bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multivariate modelling of faecal bacterial profiles of patients with IBS predicts responsiveness to a diet low in FODMAPs
Authors: Bennet Sean M P , Böhn Lena , Störsrud Stine , Liljebo Therese , Collin Lena , Lindfors Perjohan , Törnblom Hans , Öhman Lena , Simrén Magnus 
Published: April 2017

ObjectiveThe effects of dietary interventions on gut bacteria are ambiguous. Following a previous intervention study, we aimed to determine how differing diets impact gut bacteria and if bacterial profiles predict intervention response.DesignSixty-seven patients with IBS were randomised to traditional IBS (n=34) or low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) (n=33) diets for 4 weeks. Food intake was recorded for 4 days during screening and intervention. Faecal samples and IBS Symptom Severity Score (IBS-SSS) reports were collected before (baseline) and after intervention. A faecal microbiota dysbiosis test (GA-map Dysbiosis Test) evaluated bacterial composition. Per protocol analysis was performed on 61 patients from whom microbiome data were available.ResultsResponders (reduced IBS-SSS by ≥50) to low FODMAP, but not traditional, dietary intervention were discriminated from non-responders before and after intervention based on faecal bacterial profiles. Bacterial abundance tended to be higher in non-responders to a low FODMAP diet compared with responders before and after intervention. A low FODMAP intervention was associated with an increase in Dysbiosis Index (DI) scores in 42% of patients; while decreased DI scores were recorded in 33% of patients following a traditional IBS diet. Non-responders to a low FODMAP diet, but not a traditional IBS diet had higher DI scores than responders at baseline. Finally, while a traditional IBS diet was not associated with significant reduction of investigated bacteria, a low FODMAP diet was associated with reducedBifidobacteriumand Actinobacteria in patients, correlating with lactose consumption.ConclusionsA low FODMAP, but not a traditional IBS diet may have significant impact on faecal bacteria. Responsiveness to a low FODMAP diet intervention may be predicted by faecal bacterial profiles.Trial registration numberNCT02107625.
Oncogenic Characterization and Pharmacologic Sensitivity of Activating Fibroblast Growth Factor Receptor (FGFR) Genetic Alterations to the Selective FGFR Inhibitor Erdafitinib
Authors: Karkera Jayaprakash D. , Cardona Gabriela Martinez , Bell Katherine , Gaffney Dana , Portale Joseph C. , Santiago-Walker Ademi , Moy Christopher H. , King Peter , Sharp Michael , Bahleda Rastislav , Luo Feng R. , Alvarez John D. , Lorenzi Matthew V. , Platero Suso J. 
Published: April 2017

Abstract
Fibroblast growth factor receptor (FGFR) genetic alterations are frequently observed in cancer, suggesting that FGFR inhibition may be a promising therapy in patients harboring these lesions. Identification of predictive and pharmacodynamic biomarkers to select and monitor patients most likely to respond to FGFR inhibition will be the key to clinical development of this class of agents. Sensitivity to FGFR inhibition and correlation with FGFR pathway activation status were determined in molecularly annotated panels of cancer cell lines and xenograft models. Pathway inhibition in response to FGFR inhibitor treatment was assessed in cell lines (both in vitro and in vivo) and in samples from patients treated with the FGFR inhibitor JNJ-42756493 (erdafitinib). Frequency of FGFR aberrations was assessed in a panel of NSCLC, breast, prostate, ovarian, colorectal, and melanoma human tumor tissue samples. FGFR translocations and gene amplifications present in clinical specimens were shown to display potent transforming activity associated with constitutive pathway activation. Tumor cells expressing these FGFR activating mutants displayed sensitivity to the selective FGFR inhibitor erdafitinib and resulted in suppression of FGFR phosphorylation and downstream signal transduction. Clinically, patients receiving erdafitinib showed decreased Erk phosphorylation in tumor biopsies and elevation of serum phosphate. In a phase I study, a heavily pretreated bladder cancer patient with an FGFR3–TACC3 translocation experienced a partial response when treated with erdafitinib. This preclinical study confirmed pharmacodynamics and identified new predictive biomarkers to FGFR inhibition with erdafitinib and supports further clinical evaluation of this compound in patients with FGFR genetic alterations. Mol Cancer Ther; 16(8); 1717–26. ©2017 AACR.
Restarting Anticoagulant Therapy After Intracranial Hemorrhage
Authors: Murthy Santosh B. , Gupta Ajay , Merkler Alexander E. , Navi Babak B. , Mandava Pitchaiah , Iadecola Costantino , Sheth Kevin N. , Hanley Daniel F. , Ziai Wendy C. , Kamel Hooman 
Published: April 2017

Background and Purpose—
The safety and efficacy of restarting anticoagulation therapy after intracranial hemorrhage (ICH) remain unclear. We performed a systematic review and meta-analysis to summarize the associations of anticoagulation resumption with the subsequent risk of ICH recurrence and thromboembolism.

