bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lack of tumour pigmentation in conjunctival melanoma is associated with light iris colour and worse prognosis
Authors: Brouwer Niels J , Marinkovic Marina , Luyten Gregorius P M , Shields Carol L , Jager Martine J 
Published: May 2018

Aim
To investigate whether differences in iris colour, skin colour and tumour pigmentation are related to clinical outcome in conjunctival melanoma.

Methods
Data of 70 patients with conjunctival melanoma from the Leiden University Medical Center (Leiden, The Netherlands) and 374 patients from the Wills Eye Hospital (Philadephia, USA) were reviewed. The relation between iris colour, skin colour and tumour pigmentation versus clinical parameters and outcome was investigated using univariate and multivariate regression analyses.

Results
A light iris colour (blue, grey, green) was present in 261 (59%) patients and a dark colour (hazel, brown) in 183 (41%). A low tumour pigmentation was detected in 130 (40%) and a high pigmentation in 197 (60%) patients. Low tumour pigmentation was associated with light iris colour (p=0.021) but not related to skin colour (p=0.92). In univariate analysis, neither iris nor skin colour was related to clinical outcome, while a low tumour pigmentation was related to metastasis formation (HR 2.37, p=0.004) and death (HR 2.42, p=0.020). In multivariate analysis, low tumour pigmentation was related to the development of recurrences (HR 1.63, p=0.043), metastasis formation (HR 2.48, p=0.004) and death (HR 2.60, p=0.014).

Conclusion
Lightly pigmented tumours occurred especially in individuals with lightly coloured irises. While iris colour or skin colour was not significantly related to clinical outcome, a low tumour pigmentation was related to a worse outcome in patients with conjunctival melanoma. The amount and type of melanin in conjunctival melanocytes may be involved in the pathogenesis and behaviour of selected conjunctival melanoma.
Improving serum calcium test ordering according to a decision algorithm
Authors: Faria Daniel K , Taniguchi Leandro U , Fonseca Luiz A M , Ferreira-Junior Mario , Aguiar Francisco J B , Lichtenstein Arnaldo , Sumita Nairo M , Duarte Alberto J S , Sales Maria M 
Published: May 2018

AimTo detect differences in the pattern of serum calcium tests ordering before and after the implementation of a decision algorithm.MethodsWe studied patients admitted to an internal medicine ward of a university hospital on April 2013 and April 2016. Patients were classified as critical or non-critical on the day when each test was performed. Adequacy of ordering was defined according to adherence to a decision algorithm implemented in 2014.ResultsTotal and ionised calcium tests per patient-day of hospitalisation significantly decreased after the algorithm implementation; and duplication of tests (total and ionised calcium measured in the same blood sample) was reduced by 49%. Overall adequacy of ionised calcium determinations increased by 23% (P=0.0001) due to the increase in the adequacy of ionised calcium ordering in non-critical conditions.ConclusionsA decision algorithm can be a useful educational tool to improve adequacy of the process of ordering serum calcium tests.
Robotic-assisted compared with conventional total hip arthroplasty: systematic review and meta-analysis
Authors: Chen Xi , Xiong Jianping , Wang Peipei , Zhu Shibai , Qi Wenting , Peng Huiming , Yu Lingjia , Qian Wenwei 
Published: May 2018

AbstractBackgroundRobotic-assisted total hip arthroplasty (THA) allows for accurate preoperative planning and component positioning, potentially enhancing implant survival and long-term outcomes. The relative efficacy and safety of robotic-assisted and conventional THA, however, are unclear. This systematic review and meta-analysis compared the safety and efficacy of robotic-assisted and conventional THA.MethodsMedline, Embase and the Cochrane Library were comprehensively searched in September 2017 to identify studies comparing the safety and efficacy of robotic-assisted and conventional THA. Seven studies were included. Data of interest were extracted and analysed using Review Manager 5.3.ResultsThe seven included studies involved 1516 patients, with 522 undergoing robotic-assisted and 994 undergoing conventional THA. Compared with conventional THA, robotic-assisted THA was associated with longer surgical time (not significant); lower intraoperative complication rates (OR: 0.12, 95% CI: 0.05 to 0.34, p&lt;0.0001 I2); better cup placement, stem placement and global offset and a higher rate of heterotopic ossifications. Functional scores, limb length discrepancy and rates of revision and stress shielding were similar in the two groups. The relative amount of blood loss was unclear.ConclusionThe results of this meta-analysis suggest that robotic-assisted THA has certain advantages over conventional THA, including the results of component positioning and rates of intraoperative complications. Additional comparative studies are required to determine the long-term clinical outcomes of robotic-assisted THA.
The birth and development of the oil and gas industry in the Northern Carpathians (up until 1939)
Authors: Krzywiec Piotr 
Published: May 2018

