bluuebunny/crossref_metadata_2025_split huggingface dataset:
A simplified radiographic score effectively predicts radiographic progression of early arthritis in a large nationwide French cohort
Authors: Carvajal Alegria Guillermo , Milin Morgane , Gandjbakhch Frédérique , Saraux Alain , Bailly Florian , Jousse-Joulin Sandrine , Schaeverbeke Thierry , Lukas Cédric , Foltz Violaine , Fautrel Bruno , Devauchelle-Pensec Valérie 
Published: September 2019

Abstract

Objective
Evaluating radiographic progression is a key component of the follow-up of patients with RA. Existing scores are ill-suited to everyday clinical practice. The objective here was to validate a new simplified radiographic score (SRS) for evaluating radiographic progression in patients with early arthritis.

Methods
Patients with arthritis of &lt;6 months’ duration were included in the large, prospective, nationwide, French ESPOIR cohort. Radiographs of the hands and feet were obtained at inclusion then 1 and 5 years later. The modified Sharp scores and SRS were determined by blinded readers. Interobserver reliability and intraobserver repeatability of each score, as well as agreement between the two scores, were assessed by computing the intraclass correlation coefficients. The rates of progression over the first year and the next 4 years were determined.

Results
The 506 patients with complete data for the first 5 years were included. At inclusion, the intraclass correlation coefficient between the two scores was good for erosions (0.715, P &lt; 0.001), joint space narrowing (0.892, P &lt; 0.001) and the total score (0.896, P &lt; 0.001). Agreement between the two scores was also good for radiographic progression after 1 year (0.781, P &lt; 0.001). The SRS had good positive and negative predictive values for slow and for rapid progression. SRS determination was less time consuming.

Conclusion
The SRS is effective for monitoring radiographic progression in early arthritis and is easier to use and less time-consuming than the Sharp score. The usefulness of the SRS in clinical practice deserves further evaluation.
The active construction of passive investors: roboadvisors and algorithmic ‘low-finance’
Authors: Hayes Adam S 
Published: September 2019

Abstract
How does algorithmic finance operate in society as it crosses the threshold into the hands of lay investors? This article builds on original ethnographic research into a new class of algorithmic trading programs known as ‘roboadvisors’—inexpensive, automated, digital financial platforms that enable ordinary people to invest very small minimum amounts and that rely to a large extent on passive, index strategies that follow the prescripts of Modern Portfolio Theory. The main argument of the article is that roboadvisors, representing an ethos of ‘low-finance’, are actively constructing passive investors by disciplining them through technologies that embody canonical models of financial economics. Roboadvisors and their algorithms reconfigure their users and objectify them through automating investment decisions and enforcing a principle of ‘don’t do’ vis-à-vis the market. Implications that bear on agency, market structure and regulatory regimes are discussed.
Identification of Candidate Risk Factor Genes for Human Idelalisib Toxicity Using a Collaborative Cross Approach
Authors: Mosedale Merrie , Cai Yanwei , Eaddy John Scott , Corty Robert W , Nautiyal Manisha , Watkins Paul B , Valdar William 
Published: September 2019

AbstractIdelalisib is a phosphatidylinositol 3-kinase inhibitor highly selective for the delta isoform that has shown good efficacy in treating chronic lymphocytic leukemia and follicular lymphoma. In clinical trials, however, idelalisib was associated with rare, but potentially serious liver and lung toxicities. In this study, we used the Collaborative Cross (CC) mouse population to identify genetic factors associated with the drug response that may inform risk management strategies for idelalisib in humans. Eight male mice (4 matched pairs) from 50 CC lines were treated once daily for 14 days by oral gavage with either vehicle or idelalisib at a dose selected to achieve clinically relevant peak plasma concentrations (150 mg/kg/day). The drug was well tolerated across all CC lines, and there were no observations of overt liver injury. Differences across CC lines were seen in drug concentration in plasma samples collected at the approximate Tmax on study Days 1, 7, and 14. There were also small but statistically significant treatment-induced alterations in plasma total bile acids and microRNA-122, and these may indicate early hepatocellular stress required for immune-mediated hepatotoxicity in humans. Idelalisib treatment further induced significant elevations in the total cell count of terminal bronchoalveolar lavage fluid, which may be analogous to pneumonitis observed in the clinic. Genetic mapping identified loci associated with interim plasma idelalisib concentration and the other 3 treatment-related endpoints. Thirteen priority candidate quantitative trait genes identified in CC mice may now guide interrogation of risk factors for adverse drug responses associated with idelalisib in humans.
High-efficient utilization and uptake of N contribute to higher NUE of ‘Qinguan’ apple under drought and N-deficient conditions compared with ‘Honeycrisp’
Authors: Wang Qian , Liu Changhai , Huang Dong , Dong Qinglong , Li Pengmin , Ma Fengwang 
Published: September 2019

