bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the Bias of South China Sea Summer Monsoon Precipitation Associated with Fast Physical Processes Using a Climate Model Hindcast Approach
Authors: Chen Wei-Ting , Wu Chien-Ming , Ma Hsi-Yen 
Published: May 2019

AbstractThe present study aims to identify the precipitation bias associated with the interactions among fast physical processes in the Community Atmospheric Model, version 5 (CAM5), during the abrupt onset of the South China Sea (SCS) summer monsoon, a key precursor of the overall East Asia summer monsoon (EASM). The multiyear hindcast approach is utilized to obtain the well-constrained synoptic-scale horizontal circulation each year during the onset period from the years 1998 to 2012. In the pre-onset period, the ocean precipitation over the SCS is insufficiently suppressed in CAM5 hindcasts and thus weaker land–ocean precipitation contrasts. This is associated with the weaker and shallower convection simulated over the surrounding land, producing weaker local circulation within the SCS basin. In the post-onset period, rainfall of the organized convection over the Philippine coastal ocean is underestimated in the hindcasts, with overestimated upper-level heating. These biases are further elaborated as the underrepresentation of the convection diurnal cycle and coastal convection systems, as well as the issue of precipitation sensitivity to environmental moisture during the SCS onset period. The biases identified in hindcasts are consistent with the general bias of the EASM in the climate simulation of CAM5. The current results highlight that the appropriate representation of land–ocean–convection interactions over coastal areas can potentially improve the simulation of seasonal transition over the monsoon regions.
The diagnostic performance of ADC value for tumor grade, deep myometrial invasion and lymphovascular space invasion in endometrial cancer: a meta-analysis
Authors: Yan Bi Cong , Xiao Mei Ling , Li Ying , Wei Qiang Jin 
Published: May 2019

Background Disputes exist regarding whether the apparent diffusion coefficient (ADC) can differentiate the tumor grade, deep myometrial invasion and lymphovascular space invasion (LVSI) in endometrial cancer. The aim of this review was to assess the diagnostic performance of the ADC value in endometrial cancer. Material and Methods The PubMed, Web of Science, Embase and Cochrane Library databases were searched for studies that used the ADC value to assess tumor grade, deep myometrial invasion and LVSI in endometrial cancer. We used forest plots to analyze the heterogeneity and generate the pooled sensitivity (SEN) and specificity (SPE). We used summary receiver operating characteristic (SROC) curves to work out the area under the SROC curve (AUC). Likelihood ratios (LRs) were also obtained. Results Of the 460 identified studies, 11 studies met our inclusion criteria and were included. Overall, nine studies (491 patients) aimed at differentiating high tumor grade had a pooled SEN, SPE and AUC of 77%, 73% and 81%, respectively; three studies (181 patients) for differentiating deep myometrial invasion had a pooled SEN, SPE and AUC of 71%, 67% and 77%, respectively; and two studies (106 patients) for differentiating LVSI had a pooled SEN and SPE of 66% and 74%, respectively. The positive and negative LRs were 2.77 and 0.35 for the tumor grade, 2.08 and 0.45 for deep myometrial invasion, and 2.48 and 0.45 for LVSI. Conclusion This meta-analysis showed that the ADC value had a moderate diagnostic performance for the tumor grade, deep myometrial invasion and LVSI in endometrial cancer.
Intrahepatic distant recurrence after radiofrequency ablation of hepatocellular carcinoma: relationship with portal hypertension
Authors: Kim Ran , Jeong Woo Kyoung , Kang Tae Wook , Song Kyoung Doo , Lee Min Woo , Ahn Soo Hyun , Rhim Hyunchul 
Published: May 2019

Background Portal hypertension might be used as a predictor for recurrence of hepatocellular carcinoma (HCC). The aim of this study was to determine whether the degree of portal hypertension assessed by computed tomography (CT) findings predicts intrahepatic distant recurrence (IDR) in patients with HCC after radiofrequency ablation (RFA). Material and Methods This retrospective study was approved by the institutional review board. A total of 78 patients who received transient elastography before RFA were included. Two radiologists evaluated the size, number of index HCC, and gastroesophageal varices at risk of recurrence (GEV-R) by investigating variceal grades on CT. Liver stiffness measurements and laboratory fibrosis indices were also investigated. Recurrence-free survival rate was assessed using Kaplan–Meier curves, and each variable was evaluated using a Cox hazards model. A validation study was also performed with other patients who underwent RFA in the same institution ( n = 89). Results Cumulative recurrence-free survival rates were 79%, 51%, and 38% at 1, 2, and 3 years, respectively. GEV-R was defined as enlarged esophageal varix (≥2 mm diameter on CT) or gastric varix (≥10 mm diameter on CT). Multivariate analysis including CT features showed that GEV-R is a significant independent predictor of IDR (hazard ratio (HR) = 3.91; p = 0.002) as well as tumor multiplicity (HR = 2.79; p = 0.030). On validation study, tumor multiplicity (HR = 2.86; p = 0.006) was statistically significant, and GEV-R also showed increased tendency of recurrence (HR = 1.68; p = 0.083). Conclusion CT-driven portal hypertension signs, such as the severity of varices could be a noninvasive predictor of IDR of HCC after RFA.
Flower cells of tropical descent: a challenging case of adult T-cell leukemia/lymphoma
Authors: Martino Giovanni , Zanelli Magda , Marra Andrea , Quintini Martina , Zizzo Maurizio , Ascani Stefano , Martelli Maria Paola , Falini Brunangelo 
Published: May 2019