Abstract

The northern segments of the Carpathians, stretching between Limanowa (Poland) and Kosów (Ukraine), belonged to the most prolific hydrocarbon province in the world in the late nineteenth and early twentieth centuries. The earliest written accounts of natural occurrences of hydrocarbons in the Carpathians date back to the sixteenth century. In the eighteenth and early nineteenth centuries, Rzączyński, Kluk, Hacquest and Staszic provided accounts on methods of practical use related to oil. Staszic's geological map shows numerous oil seeps and different rock types containing hydrocarbons. The development of the oil industry was triggered by Łukasiewicz's discovery of an oil-distillation process and the construction of a kerosene lamp. Following this, the oil industry flourished in the Northern Carpathians. Oil production peaked at 2 Mt (million tons) of crude oil in 1910. In subsequent years, the level of oil production steadily decreased due to a turbulent economy. Exploration for oil, gas and ozokerite resulted in the development of modern micropalaeontology and geological mapping, with a prime example being the regional coverage of almost the entire Northern Carpathians provided by the
Atlas Geologiczny Galicyi
(
Geological Atlas of Galicia
), which consisted of 99 high-quality geological maps at a scale of 1:75 000. Geophysical surveying techniques were applied to subsurface mapping, and higher educational institutions were established in order to support exploration efforts.
Venoarterial communication mediates arterial wall shear stress-induced maternal uterine vascular remodeling during pregnancy
Authors: Ko Nga Ling , Mandalà Maurizio , John Liam , Gelinne Aaron , Osol George 
Published: May 2018

Although expansive remodeling of the maternal uterine circulation during pregnancy is essential for maintaining uteroplacental perfusion and normal fetal growth, the underlying physiological mechanisms are not well understood. Using a rat model, surgical approaches were used to alter uterine hemodynamics and wall shear stress (WSS) to evaluate the effects of WSS and venoarterial communication (e.g., transfer of placentally derived growth signals from postplacental veins to preplacental arteries) on gestational uterine vascular remodeling. Changes in WSS secondary to ligation of the cervical but not the ovarian end of the main uterine artery and vein provoked significant expansive remodeling at the opposite end of both vessels, but only in pregnant animals. The ≈50% increase in lumen diameter (relative to the contralateral horn) was associated with an upregulation of total endothelial nitric oxide (NO) synthase expression and was abolished by in vivo NO synthase inhibition with N-nitro-l-arginine methyl ester. Complete removal of a venous segment adjacent to the uterine artery to eliminate local venous influences significantly attenuated the WSS-induced remodeling by about one-half ( P < 0.05). These findings indicate that, during pregnancy, 1) increased WSS stimulates uterine artery growth via NO signaling and 2) the presence of an adjacent vein is required for arterial remodeling to fully occur. NEW & NOTEWORTHY This study provides the first in vivo evidence for the importance of venous influences on arterial growth within the uteroplacental circulation.
Exercise cardiac MRI unmasks right ventricular dysfunction in acute hypoxia and chronic pulmonary arterial hypertension
Authors: Jaijee Shareen , Quinlan Marina , Tokarczuk Pawel , Clemence Matthew , Howard Luke S.G.E. , Gibbs J. Simon R. , O’Regan Declan P. 
Published: May 2018

