bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of Apixaban-Treated Patients, Evaluation of the Dose Prescribed, and the Persistence of Treatment
Authors: Gomez-Lumbreras Ainhoa , Cortes Jordi , Giner-Soriano Maria , Quijada-Manuitt M. Angeles , Morros Rosa 
Published: May 2018

Background: Apixaban is a direct oral anticoagulant, which inhibits factor Xa. It has demonstrated clinical efficacy in prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation and a better safety profile compared to warfarin. Objectives: (1) To describe the characteristics of patients with nonvalvular atrial fibrillation beginning treatment with apixaban, (2) to analyze concomitant prescriptions of medications that could potentially interact with apixaban, (3) to evaluate the level of appropriate usage according to the recommended dosage, and (4) to estimate the level of apixaban persistence among naive and non-naive patients. Methods: Cohort study using data from primary care (System for Research in Primary Care database, users of the Institut Català de la Salut; Catalonia, Spain) from August 2013 to December 2015. Results: Mean age for apixaban-treated patients was 71.8 years (standard deviation = 11.1) and 55.6% were male. In all, 3.2% of patients receiving apixaban were taking drugs described as potentially related to either pharmacokinetic or pharmacodynamic interactions. According to the summary of product characteristics, 81.1% of patients with a recommended dose of 2.5 mg twice daily and 51.8% with a recommended dose of 5 mg twice daily actually took this dose. After 1 year of follow-up, 62.6% of the apixaban users showed good adherence. Conclusion: The prescribed dose of apixaban did not fully follow the recommended dose, particularly in patients who were treatment naive. Patients with a prior history of anticoagulant treatment were more likely to remain persistent to treatment with apixaban.
The effect and importance of physical activity on behavioural and psychological symptoms in people with dementia: A systematic mixed studies review
Authors: Junge Tina , Ahler Jonas , Knudsen Hans K , Kristensen Hanne K 
Published: May 2018

Background People with dementia may benefit from the effect of physical activity on behavioural and psychological symptoms of dementia. Qualitative synthesis of the importance of physical activity might complement and help clarify quantitative findings on this topic. The purpose of this systematic mixed studies review was to evaluate findings from both quantitative and qualitative methods about the effect and importance of physical activity on behavioural and psychological symptoms of dementia in people with dementia. Methods The systematic literature search was conducted in EMBASE, CINAHL, PubMed, PEDro and PsycINFO. Inclusion criteria were: people with a light to moderate degree of dementia, interventions including physical activity and outcomes focusing on behavioural and psychological symptoms of dementia or quality of life. To assess the methodological quality of the studies, the AMSTAR and GRADE checklists were applied for the quantitative studies and the CASP qualitative checklist for the qualitative studies. Results A small reduction in depression level and improved mood were seen in some quantitative studies of multi-component physical activity interventions, including walking. Due to high heterogeneity in the quantitative studies, a single summary of the effect of physical activity on behavioural and psychological symptoms of dementia should be interpreted with some caution. Across the qualitative studies, the common themes about the importance of physical activity were its ‘socially rewarding’ nature, the ‘benefits of walking outdoors’ and its contribution to ‘maintaining self-hood’. Conclusion For people with dementia, there was a small, quantitative effect of multi-component physical activity including walking, on depression level and mood. People with dementia reported the importance of walking outdoors, experiencing the social rewards of physical activity in groups, as well as physical activity were a means toward maintaining self-hood.
Procedural and clinical outcomes of endovascular recanalization therapy in patients with cancer-related stroke
Authors: Jung Seunguk , Jung Cheolkyu , Hyoung Kim Jae , Se Choi Byung , Jung Bae Yun , Sunwoo Leonard , Geol Woo Ho , Young Chang Jun , Joon Kim Beom , Han Moon-Ku , Bae Hee-Joon 
Published: May 2018

