bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of feline splenic radiographic measurements and their correlation to ultrasonographic measurements
Authors: Johnson Kryssa L , Porter Erin G , Berry Clifford R 
Published: September 2016

Objectives The purpose of this study was to establish a method for feline splenic measurement on abdominal radiographs and evaluate for correlation between the radiographic measurements and ultrasonographic measurements. Methods One hundred cats with normal abdominal radiographs and ultrasound (US) studies of the spleen were evaluated. The hypothesis was that the measurement of the spleen on the radiographs would correlate with the measurement of the spleen on US. The radiographic and ultrasonographic measurements were tabulated and compared using linear regression and t-tests using unequal variances. Results The measurement of the spleen on the ventrodorsal projection was characterized as one of three shapes (A, B or C), and thereby based on the thickest part of the spleen (when corrected for radiographic magnification: A = 9.9 ± 2.2 mm; B = 8.1 ± 1.8 mm; C = 8.0 ± 2.3 mm). There were 48 cats where the head of the spleenwas seen on the right lateral (n = 10), the left lateral (n = 24) or both (n = 14) projections. On one left lateral, both the head and tail of the spleen were seen. There was weak correlation between the radiographic and US measurements(R ⩼0.6). Splenic thickness of shape A on the ventrodorsal projection was significantly greater than categories B and C. Conclusions and relevance Radiographic measurement of the spleen is not a reliable indicator of its ultrasonographic measurement. The ultrasonographic measurements seen in this study (mean of 8.0 ± 1.6 mm) were similar to measurements of the spleen reported in previous studies. It is rare to see the tail of the spleen on lateral feline abdominal radiographs.
Longitudinal changes of cerebral glutathione (GSH) levels associated with the clinical course of disease progression in patients with secondary progressive multiple sclerosis
Authors: Choi In-Young , Lee Phil , Hughes Abbey J , Denney Douglas R , Lynch Sharon G 
Published: September 2016

Background: Increased oxidative stress leads to loss of glutathione (GSH). We have reported lower cerebral GSH in patients with secondary progressive multiple sclerosis (SPMS), indicating the involvement of oxidative stress in multiple sclerosis (MS) pathophysiology. Objective: This study expanded upon our earlier work by examining longitudinal changes in cerebral GSH in patients with SPMS in relation to their clinical status. Methods: A total of 13 patients with SPMS (Expanded Disability Status Scale (EDSS) = 4.0–6.5; MS duration = 21.2 ± 8.7 years) and 12 controls were studied over 3–5 years. GSH mapping was acquired from frontal and parietal regions using a multiple quantum chemical shift imaging technique at 3 T. Clinical assessments of the patient’s disability included EDSS, gait, motor strength, ataxia, tremor, brainstem function and vision changes. Results: Brain GSH concentrations in patients were lower than those in controls for both baseline and 3- to 5-year follow-ups. Longitudinal GSH changes of patients were associated with their neurologist’s blinded appraisal of their clinical progression. Patients judged to have worsening clinical status had significantly greater declines in frontal GSH concentrations than those with stable clinical status. Conclusion: GSH provides a distinct measure associated with the disease progression in SPMS, possibly due to its dynamic alignment with pathogenic processes of MS related to oxidative stress.
Ethnic/Racial, Religious, and Demographic Predictors of Organ Donor Registration Status Among Young Adults in the Southwestern United States
Authors: Ginossar Tamar , Benavidez Julian , Gillooly Zachary D. , Kanwal Attreya Aarti , Nguyen Hieu , Bentley Joshua 
Published: September 2016

