bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Moringa oleifera Lam. leaf powder on the pharmacokinetics of nevirapine in HIV-infected adults: a one sequence cross-over study
Authors: Monera-Penduka Tsitsi G. , Maponga Charles C. , Wolfe Alan R. , Wiesner Lubbe , Morse Gene D. , Nhachi Charles F. B. 
Published: March 2017

AbstractBackgroundMoringa oleiferaLam., an herb commonly consumed by HIV-infected people on antiretroviral therapy, inhibits cytochrome P450 3A4, 1A2 and 2D6 activity in vitro; and may alter the pharmacokinetics (PK) of antiretroviral drugs metabolized via the same pathways. However, in vitro drug interaction activity may not translate to a clinically significant effect. Therefore, the effect of moringa leaf powder on the PK of nevirapine in HIV-infected people was investigated.MethodsAdult patients at steady-state dosing with nevirapine were admitted for 12-h intensive PK sampling following a 21-day herbal medicine washout. Blood sampling was repeated after 14 days of nevirapine and moringa (1.85 g leaf powder/day) co-administration. Nevirapine plasma concentrations were determined by liquid chromatography-tandem mass spectrometry. To assess the effect of moringa on nevirapine PK, the change in nevirapine area under the plasma concentration–time curve (AUC) was determined. The mean difference in pre- and post-moringa nevirapine, maximum concentration (Cmax) and concentration at 12 h (C12h) were also calculated. The PK parameters were compared by assessing the post/pre geometric mean ratios (GMRs) and associated 90% confidence intervals (CIs).ResultsPharmacokinetics analyses were performed on the results from 11 participants for whom complete data were obtained. The post/pre GMRs and associated 90% CIs for nevirapine were 1.07 (1.00–1.14) for the AUC; 1.06 (0.98–1.16) for Cmaxand 1.03 (0.92–1.16) for C12h.ConclusionCo-administration ofMoringa oleiferaLam. leaf powder at the traditional dose did not significantly alter the steady-state PK of nevirapine.Trial registration numberNCT01410058 (ClinicalTrials.gov)
Transoral robotic surgery with radial forearm free flap reconstruction: Case control analysis
Authors: Biron Vincent L. , O'Connell Daniel A. , Barber Brittany , Clark Jessica M. , Andrews Colin , Jeffery Caroline C. , Côté David W. J. , Harris Jeffrey , Seikaly Hadi 
Published: March 2017

Background The resection of large oropharyngeal tumors traditionally involves a lip-splitting mandibulotomy for adequate margin visualization and free flap reconstruction of the surgical defect. Transoral robotic surgery (TORS) has emerged as a technique that can resect large and complex oropharyngeal tumors, avoiding a lip-splitting approach. The aim of this study is to compare the lip-splitting mandibulotomy approach versus TORS for the management of advanced stage oropharyngeal carcinomas. Methods Prospectively collected data from 18 patients with advanced stage oropharyngeal squamous cell carcinoma (OPSCC) who received TORS with radial forearm free flap reconstruction (RFFF) was compared to a matched cohort of 39 patients who received a lip-splitting mandibulotomy and RFFF. Patients were matched for stage, p16 positivity, smoking, age and gender. Length of hospital stay (LOHS), tracheostomy decanulation time, operative time, surgical margin status, and post-operative complications were compared between groups. Results Patients who received TORS with RFFF had a significantly lower mean LOHS, compared to patients who were treated by lip-splitting mandibulotomy and RFFF (14.4 vs 19.7 days, p = 0.03). No significant differences were seen between groups in terms of operative time, tracheostomy decannulation time, margin positivity and post-operative complications. Conclusion TORS with radial forearm free flap reconstruction is a safe, effective and cost-saving alternative to the lip-splitting mandibulotomy approach for the treatment of advanced stage OPSCC.
Lymphoma Remissions Caused by Anti-CD19 Chimeric Antigen Receptor T Cells Are Associated With High Serum Interleukin-15 Levels
Authors: Kochenderfer James N. , Somerville Robert P.T. , Lu Tangying , Shi Victoria , Bot Adrian , Rossi John , Xue Allen , Goff Stephanie L. , Yang James C. , Sherry Richard M. , Klebanoff Christopher A. , Kammula Udai S. , Sherman Marika , Perez Arianne , Yuan Constance M. , Feldman Tatyana , Friedberg Jonathan W. , Roschewski Mark J. , Feldman Steven A. , McIntyre Lori , Toomey Mary Ann , Rosenberg Steven A. 
Published: March 2017