Objective Embolism due to coagulopathy might be the main pathomechanism underlying cancer-related stroke (CRS). CRS patients with a large artery occlusion could be candidates for endovascular recanalization therapy (ERT), although its procedural and clinical outcomes are not well known. This study aimed to investigate the procedural and clinical outcomes of ERT in CRS patients and the characteristics associated with outcomes compared with those of conventional stroke patients. Methods A registry of consecutive acute ischemic stroke patients who underwent ERT between January 2011 and October 2015 was retrospectively reviewed. CRS patients are described as those who had (a) cryptogenic stroke with advanced or metastatic cancer; (b) no other possible causes of stroke such as cardioembolism (CE) and large artery atherosclerosis (LAA); and (c) elevated D-dimer levels or diffusion-restricted lesions in multiple vascular territories. We compared procedural and clinical outcomes at discharge among CRS, CE, and LAA patients. Results A total of 329 patients were finally enrolled in this study; of these, 19 were CRS patients. The rate of successful recanalization, defined as modified treatment in cerebral infarction grade 2b or 3, was lower in the CRS group than in the LAA and CE groups (63% versus 84% versus 84%, p = .06). CRS subtype was an independent predictor for successful recanalization after ERT in the multivariate analysis (odds ratio, 0.317; 95% confidence interval, 0.116–0.867; p < .001). No significant difference in the rate of good clinical outcomes at discharge was observed among groups. Conclusions Although clinical outcomes at discharge were similar for CE and LAA patients, complete recanalization seemed more difficult to achieve in CRS patients than in conventional stroke patients.
Innovation in the imaging of perianal fistula: a step towards personalised medicine
Authors: Sahnan Kapil , Adegbola Samuel O. , Tozer Philip J. , Patel Uday , Ilangovan Rajpandian , Warusavitarne Janindra , Faiz Omar D. , Hart Ailsa L. , Phillips Robin K. S. , Lung Phillip F. C. 
Published: May 2018

Background: Perianal fistula is a topic both hard to understand and to teach. The key to understanding the treatment options and the likely success is deciphering the exact morphology of the tract(s) and the amount of sphincter involved. Our aim was to explore alternative platforms better to understand complex perianal fistulas through three-dimensional (3D) imaging and reconstruction. Methods: Digital imaging and communications in medicine images of spectral attenuated inversion recovery magnetic resonance imaging (MRI) sequences were imported onto validated open-source segmentation software. A specialist consultant gastrointestinal radiologist performed segmentation of the fistula, internal and external sphincter. Segmented files were exported as stereolithography files. Cura (Ultimaker Cura 3.0.4) was used to prepare the files for printing on an Ultimaker 3 Extended 3D printer. Animations were created in collaboration with Touch Surgery™. Results: Three examples of 3D printed models demonstrating complex perianal fistula were created. The anatomical components are displayed in different colours: red: fistula tract; green: external anal sphincter and levator plate; blue: internal anal sphincter and rectum. One of the models was created to be split in half, to display the internal opening and allow complexity in the intersphincteric space to better evaluated. An animation of MRI fistulography of a trans-sphincteric fistula tract with a cephalad extension in the intersphincteric space was also created. Conclusion: MRI is the reference standard for assessment of perianal fistula, defining anatomy and guiding surgery. However, communication of findings between radiologist and surgeon remains challenging. Feasibility of 3D reconstructions of complex perianal fistula is realized, with the potential to improve surgical planning, communication with patients, and augment training.
Cardiovascular Screening Practices and Attitudes From the NCAA Autonomous “Power” 5 Conferences
Authors: Miars Christopher W. , Stamatis Andreas , Morgan Grant B. , Drezner Jonathan A. 
Published: May 2018

