bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Glucocorticoids on the Clinical and Radiographic Efficacy of Tofacitinib in Patients with Rheumatoid Arthritis: A Posthoc Analysis of Data from 6 Phase III Studies
Authors: Charles-Schoeman Christina , van der Heijde Désirée , Burmester Gerd R. , Nash Peter , Zerbini Cristiano A.F. , Connell Carol A. , Fan Haiyun , Kwok Kenneth , Bananis Eustratios , Fleischmann Roy 
Published: November 2017

Objective.Tofacitinib has been investigated for the treatment of rheumatoid arthritis (RA) in phase III studies in which concomitant glucocorticoids (GC) were allowed. We analyzed the effect of GC use on efficacy outcomes in patients with RA receiving tofacitinib and/or methotrexate (MTX) or conventional synthetic disease-modifying antirheumatic drugs (csDMARD) in these studies.Methods.Our posthoc analysis included data from 6 phase III studies (NCT01039688; NCT00814307; NCT00847613; NCT00853385; NCT00856544; NCT00960440). MTX-naive patients or patients with inadequate response to csDMARD or biological DMARD received tofacitinib 5 or 10 mg twice daily alone or with csDMARD, with or without concomitant GC. Patients receiving GC (≤ 10 mg/day prednisone or equivalent) before enrollment maintained a stable dose throughout. Endpoints included the American College of Rheumatology (ACR) 20/50/70 response rates, rates of Clinical Disease Activity Index (CDAI)-defined low disease activity (LDA; CDAI ≤ 10) and remission (CDAI ≤ 2.8), and changes from baseline in CDAI, 28-joint count Disease Activity Score (DAS28-4)–erythrocyte sedimentation rate (ESR), Health Assessment Questionnaire–Disability Index (HAQ-DI), pain visual analog scale (VAS), and modified total Sharp score.Results.Of 3200 tofacitinib-treated patients, 1258 (39.3%) received tofacitinib monotherapy and 1942 (60.7%) received tofacitinib plus csDMARD; 1767 (55.2%) received concomitant GC. ACR20/50/70 response rates, rates of CDAI LDA and remission, and improvements in CDAI, DAS28-4-ESR, HAQ-DI, and pain VAS with tofacitinib were generally similar with or without GC in monotherapy and combination therapy studies. GC use did not appear to affect radiographic progression in tofacitinib-treated MTX-naive patients. MTX plus GC appeared to inhibit radiographic progression to a numerically greater degree than MTX alone.Conclusion.Concomitant use of GC with tofacitinib did not appear to affect clinical or radiographic efficacy. MTX plus GC showed a trend to inhibit radiographic progression to a greater degree than MTX alone.
CD169+ Macrophages Restrain Systemic Inflammation Induced by Staphylococcus aureus Enterotoxin A Lung Response
Authors: Svedova Julia , Ménoret Antoine , Yeung Stephen T , Tanaka Masato , Khanna Kamal M , Vella Anthony T 
Published: November 2017

Abstract
Alveolar macrophages (AMs) are considered the first line of defense in the airways. Exposure to harmful substances and certain infections can lead to dysfunction or depletion of AMs. Importantly, these conditions have been associated with increased risk of sepsis and acute lung injury. Staphylococcus aureus enterotoxins are superantigens that induce oligoclonal activation of T cells and a robust cytokine release, leading to systemic inflammatory response and tissue injury. In this study we investigated the relationship between S. aureus enterotoxins and AMs. Following inhalation, S. aureus enterotoxin was preferentially bound to AMs and MHC class II was not required. Furthermore, the enterotoxin was internalized and its presence in the cells decreased by 24 h after exposure. Ablation of AMs in CD169–diphtheria toxin receptor mice was associated with increased activation of enterotoxin-specific T cells and enhanced cytokine release into circulation. Thus, conditions causing depletion of AMs may increase the risk of S. aureus enterotoxin–induced diseases.
Calling Injury Timeouts for the Medical Evaluation of Concussion: Determinants of Collegiate Football Officials' Behavior
Authors: Kroshus Emily , Parsons John , Hainline Brian 
Published: November 2017

Context:
Sports officials can play an important role in concussion safety by calling injury timeouts so that athletic trainers can evaluate athletes with possible concussions. Understanding the determinants of whether officials call an injury timeout when they suspect a concussion has important implications for the design of interventions to better support officials in this role.