Background: Adult T-cell leukemia/lymphoma (ATLL) is an aggressive disease associated with human T-lymphotropic virus type 1 infection, with a very high prevalence in tropical areas but exceptionally rare in Europe and Western countries. Case presentation: We describe a challenging case of ATLL in a young male patient with Brazilian origin and adopted as a child by an Italian family, presenting to our clinic with atypical T-lymphocytosis and life-threatening lung infections. Conclusions: Diagnosis of ATLL outside of endemic areas can be difficult, requiring a high index of clinical suspicion with careful evaluation of the patient’s clinical history. Prognosis is affected by disease stage at presentation and degree of immunosuppression. Few effective treatments are available, although new molecular insights have highlighted the role of host immune response and immune checkpoint blockade inhibitors, given the overexpression of PD-L1 on lymphoma cells and on microenvironment cells.
Assessment of antiretroviral third agent virologic durability after initiation of first antiretroviral regimen
Authors: Varriano Brenda , Sandler Ina , Loutfy Mona , Steinberg Samantha , Smith Graham , Kovacs Colin , Brunetta Jason , Fletcher David , Knox David , Merkley Barry , Chang Benny , Tilley David , Acsai Megan , Crouzat Fred 
Published: May 2019

Information on the virologic durability of modern antiretroviral regimens is important to clinicians. We aimed to describe virologic durability of first-line integrase strand transfer inhibitor (INSTI)-, nonnucleoside reverse transcriptase inhibitor (NNRTI)-, or protease inhibitor (PI)-based antiretroviral regimens. This was a retrospective study of antiretroviral-naïve patients that initiated first-line antiretroviral regimens with two nucleoside reverse transcriptase inhibitors and an INSTI, NNRTI, or PI between January 2006 and June 2016. The outcome was time to virologic failure, which was assessed by Kaplan–Meier survival analysis and Cox regression models. There were 780 patients (median age = 37 years [interquartile range (IQR) = 30–45], 93.3% male, 56.2% Caucasian, median HIV duration = 1.8 years [IQR = 0.4–5.4], baseline log10 viral load [VL]=4.6 [IQR = 4.1–5.1], and baseline CD4+ cell count = 320 cells/µl [IQR = 217–440]). In total, 189/780 were on a third agent INSTI, 339/780 on a third agent NNRTI, and 252/780 on a third agent PI. Kaplan–Meier survival probability revealed longer time to virologic failure for INSTI, followed by NNRTI then PI (p < 0.001). Multivariable Cox regression revealed that being on an INSTI regimen (aHR = 0.27; 95%CI = 0.18–0.41) or NNRTI regimen (aHR = 0.64; 95%CI = 0.47–0.87) versus PI regimen, frequent VL testing (per year), (aHR = 0.64; 95%CI = 0.47–0.87), and duration of ART (aHR = 0.22; 95%CI = 0.17–0.30) (years) were inversely associated with time to virologic failure, and log10 of baseline VL (aHR = 1.94; 95%CI = 1.58–2.39 per log10) increased risk. Virologic failure was delayed and virologic durability prolonged for INSTI- compared to NNRTI- and PI-based regimens, supporting current antiretroviral therapy guidelines.
Influence of Tobacco Smoke Exposure on the Protein Expression of α7 and α4 Nicotinic Acetylcholine Receptors in Squamous Cell Carcinoma Tumors of the Upper Aerodigestive Tract (Out of the Larynx)
Authors: Montaño-Velázquez Bertha B , Benavides Méndez Juan C , García-Vázquez Francisco J , Conde-Vázquez Ernesto , Sánchez-Uribe Magdalena , Taboada-Murrieta Cecilia R , Jáuregui-Renaud Kathrine 
Published: May 2019

