bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phase I Study of Epigenetic Priming with Azacitidine Prior to Standard Neoadjuvant Chemotherapy for Patients with Resectable Gastric and Esophageal Adenocarcinoma: Evidence of Tumor Hypomethylation as an Indicator of Major Histopathologic Response
Authors: Schneider Bryan J. , Shah Manish A. , Klute Kelsey , Ocean Allyson , Popa Elizabeta , Altorki Nasser , Lieberman Michael , Schreiner Andrew , Yantiss Rhonda , Christos Paul J. , Palmer Romae , You Daoqi , Viale Agnes , Kermani Pouneh , Scandura Joseph M. 
Published: November 2016

Abstract
Purpose: Epigenetic silencing of tumor suppressor genes (TSG) is an acquired abnormality observed in cancer and is prototypically linked to DNA methylation. We postulated that pretreatment (priming) with 5-azacitidine would increase the efficacy of chemotherapy by reactivating TSGs. This study was conducted to identify a tolerable dose of 5-azacitidine prior to EOX (epirubicin, oxaliplatin, capecitabine) neoadjuvant chemotherapy in patients with locally advanced esophageal/gastric adenocarcinoma (EGC).
Experimental Design: Eligible patients had untreated, locally advanced, resectable EGC, ECOG 0–2, and adequate organ function. 5-Azacitidine (V, 75 mg/m2) was given subcutaneously for 3 (dose level, DL 1) or 5 (DL 2) days prior to each 21-day cycle of EOX (E, 50 mg/m2; O, 130 mg/m2; X, 625 mg/m2 twice daily for 21 days). Standard 3+3 methodology guided V dose escalation. DNA methylation at control and biomarker regions was measured by digital droplet, bisulfite qPCR in tumor samples collected at baseline and at resection.
Results: All subjects underwent complete resection of residual tumor (R0). Three of the 12 patients (25%) achieved a surgical complete response and 5 had partial responses. The overall response rate was 67%. The most common toxicities were gastrointestinal and hematologic. Hypomethylation of biomarker genes was observed at all dose levels and trended with therapeutic response.
Conclusions: Neoadjuvant VEOX was well-tolerated with significant clinical and epigenetic responses, with preliminary evidence that priming with V prior to chemotherapy may augment chemotherapy efficacy. The recommended phase II trial schedule is 5-azacitidine 75 mg/m2 for 5 days followed by EOX chemotherapy every 21 days. Clin Cancer Res; 23(11); 2673–80. ©2016 AACR.
A High-Resolution Aerial Survey and Radar Analysis of Quasi-Linear Convective System Surface Vortex Damage Paths from 31 August 2014
Authors: Skow Kevin D. , Cogil Craig 
Published: November 2016

Abstract
On the evening of 31 August 2014, a powerful quasi-linear convective system (QLCS) impacted much of Iowa. In the weeks following the event, the entire path of the QLCS was imaged at ~1-m resolution using aerial photography through the National Agriculture Imagery Program. The predominantly flat, mature agricultural land cover of central Iowa provided an excellent medium on which to document wind phenomena of varying scales. The high-resolution aerial data, in combination with recent spatial, temporal, and polarimetric upgrades to the Weather Surveillance Radar-1988 Doppler (WSR-88D) network, offer an extraordinary glimpse into the quantity, evolution, and scale of surface vortices generated throughout the entire lifespan of this QLCS. One hundred eleven damage tracks associated with these vortices were cataloged along the storm’s 350-km path, ranging in length from 130 m to nearly 18 km. This study classified 35 of these circulations as tornadoes using a series of tests that weighed track characteristics and radar data. Unusual features, such as a likely tornado merger and multiple instances of tornadoes occluding behind the leading edge of the QLCS surface cold pool, are examined. Possible genesis mechanisms and National Weather Service operational implications are also discussed. A new, behavioral-based approach for identifying a tornadic debris signature (TDS) is presented that may be better suited for QLCS tornadoes. Twelve TDSs were cataloged on 31 August 2014 using this methodology at ranges up to 90 km from the Des Moines, Iowa, WSR-88D.
Multivariate Analysis of Risk Factors in the Development of a Lower-Pitched Voice After Thyroidectomy
Authors: Park Jun-Ook , Bae Ja-Sung , Lee So-Hee , Shim Mi-Ran , Hwang Yeon-Shin , Joo Young-Hoon , Park Young Hak , Sun Dong-Il 
Published: November 2016