Objective:
To assess the knowledge of US collegiate football officials about concussion symptoms and to determine the associations between knowledge, perceived injunctive norms, and self-efficacy in calling injury timeouts for suspected concussions.

Design:
Cross-sectional study.

Setting:
Electronic survey.

Patients or Other Participants:
Of the 3074 US collegiate football officials contacted, 1324 (43% response rate) participated.

Main Outcome Measure(s):
Concussion knowledge, injunctive norms (belief about what others would want them to do), and behavioral self-efficacy (confidence in their ability to call injury timeouts for suspected concussions in athletes during challenging game-day conditions).

Results:
Officials reported calling approximately 1 injury timeout for a suspected concussion every 4 games during the 2015 season. Structural equation modeling indicated that officials with more concussion-symptom knowledge had greater self-efficacy. Independent of an official's symptom knowledge, injunctive norms that were more supportive of calling an injury timeout were associated with greater self-efficacy.

Conclusions:
Concussion education for officials is important because when officials are aware of concussion symptoms, they are more confident in calling injury timeouts. Beyond increasing symptom knowledge, fostering sports environments that encourage concussion safety can support officials in calling injury timeouts. Athletic trainers can help by educating stakeholders, including officials, about the importance of concussion safety. When officials believe that other stakeholders support concussion safety, they are more likely to call injury timeouts if they suspect a concussion has occurred.
Predictors of Dropout from Outpatient Mental Health Services; A Study from Rohtak, India
Authors: Jain Nikhil , Arya Sidharth , Gupta Rajiv 
Published: November 2017

ABSTRACT
Context: Dropout from mental health services is problematic in both developed and developing nations and often leads to poor outcomes. There is a lack of hospital-based studies assessing the factors responsible for treatment dropout from mental health services in Indian settings. This study aims to contribute in that direction by presenting a study done in a tertiary care hospital in North India. Methodology: This was a hospital-based retrospective chart review carried out on randomly selected 139 patients at a tertiary hospital from January 1, 2014, to June 30, 2014. For this chart review, an abstraction form was designed that recorded six sociodemographic variables, nine clinical factors, and two outcome variables (more than one follow-up and active follow-up till 6 months). Results: Out of 139 patients, 53 patients dropped out after the first visit and 105 patients dropped out by the end of 6 months. Lower education status (odds ratio [OR] = 8.2, 95% confidence interval [CI]: 2.30–29.50), severe mental illness (OR = 2.6, 95% CI: 1.05–6.49), and early referral to clinical psychologist (CP) (OR = 7.8, 95% CI: 1.87–6.49) were predictors of better rates of follow-up after first visit. Lower education status (OR = 4.9, 95% CI: 1.45–17.08), early referral to CP (OR = 5.8, 95% CI: 2.09–38.35), and previous treatment history (OR = 8.9, 95% CI: 1.97–17.52) were predictors of better rates of follow-up at the end of 6 months. Conclusion: The findings that education status, diagnosis, utilizing services of CP, and psychiatric services in past are correlated with dropout rates may be helpful in targeting patients who are more vulnerable to dropping out of care in the given setting.
Sir Hugh Cairns: The Neurosurgeon Who Introduced Crash Helmets
Authors: Sundaravadhanan Shahsivadhanan Col 
Published: November 2017

ABSTRACTStatistics prove that more Indians die in Road traffic related accidents than in wars. Prior to World War II, the death toll across the world used to be very high. It was at this juncture that a Military Neurosurgeon named Hugh Cairns introduced the compulsory wearing of crash helmets and brought about a reduction in mortality by more than 50%. Within a decade of introduction of crash helmets in Britain, the entire world followed suit. The results of his efforts are here for all of us to see. This innovative military neurosurgeon is credited as the one who introduced the concept of mobile neurosurgical units during world war and also the first proponent of usage of penicillin in war. His concepts in war surgery are still followed by militaries across the world. This article comes as a tribute to this great Neurosurgeon who helped in saving millions of lives.
How Long does Denervation Take in Poliomyelitis? Or is it a Lifetime?”
Authors: Şenol Mehmet Güney , Kaplan Cengiz , Ozdağ Fatih , Saraçoğlu Mehmet 
Published: November 2017