Purpose T cells genetically modified to express chimeric antigen receptors (CARs) targeting CD19 (CAR-19) have potent activity against acute lymphoblastic leukemia, but fewer results supporting treatment of lymphoma with CAR-19 T cells have been published. Patients with lymphoma that is chemotherapy refractory or relapsed after autologous stem-cell transplantation have a grim prognosis, and new treatments for these patients are clearly needed. Chemotherapy administered before adoptive T-cell transfer has been shown to enhance the antimalignancy activity of adoptively transferred T cells. Patients and Methods We treated 22 patients with advanced-stage lymphoma in a clinical trial of CAR-19 T cells preceded by low-dose chemotherapy. Nineteen patients had diffuse large B-cell lymphoma, two patients had follicular lymphoma, and one patient had mantle cell lymphoma. Patients received a single dose of CAR-19 T cells 2 days after a low-dose chemotherapy conditioning regimen of cyclophosphamide plus fludarabine. Results The overall remission rate was 73% with 55% complete remissions and 18% partial remissions. Eleven of 12 complete remissions are ongoing. Fifty-five percent of patients had grade 3 or 4 neurologic toxicities that completely resolved. The low-dose chemotherapy conditioning regimen depleted blood lymphocytes and increased serum interleukin-15 (IL-15). Patients who achieved a remission had a median peak blood CAR+ cell level of 98/μL and those who did not achieve a remission had a median peak blood CAR+ cell level of 15/μL ( P = .027). High serum IL-15 levels were associated with high peak blood CAR+ cell levels ( P = .001) and remissions of lymphoma ( P < .001). Conclusion CAR-19 T cells preceded by low-dose chemotherapy induced remission of advanced-stage lymphoma, and high serum IL-15 levels were associated with the effectiveness of this treatment regimen. CAR-19 T cells will likely become an important treatment for patients with relapsed lymphoma.
Investigating Associations Between Health-Related Quality of Life and Endocrine Therapy Underuse in Women With Early-Stage Breast Cancer
Authors: Pinheiro Laura C. , Wheeler Stephanie B. , Reeder-Hayes Katherine E. , Samuel Cleo A. , Olshan Andrew F. , Reeve Bryce B. 
Published: March 2017

Purpose: Endocrine therapy (ET) underuse puts women at increased risk for breast cancer (BC) recurrence. Our objective was to determine if health-related quality of life (HRQOL) subgroups were associated with underuse. Methods: Data came from the third phase of the Carolina Breast Cancer Study. We included 1,599 women with hormone receptor–positive BC age 20 to 74 years. HRQOL was measured, on average, 5 months postdiagnosis. Subgroups were derived using latent profile (LP) analysis. Underuse was defined as not initiating or adhering to ET by 36 months postdiagnosis. Multivariable logistic regression models estimated adjusted odds ratios (ORs) between HRQOL LPs and underuse. The best HRQOL LP was the reference. Chemotherapy- and race-stratified models were estimated, separately. Results: Initiation analyses included 953 women who had not begun ET by their 5-month survey. Of these, 154 never initiated ET. Adherence analyses included 1,114 ET initiators, of whom 211 were nonadherent. HRQOL was not significantly associated with noninitiation, except among nonchemotherapy users, with membership in the poorest LP associated with increased odds of noninitiation (adjusted OR, 5.5; 95% CI, 1.7 to 17.4). Membership in the poorest LPs was associated with nonadherence (LP1: adjusted OR, 2.2; 95% CI, 1.2 to 4.0 and LP2: adjusted OR,1.9; 95% CI, 1.1 to 3.6). Membership in the poorest LP was associated with nonadherence among nonchemotherapy users (adjusted OR, 2.1; 95% CI, 1.2 to 5.1). Conclusion: Our results suggest women with poor HRQOL during active treatment may be at increased risk for ET underuse. Focusing on HRQOL, a modifiable factor, may improve targeting of future interventions early in the BC continuum to improve ET initiation and adherence and prevent BC recurrence.
Mild Cognitive Impairment and Exposure to General Anesthesia for Surgeries and Procedures: A Population-Based Case–Control Study
Authors: Sprung Juraj , Roberts Rosebud O. , Knopman David S. , Price Lauren L. , Schulz Hunter P. , Tatsuyama Christie L. , Weingarten Toby N. , Schroeder Darrell R. , Hanson Andrew C. , Petersen Ronald C. , Warner David O. 
Published: March 2017

BACKGROUND:
To examine whether exposure to general anesthesia for procedures at age ≥40 years is associated with prevalent mild cognitive impairment (MCI) in the elderly.

