bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using NCI-Designated Cancer Center Catchment-Area Data to Understand an Ignored but High-Need Constituent: People Uncertain or Avoidant about Their Cancer Risk
Authors: Hay Jennifer L. , Kiviniemi Marc T. , Orom Heather , Waters Erika A. 
Published: September 2019

Abstract
In 2016, the NCI provided supplemental funding to 15 NCI-designated cancer centers to enhance cancer centers' capacity to collect critical catchment-area data across behavioral and psychosocial domains [March 2019 issue of Cancer Epidemiology, Biomarkers & Prevention (CEBP)—CEBP Focus]. In response, we highlight opportunities for cancer risk perception research when collecting and utilizing catchment-area data given the remarkably high proportions of individuals who report they are at average cancer risk, high levels of cancer risk information avoidance, and extremely negative (“death”) associations with cancer. First, we advocate for enhanced measurement specificity regarding whether some participants may be uncertain regarding their cancer risk. Second, we advocate for examination of whether the large proportion of people who rate their risk as average have common (demographic and attitudinal) characteristics, which may dictate specific and targeted cancer prevention and control intervention. Finally, we advocate for further examination of cancer risk information avoidance and negative cancer associations to clarify subgroups that may fail to engage with risk information. Given the ubiquity of risk uncertainty, information avoidance, and negative cancer associations, further research into these prevalent beliefs will enhance our ability to bring the latest information regarding cancer prevention and control to the general population of the United States.
Acquired Resistance to EGFR TKIs Mediated by TGFβ1/Integrin β3 Signaling in EGFR-Mutant Lung Cancer
Authors: Wang Caiyun , Wang Tao , Lv Dacheng , Li Ling , Yue Jinnan , Chen Hong-Zhuan , Xu Lu 
Published: September 2019

Abstract
Investigation of novel molecular mechanisms is essential to develop strategies to overcome acquired resistance to EGFR tyrosine kinase inhibitors (TKI). Integrin has been demonstrated as a regulator of cancer progression. The aim of this study was to identify which specific integrins are involved and regulated in acquired resistance to EGFR TKIs in EGFR-mutant lung cancer. The expression levels of integrin subunits were examined in EGFR-mutant lung cancer cells and xenograft tumors with acquired resistance to EGFR TKIs. Manipulation of integrin β3 was performed to explore whether integrin β3 overexpression was associated with TKI resistance, anoikis resistance, EMT, and cancer stemness in resistant lung cancer. To explore the mechanism, TGFβ1 level was examined, and TGFβ1 inhibitor was then used. Integrin β3 was dramatically and consistently overexpressed in acquired gefitinib- or osimertinib-resistant lung cancer in vitro and in vivo. Integrin β3 was also involved in the progression of lung adenocarcinoma. Antagonizing integrin β3 increased the TKI sensitivity and delayed the occurrence of TKI resistance in vitro and in vivo, as well as suppressed proliferation, anoikis resistance, and EMT phenotype in lung cancer cells. Overexpression of integrin β3 was also associated with the enhanced cancer stemness that was acquired in the development of resistance and suppressed by antagonizing integrin β3. Mechanistically, integrin β3 was induced by increased TGFβ1 levels in acquired TKI-resistant lung cancer. Our study identified the TGFβ1/integrin β3 axis as a promising target for combination therapy to delay or overcome acquired resistance to EGFR TKIs in EGFR-mutant lung cancer.
Number of Cardiologists per Cardiovascular Beds and In‐Hospital Mortality for Acute Heart Failure: A Nationwide Study in Japan
Authors: Kanaoka Koshiro , Okayama Satoshi , Nakai Michikazu , Sumita Yoko , Onoue Kenji , Soeda Tsunenari , Nishimura Kunihiro , Kawakami Rika , Okura Hiroyuki , Miyamoto Yoshihiro , Yasuda Satoshi , Tsutsui Hiroyuki , Komuro Issei , Ogawa Hisao , Saito Yoshihiko 
Published: September 2019

Background

Little evidence is available about the number of cardiologists required for appropriate treatment of heart failure (
HF
). Our objective was to determine the association between the number of cardiologists per cardiology beds for treating patients with acute
HF
and in‐hospital mortality.