Context and Setting: New Mexico (NM) is a minority–majority state. Despite its unique cultural characteristics and documented ethnic/racial disparities in deceased organ donation (DOD), past studies did not explore predictors of organ donor registration status (ODRS) in this state. Objectives: This study aimed at identifying demographic, cultural, and religious predictors of ODRS among a diverse sample of young adults in NM. Design: This study focused on recruitment of American Indian, Hispanic, and Asian American participants through online social network sites and university listservs. Participants (N = 602) answered an online survey. The largest racial/ethnic group included American Indians (n = 200). Main outcome measures included ODRS, demographics, religious affiliation, and open-ended question on reasons for objections to DOD. Results: Race/ethnicity, religion, and educational attainment were significant predictors of ODRS. Non-Hispanic whites (NHWs) were most likely to be registered as donors, with no significant difference between NHWs and Asians or Pacific Islanders. Non-Catholic Christians were most likely to be registered donors, followed by Catholics, practitioners of American Indian/Native American traditional religions, and Hindus, with Buddhists the least likely to register. This pattern was consistent with the propensity of individuals from these religious groups to cite religious objections to DOD. Finally, respondents who had graduated from high schools in NM were 2.3 times less likely to be registered as organ donors compared to those who had graduated in other states. Conclusion: This study provides evidence for the need for culturally tailored interventions targeting diverse communities in NM.
The utility of electronic health record-based hygiene notes for chlorhexidine bathing practice evaluation
Authors: Kettelhut Valeriya , Van Schooneveld Trevor , McClay James , Fruhling Ann , Dempsey Kathryn 
Published: September 2016

Background: Unreliable compliance with infection prevention procedures necessitates an analysis of contributing factors. Methods: A retrospective study explored utility of 3236 nursing hygiene notes in the electronic healthcare record system (EHR). This 2012–2013 study identified defects in the chlorhexidine (CHG) bathing practice for a hospital unit. Results: The overall compliance with CHG bathing was 22.99%. Patients with length of stay less than 3 days, in most cases, did not have documentation for CHG bathing. Patient refusal to bathe was the most prevalent documented reason (66%) of the unsuccessful initial and repeated offers to bathe. The regular staff were statistically less successful in convincing patients to bathe. The 1455 notes produced by the regular staff (n = 10) demonstrated a significantly higher failure rate (56.08%) to execute this procedure in comparison with 1770 notes documented by the 246 temporary staff (31.19% failure rate) ( P value <0.001) . Discussion: This analysis yielded three main insights: lack of the CHG documentation in a large number of short admissions; inconsistent use of CHG baths; and presence of workarounds due to patient refusals to bathe. The study concluded that EHR structured and unstructured data can unlock the opportunity for identifying hidden defects and inform decision-makers about the need for change.
Early Detection of Infusion Set Failure During Insulin Pump Therapy in Type 1 Diabetes
Authors: Cescon Marzia , DeSalvo Daniel J. , Ly Trang T. , Maahs David M. , Messer Laurel H. , Buckingham Bruce A. , Doyle Francis J. , Dassau Eyal 
Published: September 2016

Background: Insulin infusion set failure resulting in prolonged hyperglycemia or diabetic ketoacidosis can occur with pump therapy in type 1 diabetes. Set failures are frequently characterized by variable and unpredictable patterns of increasing glucose values despite increased insulin infusion. Early detection may minimize the risk of prolonged hyperglycemia, an important consideration for automated insulin delivery and closed-loop applications. Methods: A novel algorithm designed to alert the patient to the onset of infusion set failure was developed based upon continuous glucose sensor values and insulin delivered from an insulin pump. The method was calibrated on 12 weeks of infusion set wear without failures recorded by 4 patients in ambulatory conditions and prospectively validated on 18 weeks of infusion set wear with and without failures belonging to 9 other subjects in ambulatory conditions. Results: The algorithm, evaluated retrospectively, identified a failure 2.52 ± 1.91 days ahead of the actual event as recorded by the clinical team, corresponding to 50% sensitivity, 66% specificity and 55% accuracy. If set failure alarms had been activated in real time, the average time >180 mg/dl would be reduced from 82.7 ± 40.9 hours/week/subject (without alarm) to 58.8 ± 31.1 hours/week/subject (with alarm), corresponding to a potential 29% reduction in time spent >180mg/dl. Conclusion: The proposed method for early detection of infusion set failure based on glucose sensor and insulin data demonstrated favorable results on retrospective data and may be implemented as an additional safeguard in a future fully automated closed-loop system.
Do We Need Updated Guidelines on the Use of Insulin Pump Therapy in Type 2 Diabetes? A Review of National and International Practice Guidelines
Authors: Cohen Ohad , Valentine William 
Published: September 2016