Background: The development of athlete-specific electrocardiogram (ECG) interpretation standards, along with recent rates of sudden cardiac death (SCD) in athletes being higher than previously estimated, has heightened the debate in the sports medicine community regarding cardiovascular screening of the college athlete, including whether certain high-risk subsets, such as male basketball athletes, should undergo more intensive screening. Hypothesis: ECG and/or echocardiography screening in National Collegiate Athletic Association Autonomous 5 Division I (A5DI) schools will be more common than previous reports, and there will be more frequent use of noninvasive cardiac screening for men’s basketball players than the general athlete population. Study Design: Cross-sectional, quantitative study. Level of Evidence: Level 4. Methods: The head team physician for each of the 65 schools in the A5DI conferences was contacted to complete an anonymous survey regarding cardiovascular screening practices at their institution. The survey inquired about current screening protocols, whether SCD epidemiology (SCD-E) was considered in establishing those practices, and whether awareness of present epidemiology altered physician attitudes toward screening. Results: A total of 45 of the 65 team physicians (69%) responded. All schools reported performing history and a physical evaluation. While 17 (38%) perform only history and physical, 26 (58%) also include an ECG, and 12 (27%) include echocardiography for all student-athletes. Specifically for male basketball athletes, 10 (22%) schools perform only history and physical, 32 (71%) include ECG, and 20 (45%) include echocardiography. Additionally, 64% reported using SCD-E in developing their screening protocol. Those that had not considered SCD-E indicated they were unlikely to change their screening protocol when presented with current SCD-E. Conclusion: The majority (62%) of A5DI institutions include ECG and/or echocardiography as part of their cardiovascular screening of all athletes, increasing to 78% when specifically analyzing male basketball athletes. Clinical Relevance: A5DI institutions, presumably with greater resources, have largely implemented more intensive cardiovascular screening than just history and physical for all student-athletes and specifically for men’s basketball—the athlete group at greatest risk.
Is There an Optimal Wound Closure Technique for Major Posterior Spine Surgery? A Systematic Review
Authors: Yilmaz Emre , Blecher Ronen , Moisi Marc , Ankush Chandra , O’Lynnger Thomas M. , Abdul-Jabbar Amir , Dettori Joseph R. , Oskouian Rod J. 
Published: May 2018

Study Design: Systematic review. Objectives: In patients undergoing posterior spinal fusion: (1) What are the types and risks of wound complications in major (≥3 levels) surgery, and does the risk vary by number of levels fused? (2) What types of fascial closure result in the fewest wound complications? (3) What subcutaneous closure technique is more effective in preventing wound complications for obese patients (body mass index >30 kg/m2)? (4) What type of skin closure results in the fewest wound complications? (5) What type of dressing results in the fewest wound complications? Methods: Electronic databases and reference lists of key articles were searched from January 1, 2000 to December 4, 2017 to identify studies meeting inclusion criteria. Results: Six lower quality retrospective studies (evidence level III) met the inclusion criteria. The risk of wound complications in patients with ≥3 level posterior spine fusion ranges from 1.5% to 3.7% depending on the definition of wound complications. Skin closure with sutures resulted in fewer wound infections compared with staples (0.0% vs 8.0%, P = .023). We were unable to demonstrate an association between the number of levels fused and infection risk. Wound infections, primarily superficial, occurred less frequently with Silverlon dressing versus routine dressing. Conclusions: We were unable to determine if infection risk changed with increasing number of levels fused. There is a lack of evidence for optimal wound closure technique in posterior spine surgery. Several questions still remain unanswered, such as the optimal fascial closure technique or the optimal subcutaneous closure technique in obese patients.
Epidemiology of War-Related Spinal Cord Injury Among Combatants: A Systematic Review
Authors: Furlan Julio C. , Gulasingam Sivakumar , Craven B. Catharine 
Published: May 2018

Study Design: Systematic review. Objectives: War-related spinal cord injuries (SCIs) are commonly more severe and complex than traumatic SCIs among civilians. This systematic review, for the first time, synthesized and critically appraised the literature on the epidemiology of war-related SCIs. This review aimed to identify distinct features from the civilian SCIs that can have an impact on the management of military and civilian SCIs. Methods: Medline, EMBASE, and PsycINFO databases were searched for articles on epidemiology of war-related SCI among combatants, published from 1946 to December 20, 2017. This review included only original publications on epidemiological aspects of SCIs that occur during an act of war. The STROBE statement was used to examine the quality of the publications. Results: The literature search identified 1594 publications, of which 25 articles fulfilled the inclusion and exclusion criteria. The studies were classified into the following topics: 17 articles reported demographics, level and severity of SCI, mechanism of injury and/or associated bodily injuries; 5 articles reported the incidence of war-related SCI; and 6 articles reported the frequency of SCI among other war-related bodily injuries. Overall, military personnel with war-related SCI were typically young, white men, with predominantly thoracic or lumbar level, complete (American Spinal Injury Association [ASIA] Impairment Scale A) SCI due to gunshot or explosion and often associated with other bodily injuries. Marines appear to be at a greater risk of war-related SCI than the military personal in the Army, Navy, and Air Force. Conclusions: The war-related SCIs among soldiers are distinct from the traumatic SCI in the general population. The majority of the current literature is based on the American experiences in most recent wars.
Adolescent Medial Patellofemoral Ligament Reconstruction: A Comparison of the Use of Autograft Versus Allograft Hamstring
Authors: Kumar Nikhil , Bastrom Tracey P. , Dennis M. Morgan , Pennock Andrew T. , Edmonds Eric W. 
Published: May 2018

