bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Retrieval of an Intraocular Needle Following Intravitreal Bevacizumab Injection
Authors: Mathai Mariam , Levinson Joshua D. , Khanifar Aziz A. , Smithen Lindsay M. 
Published: June 2019

Purpose: The purpose of this case report is to describe a case of iatrogenic intraocular foreign body due to a fractured 30-gauge needle following intravitreal injection of bevacizumab. Methods: A case report is presented. Results: The patient presented with a 30-gauge needle in the vitreous cavity after receiving an intravitreal injection of bevacizumab for diabetic macular edema. Bilateral eye shields were placed to reduce movement of the foreign body and decrease the risk of injury to the lens or retina. The needle was successfully removed via a combination of 23-gauge pars plana vitrectomy and removal of the foreign body via a transscleral approach through the initial injection site. Visual acuity improved to 20/25 2 months after surgery. Conclusions: We present the successful preoperative management and surgical removal of a needle fragment from the vitreous cavity after the needle fractured during intravitreal injection.
Evaluation of event-free survival as a robust end point in untreated acute myeloid leukemia (Alliance A151614)
Authors: Yin Jun , LaPlant Betsy , Uy Geoffrey L. , Marcucci Guido , Blum William , Larson Richard A. , Stone Richard M. , Mandrekar Sumithra J. 
Published: June 2019

Abstract
Event-free survival (EFS) is controversial as an end point for speeding approvals in newly diagnosed acute myeloid leukemia (AML). We aimed to examine the robustness of EFS, specifically timing of complete remission (CR) in defining induction failure and impact of hematopoietic cell transplantation (HCT). The study included 1884 untreated AML patients enrolled across 5 trials conducted through Alliance for Clinical Trials in Oncology using anthracycline and cytarabine induction chemotherapy. EFS was defined as time from randomization/registration to induction failure, relapse, or death. Three definitions of induction failure were evaluated: failure to achieve CR by 60 days after randomization/registration, failure to achieve CR by the end of all protocol-defined induction courses, and failure to achieve CR by the end of all protocol-defined treatment. We considered either censoring or no censoring at time of non–protocol-mandated HCT. Although relapse and death are firm end points, the determination of induction failure was not consistent across studies. There was minimal impact of censoring at HCT on EFS estimates; however, median EFS estimates differed considerably based on the timing of CR in defining induction failure, with the magnitude of difference being large enough in most cases to lead to incorrect conclusions about efficacy in a single-arm trial, if the trial definition was not consistent with the definition used for the historical control. Timing of CR should be carefully examined in the historical control data used to guide the design of single-arm trials using EFS as the primary end point. Trials were registered at www.clinicaltrials.gov as #NCT00085124, #NCT00416598, # NCT00651261, #NCT01238211, and #NCT01253070.
Entropy of mitochondrial DNA circulating in blood is associated with hepatocellular carcinoma
Authors: Campo David S. , Nayak Vishal , Srinivasamoorthy Ganesh , Khudyakov Yury 
Published: June 2019

Abstract

Background
Ultra-Deep Sequencing (UDS) enabled identification of specific changes in human genome occurring in malignant tumors, with current approaches calling for the detection of specific mutations associated with certain cancers. However, such associations are frequently idiosyncratic and cannot be generalized for diagnostics. Mitochondrial DNA (mtDNA) has been shown to be functionally associated with several cancer types. Here, we study the association of intra-host mtDNA diversity with Hepatocellular Carcinoma (HCC).

Results
UDS mtDNA exome data from blood of patients with HCC (n = 293) and non-cancer controls (NC, n = 391) were used to: (i) measure the genetic heterogeneity of nucleotide sites from the entire population of intra-host mtDNA variants rather than to detect specific mutations, and (ii) apply machine learning algorithms to develop a classifier for HCC detection. Average total entropy of HCC mtDNA is 1.24-times lower than of NC mtDNA (p = 2.84E-47). Among all polymorphic sites, 2.09% had a significantly different mean entropy between HCC and NC, with 0.32% of the HCC mtDNA sites having greater (p < 0.05) and 1.77% of the sites having lower mean entropy (p < 0.05) as compared to NC. The entropy profile of each sample was used to further explore the association between mtDNA heterogeneity and HCC by means of a Random Forest (RF) classifier The RF-classifier separated 232 HCC and 232 NC patients with accuracy of up to 99.78% and average accuracy of 92.23% in the 10-fold cross-validation. The classifier accurately separated 93.08% of HCC (n = 61) and NC (n = 159) patients in a validation dataset that was not used for the RF parameter optimization.