Objectives: Thyroid surgeons frequently encounter outpatients with mobile vocal cords complaining of lower-pitched voices following thyroidectomy. This study investigated the clinical and pathological parameters affecting voice pitch following thyroid surgery. Methods: We analyzed the data of 393 patients with mobile vocal cords and who also underwent thyroid surgery. Speaking fundamental frequency (SFF) and fundamental frequency (F0) were compared before and after surgery. Results: Approximately 26.7% of patients had significantly lowered SFFs (ΔSFF ≥ 12 Hz), and 30.2% exhibited significantly lower sustained vowel F0s (ΔF0 ≥ 12 Hz) following thyroid surgery. On multivariate analysis, only gender: female remained a significant predictor of a clinically significant change in SFF following thyroid surgery ( P < .001). Gender: female and extent of surgery: total remained significant predictors of a clinically significant change in F0 after surgery ( P = .006 and P = .007, respectively). Conclusions: Appreciable proportions of patients experience lower-pitched voice and related vocal symptoms early after thyroid surgery. Such problems develop more frequently in females who underwent total thyroidectomy.
Nasal and Tracheal Cytological Changes After Total Laryngectomy in Long-Term Survivors
Authors: Riva Giuseppe , Boita Monica , Corvino Andrea , Sensini Matteo , Peruzzetto Daniela , Chiusa Luigi , Pecorari Giancarlo , Garzaro Massimiliano 
Published: November 2016

Objective: Complete separation of upper and lower respiratory tract after total laryngectomy results in permanent effects on nasal cavities and tracheo-bronchial airways. Aim of this study is evaluating nasal and tracheal cytological alterations of mucosa in laryngectomy long-term survivors, analyzing the feasibility of scraping for cytological examination of tracheal mucosa. Methods: Twenty-five laryngectomy patients underwent symptoms’ evaluation, endoscopic fiber optic examination, prick tests, and nasal and tracheal scraping for cytological exam. Twenty-five healthy subjects underwent the same assessment, except for tracheal scraping. Eleven laryngectomy patients accepted inferior turbinate biopsy for histological examination. Results: Nasal cytological analysis demonstrated mucous cell metaplasia in 20% of laryngectomized patients, but it was absent in all healthy subjects; no squamous cell metaplasia was found in both groups. In 15 patients (60%), bacteria were present, without inflammatory infiltrate. Tracheal cytological analysis demonstrated a quite high rate of squamous cell metaplasia (24%), neutrophilic infiltrate (32%), and presence of bacteria (40%). Histological examination of inferior turbinate showed submucosal stromal fibrosis in all patients and submucosal inflammatory infiltrate in 1 case (9%). Conclusion: Nasal cavities and trachea of laryngectomy patients undergo long-term cytological and histological changes of mucosa and submucosa, probably due to airflow modifications.
Soft Palate Injuries During Orotracheal Intubation With the Videolaryngoscope
Authors: Pham Quang , Lentner Mark , Hu Amanda 
Published: November 2016

Objective: The videolaryngoscope has gained popularity for providing superior visualization in intubations. A rare complication of this technology is soft palate injury. Through a literature review and case series, we highlight the risks associated with the Glidescope and McGrath videolaryngoscopes and the management of soft palate injuries. Method: A case series of multi-institutional review of medical records was performed to identify patients with soft palate injuries from the videolaryngoscope. A literature review was also performed to analyze risk factors, mechanism of injury, complications, and management of palate injuries. Results: Of 9 cases, 3 resulted in soft palate perforations, which required primary closure. The remaining 6 patients sustained a soft palate laceration, which was treated conservatively. This injury commonly occurs when the intubator is focused on the video monitor and blindly inserts the Glidescope into the oropharynx. The rigid stylet used with the Glidescope increases the propensity for oropharyngeal injuries during blind insertions. Conclusion: Proper training, an awareness of this potential complication, and direct oral cavity visualization are recommended while inserting the videolaryngoscope. Repair is recommended for through-and-through perforations or if a large hanging flap is present. Antibiotics should be considered for lacerations greater than 1 to 2 cm.
Diagnostic Challenges in a Case of IgG4-RD Affecting the Temporal Bone
Authors: Vuncannon Jackson Ross , Panella Nicholas John , Magliocca Kelly R , Mattox Douglas E. 
Published: November 2016