Methods—
We searched published medical literature to identify cohort studies involving adults with anticoagulation-associated ICH. Our predictor variable was resumption of anticoagulation. Outcome measures were thromboembolic events (stroke and myocardial infarction) and recurrence of ICH. After assessing study heterogeneity and publication bias, we performed a meta-analysis using random-effects models to assess the strength of association between anticoagulation resumption and our outcomes.

Results—

Eight studies were eligible for inclusion in the meta-analysis, with 5306 ICH patients. Almost all studies evaluated anticoagulation with vitamin K antagonists. Reinitiation of anticoagulation was associated with a significantly lower risk of thromboembolic complications (pooled relative risk, 0.34; 95% confidence interval, 0.25–0.45;
Q
=5.12,
P
for heterogeneity=0.28). There was no evidence of increased risk of recurrent ICH after reinstatement of anticoagulation therapy, although there was significant heterogeneity among included studies (pooled relative risk, 1.01; 95% confidence interval, 0.58–1.77;
Q
=24.68,
P
for heterogeneity <0.001). No significant publication bias was detected in our analyses.

Conclusions—
In observational studies, reinstitution of anticoagulation after ICH was associated with a lower risk of thromboembolic complications and a similar risk of ICH recurrence. Randomized clinical trials are needed to determine the true risk–benefit profile of anticoagulation resumption after ICH.
Numerical Simulations of a Tornadic Supercell over the Mediterranean
Authors: Miglietta Mario Marcello , Mazon Jordi , Rotunno Richard 
Published: April 2017

Abstract
On 28 November 2012, a multivortex EF3 tornado occurred in southeastern Italy causing one fatality and estimated damage of 60 million euros. At approximately 1050 LT (0950 UTC), this tornado, which initially formed in association with a supercell thunderstorm over the Ionian Sea, moved inland. The environment where the tornadic supercell developed was characterized by large vertical wind shear in the lowest 1 km of the atmosphere and moderate conditional instability. Mesoscale-model numerical simulations show that it is possible to produce a simulated supercell thunderstorm with a track, change in intensity, and evolution similar to the actual one that spawned the tornado in Taranto, southern Italy. The genesis of the simulated supercell is due to a combination of mesoscale meteorological features: warm low-level air advected toward the Ionian Sea, combined with midlevel cooling due to an approaching trough, increased the potential instability; the intense vertical shear favored the possibility of supercell development; and boundary layer rolls over the Ionian Sea moved in phase with the cells produced by the orography of Calabria to supply ascent, moisture, and heat to the convection. An unusual feature of the present case is the central role of the orography, which was verified in a sensitivity experiment where it was reduced by 80%.
Use of a Novel Airway Kit and Simulation in Resident Training on Emergent Pediatric Airways
Authors: Melzer Jonathan M. , Hamersley Erin R. S. , Gallagher Thomas Q. 
Published: April 2017

ObjectiveDevelopment of a novel pediatric airway kit and implementation with simulation to improve resident response to emergencies with the goal of improving patient safety.MethodsProspective study with 9 otolaryngology residents (postgraduate years 1‐5) from our tertiary care institution. Nine simulated pediatric emergency airway drills were carried out with the existing system and a novel portable airway kit. Response times and time to successful airway control were noted with both the extant airway system and the new handheld kit. Results were analyzed to ensure parametric data and compared with t tests. A Bonferroni adjustment indicated that an alpha of 0.025 was needed for significance.ResultsUse of the airway kit significantly reduced the mean time of resident arrival by 47% (P =. 013) and mean time of successful intubation by 50% (P =. 007). Survey data indicated 100% improved resident comfort with emergent airway scenarios with use of the kit.DiscussionTimes to response and meaningful intervention were significantly reduced with implementation of the handheld airway kit. Use of simulation training to implement the new kit improved residents’ comfort and airway skills. This study describes an affordable novel mobile airway kit and demonstrates its ability to improve response times.Implications for PracticeThe low cost of this airway kit makes it a tenable option even for smaller hospitals. Simulation provides a safe and effective way to familiarize oneself with novel equipment, and, when possible, realistic emergent airway simulations should be used to improve provider performance.
A Fresh Cadaver Model for the Instruction of Ultrasound‐Guided Fine‐Needle Aspiration of Thyroid Nodules
Authors: McCrary Hilary C. , Faucett Erynne A. , Hurbon Audriana N. , Milinic Tijana , Cervantes Jose A. , Kent Sean L. , Adamas‐Rappaport William J. 
Published: April 2017