Methods and Results

This was a cross‐sectional study, and we used the Japanese Registry of All Cardiac and Vascular Diseases Diagnosis Procedure Combination discharge database. The data of patients with HF on emergency admission from April 1, 2012, to March 31, 2014, were extracted. The patients were categorized into 4 groups by the quartiles of the numbers of cardiologists per 50 cardiovascular beds (first group: median, 4.4 [interquartile range, 3.5–5.0]; second group: median, 6.7 [interquartile range, 6.5–7.5]; third group: median, 9.7 [interquartile range, 8.8–10.1]; and fourth group: median, 16.7 [interquartile range, 14.0–23.8]). Using multilevel mixed‐effect logistics regression, we determined adjusted odds ratios for in‐hospital mortality. We identified 154 290 patients with HF on emergency admissions. There were 29 626, 36 587, 46 451, and 41 626 patients in the first, second, third, and fourth groups, respectively.
HF
severity, on the basis of New York Heart Association classification, was similar in the 3 groups. Adjusted odds ratios (95% CIs) for in‐hospital mortality were 0.92 (0.82–1.04;
P
=0.20), 0.82 (0.72–0.92;
P
<0.001), and 0.70 (0.61–0.80;
P
<0.001) for the second, third, and fourth groups, respectively. The proportion of medication used, including angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers, β blockers, and mineralocorticoid receptor antagonists, was positively correlated to the number of cardiologists.

Conclusions

Patients hospitalized for
HF
in hospitals with larger numbers of cardiologists per cardiovascular beds had lower 30‐day mortality.
Flat Panel Computed Tomography Pooled Blood Volume and Infarct Prediction in Endovascular Stroke Treatment
Authors: Mueller Aneka , Wagner Marlies , Hattingen Elke , Seiler Alexander , You Se-Jong , Samp Patrick , Singer Oliver C. 
Published: September 2019

Background and Purpose—
Patients with large-vessel stroke frequently need to be transferred to comprehensive stroke centers for endovascular treatment. An update of physiological perfusion parameters and stroke progression on arrival is desirable. We examined the reliability of preinterventional pooled blood volume (PBV)-maps acquired by flat-panel detector computed tomography (CT) in the interventional angiography suite.

Methods—
The volumes of preinterventional perfusion deficit in flat-panel detector CT-PBV source images were compared with final infarct volume on follow-up multislice-CT after endovascular treatment of 29 consecutive patients with occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA).

Results—
Endovascular treatment was successful in 26 patients (Thrombolysis in Cerebral Infarction, 2b-3). Overall, the median preinterventional PBV-deficit was 9×larger than median final infarct volume on multislice-CT (86.4 mL [10.3; 111.6] versus 9.6 mL [3.6; 36.8]). This was especially evident in the subgroup of successful recanalization (PBV-deficit: 87.5 mL [10.6; 115.1], final infarct: 8.7 mL [3.6; 29]). In futile recanalization, the final infarct tended to be underestimated (PBV-deficit: 86.4 mL [5.9; –] and final infarct: 116.4 mL [3.5; –]).

Conclusions—
Flat panel detector CT-PBV is not reliable in predicting the final infarct volume and should not be used in clinical decision making for endovascular treatment of acute cerebral artery occlusions.
Get Ready for Being Chauffeured
Authors: Mühl Kristin , Strauch Christoph , Grabmaier Christoph , Reithinger Susanne , Huckauf Anke , Baumann Martin 
Published: September 2019

Objective We investigated passenger’s trust and preferences using subjective, qualitative, and psychophysiological measures while being driven either by human or automation in a field study and a driving simulator experiment. Background The passenger’s perspective has largely been neglected in autonomous driving research, although the change of roles from an active driver to a passive passenger is incontrovertible. Investigations of passenger’s appraisals on self-driving vehicles often seem convoluted with active manual driving experiences instead of comparisons with being driven by humans. Method We conducted an exploratory field study using an autonomous research vehicle ( N = 11) and a follow-up experimental driving simulation ( N = 24). Participants were driven on the same course by a human and an autonomous agent sitting on a passenger seat. Skin conductance, trust, and qualitative characteristics of the perceived driving situation were assessed. In addition, the effect of driving style (defensive vs. sporty) was evaluated in the simulator. Results Both investigations revealed a close relation between subjective trust ratings and skin conductance, with increased trust and by trend reduced arousal for human compared with automation in control. Even though driving behavior was equivalent in the simulator when being driven by human and automation, passengers most preferred and trusted the human-defensive driver. Conclusion Individual preferences for driving style and human or autonomous vehicle control influence trust and subjective driving characterizations. Application The findings are applicable in human-automation research, reminding to not neglect subjective attributions and psychophysiological reactions as a result of ascribed control duties in relation to specific execution characteristics.
Parliamentary Disqualification for Financial Conflicts
Authors: Orr Graeme 
Published: September 2019