Conclusions
Polymorphic sites contributing most to the mtDNA association with HCC are scattered along the mitochondrial genome, affecting all mitochondrial genes. The findings suggest that application of heterogeneity profiles of intra-host mtDNA variants from blood may help overcome barriers associated with the complex association of specific mutations with cancer, enabling the development of accurate, rapid, inexpensive and minimally invasive diagnostic detection of cancer.
Polygenic effects of schizophrenia on hippocampal grey matter volume and hippocampus–medial prefrontal cortex functional connectivity
Authors: Liu Shu , Li Ang , Liu Yong , Yan Hao , Wang Meng , Sun Yuqing , Fan Lingzhong , Song Ming , Xu Kaibin , Chen Jun , Chen Yunchun , Wang Huaning , Guo Hua , Wan Ping , Lv Luxian , Yang Yongfeng , Li Peng , Lu Lin , Yan Jun , Wang Huiling , Zhang Hongxing , Wu Huawang , Ning Yuping , Zhang Dai , Jiang Tianzi , Liu Bing 
Published: June 2019

BackgroundSchizophrenia is a complex mental disorder with high heritability and polygenic inheritance. Multimodal neuroimaging studies have also indicated that abnormalities of brain structure and function are a plausible neurobiological characterisation of schizophrenia. However, the polygenic effects of schizophrenia on these imaging endophenotypes have not yet been fully elucidated.AimsTo investigate the effects of polygenic risk for schizophrenia on the brain grey matter volume and functional connectivity, which are disrupted in schizophrenia.MethodGenomic and neuroimaging data from a large sample of Han Chinese patients with schizophrenia (N = 509) and healthy controls (N = 502) were included in this study. We examined grey matter volume and functional connectivity via structural and functional magnetic resonance imaging, respectively. Using the data from a recent meta-analysis of a genome-wide association study that comprised a large number of Chinese people, we calculated a polygenic risk score (PGRS) for each participant.ResultsThe imaging genetic analysis revealed that the individual PGRS showed a significantly negative correlation with the hippocampal grey matter volume and hippocampus–medial prefrontal cortex functional connectivity, both of which were lower in the people with schizophrenia than in the controls. We also found that the observed neuroimaging measures showed weak but similar changes in unaffected first-degree relatives of patients with schizophrenia.ConclusionsThese findings suggested that genetically influenced brain grey matter volume and functional connectivity may provide important clues for understanding the pathological mechanisms of schizophrenia and for the early diagnosis of schizophrenia.
Dual-Task Walking Capacity Mediates Tai Ji Quan Impact on Physical and Cognitive Function
Authors: LI FUZHONG , HARMER PETER , CHOU LI-SHAN 
Published: June 2019