ObjectiveThe aim of our study is to determine if a fresh cadaver model (FCM) for the instruction of ultrasound (US)–guided fine‐needle aspiration (FNA) of thyroid nodules is a practical method for instruction.Study DesignPre‐ and postinstruction assessment of medical students’ ability to perform US‐guided FNA of artificially created thyroid nodules placed adjacent to the thyroid gland of a fresh cadaver.SettingUniversity‐based fresh cadaver laboratory.Subjects and MethodsStudy participants included a total of 17 first‐ and second‐year medical students with minimal US training. Technical skills were assessed using a 10‐item checklist. In addition, a cognitive assessment regarding the indications, contraindications, and complications of the procedure was completed. A postinstruction assessment was provided for participants 5 weeks after their initial assessment. Differences between pre‐ and postinstruction assessment scores of technical skills were analyzed using McNemar’s test. The mean cognitive knowledge gain was analyzed using a paired 2‐sample t test.ResultsEight of 10 items on the skills checklist were statistically significant between pre‐ and postinstruction skills assessment (P <. 05). There was a statistically significant change in cognitive knowledge gain regarding the contraindications of the procedure (P =. 001), but not for indications or complications (P =. 104 and P =. 111, respectively).ConclusionUS‐guided FNA continues to be an important diagnostic procedure in the workup of thyroid nodules, making it an essential skill to integrate into surgical skills lab. Our FCM for the instruction of US‐guided FNA is the first of its kind, and this pilot study shows this is a viable method for instruction.
Anatomic Characteristics, Identification, and Protection of the Nonrecurrent Laryngeal Nerve during Thyroidectomy
Authors: Qiao Na , Wu Lin‐feng , Gao Wei , Qu Feng‐zhi , Duan Peng‐yu , Cao Cheng‐liang , Li Pan‐quan , Sun Bei , Wang Gang 
Published: April 2017

ObjectiveWe aimed to investigate the anatomical features and variation pattern of the nonrecurrent laryngeal nerve (NRLN), summarize the methods for identifying the NRLN before and during thyroidectomy, and share experiences regarding preventing and treating its injury.Study DesignRetrospective case data analysis.SettingFirst Affiliated Hospital of Harbin Medical University.Subjects and MethodsBetween January 2002 and May 2016, 7392 patients underwent thyroidectomy in our hospital. Of them, 28 patients with NRLN were identified, and their clinical data were retrospectively analyzed.ResultsThis study included 7392 patients in which the recurrent laryngeal nerves (RLNs) were routinely identified during surgery. The presence of NRLN was intraoperatively confirmed in 28 patients. All the NRLNs were located on the right side and its overall incidence was 0.37%. Five of the NRLNs were classified as type I, 19 as type IIa, and 4 as type IIb. Of the 28 cases, 4 NRLNs were injured during surgery, in which primary end‐to‐end anastomosis or local seal with corticosteroid injection was performed as a remedy. In the 4 patients with NRLN injury, 2 presented with postoperative hoarseness that indicated vocal cord paralysis confirmed by laryngoscope; the other 2 patients’ voices had no significant changes.ConclusionThe NRLN, which is rare in clinical practice and predominantly right‐sided, is anatomically more complex and variant at a higher risk of surgical injury. The key factors to accurately identify NRLN and to effectively prevent its injury include careful interpretation of auxiliary examination results before surgery, raising awareness of its presence, meticulous dissection, and routine exposure of the RLN during surgery.
Case‐Logging Practices in Otolaryngology Residency Training: National Survey of Residents and Program Directors
Authors: Dermody Sarah M. , Gao William , McGinn Johnathan D. , Malekzadeh Sonya 
Published: April 2017

