bluuebunny/crossref_metadata_2025_split huggingface dataset:
Larger size ratio associated with the rupture of very small (≤3 mm) anterior communicating artery aneurysms
Authors: Xu Ting , Lin Boli , Liu Shuailiang , Shao Xiaotong , Xia Nengzhi , Zhang Yue , Xu Haoli , Yang Yunjun , Zhong Ming , Zhuge Qichuan , Zhao Bing , Chen Weijian 
Published: March 2016

BackgroundAnterior communicating artery (AcoA) aneurysms have a high rupture risk, and ruptured AcoA aneurysms tend to be smaller than other intracranial aneurysms. We aimed to determine the incidence and morphologic predictors of aneurysm rupture of very small AcoA aneurysms.MethodsWe conducted a retrospective analysis of 519 consecutive patients with single AcoA aneurysms between December 2007 and February 2015 in our hospital. Aneurysm morphologies were re-measured using CT angiography images. Very small aneurysms were defined as those with a maximum size ≤3 mm, and small aneurysms were defined as those with a maximum size ≤5 mm. Multivariate regression analyses were used to determine the association between aneurysm morphology and aneurysm rupture status.ResultsOf the 474 ruptured AcoA aneurysms, 134 (28.3%) aneurysms were very small and 278 (58.6%) aneurysms were small. In the univariate analysis for very small aneurysms, larger aneurysm size (p=0.037), larger size ratio (p=0.002), higher aneurysm height (p=0.038), smaller vessel size (p=0.012), and dominant A1 segment configuration (p=0.011) were associated with aneurysm rupture. Multivariate analysis revealed that a larger size ratio was independently associated with the rupture status of the very small aneurysms (OR 3.69, 95% CI 1.5 to 9.0; p=0.004), and larger aneurysm size, larger size ratio, and dominant A1 segment configuration were associated with the rupture of small aneurysms.ConclusionsAbout one-third of ruptured AcoA aneurysms were very small. A larger size ratio, rather than other aneurysm morphologies, was independently associated with the rupture of very small AcoA aneurysms.
Effectiveness of soil in vegetated buffers to retain nutrients and sediment transported by concentrated runoff through deep gullies
Authors: Miller J.J. , Curtis T. , Chanasyk D.S. , Reedyk S. , Willms W.D. 
Published: March 2016

Little research has evaluated naturally vegetated buffers to retain pollutants in soil from concentrated runoff through deep (2–14 m) gullies. Soil enrichment in the flow path of 11 naturally vegetated gullies in southern Alberta, Canada, was used as a long-term signature of filtering during concentrated flow. Soil was sampled at three depth intervals (0–2.5, 2.5–5, and 5–10 cm) along two 50-m transects inside and outside the flow path of the vegetated gullies in each of 3 yr (2011–2013). The influence of soil type, flow path (inside vs. outside), distance into vegetated flow path, depth, and their interactions on enrichment of nutrients (NH4–N, NO3–N, soil test P (STP), total P) and particle size fractions (clay, silt, and sand) was determined. Significantly (P ≤ 0.05) greater enrichment of nutrients and specific particle size fractions inside than outside the flow path of the vegetated gully suggested that greater deposition occurred inside the concentrated flow path. In contrast, there was little evidence for enrichment of nutrients and sediment at the front or inlet of the buffer (except STP), or for infiltration of more soluble nutrients into the subsoil. Soil enrichment in buffers may reveal long-term filtering processes that may not be shown with short-term runoff experiments.
Colorectal Cancer Screening: Video-Reviewed Flexible Sigmoidoscopy by Nurse Endoscopists — A Canadian Community-Based Perspective
Authors: Shapero TF , Alexander PE , Hoover J , Burgis E , Schabas R 
Published: March 2016