Background: Continuous subcutaneous insulin infusion (CSII) is used less for type 2 than for type 1 diabetes because of inconsistencies in evidence of effectiveness. We reviewed published guidelines on intensive insulin therapy in type 2 diabetes to assess whether updating of guidance is needed with respect to evidence used and recommendations for CSII in diabetes management. Methods: A literature review was performed to identify published national and international guidelines on type 2 diabetes management. Searches were performed using PubMed, Cochrane Library, and Embase databases, and websites of national health care agencies, reimbursement agencies, and professional associations. Searches were limited to articles published in English between 2004 and 2014 and 1666 unique hits were identified, of which 22 were reviewed following screening. Results: Only 6 of the 22 guidelines identified from North and South America, Western Europe, Greece, and Israel provided specific recommendations on intensive insulin therapy and the role of CSII, and only 1 provided information on the grade of evidence supporting recommendations. Quality appraisal based on the AGREE II tool suggested that published guidelines may have limitations in terms of search methodology and evidence grading, and findings were of mixed rigor and clarity. Only 3 guidelines described the population for whom CSII may be appropriate. Conclusions: Guidelines need to improve the evidence base, rigor, clarity, and grading of evidence associated with recommendations on intensive insulin therapy in type 2 diabetes. Future updates may benefit from considering recent evidence on the efficacy of CSII in poorly controlled patients on MDI.
Exploration of the Performance of a Hybrid Closed Loop Insulin Delivery Algorithm That Includes Insulin Delivery Limits Designed to Protect Against Hypoglycemia
Authors: de Bock Martin , Dart Julie , Roy Anirban , Davey Raymond , Soon Wayne , Berthold Carolyn , Retterath Adam , Grosman Benyamin , Kurtz Natalie , Davis Elizabeth , Jones Timothy 
Published: September 2016

Background: Hypoglycemia remains a risk for closed loop insulin delivery particularly following exercise or if the glucose sensor is inaccurate. The aim of this study was to test whether an algorithm that includes a limit to insulin delivery is effective at protecting against hypoglycemia under those circumstances. Methods: An observational study on 8 participants with type 1 diabetes was conducted, where a hybrid closed loop system (HCL) (Medtronic™ 670G) was challenged with hypoglycemic stimuli: exercise and an overreading glucose sensor. Results: There was no overnight or exercise-induced hypoglycemia during HCL insulin delivery. All daytime hypoglycemia was attributable to postmeal bolused insulin in those participants with a more aggressive carbohydrate factor. Conclusion: HCL systems rely on accurate carbohydrate ratios and carbohydrate counting to avoid hypoglycemia. The algorithm that was tested against moderate exercise and an overreading glucose sensor performed well in terms of hypoglycemia avoidance. Algorithm refinement continues in preparation for long-term outpatient trials.
Comparisons of Patient Demographics in Prospective Sports, Shoulder, and National Database Initiatives
Authors: Saltzman Bryan M. , Cvetanovich Gregory L. , Bohl Daniel D. , Cole Brian J. , Bach Bernard R. , Romeo Anthony A. 
Published: September 2016

Background: There has been increased emphasis in orthopaedics on high-quality prospective research to provide evidence-based treatment guidelines, particularly in sports medicine/shoulder surgery. The external validity of these studies has not been established, and the generalizability of the results to clinical practice in the United States is unknown. Hypothesis: Comparison of patient demographics in major prospective studies of arthroscopic sports and shoulder surgeries to patients undergoing the same procedures in the National Surgical Quality Improvement Program (NSQIP) database will show substantial differences to question the generalizability and external validity of those studies. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This study utilized patients undergoing arthroscopic anterior cruciate ligament reconstruction (ACLR), meniscectomy (MX), rotator cuff repair (RCR), and shoulder stabilization (SS) from the NSQIP database (2005-2013). Two prospective studies (either randomized controlled trials or, in 1 case, a major cohort study) were identified for each of the 4 procedures for comparison. Demographic variables available for comparison in both the identified prospective studies and the NSQIP included age, sex, and body mass index (BMI). Results: From the NSQIP database, 5576 ACLR patients, 18,882 MX patients, 7282 RCR patients, and 993 SS patients were identified. The comparison clinical studies included cohort sizes as follows: ACLR, n = 121 and 2683; MX, n = 146 and 330; RCR, n = 90 and 103; SS, n = 88 and 196. Age differed significantly between the NSQIP and the patients in 6 of the 8 prospective clinical studies. Sex differed significantly between the NSQIP and the patients in 7 of the 8 prospective clinical studies. BMI differed significantly between the NSQIP and the patients of all 4 of the prospective clinical studies that reported this demographic variable. Conclusion: Significant differences exist for patient age, sex, and BMI between patients included in major sports medicine/shoulder prospective studies and corresponding patients undergoing the same procedures in a nationwide database of academic and community centers in the United States. Future work is needed to understand whether major prospective clinical studies—frequently performed in high-volume, specialized practices—are truly indicative of the types of patients treated and expected results in the general orthopaedic practice. This study additionally argues for the importance of initiating a national registry dedicated to patients undergoing orthopaedic procedures in the United States.
Long non-coding RNA XIST regulates gastric cancer progression by acting as a molecular sponge of miR-101 to modulate EZH2 expression
Authors: Chen Dong-liang , Ju Huai-qiang , Lu Yun-xin , Chen Le-zong , Zeng Zhao-lei , Zhang Dong-sheng , Luo Hui-yan , Wang Feng , Qiu Miao-zhen , Wang De-shen , Xu Da-zhi , Zhou Zhi-wei , Pelicano Helene , Huang Peng , Xie Dan , Wang Feng-hua , Li Yu-hong , Xu Rui-hua 
Published: September 2016