AbstractWhen should financial interests bar someone from election to or service in Parliament? This article critically analyses the case law on the Constitution’s provisions on pecuniary interests and offices of profit. These cases are seeing the High Court sculpting new law out of old stone. The article is structured both chronologically and thematically, and explores the case law’s litigational and political context, and its relationship to pecuniary interest registers, as well as its jurisprudential value. Ultimately, the Court is found to be grappling with—and somewhat at sea in — fixing workable and consistent purposes for the constitutional provisions, especially given the need to fit these provisions within the broader values of parliamentary and electoral law and practice. The article concludes by assaying and proposing reform options.
Mir-142-3p Regulates Inflammatory Response by Contributing to Increased TNF-α in Chronic Rhinosinusitis With Nasal Polyposis
Authors: Qing Xiang , Zhang Yongquan , Peng Ya , He Guangxiang , Liu An , Liu Huowang 
Published: September 2019

Objective: Previous studies suggested that microRNAs played an important role in the progression of inflammation and remodeling of chronic rhinosinusitis with nasal polyposis. However, the abnormal expression of microRNAs and regulation cytokine expression in nasal polyposis are not clear. Method: The miR-142-3p and tumor necrosis factor α (TNF-α) expression levels in chronic rhinosinusitis with nasal polyposis were detected by quantitative reverse transcription polymerase chain reaction (qRT-PCR). The miR-142-3p and TNF-α levels in human nasal epithelial cells (HNEpC) after stimulation by lipopolysaccharide (LPS) were detected by qRT-PCR. Moreover, HNEpCs were transfected by miR-142-3p mimics or inhibitor or cotransfected with si-TNF-α to evaluate the regulation of miR-142-3p on TNF-α which affects the production of inflammatory factors. Results: The miR-142-3p and TNF-α were significantly higher in nasal mucosa of chronic rhinosinusitis with polyps patients compared to normal human. MiR-142-3p and TNF-α expression levels were increased after LPS stimulation in a dose- and time-dependent manner. Knockdown of miR-142-3p in HNEpCs downregulated TNF-α expression at both messenger RNA and protein levels. Conclusions: It is indicated that miR-142-3p may participate in the regulation of the body’s inflammatory response through the LPS-TLR-TNF-α signaling pathway in chronic rhinosinusitis with nasal polyposis.
Intracameral bevacizumab role in trabeculectomy: A 1-year prospective randomized controlled study
Authors: Rabina Gilad , Barequet Dana , Mimouni Michael , Kurtz Shimon , Shemesh Gabi , Rosenblatt Amir , Rosenfeld Eldar 
Published: September 2019

Purpose: To evaluate the effect of intracameral Bevacizumab on trabeculectomy success rates. Methods: A prospective, randomized, interventional clinical trial. Patients with primary open-angle glaucoma were randomly assigned to two groups: trabeculectomy with mitomycin C and trabeculectomy with mitomycin C and intracameral bevacizumab. Complete success is defined as an intraocular pressure (IOP) reduction of at least 30% from baseline IOP to a measured pressure of between 5 and 18 mm Hg without the use of IOP lowering medications. Qualified success is defined as same achievement of reduced IOP, but with the use of IOP lowering medications. Overall success is defined as same achievement of reduced IOP with or without the use of IOP lowering medications. Results: Thirty-three patients in the mitomycin C group and 36 patients in the mitomycin C and bevacizumab group were included in final analyses. The IOP at presentation was 28.3 ± 8 and 28.4 ± 8.6 mm Hg, compared to 10.8 ± 3.4 and 12.3 ± 3.7 mm Hg at 12 months (p < 0.0001) for the mitomycin C group and the mitomycin C and bevacizumab group, respectively. Complete success at 12 months was achieved in 65% of the mitomycin C group compared to 60% of the mitomycin C and bevacizumab group (p = 0.77). Overall success was achieved in 82% compared to 80% of patients at 12 months (p = 0.78). Both groups showed a statistically significant reduction in IOP after 6 and 12 months (p ⩽ 0.001). There were no statistically significant differences in visual acuity and complications. Conclusion: Intracameral bevacizumab during mitomycin C trabeculectomy in patients with primary open-angle glaucoma apparently does not improve success rates. The adjuvant use of intracameral bevacizumab is therefore not justified.
Jury verdicts and outcomes of malpractice cases involving arteriovenous hemodialysis access
Authors: Phair John , Carnevale Matthew , Wilson Eelin , Koleilat Issam 
Published: September 2019