BACKGROUND: Colorectal cancer (CRC) is the third most common incident cancer and the second most fatal cancer in Canada. Flexible sigmoidoscopy (FS) is one of the modalities under consideration for CRC screening. The present series reports on a screening program of FS performed by nonphysician endoscopists in a Canadian community setting, with video review of procedures by physicians and recommendation of follow-up colonoscopy where polyps are identified.RESULTS: Five hundred twenty-five, average-risk, asymptomatic patients were examined. After exclusion of inappropriate referrals, 488 remained for analysis. The duration and extent of examination were comparable with those of previous studies elsewhere. Compliance with suggested follow-up was 97.3%. Polyps were identified at FS in 15.4% of examinees. In 8.2% of patients, the polyps were neoplastic at subsequent histology. Four malignant lesions were detected, all at an early stage. There were no complications of FS.INTERPRETATION: This report shows that FS can be carried out safely and effectively by nonphysician personnel in a community setting in Canada. The manpower cost for nonphysician operators is considerably less than that for specialist physician endoscopists. This approach deserves consideration in cost effectiveness analyses of CRC screening.
Gastric Acid Secretory Response inHelicobacter pylori-Positive Patients with Duodenal Ulcer Disease
Authors: Jacobson Kevan , Chiba Naoki , Chen Ying , Barrientos Miguel , James Cindy , Riddell Robert H , Hunt Richard H 
Published: March 2016

BACKGROUND: Patients with duodenal ulcer (DU) have an increased parietal cell mass and sensitivity to secretagogues, with increased acid output.AIM: To determine the effect ofHelicobacter pylorieradication on parietal cell sensitivity and gastric acid secretion.SUBJECTS AND METHODS: Twenty-fiveH pylori-positive DU patients and 18H pylori-negative healthy volunteers were studied. SerumH pyloriimmunoglobulin G, basal acid output and acid secretory response to graded doses of pentagastrin were determined before and after treatment, at six months and at one year. Subjects were randomly assigned to ranitidine or sucralfate treatment for six weeks, and all DU patients received bismuth subsalicylate, metronidazole and tetracycline for the first two weeks.RESULTS:H pyloriwas eradicated in 66% of patients receiving sucralfate and 92% receiving ranitidine. Compared with healthy volunteers, DU patients demonstrated a 2.7-fold greater basal acid output, a 1.3-fold greater peak acid output, significantly higher acid output for each dose of pentagastrin and a 1.38-fold increase in the area under the pentagastrin dose acid response curve. Cure ofH pylori, irrespective of ulcer healing regimen, resulted in a gradual decrease in acid secretory capacity with basal acid output, peak acid output and area under the pentagastrin dose acid response curve returning to healthy volunteer levels by one year. No demonstrable differences were observed in parietal cell sensitivity in all subjects before or after treatment. These data suggest that disturbances in acid secretion inH pylori-positive DU patients are not due to an increased parietal cell sensitivity to pentagastrin but rather due to an increased parietal cell mass with increased capacity to secrete acid, which gradually resolves following cure.
Laparoscopic versus Open Bowel Resection for Crohn's Disease
Authors: Tabet Jeanine , Hong Dennis , Kim Cei-Whan , Wong Jason , Goodacre Robert , Anvari Mehran 
Published: March 2016

BACKGROUND: Laparoscopic bowel resection is an alternative to open surgery for patients with Crohn's disease requiring surgical resection. The present report describes a seven-year experience with the laparoscopic treatment of Crohn's disease compared with the open technique in a tertiary Canadian centre.PATIENTS AND METHODS: A retrospective analysis of 61 consecutive patients undergoing elective resection for Crohn's disease was carried out between October 1992 and June 1999. This analysis included 32 laparoscopic resections (mean age 33 years) and 29 open resections (mean age 42 years). Patient demographics were compared, as well as short and long term outcomes after surgery (mean follow-up 39 months).RESULTS: Patients in the laparoscopic group were younger and had fewer previous bowel surgeries than patients who had open resections. Indications for surgery and operative times were similar between the groups. Patients who underwent laparoscopic resections required fewer doses of narcotic analgesics. The resumption of bowel function after surgery, and tolerance of a clear liquid and solid diet was quicker in the laparoscopic group. Patients who underwent laparoscopic resections had significantly shorter hospital stays than those who underwent open resections. Fifteen patients (48.4%) in the laparoscopic group experienced recurrence of disease compared with 13 patients (44.8%) in the open group. In both groups, the most common site of recurrence was at the anastomosis. The disease-free interval was the same length for both groups (23.9±17.3 months for the laparoscopic resection patients compared with 23.9±20.2 months for the open resection patients; P=1.00).CONCLUSIONS: Laparoscopic resection for Crohn's disease can be performed safely and effectively. Quicker resumption of oral feeds, less postoperative pain and earlier discharge from hospital are advantages of the laparoscopic method. No differences in the recurrence rate or the disease-free interval were noted.
Upper Gastrointestinal Bleeding as a Metastatic Manifestation of Breast Cancer: A Case Report and Review of the Literature
Authors: Reiman Tony , Butts Charles A 
Published: March 2016