ABSTRACT
Background and Objective: This study aims to determine the period of reinnervation in patients with poliomyelitis. This research was conducted to identify the appearance of denervation potentials in patients with poliomyelitis as indicators for reinnervation. Materials and Methods: A total of 246 male patients with poliomyelitis were assessed electrophysiologically between 1988 and 2007. The mean age was 22.8 (18±42). It has been an average of 19.9 ± 4.9 years since the beginning of complaints from the patients. Results: The patients had no complaints of newly developing muscle weakness, fatigue, muscle and joint pain, and difficulties in breathing and swallowing. Neurological examinations revealed the absence of myotomal pain and sensory loss. Upon assessment of the patients' limbs, the following findings were revealed: two patients had left upper and lower limb involvement, two patients had left upper and right lower limb involvement, 6 patients had left upper limb involvement, 12 patients had both lower limb involvement, 105 patients had left lower limb involvement, 1 patient had both upper limb involvement, 2 patients had right lower and upper limb involvement, 12 patients had right upper limb involvement, 6 patients had both lower limb involvement, 95 patients had right lower limb involvement, and 3 had all the three extremities affected. The needle electromyography revealed the presence of denervation potentials in 25.2% (62) of the patients. Conclusion: When poliovirus attacks the motor neuron, this neuron may be completely destroyed, damaged, or unaffected. Reinnervation occurs when nearby functioning motor units send out terminal axon sprouts to reinnervate the damaged muscle fibers. As a consequence of poliomyelitis, several muscle fibers become atrophic and fibrotic, but others continue to survive. This study showed that patients with a history of poliomyelitis experienced denervation with subsequent reinnervation for many years.
Clinical Evaluation and Diagnostic Utilities of Different Nerve Conduction Tests in 100 Patients with Carpal Tunnel Syndrome
Authors: Chaurasia Rameshwar Nath , Kawale Sagar S. , Pathak Abhishek , Mishra Vijaya Nath , Joshi Deepika 
Published: November 2017

ABSTRACT
Background and Purpose: The purpose of the study is to determine whether the clinical profile of patients with carpal tunnel syndrome (CTS) has been same over the years with the help of routine and comparative electrodiagnostic tests. Methods: A prospective study of 100 patients with suspected CTS was conducted without controls. Three provocative maneuvers were performed. Routine and comparison nerve conduction tests were performed, i.e., second lumbrical interossei motor latency difference (2 LIMLD), digit 4 median-ulnar sensory latency difference (D4MUSLD), palm wrist distal sensory latency difference (PWDSLD), and digit 1 median-radial sensory latency difference (D1MRSLD). Data entry, analysis, and statistical evaluation were done using International Business Machines Corporation Statistical Package for the Social Sciences statistics package (IBM, SPSS). Results: A total of 195 hands of 100 patients met the criteria for CTS. Forty-three percentage of patients were homemakers. Considering the rapidly changing communication technology, we observed 84% patients had aggravation of symptoms with continuous long-term daily mobile phone use (>30 min per session per day). We noted positive Tinel's sign in only 25%. Phalen's sign was positive in 53 right hands with mean duration of 11.49s (standard deviation [SD] ± 2.54 s) and was positive in 26 left hands with mean being 10.4 s (SD ± 1.91 s). The mean motor distal latency of median was 4.67 ms (SD ± 1.71 ms) and mean sensory distal latency of median was 3.24 ms (SD ± 1 ms). On internal comparison testing, mean difference in 2 LIMLD was 0.7 ± 0.3 ms, in D4MUSLD was 0.81 ± 0.32, in PWDSLD was 0.71 ± 0.20, and in D1MRSLD was 0.76 ± 0.32. Conclusion: Further analysis of clinical profile needs to be done, and new risk or provoking factors should be analyzed in patients with CTS.
Staged Multimodality Treatment of a Large Ruptured Fusiform Supraclinoid Internal Carotid Artery Aneurysm: Microsurgical Clip.assisted Endovascular Coiling
Authors: Ding Dale , Buell Thomas J. , Chen Ching-Jen , Raper Daniel M. , Liu Kenneth C. , Vollmer Dennis G. 
Published: November 2017