Purpose: To assess protein expression of α7 and α4 nicotinic acetylcholine receptors (nAChR) subtypes in squamous cell carcinoma of the upper aerodigestive track (out of the larynx) according to tobacco smoke exposure, considering the general characteristics of the patients. Methods: The α7 and α4 nAChR subtypes were assessed by immunohistochemistry in tumor samples from 33 patients with novel diagnosis of squamous cell carcinoma of the upper aerodigestive tract (out of the larynx). Results: Current smokers were middle-age men with alcohol consumption, whereas elderly women with no alcohol consumption prevailed among nonsmokers. Expression of α4 nAChR was high in all groups, with an influence of alcohol use, although expression of α7 nAChR was low in current smokers with alcohol use. Expression of α4 with no expression of α7 nAChR was associated with advanced disease. Conclusions: Squamous cell carcinoma tumors of the upper aerodigestive tract (out of the larynx) may show desensitization of α4 nAChR. Advanced disease at diagnosis might be associated with desensitization of α4 with decrease in α7 nAChR.
Comparison of Quetiapine Abuse and Misuse Reports to the FDA Adverse Event Reporting System With Other Second-Generation Antipsychotics
Authors: Evoy Kirk E , Teng Chengwen , Encarnacion Victor G , Frescas Brian , Hakim John , Saklad Stephen , Frei Christopher R 
Published: May 2019

Background: Second-generation antipsychotics (SGAs) are assumed to have little abuse potential. However, reports of quetiapine abuse have emerged as prescribing has increased in recent years. The US Food and Drug Administration’s (FDA) Adverse Event Reporting System (FAERS) provides postmarketing information regarding adverse drug events (ADEs). This is the first study to analyze quetiapine abuse-related ADEs reported to FAERS to determine whether a disproportionate rate of such events have been reported when compared with other commonly used SGAs. Methods: A cross-sectional analysis of FAERS data from January 1, 2015, to December 31, 2017, was performed. The total number of all-cause and abuse-related ADEs reported to FAERS regarding quetiapine, olanzapine, aripiprazole, and risperidone were identified, along with demographic and mortality data. The proportional reporting ratio (PRR) was calculated to assess disproportionate reporting of abuse-related adverse drug reactions between quetiapine and each of three alternative SGA medications. Results: Abuse-related ADEs represented 11% (3144/27 962) of total ADEs reported for quetiapine, 8% for olanzapine (1548/19 228), 5% (1380/29 699) for aripiprazole, and 3% (1168/45 518) for risperidone. The PRRs (95% confidence interval) for quetiapine versus olanzapine, aripiprazole, and risperidone were 1.40 (1.32-1.48), 2.42 (2.28-2.57), and 4.38 (4.10-4.68), respectively, indicating that abuse-related events were significantly more likely to be reported with quetiapine than each comparator drug. In addition, more deaths were reported among the abuse-related events regarding quetiapine (673) than olanzapine (200), aripiprazole (88), and risperidone (143). Conclusion: This study corroborates recent evidence indicating that quetiapine might possess a significantly higher abuse potential than other commonly used SGAs. Although prospective studies are needed to better understand the abuse potential of quetiapine, increased vigilance in monitoring for signs of substance abuse might be warranted when prescribing quetiapine.
Major Stressful Life Events and Risk of Developing Lung Cancer: A Case-Control Study
Authors: Jafri Syed H , Ali Faisal , Mollaeian Arash , Mojiz Hasan Syed , Hussain Rahat , Akkanti Bindu , Williams Jessica , Shoukier Mahran , el-Osta Hazem 
Published: May 2019

Background: Lung cancer is the leading cause of cancer-related mortality and is strongly linked with smoking. We sought to determine whether major stressful life events (e.g. divorce) are also a risk factor for developing lung cancers. Methods: We performed a matched case-control study. Cases (CA) were lung cancer patients diagnosed within the previous 12 months. Controls (CO) were patients without a prior history of malignancy. Data on major stressful life events were collected using the modified Holmes-Rahe stress scale. The primary endpoint was the odds of having a major stressful life event between CA and CO. A sample of 360 patients (CA = 120, CO = 240) was needed to achieve 80% power to detect an odds ratio (OR) of 2.00 versus the alternative of equal odds using χ2 = 0.05. Results: Between May 2015 and December 2016, we enrolled 301 patients (CA = 102, CO = 199), matched for median age (CA = 64.4 years, CO = 63.9 years), sex (CA-Male = 48%, CO-Male = 49.2%), and smoking status (ever smoker, CA = 84%, CO = 85%). There was no difference in lifetime stressful life event rate between CA and CO (95% vs 93.9%; P = .68). However, CA were significantly more likely to have had a stressful event within the preceding 5 years than CO (CA = 77.4% vs CO = 65.8%; P = .03, OR = 1.78). β-blocker use was significantly higher among CO (CA = 29.4%, CO = 49.7%; P = .0007, OR = 0.42), suggesting a protective effect. Conclusion: Patients with lung cancer are significantly more likely to have had a major stressful life event within the preceding 5 years. In addition, use of β-blockers may be protective against lung cancer.
Agreement and Correlation of Arterial and Venous Blood Gas Analysis in a Diverse Population
Authors: Chung Paul A , Scavone Anthony , Ahmed Asrar , Kuchta Kristine , Bellam Shashi K 
Published: May 2019

