bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of incision location on specimen quality and complications for temporal artery biopsy
Authors: Czyz Craig N , Allen John B , Cahill Kenneth V , Nabavi Cameron B , Foster Jill A 
Published: December 2018

Objectives Giant cell arteritis is a vision and potentially life-threatening condition requiring prompt and accurate diagnosis. The current gold standard of diagnosis is temporal artery biopsy. The purpose of this study is to review the technique of temporal biopsy in regard to incision placement, and to determine specimen quality and the incidence of complications, specifically seventh nerve injury. Methods Retrospective cohort study of 125 consecutive patients (137 biopsies) who underwent temporal artery biopsy. Variables concerning the procedure collected included laterality, incision placement, Doppler ultrasound utilization, length of intraoperative and pathologic specimens, result of the biopsy, motor nerve deficit, brow ptosis, and any intra or postoperative complications. Results The patient population was 73% female and 86% Caucasian. The average age at the time of the biopsy was 73.8 (range = 56–89, SD = 8.7). Doppler localization was used on 45% of patients. The mean intraoperative specimen length was 2.6 cm (range = 1.5–4.1, SD = 0.6) and fixed specimen length was 2.0 cm (range = 0.8–4.0, SD = 0.7). Biopsy results were positive in 18% of cases. There were no patients who displayed seventh nerve injury at one-week follow-up. One patient (0.7%) reported persistent anesthesia and one (0.7%) reported persistent paresthesia at the incision site. There were no other intraoperative or postoperative complications reported. Conclusions Placement of the incision at or posterior to the temporal hairline reduces the risk of seventh nerve injury. The posterior incision placement did not affect the quality of specimens or decrease the yield of biopsy results as compared to other studies. The overall complication rate (3%) was minimal and did not involve any motor nerve injury.
Endoscopic treatment of chronic pancreatitis in pediatric population: Long‐term efficacy and safety
Authors: Kohoutova D , Tringali A , Papparella G , Perri V , Boškoski I , Hamanaka J , Costamagna G 
Published: December 2018

BackgroundChronic pancreatitis (CP) in children is an inreasingly recognized disease.ObjectiveThe purpose of study was to analyse the safety and long‐term efficacy of endoscopic treatment in children with CP.MethodsRecords of 38 patients aged <18 years, referred to the Digestive Endoscopy Unit at Catholic University, Fondazione Policlinico “A. Gemelli” IRCCS between 1991 and 2017, were reviewed. Abdominal pain, analgesia and number of episodes of acute pancreatitis in the pre‐ and post‐ endoscopic retrograde cholangiopancreatography (ERCP) period were evaluated. Need for surgery was assessed. Therapeutic intervention data and complications were interrogated.ResultsIn total 158 ERCPs were performed. Median post‐ERCP follow‐up was 7 years. The majority of patients had CP type IV (47%) and type Ib (37%) (Cremer's classification). Major papilla pancreatic sphincterotomy was performed in 47%, major and minor in 24% and minor in 29% of patients. Stones/plugs were removed in at least one ERCPs in 66% individuals. Eleven out of 38 patients had stricture of the pancreatic duct; these were dilated and stented in 5/11 and stented in 6/11. Five complications were recorded (3%). Severity and frequency of abdominal pain improved significantly; p < 0.001. Use of analgesia and number of episodes of acute pancreatitis decreased significantly; p < 0.001. One child required subsequent surgery.ConclusionEndoscopic management of symptomatic CP in children is safe and effective.
Charcoal granuloma mimicking breast cancer: an emerging diagnosis
Authors: Salvador Gabriel Lucca de Oliveira , Barbieri Poliana Palma , Maschke Laura , Nunes Anna Luisa Aranha , Louveira Maria Helena , Budel Vinicius Milani 
Published: December 2018