Abstract
Drought and nitrogen (N) deficiency are common factors that limit apple production in the Loess Plateau region of China. Different apple cultivars respond to drought and low N differently; however, the mechanism that underlies the difference in nitrogen-use efficiency (NUE) under drought conditions is not well understood. In this study, by comparing the physiological responses of two apple (Malus domestica Borkh.) cultivars with contrasting NUE, ‘Qinguan’ (higher NUE) and ‘Honeycrisp’ (lower NUE), under low N and drought conditions, we discovered that, ‘Qinguan’ had larger stomatal apertures, higher chlorophyll fluorescence levels, more active N metabolism and antioxidant enzymes, higher abscisic acid and auxin concentrations, larger root size and more efficient N uptake mediated by higher expression of MdNRT2.4 in rootstock than that of ‘Honeycrisp’. Additionally, we experimentally confirmed that MdNRT2.4 enhanced low N and osmotic stress tolerance in Arabidopsis when being overexpressed. Taken together, our findings shed light on the mechanism that underlies the difference in NUE of apple under drought and N-deficient conditionss and provide MdNRT2.4 as a candidate gene for future genetic engineering.
Evaluation of the effectiveness of community health workers in the fight against malaria in the Central African Republic (2012–2017)
Authors: Ferdinand Djerandouba Yotobumbeti , Nadlaou Bessimbaye , Samuel Nzalapan , Oscar Bekaka Youlet , Raphael Mbailao , Christophe Ndoua , Lopes Sergio , Allan Richard 
Published: September 2019

Abstract

Background
This last decade’s ongoing conflict in the Central African Republic (CAR) has led to gradual and continuous destruction of health services. With severe gaps in qualified health professionals, community health workers (CHWs) have become essential to ensuring health care access to the affected population. This article aims to evaluate the effectiveness of a 10-y CHW program in the CAR.

Methods
Routine case management data from CHWs were collected in the Paoua district from January 2012 to December 2017 and analysed. Structured interviews were conducted in the Paoua and Carnot health districts among individuals from three different groups (health service beneficiaries, CHWs and health facility managers).

Results
From 2012 to 2017, 353 948 people consulted for malaria suspicion with CHWs and 86% were found to be malaria positive after a rapid diagnostic test. Among those diagnosed patients, 98.5% received adequate treatment and nearly 1.5% were referred to health facilities. Also, 94.5% of respondents identified fever as the major malaria symptom. About 70% of the population could identify three malaria signs/symptoms and 84.4% accepted and used CHW services. Interviews with CHWs revealed that 45.8% of them received at least four training sessions per month as part of their capacity building.

Conclusions
CHWs can be a resourceful solution when other health professional are scarce. This study showed that CHWs are not only able to deliver curative and preventive health services, but they are also well accepted by the served communities.
Effect of Polyethylene-glycolated Carboxyhemoglobin on Renal Microcirculation in a Rat Model of Hemorrhagic Shock
Authors: Guerci Philippe , Ergin Bulent , Kapucu Aysegul , Hilty Matthias P. , Jubin Ronald , Bakker Jan , Ince Can 
Published: September 2019

Abstract

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background
Primary resuscitation fluid to treat hemorrhagic shock remains controversial. Use of hydroxyethyl starches raised concerns of acute kidney injury. Polyethylene-glycolated carboxyhemoglobin, which has carbon monoxide–releasing molecules and oxygen-carrying properties, was hypothesized to sustain cortical renal microcirculatory Po
2 after hemorrhagic shock and reduce kidney injury.

Methods
Anesthetized and ventilated rats (n = 42) were subjected to pressure-controlled hemorrhagic shock for 1 h. Renal cortical Po
2 was measured in exposed kidneys using a phosphorescence quenching method. Rats were randomly assigned to six groups: polyethylene-glycolated carboxyhemoglobin 320 mg · kg−1, 6% hydroxyethyl starch (130/0.4) in Ringer’s acetate, blood retransfusion, diluted blood retransfusion (~4 g · dl−1), nonresuscitated animals, and time control. Nitric oxide and heme oxygenase 1 levels were determined in plasma. Kidney immunohistochemistry (histologic scores of neutrophil gelatinase-associated lipocalin and tumor necrosis factor-α) and tubular histologic damages analyses were performed.

