate metastatic axillary lymph node in breast cancer patients, which can provide useful information for surgical procedure selection.
FOXM1: A potential indicator to predict lymphatic metastatic recurrence in stage IIA esophageal squamous cell carcinoma
Authors: Xiao Zhaohua , Jia Yang , Jiang Wenpeng , Wang Zhou , Zhang Zhiping , Gao Yanyun 
Published: June 2018

BackgroundPrevious studies have elucidated that FOXM1 may predict poor prognosis in patients with multiple solid malignant tumors. In this study we explored the differential expression of FOXM1 in stage IIA esophageal squamous cell carcinoma (ESCC) and investigated its prognostic value.MethodsImmunohistochemistry (IHC) and Western blot were used to detect FOXM1 expression in ESCC. Correlations between FOXM1 expression and clinicopathological variables, and five‐year lymphatic metastatic recurrence (LMR) and overall survival (OS) of patients were analyzed.ResultsFOXM1 was aberrantly expressed in ESCC. Statistical analysis revealed a close relationship between FOXM1 expression and tumor size (P = 0.024), depth of invasion (P = 0.048), and degree of differentiation (P = 0.043). The five‐year LMR of patients in the FOXM1 overexpression group was significantly increased compared to the low expression group (P = 0.001). The five‐year OS of patients in the FOXM1 overexpression group was significantly reduced compared to the low expression group (P = 0.007). Log‐rank tests demonstrated that large tumor size (P = 0.044), poor differentiation degree (P = 0.005), deep invasion (P = 0.000), and FOXM1 overexpression (P = 0.007) may indicate poor prognosis in stage IIA ESCC. Cox multivariate regression analysis revealed that all of these variables were independent predictors of unfavorable outcome (P < 0.05).ConclusionFOXM1 could be a predictor of lymphatic metastatic recurrence in stage IIA ESCC after Ivor Lewis esophagectomy.
Tree‐Based Models for Political Science Data
Authors: Montgomery Jacob M. , Olivella Santiago 
Published: June 2018

AbstractPolitical scientists often find themselves analyzing data sets with a large number of observations, a large number of variables, or both. Yet, traditional statistical techniques fail to take full advantage of the opportunities inherent in “big data,” as they are too rigid to recover nonlinearities and do not facilitate the easy exploration of interactions in high‐dimensional data sets. In this article, we introduce a family of tree‐based nonparametric techniques that may, in some circumstances, be more appropriate than traditional methods for confronting these data challenges. In particular, tree models are very effective for detecting nonlinearities and interactions, even in data sets with many (potentially irrelevant) covariates. We introduce the basic logic of tree‐based models, provide an overview of the most prominent methods in the literature, and conduct three analyses that illustrate how the methods can be implemented while highlighting both their advantages and limitations.
Incidence and risk factors of major bleeding following major orthopaedic surgery with fondaparinux thromboprophylaxis. A time‐to‐event analysis
Authors: Zufferey P. J. , Ollier E. , Delavenne X. , Laporte S. , Mismetti P. , Duffull S. B. 
Published: June 2018

AimsIncreased exposure to fondaparinux, as observed in patients with renal impairment, may increase bleeding risk. This study aims to determine the time course of major bleeding after major orthopaedic surgery, identify predictors of bleeding and simulate the effect of a reduced dose of fondaparinux on bleeding for patients with moderate renal impairment (creatinine clearance = 20–50 ml min−1).MethodsData including fondaparinux anti‐Xa activities from two multicentre prospective cohorts were used. In the first cohort, patients (n = 957) received fondaparinux 2.5 mg once a day. In the second, patients with moderate renal impairment (n = 436) received 1.5 mg once per day. The time‐to‐major bleeding after the end of surgery was modelled using a parametric survival analysis in NONMEM.ResultsThe observed rate of major bleeding up to day 11 was 5.2%. The time‐to‐event analysis indicated that the hazard of bleeding was highest in the first days following surgery and then remained low thereafter. Independent significant predictors of an increased hazard of major bleeding were male sex, lower body weight and increased drug exposure. Simulated rates of major bleeding up to day 11 in patients with moderate renal impairment were 6.5% with fondaparinux 2.5 mg once daily and 3.8% with fondaparinux 1.5 mg once daily.ConclusionThe hazard of major bleeding is highest in the first postoperative days and increases with fondaparinux exposure. To reduce the risk of bleeding in patients with moderate renal impairment, this study supports the use of a lower dose of fondaparinux 1.5 mg once daily.
The Basal Ganglia: More than just a switching device
Authors: Florio Tiziana Marilena , Scarnati Eugenio , Rosa Ilaria , Di Censo Davide , Ranieri Brigida , Cimini Annamaria , Galante Angelo , Alecci Marcello 
Published: June 2018

SummaryThe basal ganglia consist of a variety of subcortical nuclei engaged in motor control and executive functions, such as motor learning, behavioral control, and emotion. The striatum, a major basal ganglia component, is particularly useful for cognitive planning of purposive motor acts owing to its structural features and the neuronal circuitry established with the cerebral cortex. Recent data indicate emergent functions played by the striatum. Indeed, cortico‐striatal circuits carrying motor information are paralleled by circuits originating from associative and limbic territories, which are functionally integrated in the striatum. Functional integration between brain areas is achieved through patterns of coherent activity. Coherence belonging to cortico‐basal ganglia circuits is also present in Parkinson’s disease patients. Excessive synchronization occurring in this pathology is reduced by dopaminergic therapies. The mechanisms through which the dopaminergic effects may be addressed are the object of several ongoing investigations. Overall, the bulk of data reported in recent years has provided new vistas concerning basal ganglia role in the organization and control of movement and behavior, both in physiological and pathological conditions. In this review, basal ganglia functions involved in the organization of main movement categories and behaviors are critically discussed. Comparatively, the multiplicity of Parkinson’s disease symptomatology is also revised.