Background Image-guided charcoal injection in suspicious breast lesions for preoperative localization is a procedure that has been increasing over the years because it is safer, faster, and more affordable when compared to needle-wire preoperative localization. To date, no complications have been associated with the method. However, in recent years there have been some reports about charcoal granulomas mimicking malignant lesions in some postoperative patients or in a conservative follow-up. Purpose To report a series of 11 cases which had suspicious imaging findings for malignancy and resulted in charcoal granulomas on histopathological analysis. Material and Methods A database of 1650 patients that attended our center from January 2007 to June 2018 was reviewed and detected 495 patients who had been previously submitted to ultrasound-guided charcoal marking in a breast lesion. Then, patients whose imaging studies were compatible with new suspicious lesions on mammography, breast ultrasound, and/or magnetic resonance imaging and biopsy of this new lesion indicating charcoal granuloma were selected. Results From 495 patients who had undergone charcoal localization injections in previous biopsies, we selected 11 who had new lesions with malignant characteristics on imaging studies but histopathological analysis resulted in charcoal granuloma. Conclusion Charcoal granuloma should be considered in patients with previous preoperative injection localization, since the residual charcoal in the breast tissue may form granulomas and mimic malignant lesions on follow-up imaging studies.
A Behavior-Modification, Clinical-Grade Mobile Application to Improve Breast Cancer Survivors' Accountability and Health Outcomes
Authors: Stubbins Renee , He Tiancheng , Yu Xiaohui , Puppala Mamta , Ezeana Chika F. , Chen Shenyi , Valdivia y Alvarado Miguel , Ensor Joe , Rodriguez Angel , Niravath Polly , Chang Jenny , Wong Stephen T.C. , Patel Tejal 
Published: December 2018

Purpose Only 34% of breast cancer survivors engage in the recommended level of physical activity because of a lack of accountability and motivation. Methodist Hospital Cancer Health Application (MOCHA) is a smartphone tool created specifically for self-reinforcement for patients with cancer through the daily accounting of activity and nutrition and direct interaction with clinical dietitians. We hypothesize that use of MOCHA will improve the accountability of breast cancer survivors and help them reach their personalized goals. Patients and Methods Women with stages I to III breast cancer who were at least 6 months post–active treatment with a body mass index (BMI) greater than 25 kg/m2 were enrolled in a 4-week feasibility trial. The primary objective was to demonstrate adherence during weeks 2 and 3 of the 4-week study period (14 days total). The secondary objective was to determine the usability of MOCHA according to the system usability scale. The exploratory objective was to determine weight loss and dietitian-participant interaction. Results We enrolled 33 breast cancer survivors who had an average BMI of 31.6 kg/m2. Twenty-five survivors completed the study, and the average number of daily uses was approximately 3.5 (range, 0 to 12) times/day; participants lost an average of 2 lbs (+4 lbs to −10.6 lbs). The average score of usability (the second objective) was 77.4, which was greater than the acceptable level. More than 90% of patients found MOCHA easy to navigate, and 84% were motivated to use MOCHA daily. Conclusion This study emphasizes the importance of technology use to improve goal adherence for patients by providing real-time feedback and accountability with the health care team. MOCHA focuses on the engagement of the health care team and is integrated into clinical workflow. Future directions will use MOCHA in a long-term behavior modification study.
Phase I/II Study of Stem-Cell Transplantation Using a Single Cord Blood Unit Expanded Ex Vivo With Nicotinamide
Authors: Horwitz Mitchell E. , Wease Stephen , Blackwell Beth , Valcarcel David , Frassoni Francesco , Boelens Jaap Jan , Nierkens Stefan , Jagasia Madan , Wagner John E. , Kuball Jurgen , Koh Liang Piu , Majhail Navneet S. , Stiff Patrick J. , Hanna Rabi , Hwang William Y.K. , Kurtzberg Joanne , Cilloni Daniela , Freedman Laurence S. , Montesinos Pau , Sanz Guillermo 
Published: December 2018

Purpose Increasing the number of hematopoietic stem and progenitor cells within an umbilical cord blood (UCB) graft shortens the time to hematopoietic recovery after UCB transplantation. In this study, we assessed the safety and efficacy of a UCB graft that was expanded ex vivo in the presence of nicotinamide and transplanted after myeloablative conditioning as a stand-alone hematopoietic stem-cell graft. Methods Thirty-six patients with hematologic malignancies underwent transplantation at 11 sites. Results The cumulative incidence of neutrophil engraftment at day 42 was 94%. Two patients experienced secondary graft failure attributable to viral infections. Hematopoietic recovery was compared with that observed in recipients of standard UCB transplantation as reported to the Center for International Blood and Marrow Transplant Research (n = 146). The median time to neutrophil recovery was 11.5 days (95% CI, 9 to 14 days) for recipients of nicotinamide-expanded UCB and 21 days (95% CI, 20 to 23 days) for the comparator ( P < .001). The median time to platelet recovery was 34 days (95% CI, 32 to 42 days) and 46 days (95% CI, 42 to 50 days) for the expanded and the comparator cohorts, respectively ( P < .001). The cumulative incidence of grade 2 to 4 acute graft-versus-host disease (GVHD) at day 100 was 44%, and grade 3 and 4 acute GVHD at day 100 was 11%. The cumulative incidence at 2 years of all chronic GVHD was 40%, and moderate/severe chronic GVHD was 10%. The 2-year cumulative incidences of nonrelapse mortality and relapse were 24% and 33%, respectively. The 2-year probabilities of overall and disease-free survival were 51% and 43%, respectively. Conclusion UCB expanded ex vivo with nicotinamide shortens median neutrophil recovery by 9.5 days (95% CI, 7 to 12 days) and median platelet recovery by 12 days (95% CI, 3 to 16.5 days). This trial establishes feasibility, safety, and efficacy of an ex vivo expanded UCB unit as a stand-alone graft.
Phase I/II Trial to Evaluate the Efficacy and Safety of Nanoparticle Albumin-Bound Paclitaxel in Combination With Gemcitabine in Patients With Pancreatic Cancer and an ECOG Performance Status of 2
Authors: Macarulla Teresa , Pazo-Cid Roberto , Guillén-Ponce Carmen , López Rafael , Vera Ruth , Reboredo Margarita , Muñoz Martin Andrés , Rivera Fernando , Díaz Beveridge Roberto , La Casta Adelaida , Martín Valadés José , Martínez-Galán Joaquina , Ales Immaculada , Sastre Javier , Perea Sofia , Hidalgo Manuel 
Published: December 2018