Coupling of right ventricular (RV) contractility to afterload is maintained at rest in the early stages of pulmonary arterial hypertension (PAH), but exercise may unmask depleted contractile reserves. We assessed whether elevated afterload reduces RV contractile reserve despite compensated resting function using noninvasive exercise imaging. Fourteen patients with PAH (mean age: 39.1 yr, 10 women and 4 men) and 34 healthy control subjects (mean ageL 35.6 yr, 17 women and 17 men) completed real-time cardiac magnetic resonance imaging during submaximal exercise breathing room air. Control subjects were then also exercised during acute normobaric hypoxia (fraction of inspired O2: 12%). RV contractile reserve was assessed by the effect of exercise on ejection fraction. In control subjects, the increase in RV ejection fraction on exercise was less during hypoxia ( P = 0.017), but the response of left ventricular ejection fraction to exercise did not change. Patients with PAH had an impaired RV reserve, with half demonstrating a fall in RV ejection fraction on exercise despite comparable resting function to controls (PAH: rest 53.6 ± 4.3% vs. exercise 51.4 ± 10.7%; controls: rest 57.1 ± 5.2% vs. exercise 69.6 ± 6.1%, P < 0.0001). In control subjects, the increase in stroke volume index on exercise was driven by reduced RV end-systolic volume, whereas patients with PAH did not augment the stroke volume index, with increases in both end-diastolic and end-systolic volumes. From baseline hemodynamic and exercise capacity variables, only the minute ventilation-to-CO2 output ratio was an independent predictor of RV functional reserve ( P = 0.021). In conclusion, noninvasive cardiac imaging during exercise unmasks depleted RV contractile reserves in healthy adults under hypoxic conditions and patients with PAH under normoxic conditions despite preserved ejection fraction at rest. NEW & NOTEWORTHY Right ventricular (RV) reserve was assessed using real-time cardiac magnetic resonance imaging in patients with pulmonary arterial hypertension and in healthy control subjects under normobaric hypoxia, which has been previously associated with acute pulmonary hypertension. Hypoxia caused a mild reduction in RV reserve, whereas chronic pulmonary arterial hypertension was associated with a marked reduction in RV reserve.
Integrin β3 Inhibition Enhances the Antitumor Activity of ALK Inhibitor in ALK-Rearranged NSCLC
Authors: Noh Ka-Won , Sohn Insuk , Song Ji-Young , Shin Hyun-Tae , Kim Yu-Jin , Jung Kyungsoo , Sung Minjung , Kim Mingi , An Sungbin , Han Joungho , Lee Se-Hoon , Lee Mi-Sook , Choi Yoon-La 
Published: May 2018

Abstract
Purpose: Anaplastic lymphoma kinase (ALK)-positive cancers are sensitive to small-molecule ALK kinase inhibitors, but most cases experience failure following treatment. Hence, additional drug targets and combination therapeutic treatments are needed. We investigated gene expression that is regulated by the expression of ALK and explored its roles in cancer progression and therapeutic implication.
Experimental Design: We screened ALK-rearranged non–small cell lung cancer (NSCLC) cases using immunohistochemistry and fluorescence in situ hybridization and then conducted multiplex gene expression analysis. We also performed a clinicopathologic analysis to validate the findings. Additional cellular experiments, including inhibition and migration assays, and in vivo lung cancer model studies were performed.
Results: Among patients with ALK-rearranged NSCLC, integrin β3 (ITGB3) was one of the overexpressed genes in comparison with that in ALK-negative NSCLC (P = 0.0003). ALK and integrin β3 expression were positively correlated, and we discovered that high integrin β3 mRNA expression was associated with metastasis and more advanced tumor stages (P &lt; 0.005; P &lt; 0.05). Furthermore, we found that inhibition of both ALK and integrin β3 led to increased drug sensitivity in vitro and in vivo (both P &lt; 0.05).
Conclusions: We discovered a positive correlation between ALK and integrin β3 expression levels in ALK-rearranged NSCLC. Our findings suggest that high integrin β3 expression in ALK-rearranged NSCLC is associated with tumor progression and a worse prognosis. This finding demonstrates the prognostic value of integrin β3 and provides a rationale for combination treatment with ALK and integrin β3 inhibitors in patients with ALK-rearranged NSCLC. Clin Cancer Res; 24(17); 4162–74. ©2018 AACR.
Effect of 2 Psoriasis Treatments on Vascular Inflammation and Novel Inflammatory Cardiovascular Biomarkers
Authors: Mehta Nehal N. , Shin Daniel B. , Joshi Aditya A. , Dey Amit K. , Armstrong April W. , Duffin Kristina Callis , Fuxench Zelma Chiesa , Harrington Charlotte L. , Hubbard Rebecca A. , Kalb Robert E. , Menter Alan , Rader Daniel J. , Reilly Muredach P. , Simpson Eric L. , Takeshita Junko , Torigian Drew A. , Werner Thomas J. , Troxel Andrea B. , Tyring Stephen K. , Vanderbeek Suzette Baez , Van Voorhees Abby S. , Playford Martin P. , Ahlman Mark A. , Alavi Abass , Gelfand Joel M. 
Published: May 2018

Background:
Psoriasis is a chronic inflammatory disease associated with dyslipidemia, cardiovascular events, and mortality. We aimed to assess and compare the effect of treatment of moderate-to-severe psoriasis with adalimumab or phototherapy on vascular inflammation and cardiovascular biomarkers.