Results
Blood and diluted blood restored renal Po
2 to 51 ± 5 mmHg (mean difference, −18; 95% CI, −26 to −11; P < 0.0001) and 47 ± 5 mmHg (mean difference, −23; 95% CI, −31 to −15; P < 0.0001), respectively, compared with 29 ± 8 mmHg for hydroxyethyl starch. No differences between polyethylene-glycolated carboxyhemoglobin and hydroxyethyl starch were observed (33 ± 7 mmHg vs. 29 ± 8 mmHg; mean difference, −5; 95% CI, −12 to 3; P = 0.387), but significantly less volume was administered (4.5 [3.3–6.2] vs. 8.5[7.7–11.4] ml; mean rank difference, 11.98; P = 0.387). Blood and diluted blood increased the plasma bioavailability of nitric oxide compared with hydroxyethyl starch (mean rank difference, −20.97; P = 0.004; and −17.13; P = 0.029, respectively). No changes in heme oxygenase 1 levels were observed. Polyethylene-glycolated carboxyhemoglobin limited tubular histologic damages compared with hydroxyethyl starch (mean rank difference, 60.12; P = 0.0012) with reduced neutrophil gelatinase-associated lipocalin (mean rank difference, 84.43; P < 0.0001) and tumor necrosis factor-α (mean rank difference, 49.67; P = 0.026) histologic scores.

Conclusions
Polyethylene-glycolated carboxyhemoglobin resuscitation did not improve renal Po
2 but limited tubular histologic damages and neutrophil gelatinase-associated lipocalin upregulation after hemorrhage compared with hydroxyethyl starch, whereas a lower volume was required to sustain macrocirculation.
Interlaminar Endoscopic Lumbar Discectomy Using a New 8.4-mm Endoscope and Nerve Root Retractor
Authors: Shim Hyeong-Ki , Choi Kyung-Chul , Cha Kyung Han , Lee Dong Chan , Park Choon-Keun 
Published: September 2019

Study Design:
Surgical technique.

Objective:
Using an 8.4-mm endoscope and endoscopic nerve root retractor, the interlaminar endoscopic lumbar discectomy (IELD) technique is introduced for lumbosacral levels.

Summary of Background Data:
Although spine surgeons are familiar with IELD, this technique is only used for L5–S1 disk herniations and requires a wide interlaminar space.

Methods:
Using an 8.4 mm-endoscope, high-speed drill, and endoscopic Kerrison punches, a nerve-root retractor facilitated the simultaneous medial retraction of the nerve root and removal of the disk fragment by the instrument’s cannula. Clinical parameters such the visual analog scale scores for back and leg pain, modified Macnab criteria, and Oswestry Disability Index were analyzed.

Results:
A total of 101 patients were enrolled. The visual analog scale scores for back and leg pain significantly decreased from 6.8±2.1 and 7.8±1.5 to 2.0±0.6 and 1.78±1.1, respectively, at the 1-year follow up (P<0.01). The Oswestry Disability Index score significantly improved from 28.6±11.7 to 7.4±2.9 (P<0.01). Ninety-nine patients (97.1%) showed good outcomes.

Conclusions:
A new IELD technique and instruments can overcome the drawbacks of existing IELD with adequate bone work and control of the affected nerve root.
Microcannula Injection of Large Gel Particle Hyaluronic Acid for Cheek Augmentation and the Correction of Age-Related Midface Contour Deficiencies
Authors: Jones Derek H. , Hessler Jill , Chapas Anne , Jonas Brandie , Crider Julie , Chopra Raj 
Published: September 2019

BACKGROUND
There is a growing trend toward the use of blunt-tip microcannulas for the treatment of midface volume loss with injectable hyaluronic acid.

OBJECTIVE
To evaluate the safety and efficacy of large gel particle hyaluronic acid with lidocaine, injected with a blunt-tip microcannula, for cheek augmentation and the correction of age-related midface contour deficiency.

MATERIALS AND METHODS
Sixty subjects with mild to substantial loss of midface fullness were treated to optimal correction. Adverse events (AEs) were obtained during each examination visit. Efficacy was evaluated using the Global Aesthetic Improvement Scale, the Medicis Midface Volume Scale (MMVS), and the FACE-Q subject satisfaction questionnaire through 16 weeks.

RESULTS
Five AEs were reported, with only one being considered injection procedure-related (mild presyncope). No serious AEs were reported. Global aesthetic improvements were reported for the majority of subjects (≥98.3% for investigator-assessed and ≥91.5% for subject-assessed) for up to 16 weeks. At 8 weeks, the MMVS responder rate was 100% and subject satisfaction scores (5/6 questions) in the FACE-Q were ≥91.5%.

