bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of pre-operative methylprednisolone on the incidence of delayed graft function in renal transplantation
Authors: Fong Nigel Jie Ming , Fan Petrina Yuen Wai , Fook-Chong Stephanie Man Chung , Kee Terence Yi Shern 
Published: February 2016

Introduction: This study explores the effect of different corticosteroid administration timings on the incidence of slow/delayed graft function. Methods: One hundred and twelve kidney transplants from January 2011 to March 2014 were retrospectively analysed. Thirty-six cases were excluded because they were donor-specific antibody positive ( n=16), received thymoglobulin/plasma exchange ( n=11), were ABO-incompatible ( n=6) or suffered graft loss from vascular thrombosis within the first week post-transplant ( n=3). The study period straddled three eras of corticosteroid administration, from intra-operative intravenous (IV) hydrocortisone (Era 1; n=26), to intra-operative IV methylprednisolone (Era 2; n=38) and pre-operative IV methylprednisolone (Era 3; n=12). The primary endpoint was the incidence of slow/delayed graft function. Secondary outcomes included estimated glomerular filtration rate at discharge and 120 and 365 days, rejection (acute and one-year), wound complications, post-transplant diabetes, increase in low-density lipoprotein or body mass index, and cytomegalovirus or BK viraemia within one year. Results: On univariate analysis, pre-operative methylprednisolone was associated with lower incidence of slow/delayed graft function (17%, 55%, 58% in Eras 3, 2, 1 respectively; p=0.041), superior estimated glomerular filtration rate at discharge (median 56, 37 and 43 ml/min for Eras 3, 2, 1 respectively; p=0.033) and at 120 days (median 60, 52, and 46 ml/min for Eras 3, 2, 1 respectively; p=0.017). On multivariate analysis, pre-operative IV methylprednisolone ( vs. Eras 1 and 2 combined; odds ratio 4.79 (90% confidence interval 1.16–19.80); p=0.07) and living donor type ( vs. deceased; odds ratio 5.56 (90% confidence interval 2.25–13.77); p=0.002) were associated with lower incidence of slow/delayed graft function. Conclusion: Pre-operative methylprednisolone was associated with reduced slow/delayed graft function and improved early estimated glomerular filtration.
Inflammatory bowel disease and risk of mortality in COPD
Authors: Vutcovici Maria , Bitton Alain , Ernst Pierre , Kezouh Abbas , Suissa Samy , Brassard Paul 
Published: February 2016

Patients with chronic obstructive pulmonary disease (COPD) have higher incidence and prevalence of other chronic inflammatory diseases, including inflammatory bowel disease (IBD). We assessed whether IBD onset increases mortality risk in patients with COPD or asthma-associated COPD.Two population-based cohorts of COPD and asthma-COPD subjects were identified using the administrative health databases in Québec, Canada, 1990–2007. Death records were retrieved from the death certificate registry. Cox proportional hazards models were used to assess the impact of newly developed IBD on mortality risk.The COPD and asthma-COPD cohorts included 273 208 and 26 575 patients, respectively, of which 697 and 119 developed IBD. IBD increased the risk of all-cause mortality in both COPD (hazard ratio 1.23, 95% CI 1.09–1.4) and asthma-COPD (hazard ratio 1.65, 95% CI 1.23–2.22). In asthma-COPD patients, IBD increased the risk of mortality from respiratory conditions (hazard ratio 2.18, 95% CI 1.31–3.64); in COPD patients, IBD increased the risk of death from digestive conditions (hazard ratio 4.45, 95% CI 2.39–8.30).IBD is a risk factor for mortality in patients with pre-existing COPD or asthma-COPD. IBD increased mortality by respiratory and digestive conditions in patients with asthma-COPD and COPD, respectively.
A powerful score-based statistical test for group difference in weighted biological networks
Authors: Ji Jiadong , Yuan Zhongshang , Zhang Xiaoshuai , Xue Fuzhong 
Published: February 2016

Abstract
Background
Complex disease is largely determined by a number of biomolecules interwoven into networks, rather than a single biomolecule. A key but inadequately addressed issue is how to test possible differences of the networks between two groups. Group-level comparison of network properties may shed light on underlying disease mechanisms and benefit the design of drug targets for complex diseases. We therefore proposed a powerful score-based statistic to detect group difference in weighted networks, which simultaneously capture the vertex changes and edge changes.

Results
Simulation studies indicated that the proposed network difference measure (NetDifM) was stable and outperformed other methods existed, under various sample sizes and network topology structure. One application to real data about GWAS of leprosy successfully identified the specific gene interaction network contributing to leprosy. For additional gene expression data of ovarian cancer, two candidate subnetworks, PI3K-AKT and Notch signaling pathways, were considered and identified respectively.

Conclusions
The proposed method, accounting for the vertex changes and edge changes simultaneously, is valid and powerful to capture the group difference of biological networks.
Chemerin in peritoneal sepsis and its associations with glucose metabolism and prognosis: a translational cross-sectional study
Authors: Horn Paul , Metzing Uta Barbara , Steidl Ricardo , Romeike Bernd , Rauchfuß Falk , Sponholz Christoph , Thomas-Rüddel Daniel , Ludewig Katrin , Birkenfeld Andreas L. , Settmacher Utz , Bauer Michael , Claus Ralf Alexander , von Loeffelholz Christian 
Published: February 2016

Abstract
Background
Stress hyperglycaemia (SHG) is a common complication in sepsis associated with poor outcome. Chemerin is an adipocytokine associated with inflammation and impaired glucose homeostasis in metabolic diseases such as type 2 diabetes (T2D). We aimed to investigate how alterations of circulating chemerin levels and corresponding visceral adipose tissue (VAT) expression are linked to glucose metabolism and prognosis in sepsis.