Background: Recurrent patellar instability is commonly treated with medial patellofemoral ligament reconstruction (MPFLR), and the use of allograft in anterior cruciate ligament reconstructions has demonstrated inferior outcomes. Purpose: To compare the outcomes of allografts versus autografts in adolescent MPFLR for patellar instability. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective chart review was completed on patients younger than 18 years who underwent MPFLR for recurrent instability after failed nonoperative management over an 8-year period with a minimum 2-year follow-up. Patients were divided into autograft or allograft hamstring cohorts for comparison. Primary outcome measures were return to normal activity, incidence of redislocation/subluxation, pain, stiffness, other complications, and Kujala scores. Statistical analysis using unpaired t tests was performed, with an alpha value set at P < .05. Results: After criteria were applied, 59 adolescents (36 allograft, 23 autograft; 38 girls, 21 boys) with a mean ± SD age of 15.2 ± 1.7 years and a mean follow-up of 4.1 ± 1.9 years (allograft, 3.3 ± 1.1 years; autograft, 5.7 ± 2.1 years; P ≤ .001) were included. Seven patients had concurrent osteotomies (3 allograft, 4 autograft), 11 patients had concurrent loose body removals (5 allograft, 6 autograft), and 9 patients had concurrent lateral release (7 allograft, 2 autograft). Between groups, no significant difference was found in change between preoperative and most recent follow-up (mean, 1.2 ± 2.1) or rate of return to sports (mean, 73.3%). In total, 9 surgeries failed (3 allograft, 6 autograft). For the surviving grafts, a statistical difference in mean Kujala scores at final follow-up was noted (allograft, 92.7; autograft, 97.4; P = .02). Conclusion: We identified no significant differences in return to activity, pain score changes, and incidences of failure between patients undergoing MPFLR with allograft versus autograft. Although teenagers with surviving autograft MPFLR reported statistically higher Kujala scores, the mean score difference of 5 points was not clinically significant. It appears that using allograft tendon instead of autograft tissue for MPFLR in this teenage population does not adversely affect long-term outcomes.
NADPH oxidase activation regulates apoptotic neutrophil clearance by murine macrophages
Authors: Bagaitkar Juhi , Huang Jing , Zeng Melody Yue , Pech Nancy K. , Monlish Darlene A. , Perez-Zapata Lizet J. , Miralda Irina , Schuettpelz Laura G. , Dinauer Mary C. 
Published: May 2018

Key PointsEfferocytosis of ACs by inflammatory macrophages activates NADPH oxidase in a CD11b-TLR2/4-MyD88–dependent manner. ROS generated positively regulate acidification and proteolysis in efferosomes, and limit cross-presentation of AC-associated antigens.
GPIbα is required for platelet-mediated hepatic thrombopoietin generation
Authors: Xu Miao , Li June , Neves Miguel Antonio Dias , Zhu Guangheng , Carrim Naadiya , Yu Ruoying , Gupta Sahil , Marshall John , Rotstein Ori , Peng Jun , Hou Ming , Kunishima Shinji , Ware Jerry , Branch Donald R. , Lazarus Alan H. , Ruggeri Zaverio M. , Freedman John , Ni Heyu 
Published: May 2018

Key PointsPlatelet GPIbα induces hepatic TPO generation and maintains TPO levels in blood. Antiextracellular GPIbα antibodies decrease TPO generation and may affect TPO levels in immune-mediated thrombocytopenias.
Loss of Chromosome 18q11.2-q12.1 Is Predictive for Survival in Patients With Metastatic Colorectal Cancer Treated With Bevacizumab
Authors: van Dijk Erik , Biesma Hedde D. , Cordes Martijn , Smeets Dominiek , Neerincx Maarten , Das Sudipto , Eijk Paul P. , Murphy Verena , Barat Anna , Bacon Orna , Prehn Jochen H.M. , Betge Johannes , Gaiser Timo , Fender Bozena , Meijer Gerrit A. , McNamara Deborah A. , Klinger Rut , Koopman Miriam , Ebert Matthias P.A. , Kay Elaine W. , Hennessey Bryan T. , Verheul Henk M.W. , Gallagher William M. , O'Connor Darran P. , Punt Cornelis J.A. , Loupakis Fotios , Lambrechts Diether , Byrne Annette T. , van Grieken Nicole C.T. , Ylstra Bauke 
Published: May 2018