Introduction: Agreement and correlation of arterial blood gases (ABGs) and venous blood gases (VBGs) at near normal values are well described but have not been well validated at extremes of values. We evaluated the agreement and correlation of ABG and VBG at extremes of values and assessed the utility of VBG as a screening tool. Methods: We performed a retrospective, observational study of ABG and VBG collected at the same time. Statistical analysis included Bland-Altman plot analysis, Pearson correlations, and sensitivity/specificity tests. For limits of agreement (LOA), we set a threshold of ±0.10 units for pH and ±2.4 mm Hg for partial pressure of carbon dioxide (pCO2). A threshold of 80% sensitivity was considered appropriate for VBG to be used as a screening tool for abnormal ABG values. Results: There were 1684, 1744, and 1769 paired pH, pCO2, and HCO3¯ results, respectively. Mean difference (MD) for arterial and venous pH was 0.017 (95% confidence interval [CI]: 0.014-0.020; 95% LOA: −0.11 to 0.15), and Pearson correlation was 0.78 ( P < .0001). At venous pH <7.35, MD was 0.025 (95% CI: 0.019-0.030; 95% LOA: −0.12 to 0.17). Sensitivity of venous pH <7.35 identifying arterial pH <7.35 was 85.0%. MD for arterial and venous pCO2 was −2.5 (95% CI: −2.9 to −2.0; 95% LOA: −21.7 to 16.8), and Pearson correlation was 0.70 ( P < .0001). At venous pCO2 >45 mm Hg, MD was −4.1 (95% CI: −4.9 to −3.3; 95% LOA: −25.7 to 17.5). Sensitivity of venous pCO2 >45 mm Hg identifying arterial pCO2 >45 mm Hg was 67.6%. MD for arterial and venous HCO3¯ was −0.3 (95% CI: −0.4 to −0.2; 95% LOA: −4.8 to 4.2), and Pearson correlation was 0.90 ( P < .0001). Conclusions: Venous blood gases cannot reliably replace ABGs due to poor agreement in acidemia and hypercarbia. Venous blood gases can be used as a screening tool for acidemia but are unsuitable for hypercarbia.
Evaluation of the Use of Argatroban or Bivalirudin for the Management of Suspected Heparin-Induced Thrombocytopenia in the Setting of Continuous Renal Replacement Therapy
Authors: Chanas Tyler , Palkimas Surabhi , Maitland Hillary S , Liszewski Amanda 
Published: May 2019

Studies have shown an association between continuous renal replacement therapy (CRRT) and thrombocytopenia. Patients on CRRT usually receive unfractionated heparin (UFH), and heparin-induced thrombocytopenia (HIT) is frequently suspected as a potential cause of thrombocytopenia. In the setting of HIT suspicion, changes in anticoagulation may put patients at risk of developing thromboembolic events or adverse medication effects. Purpose: The purpose of this study was to investigate current management of anticoagulation in patients with suspected HIT while on CRRT and identify complications associated with anticoagulation in this setting. Methods: This is a retrospective study of patients on CRRT with suspicion for HIT. Prevalence of HIT and anticoagulant use were collected for all patients. Outcomes included thromboembolic and bleeding events, final therapeutic doses of each anticoagulant, and time to reach therapeutic range. Thromboembolic and bleeding outcomes were compared between anticoagulants. Results: From January 2013 through December 2015, 74 patients were identified with suspicion of HIT while on CRRT. During the period of HIT suspicion, 20 patients received argatroban, 18 received bivalirudin, 1 received fondaparinux, 4 received UFH infusions, 10 received prophylactic dosing subcutaneous UFH, and 21 received no anticoagulation. The median final therapeutic doses of argatroban and bivalirudin were 1.00 μg/kg/min and 0.075 mg/kg/h, respectively, with no difference in time to therapeutic range (17.6 h vs 18.2 h, P = .485). Compared with bivalirudin, patients treated with argatroban had significantly more therapeutic activated partial thromboplastin time (aPTT) values (54.5% vs 42.8%, P = .008). Four patients (20.0%) treated with argatroban and 5 patients (27.8%) treated with bivalirudin experienced major bleeding ( P = .709). Three patients (15.0%) treated with argatroban and 4 patients (22.2%) treated with bivalirudin experienced thromboembolic events ( P = .687). Conclusion: Argatroban and bivalirudin were associated with similar rates of bleeding and thromboembolic events during the period of concurrent CRRT and thrombocytopenia, although patients treated with argatroban had more therapeutic aPTT values.
Linear Accelerator-Based Stereotactic Radiotherapy for Low-Grade Meningiomas: Improved Local Control With Hypofractionation
Authors: Wegner Rodney E , Hasan Shaakir , Abel Stephen , Anderson Sidney , Fuhrer Russell , Williamson Richard W , Karlovits Stephen M 
Published: May 2019