AbstractBackgroundLong non-coding RNAs (lncRNAs) have emerged as critical regulators of tumor progression. However, the role and molecular mechanism of lncRNA XIST in gastric cancer is still unknown.MethodsReal-time PCR analysis was performed to measure the expression levels of lncRNA XIST in gastric cancer tissues and cell lines, the correlation between lncRNA XIST expression and clinicopathological characteristics and prognosis was analyzed in gastric cancer patients. The biological function of lncRNA XIST on gastric cancer cells were determined both in vitro and in vivo. The regulating relationship between lncRNA XIST and miR-101 was investigated in gastric cancer cells.ResultslncRNA XIST was significantly up-regulated in gastric cancer tissues and cell lines. Overexpression of lncRNA XIST was markedly associated with larger tumor size, lymph node invasion, distant metastasis and TNM stage in gastric cancer patients. Functionally, knockdown of lncRNA XIST exerted tumor-suppressive effects by inhibiting cell proliferation, migration and invasion in vitro and tumor growth and metastasis in vivo. Furthermore, an inverse relationship between lncRNA XIST and miR-101 was found. Polycomb group protein enhancer of zeste homolog 2 (EZH2), a direct target of miR-101, could mediated the biological effects that lncRNA XIST exerted.ConclusionslncRNA XIST is up-regulated and is associated with aggressive tumor phenotypes and patient survival in gastric cancer, and the newly identified lncRNA XIST/miR-101/EZH2 axis could be a potential biomarkers or therapeutic targets for gastric cancer patients.
Drug development in Alzheimer’s disease: the path to 2025
Authors: Cummings Jeffrey , Aisen Paul S. , DuBois Bruno , Frölich Lutz , Jack Clifford R. , Jones Roy W. , Morris John C. , Raskin Joel , Dowsett Sherie A. , Scheltens Philip 
Published: September 2016

AbstractThe global impact of Alzheimer’s disease (AD) continues to increase, and focused efforts are needed to address this immense public health challenge. National leaders have set a goal to prevent or effectively treat AD by 2025. In this paper, we discuss the path to 2025, and what is feasible in this time frame given the realities and challenges of AD drug development, with a focus on disease-modifying therapies (DMTs). Under the current conditions, only drugs currently in late Phase 1 or later will have a chance of being approved by 2025. If pipeline attrition rates remain high, only a few compounds at best will meet this time frame. There is an opportunity to reduce the time and risk of AD drug development through an improvement in trial design; better trial infrastructure; disease registries of well-characterized participant cohorts to help with more rapid enrollment of appropriate study populations; validated biomarkers to better detect disease, determine risk and monitor disease progression as well as predict disease response; more sensitive clinical assessment tools; and faster regulatory review. To implement change requires efforts to build awareness, educate and foster engagement; increase funding for both basic and clinical research; reduce fragmented environments and systems; increase learning from successes and failures; promote data standardization and increase wider data sharing; understand AD at the basic biology level; and rapidly translate new knowledge into clinical development. Improved mechanistic understanding of disease onset and progression is central to more efficient AD drug development and will lead to improved therapeutic approaches and targets. The opportunity for more than a few new therapies by 2025 is small. Accelerating research and clinical development efforts and bringing DMTs to market sooner would have a significant impact on the future societal burden of AD. As these steps are put in place and plans come to fruition, e.g., approval of a DMT, it can be predicted that momentum will build, the process will be self-sustaining, and the path to 2025, and beyond, becomes clearer.
Sunscreen Use and Subsequent Melanoma Risk: A Population-Based Cohort Study
Authors: Ghiasvand Reza , Weiderpass Elisabete , Green Adele C. , Lund Eiliv , Veierød Marit B. 
Published: September 2016