CASE PRESENTATION: 64-year-old woman with known metastatic lobular breast cancer presented with fever, epigastric pain, hematemesis and melena. A bleeding, ulcerated gastric metastasis was found and was treated with endoscopic therapy, omeprazole and hormonal therapy; the patient was alive and well 13 months later. The bleeding was probably precipitated by necrosis of the lesion during chemotherapy.DISCUSSION: Gastrointestinal tract metastases from primary breast carcinoma are present in 14% to 35% of cases in autopsy series, with gastric involvement in 6% to 18%. Recognized much less commonly during life than in autopsy studies, they can occur anywhere in the gut and can mimic virtually any gastrointestinal disorder. Endoscopy and barium studies facilitate diagnosis. Gastric lesions seen include 'linitis plastica', nodules, polyps and ulcers. They are usually due to lobular breast carcinoma and resemble primary gastric carcinoma on microscopy. Reported cases of bleeding gastric metastases have been treated successfully with various local and systemic modalities. The median survival time of reviewed cases was four months from presentation (range, 0 to 24 months).CONCLUSION: Gastrointestinal metastasis is an underdiagnosed complication of breast cancer. Gastrointestinal bleeding from metastatic breast cancer is an uncommon presentation that is readily diagnosed and that can be treated successfully by endoscopic hemostatic therapy.
Genomically Driven Tumors and Actionability across Histologies:BRAF-Mutant Cancers as a Paradigm
Authors: Turski Michelle L. , Vidwans Smruti J. , Janku Filip , Garrido-Laguna Ignacio , Munoz Javier , Schwab Richard , Subbiah Vivek , Rodon Jordi , Kurzrock Razelle 
Published: March 2016

AbstractThe diagnosis, classification, and management of cancer are traditionally dictated by the site of tumor origin, for example, breast or lung, and by specific histologic subtypes of site-of-origin cancers (e.g., non–small cell versus small cell lung cancer). However, with the advent of sequencing technologies allowing for rapid, low cost, and accurate sequencing of clinical samples, new observations suggest an expanded or different approach to the diagnosis and treatment of cancer—one driven by the unique molecular features of the tumor. We discuss a genomically driven strategy for cancer treatment using BRAF as an example. Several key points are highlighted: (i) molecular aberrations can be shared across cancers; (ii) approximately 15% of all cancers harbor BRAF mutations; and (iii) BRAF inhibitors, while approved only for melanoma, have reported activity across numerous cancers and related disease types bearing BRAF aberrations. However, BRAF-mutated colorectal cancer has shown poor response rate to BRAF inhibitor monotherapy, striking a cautionary note. Yet, even in this case, emerging data suggest BRAF-mutated colorectal cancers can respond well to BRAF inhibitors, albeit when administered in combination with other agents that impact resistance pathways. Taken together, these data suggest that molecular aberrations may be the basis for a new nosology for cancer. Mol Cancer Ther; 15(4); 533–47. ©2016 AACR.
Home treatment of patients with low-risk pulmonary embolism with the oral factor Xa inhibitor rivaroxaban
Authors: Barco Stefano , Lankeit Mareike , Binder Harald , Schellong Sebastian , Christ Michael , Beyer-Westendorf Jan , Duerschmied Daniel , Bauersachs Rupert , Empen Klaus , Held Matthias , Schwaiblmair Martin , Fonseca Cândida , Jiménez David , Becattini Cecilia , Quitzau Kurt , Konstantinides Stavros 
Published: March 2016