ABSTRACTIn the contemporary era of aneurysm management, large fusiform aneurysms presenting with subarachnoid hemorrhage (SAH) remain particularly challenging lesions to successfully manage. We describe a staged, multimodal treatment strategy for a 71-year-old patient who presented with a large ruptured fusiform aneurysm of the supraclinoid internal carotid artery (ICA) and a fetal posterior communicating artery which originated from the inferomedial aspect of the aneurysm. In the first stage, we performed a partial microsurgical clip reconstruction of the fusiform aneurysm and secured its rupture site, which was identified intraoperatively. This left two residual saccular components of the aneurysm, which were targeted with endovascular coiling in the same hospitalization after the patient had convalesced from the SAH and was beyond the vasospasm window. We believe that this combined approach of clip-assisted coiling can be employed instead of endovascular flow diversion or microsurgical bypass for appropriately selected patients with ruptured fusiform ICA aneurysms.
Histopathologic Review of Previously Negative Prostatic Core Needle Biopsies following a New Diagnosis of Adenocarcinoma of the Prostate by Core Needle Biopsies: Implications for Quality Assurance Programs
Authors: Patel Jay , Layfield Lester J. 
Published: November 2017

Programs for quality assurance are increasingly important in surgical pathology. Many quality assurance (QA) techniques for surgical pathology were adopted from procedures introduced in cytopathology. Surgical pathology specimens have diminished in size such that the majority of diagnostic biopsies of prostatic lesions are now core needle biopsies. These specimens raise issues similar to those of cytology specimens, including concerns regarding adequacy and the representative nature of the biopsy. Due to sample size, some neoplasms may not be diagnosed on initial biopsy, raising concerns regarding false negative results. Cytopathologists have instituted QA procedures including review of all previously negative slides received within five years prior to the new diagnosis of high grade squamous intraepithelial lesion or gynecologic malignancy. No such requirement exists in surgical pathology for review of core biopsies. The Department of Pathology at the University of Utah instituted a QA policy requiring review of prior negative prostatic needle biopsies following a new diagnosis of prostatic adenocarcinoma. We reviewed five years of QA records of prostate needle biopsy review. During this time, nine hundred and fifty-eight core biopsy sets were performed. Two hundred and ninety-five of these contained at least one biopsy with a diagnosis of adenocarcinoma. Two hundred and eight patients had a prior set of prostatic needle biopsies with a diagnosis of adenocarcinoma. The remaining 87 had prior biopsies with either a diagnosis of prostatic intraepithelial neoplasia (23), small atypical acinar proliferation (21) or no evidence of malignancy (43). QA review of these 87 cases revealed two biopsies which revealed foci of adenocarcinoma. Both had been initially diagnosed as no evidence of malignancy. The false negative rate for core biopsy was 0.68%. In an additional twenty-one cases, microscopic foci of atypical small acinar proliferations were found in core biopsies antedating the positive core biopsy (7.1%).
Combination of Immunohistochemistry and Ploidy Analysis to Assist Histopathological Diagnosis of Molar Diseases
Authors: Osterheld M.C. , Caron L. , Chaubert P. , Meagher-Villemure K. 
Published: November 2017

Background Differential diagnosis between hydropic abortion, partial mole and complete mole is still a challenge for pathologists but really important for patient management. Material and Method In this study, we have evaluated 111 products of conception from the first trimester. Histological analysis was made according to the main diagnostic histopathological features described in the literature and the cases were categorized in hydropic abortus (HA), partial mole (PM) and complete mole (CM). Immunohistochemistry was performed using monoclonal antibody against p57kip protein a putative paternally imprinted inhibitor gene and DNA ploidy was analysed in all cases by image cytometry. Results All 23 HAs presented a diploid DNA content and were p57kip2 positive. From the 28 CMs, 12 cases (43%) were diploid and 16 cases (57%) were tetraploid but no expression of p57kip2 was found with positive internal controls. From the 60 PMs, 58 cases were positive for p57kip2 expression and 53 cases (88%) were triploid, 6 cases (10%) tetraploid and 1 case (2%) diploid. Conclusion This study on 111 cases of early pregnancies confirms the usefulness of immunohistochemistry and cytometry but demonstrates the importance of the combination of both techniques to assist histology for the best reliable diagnosis.
O corpo na contemporaneidade: Uma análise psicanalítica do trabalho na alta complexidade hospitalar
Authors: Santana Cunha Larissa , Mandelli de Marsillac Ana Lúcia 
Published: November 2017