Purpose Gemcitabine plus nanoparticle albumin-bound (NAB) paclitaxel (GA) significantly improved survival compared with gemcitabine alone in patients with metastatic pancreatic ductal adenocarcinoma (PDAC) and a Karnofsky performance status (PS) of 70% or greater. Because of the low number of patients with reduced PS, the efficacy of this regimen in fragile patients remains unclear. This study aimed to evaluate the efficacy and tolerability of different GA dosing regimens in patients with a poor PS. Patients and Methods In the phase I part of this study, patients were randomly assigned to one of the following four parallel GA treatment arms (six patients per arm): a biweekly schedule of NAB-paclitaxel (150 mg/m2 [arm A] or 125 mg/m2 [arm C]) plus gemcitabine 1,000 mg/m2 or a standard schedule of 3 weeks on and 1 week off of NAB-paclitaxel (100 mg/m2 [arm B] or 125 mg/m2 [arm D]) plus gemcitabine 1,000 mg/m2. The two regimens with the better tolerability profile on the basis of predefined criteria were evaluated in the phase II part of the study, the primary end point of which was 6-month actuarial survival. Results Arms B and D were selected for the phase II part of the study. A total of 221 patients (111 patients in arm B and 110 patients in arm D) were enrolled. Baseline characteristics including median age (71 and 68 years in arms B and D, respectively), sex (51% and 55% men in arms B and D, respectively), and metastatic disease (88% and 84% in arms B and D, respectively) were comparable between arms. The most frequent grade 3 or 4 toxicities in arms B and D were anemia (12% and 7%, respectively), neutropenia (32% and 30%, respectively), thrombocytopenia (7% and 11%, respectively), asthenia (14% and 16%, respectively), and neurotoxicity (11% and 16%, respectively). In arms B and D, there were no significant differences in response rate (24% and 28%, respectively), median progression-free survival (5.7 and 6.7 months, respectively), and 6-month overall survival (63% and 69%, respectively). Conclusion NAB-paclitaxel administered at either 100 and 125 mg/m2 in combination with gemcitabine on days 1, 8, and 15 every 28 days is well tolerated and results in acceptable safety and efficacy in patients with metastatic pancreatic ductal adenocarcinoma and a poor PS.
Unplanned Hospitalization Among Individuals With Cancer in the Year After Diagnosis
Authors: Whitney Robin L. , Bell Janice F. , Tancredi Daniel J. , Romano Patrick S. , Bold Richard J. , Wun Ted , Joseph Jill G. 
Published: December 2018