ABSTRACTPurposeEmerging evidence indicates exercise training improves mobility and cognition and reduces falls in older adults, but underlying mechanisms are not well understood. This study tested the hypothesis that change in dual-task walking capacity mediates the positive effect of Tai Ji Quan and multimodal exercise on physical performance, activity confidence, global cognition, and falls among community-dwelling older adults at high risk of falling.MethodsWe conducted a secondary analysis of a 6-month randomized clinical trial comparing Tai Ji Quan: Moving for Better Balance (TJQMBB) and multimodal exercise to stretching exercise in a sample of 670 adults older than 70 yr who had a history of falls or impaired mobility. Distal outcome measures, ascertained at a 12-month follow-up, were the Short Physical Performance Battery, Activities-Specific Balance Confidence, Montreal Cognitive Assessment, and falls. The mediator hypothesized to account for the intervention effects was dual-task cost estimated by calculating changes in gait speed from single-task to dual-task walking from baseline to the end of intervention.ResultsAt 12 months, compared with stretching exercise, multimodal exercise significantly improved Short Physical Performance Battery and Activities-Specific Balance Confidence outcomes and reduced the number of falls (P< 0.05). However, it did not lower dual-task cost or mediate the intervention effects on distal outcomes. In contrast, TJQMBB significantly reduced dual-task cost relative to multimodal and stretching exercises (P< 0.05) which in turn resulted in improvements in lower-extremity physical performance, activity confidence, global cognitive function, and reductions in falls (P< 0.05) during follow-up.ConclusionsEnhanced dual-task walking capacity as a result of Tai Ji Quan training mediated improvements in physical and cognitive outcomes in older adults at high risk of falling.
Aerobic Training and Green Tea Extract Protect against N-methyl-N-nitrosourea–induced Prostate Cancer
Authors: SAEDMOCHESHI SABER , SAGHEBJOO MARZIYEH , VAHABZADEH ZAKARIA , SHEIKHOLESLAMI-VATANI DARIUSH 
Published: June 2019

ABSTRACT

Introduction
Aerobic training and green tea extract can be used to reduce the risk of prostate cancer. The goal of this study was to evaluate the effects of 8-wk aerobic exercise training and administration of green tea extract on the level of nuclear factor kappa B (NF-kB), cyclooxygenase-2 (COX-2) and p53 tumor suppressor protein (p53) in prostate of rats which were stimulated by N-methyl-N-nitrosourea to induce the prostate cancer.

Methods
Sixty adult male Wistar rats were assigned into six groups including healthy control, cancer control (CCt), cancer training (CTr: 45 min·d−1 at low to moderate intensity, five times per week, 8 wk), cancer extract (CEx: 1.34 mL of green tea extract, three times per week, 8 wk), cancer training+ cancer extract (CTr + CEx) and sham groups. Rats were sacrificed 48 h after the last intervention session, and the prostate tissue was isolated to measure the levels of NF-kB, COX-2, and p53.

Results
The NF-kB level in CCt group was increased significantly compared to the healthy control (P = 0.02). In the CTr group, NF-kB level was decreased significantly compared to the CCt and CEx groups (P = 0.001 and 0.05, respectively). In addition, the levels of P53 protein were reduced in CTr, CEx, and CTr + CEx groups compared to CCt group (P = 0.001, 0.02 and 0.004, respectively). No significant changes were found in the level of COX-2 between groups.

Conclusions
These results suggest that a long-term exercise training combined with the intake of green tea extract may reduce levels of NF-kB and p53 in rats with prostate cancer. Given the importance of recognizing complementary therapies in this regard, future studies are warranted.
Non-communicable diseases in the Western Area District, Sierra Leone, following the Ebola outbreak
Authors: Koroma Ibrahim Baimba , Javadi Dena , Hann Katrina , Harries Anthony D , Smart Francis , Samba Thomas 
Published: June 2019

Background: Non-communicable diseases (NCDs) are the leading causes of morbidity and mortality in the world. During infectious disease outbreaks, such as the Ebola virus disease outbreak in West Africa from 2014-2015, the health system is often strained, and diagnosis, management and care of NCDs may be compromised. This study assessed numbers and distribution of NCDs in all health facilities in the Western-Area District, Sierra Leone, in the post-Ebola period (June–December 2015) comparing findings with the pre-Ebola (June–December 2013) and Ebola outbreak (June–December 2014) periods. Methods: This was a cross-sectional study using secondary data from routine records of aggregate monthly NCD reports. Data were analysed using Open EPI and comparisons were made between the post-Ebola and pre-Ebola/Ebola periods using the chi square test. Results: There were 10,011 people reported with NCDs during the three six-month periods, with 6194 (62%) presenting at peripheral health units (PHU). Reported NCDs decreased during Ebola and increased post-Ebola, but did not recover to pre-Ebola levels. Hypertension cases remained fairly constant throughout being mainly managed at PHU. Numbers with diabetes mellitus generally stayed the same except for a significant post-Ebola increase in tertiary hospitals. Small numbers were reported with mental health disorders across all facilities in all time periods. Conclusion: NCD reporting is recovering in the immediate post-Ebola period. Decentralization of NCD care is welcome and is an effective strategy for management as evidenced by hypertension. To be successful, this must be supported by strengthening other elements of the health system such as training of health workers, robust information and referral systems and reliable medicine supply chains.
The time-course effects of talus taping on ankle dorsiflexion range of motion
Authors: Dearlove David J , Newman Ellesse , Zasada Matt 
Published: June 2019