CONCLUSION
Hyaluronic acid with lidocaine, injected with a blunt-tip microcannula, has a favorable safety profile and is effective up to 16 weeks for cheek augmentation and the correction of age-related midface contour deficiencies (NCT03160716).
Update in Soft-Tissue Filler–Associated Blindness
Authors: Sorensen Eric P. , Council M. Laurin 
Published: September 2019

BACKGROUND
Soft-tissue filler administration is an increasingly popular minimally invasive cosmetic procedure. Simultaneously, there have been a greater number of adverse events reported, including the devastating complication of blindness.

OBJECTIVE
To report cases of filler-related blindness published since 2015.

MATERIALS AND METHODS
The Ovid MEDLINE database was searched from January 1, 2015, to August 1, 2018, using a previously described Boolean string.

RESULTS
Sixty new cases of filler blindness were identified. The most common type of filler reported was hyaluronic acid (HA) (N = 42, 70.0%), followed by autologous fat (N = 7, 11.7%), and calcium hydroxyapatite (CaHA) (N = 7, 11.7%). The most common injection locations were the nose (N = 33, 55.0%), glabella (N = 21, 35.0%), and forehead (N = 11, 18.3%). Ten cases reported vision restoration (16.7%). Four of the successful cases involved hyaluronidase administration, including 1 retrobulbar hyaluronidase injection.

CONCLUSION
Since 2015, there have been 60 newly reported cases of soft-tissue filler blindness. Most recent cases have occurred with HA, which is a shift from previous reports. In HA cases, hyaluronidase injection may be successful in restoring vision if administered promptly. It is imperative for providers to be familiar with strategies for managing soft-tissue filler blindness.
Intralesional Triamcinolone May Not Be Beneficial for Treating Acute Hidradenitis Suppurativa Lesions: A Double-Blind, Randomized, Placebo-Controlled Trial
Authors: Fajgenbaum Kristen , Crouse Lauren , Dong Li , Zeng Donglin , Sayed Christopher 
Published: September 2019

BACKGROUND
Hidradenitis suppurativa (HS) is a chronic, inflammatory condition characterized by recurrent nodules, sinus tracts, comedones, and scarring. Hidradenitis suppurativa is often associated with pain and decreased quality of life. Limited clinical trial data exist regarding the management of acute HS lesions, but clinical experience and a prospective case series suggest that intralesional triamcinolone may be useful.

OBJECTIVE
To compare the efficacy of intralesional triamcinolone to placebo for the treatment of HS inflammatory lesions.

MATERIALS AND METHODS
This is a double-blind, randomized, placebo-controlled trial comparing intralesional triamcinolone 10 mg/mL, triamcinolone 40 mg/mL, and normal saline (NS). Thirty-two subjects at University of North Carolina Dermatology and Skin Cancer Centers were enrolled for a total of 67 lesions. Subjects reported pain scores, days to resolution, and satisfaction on a standardized survey over a 14-day period.

RESULTS
When intralesional injections of triamcinolone 10 mg/mL, triamcinolone 40 mg/mL, and NS were compared, no significant difference was found for days to HS inflammatory lesion clearance, pain reduction at Day 5, or patient satisfaction.

CONCLUSION
No statistically significant difference was found between varying concentrations of triamcinolone and NS for the treatment of HS lesions. Steroid injections may be less effective for the management of acute HS than typically presumed.
Characteristics of Patients Hospitalized for Cutaneous Squamous Cell Carcinoma
Authors: Tripathi Raghav , Knusel Konrad D. , Ezaldein Harib H. , Bordeaux Jeremy S. , Scott Jeffrey F. 
Published: September 2019

BACKGROUND
Knowledge regarding the inpatient burden of cutaneous squamous cell carcinoma (cSCC) is limited.

OBJECTIVE
To provide nationally representative estimates for hospitalization characteristics due to cSCC and determine predictors for increased length of stay (LOS) and cost of care.

METHODS/MATERIALS
A retrospective cohort study of the 2009 to 2015 National Inpatient Sample. Weighted multivariate logistic/linear regression models were created to evaluate sociodemographic factors associated with cSCC hospitalization and to assess characteristics associated with cost of care and LOS.

RESULTS
This study included 15,784 cSCC and 255,244,626 non-SCC inpatients (prevalence = 6.2/100,000 inpatients). On average, cSCC hospitalizations lasted 5.8 days and cost $66,841.00. Cutaneous squamous cell carcinoma most often occurred on the scalp (30.57%), face (21.08%), and lower limb (11.93%). Controlling for all other factors, cSCC inpatients presented to larger/urban/teaching hospitals and were most often older non-Hispanic white women. More chronic conditions/diagnoses/procedures and nonwhite race were associated with greater cost of care and LOS. Cost of care and LOS significantly differed between cSCCs of different anatomical sites. The most common procedures performed were skin grafts (27.96%), excisions (25.83%), and lymph node biopsies (11.39%).