PURPOSE: Reducing acute care use is an important strategy for improving value in cancer care. However, little information is available to describe and compare population-level hospital use across cancer types. Our aim was to estimate unplanned hospitalization rates and to describe the reasons for hospitalization in a population-based cohort recently diagnosed with cancer. MATERIALS AND METHODS: California Cancer Registry data linked with administrative inpatient data were used to examine unplanned hospitalization among individuals diagnosed with cancer between 2009 and 2012 (n = 412,850). Hospitalizations for maintenance chemotherapy, radiotherapy, or planned surgery were excluded. Multistate models were used to estimate age-adjusted unplanned hospitalization rates, accounting for survival. RESULTS: Approximately 67% of hospitalizations in the year after diagnosis were unplanned, 35% of newly diagnosed individuals experienced an unplanned hospitalization, and 67% of unplanned hospitalizations originated in the emergency department (ED). Nonmalignancy principal diagnoses most frequently associated with unplanned hospitalization included infection (15.8%) and complications of a medical device or care (6.5%). Unplanned hospitalization rates were highest for individuals with hepatobiliary or pancreatic cancer (2.08 unplanned hospitalizations per person-year at risk), lung cancer (1.58 unplanned hospitalizations), and brain or CNS cancer (1.47 unplanned hospitalizations), and were lowest among individuals with prostate cancer (0.18 unplanned hospitalizations) and melanoma (0.25 unplanned hospitalizations). CONCLUSION: The population burden of unplanned hospitalization among individuals newly diagnosed with cancer is substantial. Many unplanned hospitalizations originate in the ED and are associated with potentially preventable admission diagnoses. Efforts to reduce unplanned hospitalization might target subgroups at higher risk and focus on the ED as a source of admission.
Proton Sensitivity of Corticotropin-Releasing Hormone Receptor 1 Signaling to Proopiomelanocortin in Male Mice
Authors: Kameda Hiraku , Yamamoto Masaaki , Tone Yukiko , Tone Masahide , Melmed Shlomo 
Published: December 2018

AbstractBecause an acidic cellular microenvironment is engendered by inflammation and may determine cell differentiation, we elucidated the impact of acidic conditions on induction of proopiomelanocortin (POMC) expression. Here, we demonstrate mechanisms for proton sensitivity of CRH receptor 1 (CRHR1) signaling to POMC and ACTH production. Low pH (6.8) resulted in doubling of POMC expression and ACTH production in pituitary cell line AtT-20 and in primary mouse pituitary cells. Using CRISPR knockout, we show that CRHR1 is necessary for acid-induced POMC expression, and this induction is mediated by CRHR1 histidine residues and calmodulin-dependent protein kinase II in both pituitary corticotroph cells and in nonpituitary cell lines expressing ectopic ACTH. In contrast, CRH ligand binding affinity to CRHR1 was decreased with acidic pH, implying that proton-induced POMC expression prevails in acidic conditions independently of CRH ligand binding. The results indicate that proton-induced CRHR1 signaling regulates ACTH production in response to an acidic microenvironment.
The overlap between miscarriage and extreme preterm birth in a limited-resource setting on the Thailand-Myanmar border: a population cohort study
Authors: McGready Rose , Paw Moo Kho , Wiladphaingern Jacher , Min Aung Myat , Carrara Verena I. , Moore Kerryn A. , Pukrittayakamee Sasithon , Nosten François H. 
Published: December 2018

Background : No universal demarcation of gestational age distinguishes miscarriage and stillbirth or extreme preterm birth (exPTB). This study provides a synopsis of outcome between 22 to <28 weeks gestation from a low resource setting. Methods : A retrospective record review of a population on the Thailand-Myanmar border was conducted. Outcomes were classified as miscarriage, late expulsion of products between 22 to < 28 weeks gestation with evidence of non-viability (mostly ultrasound absent fetal heart beat) prior to 22 weeks; or exPTB (stillbirth/live born) between 22 to < 28 weeks gestation when the fetus was viable at ≥22 weeks. Termination of pregnancy and gestational trophoblastic disease were excluded. Results : From 1995-2015, 80.9% (50,046/ 61,829) of registered women had a known pregnancy outcome, of whom 99.8% (49,931) had a known gestational age. Delivery between 22 to <28 weeks gestation included 0.9% (472/49,931) of pregnancies after removing 18 cases (3.8%) who met an exclusion criteria. Most pregnancies had an ultrasound: 72.5% (n=329/454); 43.6% (n=197) were classified as miscarriage and 56.4% (n=257) exPTB. Individual record review of miscarriages estimated that fetal death had occurred at a median of 16 weeks, despite late expulsion between 22 to <28 weeks. With available data (n=252, 5 missing) the proportion of stillbirth was 47.6% (n=120), congenital abnormality 10.5% (24/228, 29 missing) and neonatal death was 98.5% (128/131, 1 missing). Introduction of ultrasound was associated with a 2-times higher odds of classification of outcome as exPTB rather than miscarriage. Conclusion : In this low resource setting few (<1%) pregnancy outcomes occurred in the 22 to <28 weeks gestational window; four in ten were miscarriage (late expulsion) and neonatal mortality approached 100%. In the scale-up to preventable newborns deaths (at least initially) greater benefits will be obtained by focusing on the viable newborns of ≥ 28 weeks gestation.
Genomic and transcriptomic comparisons of closely related malaria parasites differing in virulence and sequestration pattern
Authors: Lin Jing-wen , Reid Adam J. , Cunningham Deirdre , Böhme Ulrike , Tumwine Irene , Keller-Mclaughlin Sara , Sanders Mandy , Berriman Matthew , Langhorne Jean 
Published: December 2018