Methods and Results:

Randomized, double-blind, trial of adalimumab, phototherapy, and placebo (1:1:1) for 12 weeks, with crossover to adalimumab for 52 weeks total. Outcomes included vascular inflammation by
18
F-fluorodeoxyglucose positron emission tomography/computed tomography and biomarkers of inflammation, insulin resistance, and lipoproteins. Ninety-seven patients were randomized, 92 completed the randomized controlled trial portion; 81 entered the adalimumab extension with 61 completing 52 weeks of adalimumab. There was no difference in change in vascular inflammation at week 12 in the adalimumab group (change compared with placebo, 0.64%; 95% confidence interval, −5.84% to 7.12%) or the phototherapy group (−1.60%; 95% confidence interval, −6.78% to 3.59%) or after 52-week adalimumab treatment (0.02% compared with initiation; 95% confidence interval, −2.85% to 2.90%). Both adalimumab and phototherapy decreased inflammation by serum CRP, interleukin-6. Only adalimumab reduced tumor necrosis factor and glycoprotein acetylation at 12 and 52 weeks. Neither had an impact on metabolic markers (insulin, adiponectin, and leptin). Only phototherapy increased high-density lipoprotein-p at 12 weeks. At 52-week of adalimumab cholesterol efflux and high-density lipoprotein-p were reduced.

Conclusions:
Adalimumab reduced key markers of inflammation including glycoprotein acetylation compared with phototherapy with no effect on glucose metabolism and vascular inflammation, and potential adverse effects on high-density lipoprotein. Glycoprotein acetylation improvement may partially explain the beneficial effects of adalimumab seen in observational studies. Larger studies with more detailed phenotyping of vascular disease should assess the comparative differences in the effects of adalimumab and phototherapy seen in our study.

Clinical Trial Registration

: URL:
https://www.clinicaltrials.gov
. Unique identifiers: NCT01866592 and NCT01553058.
Clinical Utility of Electronic Alberta Stroke Program Early Computed Tomography Score Software in the ENCHANTED Trial Database
Authors: Nagel Simon , Wang Xia , Carcel Cheryl , Robinson Thompson , Lindley Richard I. , Chalmers John , Anderson Craig S. 
Published: May 2018

Background and Purpose—
Clinical utility of electronic Alberta Stroke Program Early CT Score (e-ASPECTS), an automated system for quantifying signs of infarction, was evaluated in a large database of thrombolyzed patients with acute ischemic stroke.

Methods—
All baseline noncontrast computed tomographic scans of patients with anterior circulation acute ischemic stroke who participated in the alteplase dose arm of the randomized controlled trial ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study) were reviewed; poor quality and large (>6 mm) slice thickness were excluded. Included scans had e-ASPECTS scores correlated with baseline neurological severity (National Institutes of Health Stroke Scale scores) and 90-day disability outcomes (modified Rankin Scale scores). Multivariable logistic regression models were used to determine the predictive ability of e-ASPECTS for disability outcomes and symptomatic intracranial hemorrhage.

Results—

Of 2426 available computed tomographic images, 1480 (61%) were included in analyses of e-ASPECTS scores (median 9 [interquartile range, 8–10], 77% with good [range, 8–10] scores). Lower e-ASPECTS scores (per 1-point decrease) were significantly associated with increasing baseline National Institutes of Health Stroke Scale scores (
r
, −0.31;
P
<0.0001) and 90-day poor outcome (modified Rankin Scale scores, 2–6;
r
, −0.27;
P
<0.001). Adjusted odds ratios and 95% confidence intervals for 90-day outcomes were death or disability (modified Rankin Scale scores, 2–6; 0.91 [0.85–0.97]), death and major disability (modified Rankin Scale scores, 3–6; 0.89 [0.83–0.95]), and death (0.86 [0.79–0.95]); and for symptomatic intracranial hemorrhage, according to the Implementation of Thrombolysis in Stroke-Monitoring Study criteria was 0.87 (0.72–1.05).

Conclusions—
e-ASPECT scores from thin computed tomographic slices (≤6 mm) were highly correlated with baseline neurological severity and independently predict functional recovery and adverse outcomes in acute ischemic stroke.