METHODS:
A case–control study nested within a population-based cohort. Olmsted County, Minnesota, residents, aged 70–91 years, underwent baseline evaluations that included the Clinical Dementia Rating scale, a neurologic evaluation, and neuropsychologic testing. Individuals identified with MCI (cases) at enrollment were matched 1:2 on age, sex, education, and apolipoprotein genotype with participants who were cognitively normal at the time of the index visit. Medical records from age 40 years until the index visit were reviewed to determine exposures to general anesthesia. Conditional logistic regression, taking into account the matched set study design and adjusting for MCI risk factors, was used to assess whether exposure to anesthesia after the age of 40 years was associated with prevalent MCI.

RESULTS:
A total of 387 Mayo Clinic Study of Aging participants (219 males, 168 females) were diagnosed with MCI at enrollment with mean age of 81 ± 5 years. Exposure to general anesthesia after the age of 40 years was not significantly associated with prevalent MCI when analyzed as a dichotomous variable (any versus none, adjusted odds ratio, 0.97 [95% confidence interval, 0.68–1.40]) or the number of exposures (odds ratio, 1.13 [0.74–1.72], 0.81 [0.53–1.22], and 1.03 [0.67–1.58] for 1, 2–3, and ≥4 exposures, respectively, with no exposure as the reference). Similar results were obtained for exposure to anesthesia after the age of 60 years and during 5, 10, and 20 years before the first visit.

CONCLUSIONS:
Exposure to general anesthesia for procedures at age ≥40 years was not associated with prevalent MCI in the elderly.
Wnt proteins synergize to activate β-catenin signaling
Authors: Alok Anshula , Lei Zhengdeng , Jagannathan N. Suhas , Kaur Simran , Harmston Nathan , Rozen Steven G. , Tucker-Kellogg Lisa , Virshup David M. 
Published: March 2017

ABSTRACT
Wnt ligands are involved in diverse signaling pathways that are active during development, maintenance of tissue homeostasis and in various disease states. While signaling regulated by individual Wnts has been extensively studied, Wnts are rarely expressed alone, and the consequences of Wnt gene co-expression are not well understood. Here, we studied the effect of co-expression of Wnts on the β-catenin signaling pathway. While some Wnts are deemed ‘non-canonical’ due to their limited ability to activate β-catenin when expressed alone, unexpectedly, we find that multiple Wnt combinations can synergistically activate β-catenin signaling in multiple cell types. WNT1- and WNT7B-mediated synergistic Wnt signaling requires FZD5, FZD8 and LRP6, as well as the WNT7B co-receptors GPR124 (also known as ADGRA2) and RECK. Unexpectedly, this synergistic signaling occurs downstream of β-catenin stabilization, and is correlated with increased lysine acetylation of β-catenin. Wnt synergy provides a general mechanism to confer increased combinatorial control over this important regulatory pathway.
Natura: Carbono Neutro
Authors: Berardi Patrícia , Monzoni Neto Mario Prestes 
Published: March 2017

Em 2005, a Natura buscou entender a questão das mudanças climáticas, com foco mais preciso no aquecimento global e em como este poderia ter impactos nos seus negócios. Quais seriam os riscos e oportunidades que o aquecimento global poderia trazer para a empresa? Buscou informação e benchmarks, dentro e fora do seu segmento de atuação, e concluiu pela adoção de uma total neutralização das emissões vinculadas ao processo produtivo de toda a cadeia. Isto colocou a Natura em uma posição de destaque, não só no seu segmento de atuação, mas até mesmo no panorama internacional.
Transplantion of autologous cells of stromal vascular fraction of adipose tissue in severe local radiation injuries of skin caused by x-ray
Authors: Бушманов  , Bushmanov Andrey , Самойлов  , Samoylov Alyeksandr , Добрынина  , Dobrynina O. , Лырщикова  , Lyrshchikova A. , Дешевой  , Deshevoy Yu. , Насонова  , Nasonova T. , Лебедев  , Lebedev V. , Мороз  , Moroz B. 
Published: March 2017