Background/Aims Talus taping may be an effective physiotherapeutic treatment for equinus (passive dorsiflexion range of motion <10°). However, the time-course effects of this intervention are unknown. The aims of this study were to identify the effect that the application of talus tape for 48 hours during normal functional activities has on dorsiflexion range of motion, and to determine whether any changes in dorsiflexion range of motion persisted until 5 days after removal (study day 7). Methods A total of 16 healthy participants (mean age 28.3 ± 8 years) were recruited. Participants' were randomly assigned to control and intervention conditions. Baseline measures of dorsiflexion range of motion were taken in both ankles using the weight-bearing lunge test. The intervention ankle had talus tape applied, which remained in place for 48 hours during normal functional activities. To determine the time-course effects, dorsiflexion range of motion was reassessed in the control and intervention ankles immediately following removal of the tape (at 48 hours) and again 5 days later, on day 7. Findings Dorsiflexion range of motion in the taped intervention ankle increased significantly between the baseline and 48-hour measures. However, when reassessed at day 7, participants' dorsiflexion range of motion had returned to baseline levels. There were no significant differences in the control ankle across all three measures. Conclusions Applying talus tape for 48 hours during normal functional activities results in immediate but not long-lasting changes in dorsiflexion range of motion.
The effects of the Mulligan concept in ankylosing spondylitis: a report of two cases
Authors: Baglan-Yentur Songül , Mete Oğuzhan , Tuna Zeynep , Tufan Abdurrahman , Oskay Deran 
Published: June 2019

Introduction/Aims The first complaint in ankylosing spondylitis is usually sacroiliac joint pain and morning stiffness. Aside from inflammation, sacroiliac joint pain is related to joint damage and mechanical stress. Many different methods are applied in the treatment of sacroiliac joint pain. This study aimed to investigate the effects of sacroiliac joint mobilisation on pain, function and mobility in patients with ankylosing spondylitis. Methods Two patients presented with sacroiliac joint pain: a 46-year-old male and a 34-year-old female. Both patients received eight sessions of mobilisation with movement, according to the Mulligan concept (sacroiliac joint mobilisation and mechanical correction). Sessions were held at 4-day intervals over a 28-day period. The patients were assessed for sacroiliac joint mobilisation immediately before and after the first session and their pain, function and mobility were assessed at the second and eighth sessions. Findings A decrease in pain and increases in functional performance and mobility were noted in both cases at the end of eight sessions. Conclusions Sacroiliac joint mobilisation might be effective in improving pain, function and mobility in patients with ankylosing spondylitis. Further studies should be conducted with an increased number of participants to confirm these findings.
The older person with diabetes: considerations for care
Authors: Hill Jill 
Published: June 2019

The UK has an ageing population more and more elderly people are living with diabetes. Jill Hill explores the condition as well as other healthcare challenges that comes with caring for this particular patient group With the increasingly ageing population worldwide, more older people are living with diabetes. The conditions that often accompany older age, such as dementia, renal impairment, visual impairment and manual dexterity difficulties, can make diabetes management complex and self-care challenging. However, the status of older people varies considerably, and so choice of glucose-lowering agents and clinical targets should be individualised to maximise safety and ensure that the risks of treatments do not outweigh the benefits. For many patients, there will be an increasing dependence on others to manage their diabetes care, therefore an appropriate skill mix among health professionals and carers, adequate training and regular competency assessment are crucial to support patients to remain safe and symptom free from diabetes.
Direct Detection of Monoclonal Free Light Chains in Serum by Use of Immunoenrichment-Coupled MALDI-TOF Mass Spectrometry
Authors: Sepiashvili Lusia , Kohlhagen Mindy C , Snyder Melissa R , Willrich Maria A V , Mills John R , Dispenzieri Angela , Murray David L 
Published: June 2019