Objective(1) Evaluate the consistency and manner in which otolaryngology residents log surgical cases. (2) Assess the extent of instruction and guidance provided by program directors on case‐logging practices.Study DesignCross‐sectional national survey.SettingAccreditation Council for Graduate Medical Education otolaryngology residency programs in the United States.Subjects and MethodsUS otolaryngology residents, postgraduate year 2 through graduating chiefs as of July 2016, were recruited to respond to an anonymous questionnaire designed to characterize surgical case‐logging practices. Program directors of US otolaryngology residency programs were recruited to respond to an anonymous questionnaire to elucidate how residents are instructed to log cases.ResultsA total of 272 residents and 53 program directors completed the survey, yielding response rates of 40.6% and 49.5%, respectively. Perceived accuracy of case logs is low among residents and program directors. Nearly 40% of residents purposely choose not to log certain cases, and 65.1% of residents underreport cases performed. More than 80% of program directors advise residents to log procedures performed outside the operating room, yet only 16% of residents consistently log such cases.ConclusionVariability in surgical case‐logging behaviors and differences in provided instruction highlight the need for methods to improve consistency of logging practices. It is imperative to standardize practices across otolaryngology residency programs for case logs to serve as an accurate measure of surgical competency. This study provides a foundation for reform efforts within residency programs and for the Resident Case Log System.
Rejecting the Cycle of Violence: When Women Say No to War (Israel-Palestine 1987–2013)
Authors: Pouzol Valérie 
Published: April 2017

AbstractDuring the already long history of the Israel-Palestine conflict, women from both sides of the Green Line have been highly visible participants in the often perilous enterprise of establishing dialogue, of maintaining links with the other side, and of thinking seriously about the conditions that will need to be brought together for the construction of a just and lasting peace. By their words, their often symbolic actions, and their activist strategies, they have durably contributed to the building of a ‘clandestine’ peace often far removed from the calendars and issues of the major international negotiations. In these collective actions, choosing the path of non-violence has often been at the heart of their repertoire of militant activities and their discourses. This article proposes to examine certain examples of such activities and involvement since the first Intifada of 1987 up until the very recent past, showing that the choice of non-violent strategies has been a significantly marked tendency of the activism of women, and that this is always associated with the formulation of renewed forms of discourse around peace and reconciliation.
Strategies to Modify the Risk of Heart Failure Readmission
Authors: Wan Thomas T. H. , Terry Amanda , Cobb Enesha , McKee Bobbie , Tregerman Rebecca , Barbaro Sara D. S. 
Published: April 2017

Background: Human factors play an important role in health-care outcomes of heart failure (HF) patients. A systematic review and meta-analysis of clinical trial studies on HF hospitalization may yield positive proofs of the beneficial effect of specific care management strategies. Purpose: To investigate how the 8 guiding principles of choice, rest, environment, activity, trust, interpersonal relationships, outlook, and nutrition reduce HF readmissions. Basic Procedures: Appropriate keywords were identified related to the (1) independent variable of hospitalization and treatment, (2) the moderating variable of care management principles, (3) the dependent variable of readmission, and (4) the disease of HF to conduct searches in 9 databases. Databases searched included CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, ERIC, MEDLINE, PubMed, PsycInfo, Science Direct, and Web of Science. Only prospective studies associated with HF hospitalization and readmissions, published in English, Chinese, Spanish, and German journals between January 1, 1990, and August 31, 2015, were included in the systematic review. In the meta-analysis, data were collected from studies that measured HF readmission for individual patients. Main Findings: The results indicate that an intervention involving any human factor principles may nearly double an individual’s probability of not being readmitted. Participants in interventions that incorporated single or combined principles were 1.4 to 6.8 times less likely to be readmitted. Principal Conclusions: Interventions with human factor principles reduce readmissions among HF patients. Overall, this review may help reconfigure the design, implementation, and evaluation of clinical practice for reducing HF readmissions in the future.
Interim PET-driven strategy in de novo diffuse large B-cell lymphoma: do we trust the driver?
Authors: Le Gouill Steven , Casasnovas René-Olivier 
Published: April 2017