Purpose: To investigate the effectiveness of autologous cells of stromal vascular fraction of adipose tissue in severe local radiation skin injuries after the
exposure of rats to X-rays.
Material and methods: Experiments were performed on Wistar rats, weighing 200–230 g. Rats were exposed locally in iliolumbar region using X-ray
machine LNC-268 (RAP 100-10) at a dose of 110 Gy (30 kV tube voltage, current 6.1 mA, thick Al filter 0.1 mm), dose rate: 17.34 Gy/min. Area of the
irradiation field was 8.2–8.5 cm2. Transplantation of autologous cells of stromal vascular fraction (SVFC) of adipose tissue was carried out on 21st or 35th
days after irradiation. SVFC isolation was performed by means of enzymatic treatment of adipose tissue. SVFC suspension was administered subcutaneously
at a dose of 1×106 cells per injection around the radiation ulcers.The severity of radiation damage to the skin and the effects of cellular therapy were evaluated
in the dynamics of clinical manifestations, with the help of plane geometry and pathomorphometry.
Results: It was found that by the 17–25th day after irradiation radiation ulcers were formedon rat skin. In the control group of animalsulcers persisted
throughout the observation period of more than 3 months. The area of ulcers was 1,87 ± 0,35 cm2 and 1.52 ± 0.24 cm2 at 83th and 90th days after irradiation,
respectively. In animals of the experimental group, with autologous stromal vascular fraction of adipose tissue, was significant decrease in ulceration the
area in comparison to control animals. In 80 % of the rats treated with SVFC on 21st day after exposure, to the 90th day after irradiation complete healing
of ulcers occurred with the formation of atrophic scar at the site of radiation injuries. These clinical observations and planimetric were correlated with the
results of histomorphometry.
Conclusion: Transplantation autologous SVFC of adipose tissue contributes to accelerate the healing of radiation ulcers after local x-ray exposure in the
experiment, indicating that the prospects of using adipose tissue cell products for the treatment of severe local radiation injuries.
Radiation Risk of Incidence of Hypertensia among Russian Recovery Operation Workers of the Chernobyl Accident
Authors: Щукина  , Shchukina N. , Власов  , Vlasov O. , Кочергина  , Kochergina E. , Корело  , Korelo A. , Туманов  , Tumanov K. , Карпенко  , Karpenko S. , Кащеев  , Kashcheev V. , Максютов  , Maksyutov M. , Чекин  , Chekin S. , Иванов  , Ivanov V. , Ловачев  , Lovachev S. 
Published: March 2017

Purpose: The main purpose of the research is to define the group of radiation risk (GRR) on the incidence of hypertension among Russian recovery operation workers of the Chernobyl accident (liquidators).
Material and methods: The object of research is the cohort of the Russian liquidators with the known individual doses of external gamma exposure of all body. Definition of GRR on incidence of hypertension is based on assessment of excess relative radiation risk (ERR) and relative radiation risk (RR) in the observed cohort of 106 thousand liquidators, having average accumulated dose of external gamma exposure of all body of 0.11 Gy and the maximum individual doses about 1 Gy.
Results: From 1986 to 2012 in this cohort 57112 cases of hypertension have been diagnosed, basically – essential (primary) hypertension (39.2 %) and hypertensive heart disease (53.8 %). The statistically significant ERR of incidence of hypertension was observed only for liquidators who entered the Chernobyl zone of recovery operations within the first year after the accident (before 26.04.1987): ERR/Gy = 0.26 with 95 % CI (0.12; 0.41), p &#60; 0.001. For other liquidators no significant associations between the explosion dose and the incidence of hypertension were revealed. For nonparametric estimates of RR in dose groups (relative to the control group with doses &#60; 0.05 Gy) the statistically significant radiation risk was observed only for the dose group over 0,25 Gy: RR = 1.07 at 95 % of CI (1.02; 1.12), p = 0.023. GRR on incidence of hypertension equal to 4 % of the number of the studied cohort of liquidators: 4515 persons with accumulated doses of 0.25 Gy and higher, arrived to the Chernobyl area within the first year after the accident. In GRR 2597 cases of diseases of hypertension were diagnosed; statistically significant (p = 0.023) assessment of RR is equal 1.07, with 95 % a confidential interval (1.02; 1.12) and an average dose 0.297 Gy. During observation from 1986 to 2012 6.5 % of cases of diseases of hypertension (170 cases) in GRR can be related to radiation-caused ones. GRR for the beginning of 2013 consisted of 2919 persons 1909 of whom had already had diagnoses of hypertension (125 – radiation caused). Since 2013 for lifetime in GRR from 43 to 66 cases of diseases of hypertension which can be related to radiation-caused are expected.
Conclusion: As hypertension is the risk factor for many circulatory diseases, address prevention and treatment of hypertension in GRR in the first years after radiation accidents could reduce the radiation-caused loss healthy years of participants of elimination of such accidents.
Incidence of Neutropenia in Veterans Receiving Lung Cancer Chemotherapy: A
Comparison of Administrative Coding and Electronic Laboratory Data
Authors: Knerr Sarah , Hu Elaine , Zeliadt Steven 
Published: March 2017