Abstract

BACKGROUND
Free light chain (FLC) quantification is the most analytically sensitive blood-based method commercially available to diagnose and monitor patients with plasma cell disorders (PCDs). However, instead of directly detecting monoclonal FLCs (mFLCs), FLC assays indirectly assess clonality based on quantifying κ and λ FLCs and determination of the к/λ FLC ratio. Often an abnormal FLC ratio is the only indication of a PCD, and confirmation by a direct method increases diagnostic confidence. The aim of this study was to develop an analytically sensitive method for direct detection of mFLCs.

METHODS
Patient sera (n = 167) previously assessed by nephelometric FLC quantification and immunofixation electrophoresis (IFE) were affinity enriched for IgG, IgA, and total and free κ and λ light chains and subjected to MALDI-TOF MS. Relative analytical sensitivity of these methods was determined using serially diluted sera containing mFLCs.

RESULTS
In sera with abnormal FLC ratios (n = 127), 43% of monoclonal proteins were confirmed by IFE, 57% by MALDI-TOF MS without FLC enrichment, and 87% with FLC enrichment MALDI-TOF MS. In sera with normal FLC ratios (n = 40), the FLC MALDI-TOF MS method identified 1 patient with an mFLC. Serial dilution and analysis of mFLC containing sera by IFE, nephelometry, and FLC MALDI-TOF MS demonstrated that FLC MALDI-TOF MS analysis had the highest analytical sensitivity.

CONCLUSIONS
FLC immunoenrichment coupled to MALDI-TOF MS enables direct detection of mFLCs and significantly increases the confirmation of abnormal serum FLC ratios over IFE and MALDI-TOF MS without FLC enrichment, thereby providing added confidence for diagnosing FLC PCDs.
OS PRECEDENTES VINCULANTES E O PROBLEMA DA CONTINGÊNCIA ONTOLÓGICA DO DIREITO
Authors: Pinto Gerson Neves , Raatz Igor , Dietrich William Galle 
Published: June 2019

O presente artigo visa revisitar o problema da contingência ontológicado Direito nas lições aristotélicas, com o fito de esclarecer como o Estagirita pensou a diferença entre praxis e poiêsis. Com isso, pretende-se sustentar que as teses precedentalistas no Brasil – sobretudo aquelas que enraizam seus objetivos teóricos na busca por mecanismos que forneçam previsibilidade e certeza ao Direito – ignoram que o problema de indeterminação do Direito é um problema ontológico, que não pode ser resolvido com nenhum “aparato epistemológico” e, por isso, passam a sustentar a cisão entre interpretação e aplicação. Em sede de conclusão, pretende-se, assim, demonstrar que o próprio marco inicial (ou o fundamento) de tais teorias é equivocado, motivo pelo qual todo o desenvolvimento teórico restante fica comprometido.
ATIVISMO JUDICIAL E CONSTRUÇÃO DO DIREITO CIVIL: ENTRE DOGMÁTICA E PRÁXIS
Authors: Tepedino Gustavo 
Published: June 2019

O triunfo do constitucionalismo democrático e da doutrina da efetividadetraz consigo um novo papel do intérprete. A magistratura, nesse contexto, possui a responsabilidade de concretizar, a partir da atividade jurisdicional, os valores e os fins constitucionais, o que, por vezes, poderá representar ativismo judicial, na medida em que se revelar necessário interferir na esfera de atuação dos demais poderes. A noção de ativismo, portanto, como ruptura do formalismo positivista, mostra-se benfazejo e alvissareiro método hermenêutico em prol da efetividade dos comandos constitucionais, contanto que se estabeleçam balizas predefinidas para a atuação do magistrado, evitando, assim, desequilíbrio na moldura institucional em que se assentam as democracias contemporâneas. Oartigo propõe, nessa linha, reflexão acerca do ativismo judicial na experiência brasileira. Procura-se ilustrar os perigos que se camuflam na adoção de técnica interpretativa conservadora na figura dos sete pecados capitais.