Background: Malaria parasite species differ greatly in the harm they do to humans. While P. falciparum kills hundreds of thousands per year, P. vivax kills much less often and P. malariae is relatively benign. Strains of the rodent malaria parasite Plasmodium chabaudi show phenotypic variation in virulence during infections of laboratory mice. This make it an excellent species to study genes which may be responsible for this trait. By understanding the mechanisms which underlie differences in virulence we can learn how parasites adapt to their hosts and how we might prevent disease. Methods: Here we present a complete reference genome sequence for a more virulent P. chabaudi strain, PcCB, and perform a detailed comparison with the genome of the less virulent PcAS strain. Results: We found the greatest variation in the subtelomeric regions, in particular amongst the sequences of the pir gene family, which has been associated with virulence and establishment of chronic infection. Despite substantial variation at the sequence level, the repertoire of these genes has been largely maintained, highlighting the requirement for functional conservation as well as diversification in host-parasite interactions. However, a subset of pir genes, previously associated with increased virulence, were more highly expressed in PcCB, suggesting a role for this gene family in virulence differences between strains. We found that core genes involved in red blood cell invasion have been under positive selection and that the more virulent strain has a greater preference for reticulocytes, which has elsewhere been associated with increased virulence. Conclusions: These results provide the basis for a mechanistic understanding of the phenotypic differences between Plasmodium chabaudi strains, which might ultimately be translated into a better understanding of malaria parasites affecting humans.
BEKERJANYA HUKUM TENTANG DESA DI RANAH PEMBERDAYAAN POLITIK, SOSIAL, DAN EKONOMI PEREMPUAN DESA
Authors: Kushandajani Kushandajani 
Published: December 2018

Kehadiran UU No. 6/2014 tentang Desa diharapkan berperan sebagai daya ungkit pembangunan desa, dimana secara eksplisit mengakui peran perempuan di dalamnya. Namun apakah perempuan yang tinggal di desa mampu menjawab persoalan ini melalui penelusuran tiga dimensi pemberdayaan perempuan yaitu politik, sosial, dan ekonomi ? Penelitian kualitatif non-doktriner dipilih dengan penggunaan teknik pengumpulan data wawancara mendalam dan FGD. Hasil penelitian menunjukkan di ranah politik keikutsertaan perempuan di struktur pemerintahan desa maupun di Badan Permusyawaratan Desa sangat sedikit dan tidak ambil peran penting dalam proses pengambilan keputusan. Dalam dimensi sosial, perempuan terlibat kuat di bidang pendidikan, kesehatan, pendampingan hukum, dan penanggulangan kemiskinan.. Dalam dimensi ekonomi perempuan juga kuat perannya dalam pengembangan ekonomi lokal, seperti pertanian dan industri rumah tangga. Simpulan riset menunjukkan bahwa pemberdayaan perempuan terlihat kuat di non-politik area.
PERLINDUNGAN HUKUM TERHADAP INVESTOR EMAS
Authors: Prananingtyas Paramita 
Published: December 2018

Emas, suatu benda yang sangat bernilai. Selama berabad-abad telah diakui sebagai logam mulia, yang mendapatkan tempat tertinggi sebagai pilihan investasi masyarakat. Investor-investor yang tergiur dengan keuntungan maksimal yang ditawarkan dari berinvestasi pada emas inilah yang menjadi sasaran empuk para pengelola investasi emas illegal. Keadaan tersebut memunculkan beberapa masalah dalam naskah ini, antara lain mengenai bentuk investasi emas dan bentuk perlindungan hukum bagi para investor yang terlibat dalam penipuan investasi emas. Metode penelitian dalam penelitian ini adalah yuridis empiris, dengan teknik purposive sampling. Hasil penelitian yang diperoleh adalah investasi emas dapat dilakukan dengan berbagai cara antara lain melalui pembelian emas perhiasan dengan kadar 22 karat. 18 karat dan 12 karat, emas batangan dengan kadar 24 karat, emas koin dengan kadar 22 karat dan berinvestasi emas secara tidak langsung atau berjangka dengan sistem online. Penipuan investasi emas dilakukan oleh para pengelola jasa investasi emas yang tidak menyerahkan emas dalam bentuk fisik kepada para investor dan memakai sistem money game atau skema ponzy untuk menarik minat para calon investor. Perlindungan hukum bagi para investor emas telah diatur oleh Otoritas Jasa Keuangan (OJK) melalui Satgas Waspada Investasi, SiPeka dan FCC. Namun pelaksanaan tugas dan kewenangan OJK ini masih belum maksimal.