Introduction: The frequency of neutropenia associated with lung cancer
chemotherapy outside of randomized trials is largely unknown because administrative
coding underestimates its prevalence. This study compared International Classification
of Diseases (ICD) diagnosis codes and electronic laboratory results, alone and in
combination, for identifying neutropenia events.Methods: Retrospective cohort study of
718 veterans receiving their first course of chemotherapy for non-small cell lung
cancer. Incidence of neutropenia was assessed using electronic laboratory results and
ICD-9 codes captured in the Department of Veterans Affairs (VA) electronic medical
records (EMR).Results: A total of 118 of 718 patients (16.4 percent) were identified
with an absolute neutrophil count (ANC) less than 1,000 cells/mm3, while only 49 of 718
patients (6.8 percent) had ICD-9 codes for neutropenia. Using the combination of
laboratory results and diagnosis codes, 136 of 718 patients (18.9 percent) experienced a
neutropenic event. Compared to laboratory results as a gold standard, diagnosis codes
were specific (not present for individuals without a laboratory-documented low ANC), but
not sensitive (missing for many individuals with a low ANC documented in their
laboratory test results).Conclusion: Relying on ICD codes to identify neutropenia in
administrative data likely results in under-reporting. The emerging availability of
electronic laboratory results provides an opportunity to more accurately quantify
patterns of neutropenia, identify individual risk factors, and assess clinical
management practices—including use of colony-stimulating factor prophylaxis—in large
community cohorts.
PENILAIAN KINERJA OBJEK WISATA TAMAN MARGASATWA MANGKANG BERDASARKAN PERSEPSI PENGUNJUNG
Authors: Handayani Siti , Sariffuddin Sariffuddin 
Published: March 2017

Semarang has a lot of potential for tourism which revealed good performance by increasing the number of tourists every year. Mangkang wildlife park is one of main attractions in Semarang developed with the primary functions of conservation and education through animal breeding attractions, and recreation as a supporting function. The main reasons for visiting zoos were family recreation and seeing many different animals, therefore the zoo environment will affect the perception of visitors. Perception can be measured by visitor satisfaction as one indicator of successfully tourism performance. Nevertheless, there are some problems on the development, management, and implementation of Mangkang wildlife park that affect its performance and makes fluctuations number of visitors every year. This research aims to assess the performance of the Mangkang wildlife park attractions based on visitors perception. The analytical method used in this study is quantitative method, and using accidental sampling as a sampling techniques with a sample of 100 respondents. Collecting data is both primary and secondary data will be analyzed using descriptive statistical analysis. The performance assessment of Mangkang wildlife park have a GOOD criteria with overall satisfaction value 0.66 or SATISFIED criteria, but the criteria is not exactly can be seen from the result of the performance assessment towards the variation and completeness of animals because most visitors are dissatisfied with the attractions of breeding animals that have poor performance. So most visitors prefer using visits to recreation because demand for the main attractions have not been met. The satisfaction of tourists during visiting to Mangkang wildlife park also influenced by the services excellence/ completely facilities, promotion, and available transportation.
Tourism-themed internet portals – are new media creating a new tourist? A case study of Polish students
Authors: Jażdżewska Iwona , Jagnuszewska Anna 
Published: March 2017

Abstract
Internet media have an influence on many tourism-related issues. This article presents the results of research into the role of tourism-themed portals in the trips taken by Polish university students between 2010 and 2012. The research sought to answer the following questions: whether tourism-related internet media have an influence on the students’ behaviour before, during the trip and when they arrive at their destination; how often they are used by the respondents during their trips; and whether Polish students actively participate in internet media by voicing their opinions. As it appears, internet media serve as one of the “travel companions” for young people. They are used when preparing the trip, the vast majority “take them” with them and check them during the trip, while almost half of them check them on vacation, e.g. to share their experience over the internet.