Introduction: Immunoglobulin G4–related disease (IgG4-RD) is a recently described fibroinflammatory condition with a characteristic histology. While IgG4-RD can affect a great variety of anatomical sites, it has been seldom described in the temporal bone. Methods: Herein, a case IgG4-RD occurring in the temporal bone of a 35-year-old woman is reported. Discussion: This case of IgG4-RD of the temporal bone proved a uniquely challenging diagnosis due to slightly atypical histology falling outside of “highly suggestive” criteria. Conclusions: We suggest that IgG4-RD remains a challenging diagnosis to reach despite increased awareness of the condition. We further suggest that clinicopathologic correlation remain the cornerstone of diagnosis as the spectrum of presentations of this newly described disease may be wider than previously anticipated.
Two‐Year Follow‐up of a Randomized Controlled Nutrition Intervention Trial in Very Low‐Birth‐Weight Infants
Authors: Roelants Jorine A. , Vlaardingerbroek Hester , van den Akker Chris H. P. , de Jonge Rogier C. J. , van Goudoever Johannes B. , Vermeulen Marijn J. 
Published: November 2016

AbstractBackground: Very low‐birth‐weight (VLBW) infants are at risk for neurodevelopment impairment. This study assessed the effect of early aggressive parenteral nutrition (PN) on long‐term outcome in VLBW infants. Materials and Methods: Directly after birth, VLBW infants (birth weight <1500 g, n = 142) were randomized to 5 different PN regimes. Controls (n = 46) received glucose and standard‐dose amino acids (AAs; 2.4 g/[kg·d]) from birth onward and pure soybean oil fat emulsion (SOY) on the second day of life. Two intervention groups received glucose, standard‐dose AAs, and lipids from birth onward: SOY (n = 24) or mixed fat emulsion (MIX, n = 25). The 2 other intervention groups received glucose, high‐dose AAs (3.6 g/[kg·d]), and lipids from birth onward: SOY (n = 24) or MIX (n = 23). The primary outcome of this follow‐up study was the composite outcome of “death or major disability” at 2 years corrected age. Secondary outcomes were death, major disabilities, neurodevelopmental scores, and anthropometry. Results: Follow‐up rate was 92% (n = 134). Thirty‐five (26%) infants had died or had a major disability, with no differences between intervention groups and controls. Increased odds for death were observed in the standard‐dose AA‐MIX group (odds ratio, 5.4; 95% confidence interval [CI], 1.1–27.0). Neurodevelopmental scores and incidence of major disabilities did not differ between groups. Growth in the high‐dose AA‐MIX group was enhanced compared with growth in controls at 2 years corrected age (+0.51 [0.01–1.02] weight SDS). Conclusion: This randomized controlled hypothesis‐generating study demonstrated no beneficial effect of early high‐dose AA administration and mixed fat emulsions on survival and neurodevelopmental outcome in VLBW infants, although growth was enhanced.
Improvement in insulin sensitivity following intensive insulin therapy and association of glucagon with long-term diabetes remission
Authors: Zhang Bo , Chen Yan-yan , Yang Zhao-jun , Wang Xin , Li Guang-wei 
Published: November 2016

Objective To investigate the role of the acute glucagon response in the long-term remission of newly diagnosed type 2 diabetes mellitus following short-term intensive insulin therapy (IIT). Methods Ten patients with newly diagnosed type 2 diabetes mellitus received IIT. Intravenous glucose tolerance tests and the clamp technique were performed pre- and post-IIT. Remission was defined as maintenance of target glycaemic control without anti-diabetic agents for 1 year. Results The remission rate was 50% (5/10). There were no differences in the acute insulin response or glucose infusion rate between groups. The acute glucagon response (AGR) in the remission group pre-IIT was significantly higher than that in the non-remission group (mean 163.02 pg/mL/min vs. mean 16.29 pg/mL/min). The mean AGR post-IIT was lower in the remission group than that in the non-remission group (0 pg/mL/min vs. 19.91 pg/mL/min). Spearman analysis indicated that the AGR pre-IIT and the change in the AGR were correlated with remission (r = 0.731). Conclusion The insulin-mediated glucose disposal rate was significantly improved with the normalization of blood glucose levels following transient IIT. Subjects with a higher AGR pre-IIT and a greater AGR decrease post-IIT displayed a greater likelihood of long-term remission.
Citation context and impact of ‘sleeping beauties’ in paediatric research
Authors: Završnik Jernej , Kokol Peter , del Torso Stefano , Blažun Vošner Helena 
Published: November 2016