SummaryPulmonary embolism (PE) is a potentially life-threatening acute cardiovascular syndrome. However, more than 95 % of patients are haemodynamically stable at presentation, and among them are patients at truly low risk who may qualify for immediate or early discharge. The Home Treatment of Pulmonary Embolism (HoT-PE) study is a prospective international multicentre single-arm phase 4 management (cohort) trial aiming to determine whether home treatment of acute lowrisk PE with the oral factor Xa inhibitor rivaroxaban is feasible, effective, and safe. Patients with confirmed PE, who have no right ventricular dysfunction or free floating thrombi in the right atrium or ventricle, are eligible if they meet none of the exclusion criteria indicating haemodynamic instability, serious comorbidity or any condition mandating hospitalisation, or a familial/social environment unable to support home treatment. The first dose of rivaroxaban is given in hospital, and patients are discharged within 48 hours of presentation. Rivaroxaban is taken for at least three months. The primary outcome is symptomatic recurrent venous thromboembolism or PE-related death within three months of enrolment. Secondary outcomes include quality of life and patient satisfaction, and health care resource utilisation compared to existing data on standard-duration hospital treatment. HoT-PE is planned to analyse 1,050 enrolled patients, providing 80 % power to reject the null hypothesis that the recurrence rate of venous thromboembolism is >3 % with α≤0.05. If the hypothesis of HoT-PE is confirmed, early discharge and out-of-hospital treatment may become an attractive, potentially cost-saving option for a significant proportion of patients with acute PE.
Does Antihypertensive Drug Class Affect Day‐to‐Day Variability of Self‐Measured Home Blood Pressure? The HOMED‐BP Study
Authors: Asayama Kei , Ohkubo Takayoshi , Hanazawa Tomohiro , Watabe Daisuke , Hosaka Miki , Satoh Michihiro , Yasui Daisaku , Staessen Jan A. , Imai Yutaka ,   the Hypertensive Objective Treatment Based on Measurement by Electrical Devices of Blood Pressure (HOMED‐BP) Study Investigators
Published: March 2016

Background

Recent literature suggests that blood pressure variability (
BPV
) predicts outcome beyond blood pressure level (
BPL
) and that antihypertensive drug classes differentially influence
BPV
. We compared calcium channel blockers, angiotensin‐converting enzyme inhibitors, and angiotensin receptor blockade for effects on changes in self‐measured home
BPL
and
BPV
and for their prognostic significance in newly treated hypertensive patients.

Methods and Results

We enrolled 2484 patients randomly allocated to first‐line treatment with a calcium channel blocker (n=833), an angiotensin‐converting enzyme inhibitor (n=821), or angiotensin receptor blockade (n=830). Home blood pressures in the morning and evening were measured for 5 days off treatment before randomization and for 5 days after 2 to 4 weeks of randomized drug treatment. We assessed
BPL
and
BPV
changes as estimated by variability independent of the mean and compared cardiovascular outcomes. Home
BPL
response in each group was significant (
P
≤0.0001) but small in the angiotensin‐converting enzyme inhibitor group (systolic/diastolic: 4.6/2.8 mm Hg) compared with the groups treated with a calcium channel blocker (systolic/diastolic: 8.3/3.9 mm Hg) and angiotensin receptor blockade (systolic/diastolic: 8.2/4.5 mm Hg). In multivariable adjusted analyses, changes in home variability independent of the mean did not differ among the 3 drug classes (
P
≥0.054). Evening variability independent of the mean before treatment significantly predicted hard cardiovascular events independent of the corresponding home
BPL
(
P
≤0.022), whereas
BPV
did not predict any cardiovascular outcome based on the morning measurement (
P
≥0.056). Home
BPV
captured after monotherapy had no predictive power for cardiovascular outcome (
P
≥0.22).

Conclusions

Self‐measured home evening
BPV
estimated by variability independent of the mean had prognostic significance, whereas antihypertensive drug classes had no significant impact on
BPV
changes. Home
BPL
should remain the primary focus for risk stratification and treatment.

Clinical Trial Registration

URL
:
http://www.umin.ac.jp/ctr/index.htm
. Unique identifier: C000000137.
The cavernous sinus in cluster headache – a quantitative structural magnetic resonance imaging study
Authors: Arkink Enrico B , Schoonman Guus G , van Vliet Jorine A , Bakels Hannah S , Sneeboer Marjolein AM , Haan Joost , van Buchem Mark A , Ferrari Michel D , Kruit Mark C 
Published: March 2016

Background It has been hypothesized that a constitutionally narrow cavernous sinus might predispose individuals to cluster headache. Cavernous sinus dimensions, however, have never been assessed. Methods In this case–control study, we measured the dimensions of the cavernous sinus, skull base, internal carotid and pituitary gland with high-resolution T2-weighted magnetic resonance imaging in 25 episodic, 24 chronic and 13 probable cluster headache patients, 8 chronic paroxysmal hemicrania patients and 22 headache-free controls. Dimensions were compared between groups, correcting for age, sex and transcranial diameter. Results On qualitative inspection, no relevant pathology or anatomic variants that were previously associated with cluster headache or chronic paroxysmal hemicranias were observed in the cavernous sinus or paracavernous structures. The left-to-right transcranial diameter at the temporal fossa level (mean ± SD) was larger in the headache groups (episodic cluster headache: 147.5 ± 7.3 mm, p = 0.044; chronic cluster headache: 150.2 ± 7.3 mm, p < 0.001; probable cluster headache: 146.0 ± 5.3 mm, p = 0.012; and chronic paroxysmal hemicrania: 145.2 ± 9.4 mm, p = 0.044) compared with controls (140.2 ± 8.0 mm). After adjusting for transcranial diameter and correcting for multiple comparisons, there were no differences in the dimensions of the cavernous sinus and surrounding structures between headache patients and controls. Conclusion Patients with cluster headache or chronic paroxysmal hemicrania had wider skulls than headache-free controls, but the proportional dimensions of the cavernous sinus were similar.
Attitudes towards reforming primary care in Belgium: social network analysis in a pluralist context
Authors: Lorant Vincent , Rihoux Benoît , Nicaise Pablo 
Published: March 2016