Objective: To analyze malpractice cases involving hemodialysis access to prevent future litigation and improve physician education. Methods: Jury verdict reviews from the WESTLAW database from 1 January 2005 to 1 January 2015 were reviewed. The search terms “hemodialysis,” “dialysis,” “graft,” “fistula,” “AVG,” “AVF,” “arteriovenous,” “catheter,” “permacatheter,” and “shiley” were used to compile data on the demographics of the defendant, plaintiff, allegation, complication, and verdict. Results: Sixty-six cases involving the litigation pertaining to hemodialysis catheter, arteriovenous fistula (AVF) or arteriovenous grafts (AVGs) were obtained. Of these, 55% involved catheter-based hemodialysis access, 18% involved AVF, and 27% involved AVG. The most frequent physician defendants were vascular surgeons (36%), internists (14%), nephrologists (14%), general surgeons (9%), and interventional radiologists (6%). Of the patients, 38% involved were male and the average patient age was 56.3 (standard deviation (SD) = 20.1) years. Region of injury was 50% in the neck or chest, 42% in the arm, and 8% in the groin. Injury was listed as death in 79% of cases. Of the deaths, 95% involved bleeding at some point in the chain of events. The most common claims related to the cases were failure to perform the surgery or procedure safely (44%), failure to diagnose and treat in a timely manner (30%), and negligent hemodialysis treatment (11%). The most common complications cited were hemorrhage (62%), loss of function of limb (15%), and ischemia due to steal syndrome (11%). A total of 26 cases (39%) were found for the plaintiff or settled. The median award was US$463,000 with a mean of US$985,299 (SD = US$1,314,557). Conclusion: While popular opinion may indicate that steal syndrome is a commonly litigated complication, our data reveal that the most common injury litigated is death which may frequently be the result of a hemorrhagic episode. In addition to hemorrhage, the remaining most common complications included steal syndrome and loss of limb function. Therefore, steps to better prevent, diagnose and treat bleeding, nerve injury, and steal syndrome in a timely manner are critical to preventing hemodialysis-access-associated litigation.
Hemodialysis access cost comparisons among incident tunneled catheter patients
Authors: Wagner Jason Kane , Fish Larry , Weisbord Steven D , Yuo Theodore H 
Published: September 2019

Background: Arteriovenous fistula is the ideal hemodialysis access, but most patients start with tunneled dialysis catheter. Arteriovenous fistula and arteriovenous graft surgery may reduce tunneled dialysis catheter use and also increase procedural expenses. We compared Medicare costs associated with arteriovenous fistula, arteriovenous graft, and tunneled dialysis catheter. Methods: Using the US Renal Data System, we identified incident hemodialysis patients in 2008 who started with tunneled dialysis catheter, survived at least 90 days, and had adequate Medicare records for analysis. We followed them until death or end of 2011; access modality was based on billing evidence of arteriovenous fistula or arteriovenous graft creation. We assumed patients without such records remained with tunneled dialysis catheter. We generated multivariate linear regression models predicting Medicare expenditures, censoring costs when patients died; we included all payments to physicians and institutions. We also created algorithms to identify access-related costs. Results: There were 113,505 patients in the US Renal Data System who started hemodialysis in 2008, of whom 51,002 Medicare patients met inclusion criteria. Of that group, 41,532 (81%) began with tunneled dialysis catheter; 27,064 patients were in the final analysis file. In the first 90 days after hemodialysis initiation, 6100 (22.5%) received arteriovenous fistula, 1813 (6.7%) arteriovenous graft, and 19,151 (70.8%) stayed with tunneled dialysis catheter. Annualized access costs by modality were tunneled dialysis catheter US$13,625 (95% confidence interval: US$13,426–US$13,285); arteriovenous fistula US$16,864 (95% confidence interval: US$16,533–US$17,194); and arteriovenous graft US$20,961 (95% confidence interval: US$20,967–US$21,654; p < .001). Multivariate linear regression demonstrated that staying with tunneled dialysis catheter had lowest access-related costs, arteriovenous fistula was intermediate, and those who underwent arteriovenous graft surgery were highest (p < .021). Access type was not significantly associated with total costs. Additional arteriovenous fistula and arteriovenous graft creation (US$3525 and US$3804 per access per year, respectively) and open and endovascular access-related interventions (US$3102 and US$3569 per procedure per year, respectively; all p < .001) were important predictors of increased cost. Conclusions: Among patients starting hemodialysis with tunneled dialysis catheter, continued tunneled dialysis catheter use is associated with lowest access-related cost. Both endovascular and open interventions are associated with significant additional costs. Further investigation is warranted to develop efficient patient-centered strategies for hemodialysis access.
Prophylaxis for postoperative atrial fibrillation: A quality initiative study exploring adherence to NICE guidance in a UK tertiary cardiothoracic intensive care unit
Authors: Zochios Vasileios , Chandan Joht Singh , Taverner Thomas , Babu Aswin , Singh Harjot 
Published: September 2019