Objectives ‘Sleeping beauties’, i.e. publications that are not cited for a long while, present interesting findings in science. This study analysed the citation trends of sleeping beauties in paediatric research. Methods The study used bibliometric software to analyse the papers citing sleeping beauties in paediatric research, to understand the context in which paediatric sleeping beauties were finally cited and the impact of these sleeping beauties on paediatric research. Results Two paediatric sleeping beauties, addressing medical homes and the transition from paediatric to adult health care, respectively, awakened in response to organizational needs. Both presented novel concepts of paediatric service organization that became important because of an increased need for optimization of services. Conclusion All sleeping beauties bring new knowledge that becomes important only after several years. Paediatric sleeping beauties exhibited unique characteristics; however, their presence in paediatric research shows that knowledge acquisition in paediatrics resembles that in other disciplines.
Using the Braess Paradox to Teach Tacit Negotiation
Authors: Merlone Ugo , Romano Angelo 
Published: November 2016

Background. Social dilemmas are situations in which following personal interest leads to collective disasters. Pollution, tropical deforestation, and the sustainable use of natural resources, can be characterized as examples of social dilemmas. In the negotiation literature, social dilemmas are known as tacit negotiations as individuals negotiate through moves rather than verbal communication. These negotiations are difficult to manage because of the absence of binding contracts and the interdependent nature of decisions of the parties involved. Therefore, it is important for participants to learn from activities addressing these issues. Although several negotiation exercises are available, it is difficult to find educational games or simulations specifically devised to allow several participants to face social dilemmas. Purpose. In this article, we present a negotiation game based on a well-known social dilemma, the Braess paradox. The Braess paradox has been observed in many real situations and is particularly suited to highlight the core concepts of social dilemmas. Approach. We will review the main negotiation activities focusing on the number ofparticipants they are implemented for. Then we will present an activity which allows to accommodate up to thirty participants and allows them to understand some interesting aspects of social dilemmas. Findings. Through the lessons gained by experiential learning, and the discussions emerging during debriefing, this activity may provide participants with a better understanding of urgent real problems.
Waterpipe smoking associated with multiple sclerosis: A population-based incident case–control study
Authors: Abdollahpour Ibrahim , Nedjat Saharnaz , Sahraian Mohammad Ali , Mansournia Mohammad Ali , Otahal Petr , van der Mei Ingrid 
Published: November 2016

Background: While cigarette and passive smoking have been identified as modifiable risk factors for multiple sclerosis (MS), there is no report regarding Waterpipe smoking–MS association. Objective: We examined the association of Waterpipe, tobacco, and passive smoking with MS. Methods: Population-based incident case–control study in Iran with 547 incident cases and 1057 general population controls (7 August 2013–17 February 2015). Logistic regression model was used. Multiplicative along with additive interaction was assessed using product term and Synergy Index (SI), respectively, and the population attributable fractions (PAFs) were calculated. Results: Having ever smoked Waterpipe, tobacco, or being exposed to passive smoking were all significantly associated with MS (odds ratio (OR) = 1.77 (1.36–2.31), OR = 1.69 (1.24–2.31), and OR = 1.85 (1.48–2.32), respectively). Clear dose–response associations were observed with the duration exposed ( p < 0.001 for all three) and the amount smoked ( p < 0.001 for Waterpipe and tobacco). Those who had all three types of smoking had an odds that was 4.1 times higher than those without any type. The three types of smoking jointly contributed to 30.9% of the MS incidence. Conclusion: We identified Waterpipe smoking as a novel risk factor for MS. Given the global increase in Waterpipe smoking, especially among young adults, this finding reinforces the need for public health interventional and educational programs to combat this global increase.
Validity and Reliability of the Vestibular/Ocular Motor Screening and Associations With Common Concussion Screening Tools
Authors: Yorke Amy M. , Smith Laura , Babcock Mitch , Alsalaheen Bara 
Published: November 2016