Objectives Health care policies are influenced by many groups which in turn influence each other. Our aim was to describe a network of nominated influential stakeholders and analyze how it affects attitudes to reforming primary care. Methods Face-to-face interviews were carried out in Belgium with 102 influential people. Each respondent was asked to score solutions for improving the role of general practice in the health care system and to nominate up to six other influential stakeholders. Social network and multivariate analyses were used to describe the nomination network and its effect on attitudes to reform. Results The network was highly centralized and homophilous (tendency to bond with people who are similar) for language groups. Despite Belgium having a strong pluralist tradition of decision making, policy makers were central to the network (average indegree = 10.8) compared to professional representatives (6.9). Respondents supported an enhanced role for general practitioners but did not support radically new policies. Conclusion Social network analysis contributes to understanding why health care reforms may languish in pluralistic, decentralized health care systems. The central position of a stakeholder in a network is related to perceived influence but does not favour a radical policy orientation. In addition, language-group homophily in the ‘perceived influence network’ leads to a weak coalition that only favours small-step reform.
The association of angiotensin-converting enzyme gene insertion/deletion polymorphisms with adaptation to high altitude: A meta-analysis
Authors: Wang Yuxiao , Lu Hongxiang , Chen Yu , Luo Yongjun 
Published: March 2016

Background: Fluid retention is linked to the physiology and pathophysiology of humans at high altitude (HA). The angiotensin-converting enzyme (ACE) gene plays a role in the regulation of plasma volume and vascular tone. Materials and methods: In this meta-analysis, eligible studies published before 1 September 2015 that focused on the association between the ACE insertion/deletion (I/D) polymorphism and HA adaption were identified by searching the PubMed, Web of Science, Embase and Medline online databases. We used a fixed-effects model and assessed the study qualities multiple times. Results: The seven selected studies included a total of 582 HA-native individuals and 497 low-altitude controls, and these subjects were analyzed for the ACE I/D gene polymorphism. A significant association was found between the ACE DD genotype and HA maladaptation. The results for genotype DD versus ID + II were as follows: Odds ratio (OR) = 0.46; 95% CI 0.31–0.70; p = 0.0002. The results for genotype ID versus DD were as follows: OR = 1.97; 95% CI 1.27–3.06; p = 0.002. Conclusions: Our findings suggested that the DD genotype of ACE is a risk factor for HA maladaptation and that the presence of fewer ACE DD allele carriers in a population indicates a greater ability of that population to adapt to HA.
Fare Prediction Websites and Transaction Prices: Empirical Evidence from the Airline Industry
Authors: Mantin Benny , Rubin Eran 
Published: March 2016

The marketing and operations disciplines have increasingly accounted for the presence of strategic consumer behavior. Theory suggests that such behavior exists when consumers are able to consider future distribution of prices, and that this behavior exposes firms to intertemporal competition that results with a downward pressure on prices. However, deriving future distribution of prices is not a trivial task. Online decision support tools that provide consumers with information about future distributions of prices can facilitate strategic consumer behavior. This paper studies whether the availability of such information affects transacted prices by conducting an empirical analysis in the context of the airline industry. Studying the effect at the route level, we find significant price reduction effects as such information becomes available for a route, both in fixed-effects and difference-in-differences estimation models. This effect is consistent across the different fare percentiles and amounts to a reduction of approximately 4%–6% in transactions’ prices. Our results lend ample support to the notion that price prediction decision tools make a statistically significant economic impact. Presumably, consumers are able to exploit the information available online and exhibit strategic behavior. Data, as supplemental material, are available at http://dx.doi.org/10.1287/mksc.2015.0965 .