Background and purpose: Meningioma is a common type of benign tumor that can be managed in several ways, ranging from close observation, surgical resection, and various types of radiation. We present here results from a 10-year experience treating meningiomas with a hypofractionated approach. Materials and methods: We reviewed the charts of 56 patients treated with stereotactic radiosurgery (SRS) or hypofractionated stereotactic radiotherapy (SRT) from 2008 to 2017. A total of 46 (82%) patients had WHO Grade 1 disease and 10 (18%) had Grade 2. Outcomes that were analyzed included local control rates and the rate and grade of any reported toxicity. Results: A total of 38 women and 18 men underwent SRS to a median dose of 15 Gy (n = 24) or hypofractionated SRT with a median dose of 25 Gy in five fractions (n = 34). Of the 56 patients, 22 had surgery before receiving treatment. The median follow-up was 36 (6-110) months. Local control at 2 and 5 years for all patients was 90% and 88%, respectively. Comparing fractionated to single-fraction treatment, there was improved local control with fractionation (91% vs 80% local control at 2 years, P = .009). There was one episode of late radionecrosis on imaging with associated symptoms after single-fraction treatment and one patient requiring resection of meningioma related to worsening symptoms (and local recurrence) after five-fraction SRT. Conclusions: This study provides further evidence for high rates of local control and minimal toxicity using a hypofractionated SRT approach, with improvement in local control through use of hypofractionation.
Candesartan in a rat model of testicular toxicity: New insight on its protective mechanism
Authors: Sherif Iman O , Sarhan Osama M 
Published: May 2019

Cisplatin (CDDP) is widely used as an effective chemotherapy; nevertheless, its use is associated with male reproductive system damage. Candesartan (Cand) is an angiotensin II receptor blocker which showed a protective effect against CDDP-induced testicular toxicity. This study was implemented to investigate further novel molecular protective effect of Cand. Animals were divided into four groups and treated for 10 days as: Group I (Normal control): received saline, Group II (Cand control): treated with Cand (10 mg/kg/day) orally, Group III (CDDP): injected with a single dose of 10 mg/kg CDDP intraperitoneally (ip), Group IV (Cand + CDDP): treated with Cand (10 mg/kg/day) orally plus a single ip dose of 10 mg/kg CDDP at day 3. Blood and testicular tissue collections were done at the end of the experiment. A marked decrease in testicular, body, and relative body weights in addition to testosterone level was observed in the CDDP group when compared with normal rats. In addition, exposure to CDDP showed a marked upregulation of testicular TNF-α mRNA level and a significant rise in testicular levels of total oxidant status, oxidative stress index (OSI) ratio, pro-apoptotic protein Bax, Bax/Bcl-2 ratio alongside with a marked reduction in testicular levels of total antioxidant status, antiapoptotic protein Bcl-2, and a significant upregulation of the testicular caspase-3 expression in comparison to normal group. Histopathological findings after CDDP injection showed apoptosis and necrosis in testicular tissues. Administration of Cand ameliorated these biochemical and histopathological findings. Cand exhibited a novel protective mechanism against CDDP induced-gonadal damage via antioxidant, anti-inflammatory, and anti-apoptotic activities. Impact statement Cisplatin is a commonly used drug in the treatment of solid tumors and its application is associated with testicular toxicity. The effect of candesartan in cisplatin-induced testicular toxicity and its fundamental mechanism of action were investigated. Candesartan had certainly repaired the testicular injury and ameliorated both biochemical and histopathological changes. Candesartan mitigated the gonadotoxicity induced by cisplatin via antioxidative, anti-inflammatory, and antiapoptotic actions.