Purpose Patients with metastatic colorectal cancer (mCRC) have limited benefit from the addition of bevacizumab to standard chemotherapy. However, a subset probably benefits substantially, highlighting an unmet clinical need for a biomarker of response to bevacizumab. Previously, we demonstrated that losses of chromosomes 5q34, 17q12, and 18q11.2-q12.1 had a significant correlation with progression-free survival (PFS) in patients with mCRC treated with bevacizumab in the CAIRO2 clinical trial but not in patients who did not receive bevacizumab in the CAIRO trial. This study was designed to validate these findings. Materials and Methods Primary mCRC samples were analyzed from two cohorts of patients who received bevacizumab as first-line treatment; 96 samples from the European multicenter study Angiopredict (APD) and 81 samples from the Italian multicenter study, MOMA. A third cohort of 90 samples from patients with mCRC who did not receive bevacizumab was analyzed. Copy number aberrations of tumor biopsy specimens were measured by shallow whole-genome sequencing and were correlated with PFS, overall survival (OS), and response. Results Loss of chromosome 18q11.2-q12.1 was associated with prolonged PFS most significantly in both the cohorts that received bevacizumab (APD: hazard ratio, 0.54; P = .01; PFS difference, 65 days; MOMA: hazard ratio, 0.55; P = .019; PFS difference, 49 days). A similar association was found for OS and overall response rate in these two cohorts, which became significant when combined with the CAIRO2 cohort. Median PFS in the cohort of patients with mCRC who did not receive bevacizumab and in the CAIRO cohort was similar to that of the APD, MOMA, and CAIRO2 patients without an 18q11.2-q12.1 loss. Conclusion We conclude that the loss of chromosome 18q11.2-q12.1 is consistently predictive for prolonged PFS in patients receiving bevacizumab. The predictive value of this loss is substantiated by a significant gain in OS and overall response rate.
ACTIVExtend: 24 Months of Alendronate After 18 Months of Abaloparatide or Placebo for Postmenopausal Osteoporosis
Authors: Bone Henry G , Cosman Felicia , Miller Paul D , Williams Gregory C , Hattersley Gary , Hu Ming-yi , Fitzpatrick Lorraine A , Mitlak Bruce , Papapoulos Socrates , Rizzoli René , Dore Robin K , Bilezikian John P , Saag Kenneth G 
Published: May 2018

Abstract

Purpose
In women with postmenopausal osteoporosis, we investigated the effects of 24 months of treatment with alendronate (ALN) following 18 months of treatment with abaloparatide (ABL) or placebo (PBO).

Methods
Women who completed ABL or PBO treatment in ACTIVE were eligible to receive up to 24 months of ALN. We evaluated the incidence of vertebral and nonvertebral fractures and changes in bone mineral density (BMD) during the entire 43-month period from ACTIVE baseline to the end of ACTIVExtend and for the 24-month extension only.

Results
Five hundred fifty-eight women from ACTIVE’s ABL group and 581 from its PBO group (92% of ABL and PBO completers) were enrolled. During the full 43-month treatment period, 0.9% of evaluable women in the ABL/ALN group experienced a new radiographic vertebral fracture vs 5.6% of women in the PBO/ALN group, an 84% relative risk reduction (RRR, P &lt; 0.001). Kaplan–Meier incidence rates for other reported fracture types were significantly lower for ABL/ALN vs PBO/ALN (all P &lt; 0.05). Gains in BMD achieved during ACTIVE were further increased during ACTIVExtend. For ACTIVExtend only, RRR for vertebral fractures was 87% with ABL/ALN vs PBO/ALN (P = 0.001). Adverse events were similar between groups. A supplemental analysis for regulatory authorities found no hip fractures in the ABL/ALN group vs five in the PBO/ALN group.

Conclusions
Eighteen months of ABL followed by 24 months of ALN reduced the risk of vertebral, nonvertebral, clinical, and major osteoporotic fractures and increased BMD. Sequential ABL followed by ALN appears to be an effective treatment option for postmenopausal women at risk for osteoporosis-related fractures.