Abstract
18F-Fluorodeoxyglucose–positron emission tomography (FDG-PET) has become a central tool for both accurate initial staging and determination of prognosis after treatment of diffuse large B-cell lymphoma (DLBCL). However, the role of PET during treatment (iPET) in daily practice remains a matter of significant debate. This perspective reviews the published studies on iPET in DLBCL, including the methods used to analyze iPET, its timing, and studies of iPET-driven therapy to illuminate where daily practice may benefit from the use of iPET. When performed after 2 and/or 4 courses of immunochemotherapy, iPET has a very good negative predictive value, utilizing both visual (qualitative) and semiquantitative methods. The visual method accurately predicts outcome for patients with limited disease. The semiquantitative method, eg, the change of the difference of maximum standardized uptake value (ΔSUVmax), is for patients with advanced DLBCL, for whom iPET identifies patients with very good outcome with continuation of standard therapy. A low ΔSUVmax also helps identify patients with a risk for relapse averaging 50% and warrants review of their scheduled therapy. To date, no trial has demonstrated the superiority of an iPET-driven strategy in DLBCL. However, the very good negative and good positive predictive values of iPET support its use in daily practice as a better predictive tool than contrast-enhanced computed tomographic scan for therapeutic decision making.
Erythrocyte sialoglycoproteins engage Siglec-9 on neutrophils to suppress activation
Authors: Lizcano Anel , Secundino Ismael , Döhrmann Simon , Corriden Ross , Rohena Cristina , Diaz Sandra , Ghosh Pradipta , Deng Lingquan , Nizet Victor , Varki Ajit 
Published: April 2017

Key PointsErythrocytes suppress neutrophil activation and apoptosis in whole blood. Sialoglycoproteins on the erythrocyte surface regulate neutrophils through Siglec-9.
Clinical updates in adult immune thrombocytopenia
Authors: Lambert Michele P. , Gernsheimer Terry B. 
Published: April 2017

AbstractImmune thrombocytopenia (ITP) occurs in 2 to 4/100 000 adults and results in variable bleeding symptoms and thrombocytopenia. In the last decade, changes in our understanding of the pathophysiology of the disorder have led to the publication of new guidelines for the diagnosis and management of ITP and standards for terminology. Current evidence supports alternatives to splenectomy for second-line management of patients with persistently low platelet counts and bleeding. Long-term follow-up data suggest both efficacy and safety, in particular, for the thrombopoietin receptor agonists and the occurrence of late remissions. Follow-up of patients who have undergone splenectomy for ITP reveals significant potential risks that should be discussed with patients and may influence clinician and patient choice of second-line therapy. Novel therapeutics are in development to address ongoing treatment gaps.
Challenges Persist Under Americans With Disabilities Act Amendments Act: How Can Oncology Providers Help?
Authors: Feuerstein Michael , Gehrke Amanda K. , McMahon Brian T. , McMahon Megan C. 
Published: April 2017

Purpose: To determine whether the Amendments to the hallmark Americans with Disabilities Act (ADA; effective January 2009), which provide increased access to the antidiscrimination laws for many with chronic illness, are related to changes in workplace discrimination allegations in individuals with a history of cancer. Methods: Information collected by the Equal Employment Opportunities Commission was used to compare allegations of discrimination and their merit before (2001 to 2008) and after (2009 to 2011) implementation of the Amendments Act. Results: Allegations related to terms of employment (eg, promotions, wages) were more likely to be filed (odds ratio [OR], 1.34; 95% CI, 1.11 to 1.61) and determined to have merit (OR, 1.35; 95% CI, 1.03 to 1.77) after implementation of the Amendments Act. Allegations related to workplace relations (eg, harassment, discipline, discharge) were also more likely to be filed post Amendments Act (OR, 1.48; 95% CI, 1.23 to 1.78), although the merit of this complaint remained stable. Filing of all other allegations of discrimination (ie, hiring, reasonable accommodation, and termination) and their merit remained unchanged post Amendments Act. Conclusion: Despite the implementation of the Amendments Act, discrimination allegations in those with a history of cancer persisted or in certain areas increased. Although prevention of workplace discrimination rests primarily with employers, the oncology care team is uniquely qualified to provide information related to residual symptoms and function that can facilitate more personalized solutions to workplace discrimination, such as successful workplace accommodations. Information is provided that can assist the oncology team in their efforts to improve work outcomes.