Este artigo é fruto de uma pesquisa que analisa as inter-relações entre a lógica dominante contemporânea e as práticas de trabalho de profissionais da alta complexidade hospitalar, através de dois analisadores: o corpo e o tempo. Com base na teoria psicanalítica, sustentam-se as concepções destes dois analisadores e o método. A pesquisa envolveu a realização de entrevistas semi-estruturadas com profissionais das unidades de internação e construção de diário de campo. Os resultados revelaram principalmente que há uma forte relação entre o corpo do profissional e do paciente, e que não é simples deparar-se com o corpo enfermo em sua complexidade biopsicossocial. Além disso, indicaram um corpo que cansa e se angustia no trabalho hospitalar em decorrência da relação com o corpo enfermo e com o corpo institucional. Também apontaram um tempo veloz e ágil, que permeia o cotidiano de trabalho do início ao fim, agindo na escassez de reflexões sobre as práticas desenvolvidas na instituição. Conclui-se que estes aspectos interferem nos modos de vivenciar o trabalho e nos processos de produção de saúde. Versión en españolEste trabajo es el resultado de una investigación que analiza las interrelaciones entre la lógica dominante contemporánea y las prácticas de trabajo de profesionales de alta complejidad hospitalaria a través de dos nociones clave: el cuerpo y el tiempo. Los fundamentos de esas nociones y del método se sostienen en la teoría psicoanalítica. La investigación se valió de entrevistas semi-estructuradas con profesionales de las unidades de hospitalización y en el uso de un diario de campo. Los resultados indicaran sobretodo una fuerte relación entre el cuerpo del profesional y del paciente, así como la dificultad de uno encarar el cuerpo enfermo en su complejidad biopsicosocial. Los datos también apuntaran un cuerpo que se cansa y angustia en el trabajo hospitalario frente a la relación con el cuerpo enfermo y el cuerpo institucional. Aún indicaron un tiempo rápido y ágil, que impregna el trabajo diario de principio a fin, influyendo en la escasez de reflexiones sobre las prácticas desarrolladas en la institución. Concluimos que estos aspectos afectan a los modos de experimentar el trabajo, así como a los procesos de producción de salud.
Cloud climatologies from the infrared sounders AIRS and IASI: strengths and applications
Authors: Stubenrauch Claudia J. , Feofilov Artem G. , Protopapadaki Sofia E. , Armante Raymond 
Published: November 2017

Abstract. Global cloud climatologies have been built from 13 years of Atmospheric Infrared Sounder (AIRS) and 8 years of Infrared Atmospheric Sounding Interferometer (IASI) observations, using an updated Clouds from Infrared Sounders (CIRS) retrieval. The CIRS software can handle any infrared (IR) sounder data. Compared to the original retrieval, it uses improved radiative transfer modelling, accounts for atmospheric spectral transmissivity changes associated with CO2 concentration and incorporates the latest ancillary data (atmospheric profiles, surface temperature and emissivities). The global cloud amount is estimated to be 0.67–0.70, for clouds with IR optical depth larger than about 0.1. The spread of 0.03 is associated with ancillary data. Cloud amount is partitioned into about 40 % high-level clouds, 40 % low-level clouds and 20 % mid-level clouds. The latter two categories are only detected in the absence of upper clouds. The A-Train active instruments, lidar and radar of the CALIPSO and CloudSat missions, provide a unique opportunity to evaluate the retrieved AIRS cloud properties. CIRS cloud height can be approximated either by the mean layer height (for optically thin clouds) or by the mean between cloud top and the height at which the cloud reaches opacity. This is valid for high-level as well as for low-level clouds identified by CIRS. IR sounders are particularly advantageous to retrieve upper-tropospheric cloud properties, with a reliable cirrus identification, day and night. These clouds are most abundant in the tropics, where high opaque clouds make up 7.5 %, thick cirrus 27.5 % and thin cirrus about 21.5 % of all clouds. The 5 % annual mean excess in high-level cloud amount in the Northern compared to the Southern Hemisphere has a pronounced seasonal cycle with a maximum of 25 % in boreal summer, in accordance with the moving of the ITCZ peak latitude, with annual mean of 4° N, to a maximum of 12° N. This suggests that this excess is mainly determined by the position of the ITCZ. Considering interannual variability, tropical cirrus are more frequent relative to all clouds when the global (or tropical) mean surface gets warmer. Changes in relative amount of tropical high opaque and thin cirrus with respect to mean surface temperature show different geographical patterns, suggesting that their response to climate change might differ.