Background: Sustaining a concussion commonly results in vestibular impairments that may be associated with balance deficits. To screen for vestibular impairments after a concussion, the Vestibular/Ocular Motor Screening (VOMS) tool was developed. The relationship between the VOMS and other concussion screening tools, such as the Balance Error Scoring System (BESS) and King-Devick (K-D), have not been explored. Hypotheses: (1) VOMS would provide reliable results and not provoke symptoms in healthy adolescents and (2) VOMS test items would measure related aspects of vestibular function that are not measured through the BESS or K-D. Study Design: Cross-sectional, descriptive. Level of Evidence: Level 4. Methods: A total of 105 healthy adolescents (53 male, 52 female; mean age, 15.4 years) completed the VOMS, BESS, and K-D tests. A subsample of 21 adolescents (16 male, 5 female; mean age, 15.5 years) completed the VOMS twice. Results: The median total symptom score for all 7 VOMS items was 0 (0-5). The majority of the individual VOMS test items total symptom scores demonstrated a significant correlation with each other ( rs = 0.25-0.66, P < 0.02). The individual VOMS items did not demonstrate a significant relationship to the BESS or K-D. VOMS items demonstrated high agreement in total symptom scores between testing trials, with near point convergence (NPC) distance demonstrating an intraclass correlation coefficient (ICC) of 0.95 (95% CI, 0.89-0.98; P < 0.001). The MDC95 (minimal detectable change with 95 confidence) for NPC distance was 4 cm. Conclusion: The VOMS did not provoke vestibular symptoms in healthy adolescents. The VOMS items measured unique aspects of vestibular function other than those measured by the BESS or K-D with good reliability. Clinical Relevance: Clinicians should consider implementing the VOMS as part of a comprehensive concussion assessment if vestibular impairment is suspected. If NPC distance is measured twice, a difference of >4 cm would be considered real change outside of measurement error.
Natural Type II Collagen Hydrogel, Fibrin Sealant, and Adipose-Derived Stem Cells as a Promising Combination for Articular Cartilage Repair
Authors: Lazarini Mariana , Bordeaux-Rego Pedro , Giardini-Rosa Renata , Duarte Adriana S. S. , Baratti Mariana Ozello , Zorzi Alessandro Rozim , de Miranda João Batista , Lenz Cesar Carlos , Luzo Ângela , Olalla Saad Sara Teresinha 
Published: November 2016

Objective Articular cartilage is an avascular tissue with limited ability of self-regeneration and the current clinical treatments have restricted capacity to restore damages induced by trauma or diseases. Therefore, new techniques are being tested for cartilage repair, using scaffolds and/or stem cells. Although type II collagen hydrogel, fibrin sealant, and adipose-derived stem cells (ASCs) represent suitable alternatives for cartilage formation, their combination has not yet been investigated in vivo for focal articular cartilage defects. We performed a simple experimental procedure using the combination of these 3 compounds on cartilage lesions of rabbit knees. Design The hydrogel was developed in house and was first tested in vitro for chondrogenic differentiation. Next, implants were performed in chondral defects with or without ASCs and the degree of regeneration was macroscopically and microscopically evaluated. Results Production of proteoglycans and the increased expression of collagen type II (COL2α1), aggrecan (ACAN), and sex-determining region Y-box 9 (SOX9) confirmed the chondrogenic character of ASCs in the hydrogel in vitro. Importantly, the addition of ASC induced a higher overall repair of the chondral lesions and a better cellular organization and collagen fiber alignment compared with the same treatment without ASCs. This regenerating tissue also presented the expression of cartilage glycosaminoglycan and type II collagen. Conclusions Our results indicate that the combination of the 3 compounds is effective for articular cartilage repair and may be of future clinical interest.
Anatomic Correlation of Posterior Aortic Root Enlarging Incisions
Authors: Subhani Habib , Hossien Abdullrazak , Tran Vi , Cook Andrew , Abid Qamar , Saad Rasheed 
Published: November 2016

Objectives: To clarify the terms surrounding the posterior aortic root enlarging incisions and correlate them anatomically. Methods: This is a human cadaveric heart study in which measurements were taken along the path of the named incisions in 42 normal and congenitally malformed hearts using calipers. Results: Our results indicate that there is a variable overlap of the left atrial wall with the anterior mitral leaflet and the aorta and that in individual cases it may not be possible to accurately predict the possibility of enlarging the root without opening the left atrium, though some papers suggest otherwise. Conclusion: Names associated with incisions are best avoided. Rather they should be described anatomically. Incision between the noncoronary sinus of Valsalva and left coronary sinus of Valsalva may be the safest approach to enlarging the root.