CONCLUSION
This study highlights the substantial burden of inpatient cSCC in the United States. Further research is necessary to prevent cSCC hospitalizations and improve inpatient dermatologic care for cSCC.
Scientist-led Exercise Testing Is Safe With Diagnostic Interpretation Equivalent to a Cardiologist
Authors: Whitman Mark , Padayachee Cliantha , Tilley Prue , Sear Casey , Rosanoff Shelley , El Shinawi Hadeir , Manolis Christiana , Jenkins Carly , Challa Prasad 
Published: September 2019

Background:
The implementation of nonphysician-led exercise stress testing (EST) has increased over the last 30 years, with endorsement by many cardiovascular societies around the world. The comparable safety of nonphysician-led EST to physician-led studies has been demonstrated, with some studies also showing agreement in diagnostic preliminary interpretations.

Objective:
The study aim was to firstly confirm the safety of nonphysician-led EST in a large cohort and secondly compare the interobserver agreement and diagnostic accuracy of cardiac scientist and junior medical officer (JMO)-led EST reports to cardiology consultant overreads.

Methods:
All ESTs performed between 1/7/2010 and 30/6/2013 were included in the study for JMO led tests (n = 1332). ESTs performed for the investigation of coronary artery disease between 1/7/2013 and 30/6/2016 were included for scientist-led testing (n = 1904).

Results:
There was one adverse event, an ST segment myocardial infarction during the recovery phase of a JMO-led EST. Interobserver agreement was superior between the cardiologist and the scientist compared with the cardiologist and the JMO (P < 0.0001). Sensitivity for JMO-led tests differed from the cardiologist overread (86.96% vs. 96.77%, P = 0.03). There were no other significant differences between the cardiologist overread and the JMO- or scientist-led interpretation.

Conclusions:
Scientist-led EST is safe in intermediate risk patients and their preliminary reports are equally diagnostic as cardiologist overreads. While JMO-led ESTs are just as safe, the preliminary reports differ significantly from cardiologist overread particularly with respect to sensitivity.
Novel Application Software for the Semi-Automated Analysis of Infrared Meibography Images
Authors: Shehzad Danish , Gorcuyeva Sona , Dag Tamer , Bozkurt Banu 
Published: September 2019

Purpose:
To develop semi-automated application software that quickly analyzes infrared meibography images taken with the CSO Sirius Topographer (CSO, Italy) and to compare them to the manual analysis system on the device (Phoenix software platform).

Methods:
A total of 52 meibography images verified as high quality were used and analyzed through manual and semi-automated meibomian gland (MG) detector software in this study. For the manual method, an experienced researcher circumscribed the MGs by putting dots around grape-like clusters in a predetermined rectangular area, and Phoenix software measured the MG loss area by percentage, which took around 10 to 15 minutes. MG loss was graded from 1 (<25%) to 4 (severe >75%). For the semi-automated method, 2 blind physicians (I and II) determined the area to be masked by putting 5 to 6 dots on the raw images and measured the MG loss area using the newly developed semi-automated MG detector application software in less than 1 minute. Semi-automated measurements were repeated 3 times on different days, and the results were evaluated using paired-sample t test, Bland–Altman, and kappa κ analysis.

Results:
The mean MG loss area was 37.24% with the manual analysis and 40.09%, 37.89%, and 40.08% in the first, second, and third runs with the semi-automated analysis (P < 0.05). Manual analysis scores showed a remarkable correlation with the semi-automated analysis performed by 2 operators (r = 0.950 and r = 0.959, respectively) (P < 0.001). According to Bland–Altman analysis, the 95% limits of agreement between manual analysis and semi-automated analysis by operator I were between −10.69% and 5% [concordance correlation coefficient (CCC) = 0.912] and between −9.97% and 4.3% (CCC = 0.923) for operator II. The limit of interoperator agreement in semi-automated analysis was between −4.89% and 4.92% (CCC = 0.973). There was good to very good agreement in grading between manual and semi-automated analysis results (κ 0.76–0.84) and very good interoperator agreement with semi-automated software (κ 0.91) (P < 0.001).

Conclusions:
For the manual analysis of meibography images, around one hundred dots have to be put around grape-like clusters to determine the MGs, which makes the process too long and prone to errors. The newly developed semi-automated software is a highly reproducible, practical, and faster method to analyze infrared meibography images with excellent correlation with the manual analysis.