Clinical Trial Registration—

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01422616.
The Distribution of Heirless Books to Morocco by the Jewish Cultural Reconstruction, Inc.
Authors: Guedj David 
Published: May 2018

Abstract
This article looks into the one-of-a-kind encounter between the inter-diasporic Jewish corporation Jewish Cultural Reconstruction (JCR), and the Alliance Israélite Universelle’s (AIU) Hebrew teachers’ seminary in Casablanca, an encounter that studies into JCR’s history have all but failed to cite. Nevertheless, Morocco’s case is of considerable significance, Morocco being the only Islamic country where the Jewish community managed to obtain books from JCR. This unique case warrants a review into what facilitated the encounter between the seminary and the corporation, and an examination in light of broader historic processes that took place as part of the Moroccan Jewish relations with other diasporic Jews.
Qualitative Assessment of Smoke-Free Policy Implementation in Low-Income Housing: Enhancing Resident Compliance
Authors: Anthony Jodi , Goldman Roberta , Rees Vaughan W. , Frounfelker Rochelle L. , Davine Jessica , Keske Robyn R. , Brooks Daniel R. , Geller Alan C. 
Published: May 2018

Purpose: As public housing agencies and other low-income housing providers adopt smoke-free policies, data are needed to inform implementation approaches that support compliance. Design: Focused ethnography used including qualitative interviews with staff, focus groups with residents, and property observations. Setting: Four low-income housing properties in Massachusetts, 12 months postpolicy adoption. Participants: Individual interviews (n = 17) with property staff (managers, resident service coordinators, maintenance, security, and administrators) and focus groups with resident smokers (n = 28) and nonsmokers (n = 47). Measures: Informed by the social–ecological model: intrapersonal, interpersonal, organizational, and community factors relating to compliance were assessed. Analysis: Utilized MAXQDA in a theory-driven immersion/crystallization analytic process with cycles of raw data examination and pattern identification until no new themes emerged. Results: Self-reported secondhand smoke exposure (SHSe) was reduced but not eliminated. Challenges included relying on ambivalent maintenance staff and residents to report violations, staff serving as both enforcers and smoking cessation counsellors, and inability to enforce on nights and weekends. Erroneous knowledge of the policy, perception that SHSe is not harmful to neighbors, as well as believing that smokers were losing their autonomy and being unfairly singled out when other resident violations were being unaddressed, hindered policy acceptance among resident smokers. The greatest challenge to compliance was the lack of allowable outdoor smoking areas that may have reduced the burden of the policy on smokers. Conclusion: Smoke-free policy implementation to support compliance could be enhanced with information about SHSe for smokers and nonsmokers, cessation support from external community partners, discussion forums for maintenance staff, resident inclusion in decision-making, and framing the policy as part of a broader wellness initiative.
Contrasts in older persons’ experiences and significant others’ perceptions of existential loneliness
Authors: Larsson Helena , Edberg Anna-Karin , Bolmsjö Ingrid , Rämgård Margareta 
Published: May 2018

Background: As frail older people might have difficulties in expressing themselves, their needs are often interpreted by others, for example, by significant others, whose information health care staff often have to rely on. This, in turn, can put health care staff in ethically difficult situations, where they have to choose between alternative courses of action. One aspect that might be especially difficult to express is that of existential loneliness. We have only sparse knowledge about whether, and in what way, the views of frail older persons and their significant others concerning existential loneliness are in concordance. Objective: To contrast frail older (>75) persons’ experiences with their significant others’ perceptions of existential loneliness. Methods: A case study design was chosen for this study. Individual interviews with frail older persons (n = 15) and interviews with their significant others (n = 19), as well as field notes, served as a basis for the study. A thematic analysis was used to interpret data. Ethical considerations: This study was conducted in accordance with the principles of research ethics. Findings: The findings showed three themes: (1) Meaningless waiting in contrast to lack of activities, (2) Longing for a deeper connectedness in contrast to not participating in a social environment and (3) Restricted freedom in contrast to given up on life. Discussion: Knowledge about the tensions between older persons’ and their significant others’ views of existential loneliness could be of use as a basis for ethical reflections on the care of older people and in the encounter with their significant others. Conclusion: It is of importance that health care professionals listen to both the frail older person and their significant other(s) and be aware of whose voice that the care given is based on, in order to provide care that is beneficial and not to the detriment of the older person.