Purpose To assess melanoma risk in relation to sunscreen use and to compare high– with low–sun protection factor (SPF) sunscreens in relation to sunbathing habits in a large cohort study. Materials and Methods We used data from the Norwegian Women and Cancer Study, a prospective population-based study of 143,844 women age 40 to 75 years at inclusion with 1,532,247 person-years of follow-up and 722 cases of melanoma. Multivariable Cox proportional hazards regression was used to estimate the association between sunscreen use (never, SPF < 15, SPF ≥ 15) and melanoma risk by calculating hazard ratios and 95% CIs. The population attributable fraction associated with sunscreen use was estimated. Results Sunscreen users reported significantly more sunburns and sunbathing vacations and were more likely to use indoor tanning devices. SPF ≥ 15 sunscreen use was associated with significantly decreased melanoma risk compared with SPF < 15 use (hazard ratio, 0.67; 95% CI, 0.53 to 0.83). The estimated decrease in melanoma (population attributable fraction) with general use of SPF ≥ 15 sunscreens by women age 40 to 75 years was 18% (95% CI, 4% to 30%). Conclusion Use of SPF ≥ 15 rather than SPF < 15 sunscreens reduces melanoma risk. Moreover, use of SPF ≥ 15 sunscreen by all women age 40 to 75 years could potentially reduce their melanoma incidence by 18%.
PICASSO III: A Phase III, Placebo-Controlled Study of Doxorubicin With or Without Palifosfamide in Patients With Metastatic Soft Tissue Sarcoma
Authors: Ryan Christopher W. , Merimsky Ofer , Agulnik Mark , Blay Jean-Yves , Schuetze Scott M. , Van Tine Brian A. , Jones Robin L. , Elias Anthony D. , Choy Edwin , Alcindor Thierry , Keedy Vicki L. , Reed Damon R. , Taub Robert N. , Italiano Antoine , Garcia del Muro Xavier , Judson Ian R. , Buck Jill Y. , Lebel Francois , Lewis Jonathan J. , Maki Robert G. , Schöffski Patrick 
Published: September 2016

Purpose Palifosfamide is the active metabolite of ifosfamide and does not require prodrug activation, thereby avoiding the generation of toxic metabolites. The PICASSO III trial compared doxorubicin plus palifosfamide with doxorubicin plus placebo in patients who had received no prior systemic therapy for metastatic soft tissue sarcoma. Patients and Methods Patients were randomly assigned 1:1 to receive doxorubicin 75 mg/m2 intravenously day 1 plus palifosfamide 150 mg/m2/d intravenously days 1 to 3 or doxorubicin plus placebo once every 21 days for up to six cycles. The primary end point was progression-free survival (PFS) by independent radiologic review. Results In all, 447 patients were randomly assigned to receive doxorubicin plus palifosfamide (n = 226) or doxorubicin plus placebo (n = 221). Median PFS was 6.0 months for doxorubicin plus palifosfamide and 5.2 months for doxorubicin plus placebo (hazard ratio, 0.86; 95% CI, 0.68 to 1.08; P = .19). Median overall survival was 15.9 months for doxorubicin plus palifosfamide and 16.9 months for doxorubicin plus placebo (hazard ratio, 1.05; 95% CI, 0.79 to 1.39; P = .74). There was a higher incidence of grade 3 to 4 adverse events in the doxorubicin plus palifosfamide arm (63.6% v 50.9%) including a higher rate of febrile neutropenia (21.4% v 12.6%). Conclusion No significant difference in PFS was observed in patients receiving doxorubicin plus palifosfamide compared with those receiving doxorubicin plus placebo. The observed median PFS and overall survival in this large, international study can serve as a benchmark for future studies of doxorubicin in metastatic soft tissue sarcoma.