Background Acute onset atrial fibrillation is a common dysrhythmia experienced by patients following cardiac surgery which can often cause morbidity and extended hospital length of stay. The primary aim of the study was to explore adherence to National Institute for Health and Care Excellence (NICE) guidance which suggests the need for prophylaxis for postoperative atrial fibrillation (POAF). Secondary aims were to explore factors contributing to the development POAF and the impact of POAF on patient-centred outcomes. Methods An analysis consisting of descriptive statistics and regression models was conducted using 138 patient’s records who underwent cardiac surgery between January and March 2017. Results We identified 83 (62%) patients on prophylactic rate control medications prior to surgery. During the study period, a total of 50 patients (36%) developed POAF, of which 28 were on prophylactic medication prior to surgery. Patients who developed POAF had significantly prolonged hospital length of stay compared to those who did not develop POAF. Conclusion Our study identified a significant proportion of patients not being offered prophylactic rate control prior to cardiac surgery. It is clear that poor patient outcomes are associated with the development of POAF and therefore there is an important need to ensure preventative measures are implemented in guidance relating to the management of these patients. Our results also suggest that tight management of clinical and physiological risk factors prior and during cardiac surgery may improve outcomes in this group of patients and could be considered in future enhanced recovery after cardiac surgery protocols.
Long‐term results of the DelIVery for Pulmonary Arterial Hypertension trial
Authors: Gomberg‐Maitland Mardi , Bourge Robert C. , Shapiro Shelley M. , Tarver James H. , Zwicke Dianne L. , Feldman Jeremy P. , Chakinala Murali M. , Frantz Robert P. , Torres Fernando , Bag Remzi , Murphy Jeffrey A. , Lautenbach Amy A. , Morris Marty , Peterson Leigh , Waxman Aaron B. 
Published: September 2019

BackgroundThe DelIVery for Pulmonary Arterial Hypertension clinical trial was a multi‐center, prospective, single arm, Investigational Device Exemption study utilizing a fully implantable, programmable intravascular delivery system consisting of a pump and a catheter for intravenous treprostinil. The study met its primary endpoint and demonstrated that the intravascular delivery system significantly reduced catheter related complications at 22,000 subject‐days of follow‐up compared with a predefined objective performance criterion. Here we summarize the results obtained during a 6.4‐year follow‐up period.MethodsThroughout study follow‐up, participants had clinic visits and medication refills at least every 12 weeks (dependent on the subjects’ dose). All adverse events and intravascular delivery system complications were evaluated and recorded.ResultsSixty pulmonary arterial hypertension subjects were followed post device implantation for approximately 282 patient‐years (range 87 days to 6.4 years). Of the 60 subjects, 14 died (1 related to intravascular delivery system pump failure), 2 withdrew after lung transplants, and 2 withdrew due to pump pocket infection. No catheter‐related bloodstream infections, catheter thrombosis or occlusions, or catheter kinks occurred through 282 patient‐years. Two participants had adverse events of abdominal pain, rash, due to subcutaneous treprostinil “leaks” after one catheter puncture and one catheter laceration during pump refill and replacement, respectively. Eight pump failure events occurred: seven pump motor stalls and one early replacement (faulty battery).ConclusionDelivery of treprostinil with an intravascular delivery system is a safe alternative to an external delivery system, while providing enhanced life experiences. To preserve the risk–benefit ratio, treatment at specialized pulmonary arterial hypertension centers is recommended until training is disseminated at other sites.