Methods
Clinical data and tissue samples were taken from a cross-sectional study including control, T2D and sepsis patients, all undergoing laparotomy. A second independent patient cohort of patients with sepsis was included to evaluate associations with prognosis. This was complemented by a murine model of peritoneal infection and a high-fat diet. We analysed circulating chemerin by enzyme-linked immunosorbent assay and VAT messenger RNA (mRNA) expression by real-time polymerase chain reaction.

Results
Circulating chemerin was increased in sepsis 1.69-fold compared with controls (p = 0.012) and 1.47-fold compared with T2D (p = 0.03). Otherwise, chemerin VAT mRNA expression was decreased in patients with sepsis (p = 0.006) and in septic diabetic animals (p = 0.009). Circulating chemerin correlated significantly with intra-operative glucose (r = 0.662; p = 0.01) and in trend with fasting glucose (r = 0.528; p = 0.052). After adjusting for body mass index or haemoglobin A1c, chemerin correlated in trend with insulin resistance evaluated using the logarithmised homeostasis model assessment of insulin resistance (r = 0.539, p = 0.071; r = 0.553, p = 0.062). Chemerin was positively associated with Acute Physiology and Chronic Health Evaluation II score in patients with sepsis (p = 0.036) and with clinical severity in septic mice (p = 0.031). In an independent study population, we confirmed association of chemerin with glucose levels in multivariate linear regression analysis (β = 0.556, p = 0.013). In patients with sepsis with SHG, non-survivors had significantly lower chemerin levels than survivors (0.38-fold, p = 0.006), while in patients without SHG, non-survivors had higher chemerin levels, not reaching significance (1.64-fold, p = 0.089). No difference was apparent in patients with pre-existing T2D (p = 0.44).

Conclusions
We show, for the first time to our knowledge, that chemerin is increased in sepsis and that it associates with impaired glucose metabolism and survival in these patients. It could be further evaluated as a biomarker to stratify mortality risk of patients with SHG.
Balloon dilation of the eustachian tube: A tympanometric outcomes analysis
Authors: Williams Blair , Taylor Benjamin A. , Clifton Neil , Bance Manohar 
Published: February 2016

Background Eustachian tube dysfunction (ETD) is a common medical issue, occurring in at least 1 % of the adult population. Patients suffering from ET dysfunction typically present with complaints of hearing loss or sensation of pressure or plugged ear, which can lead to impaired quality of life. Over time ETD can result in conductive hearing loss or choleastatoma formation. Effective theraputic options for ET dysfunction are few. Eustachian tube balloon dilation is a novel surgical technique being used to treat ETD. The aim of our study is to objectively measure the success of Eustachian tube balloon dilation by comparing pre and post-operative middle ear pressures using tympanometric testing. Methods RA retrospective chart review was preformed on all patients who underwent balloon dilation of the Eustachian tube by authors NC or MB from 2010 to 2014. Pre and post-operative tympanograms were analyzed and categorized based on type (Type A, Type B, Type C). Success was defined by an improvement in tympanogram type: Type B or C to Type A, or Type B to type C. Pre and post-operative tympanograms were further analyzed using middle ear pressure values. Follow-up ranged from 3 to 15 months. Results Twenty-five ears (18 patients) were included in the study. Overall 36 % of ears had improvement in tympanogram type, and 32 % had normalization of tympanogram post-operatively. The Jerger tympanogram type improved significantly following the procedure ( p = 0.04). Patients also had statistically significant improvement in measured middle ear pressure post-operatively ( P = 0.003). Conclusion The natural history of Eustachian tube dysfunction is poorly understood, and evidence for current treatments are limited. Eustachian tube balloon dilation is a safe procedure, and produces significant improvement in tympanogram values up to 15 months post-operatively. Further refinement of patient selection and standardization of technique is required to optimize the effect of this therapy. Longterm follow-up data will clarify the persistence of the effect.
Differentiation of epithelial ovarian cancer subtypes by use of imaging and clinical data: a detailed analysis
Authors: Tanaka Yumiko Oishi , Okada Satoshi , Satoh Toyomi , Matsumoto Koji , Oki Akinori , Saida Tsukasa , Yoshikawa Hiroyuki , Minami Manabu 
Published: February 2016

Abstract

Background
Primary epithelial ovarian carcinoma is sub-classified into serous, mucinous, endometrioid and clear cell subtypes. Neoadjuvant chemotherapy has become an alternative treatment option past several years, as serous carcinoma, the most common subtype, is known as chemotherapy-sensitive tumor. On the other hand, mucinous and clear cell carcinoma are known as chemotherapy-resistive. Therefore, it may be meaningful to estimate subtype of ovarian carcinoma using imaging modality. The purpose of this study is to study whether CT or MRI can determine the subtypes of epithelial ovarian cancers.

Methods
The imaging and clinical findings obtained from 125 consecutive patients with primary ovarian carcinoma were retrospectively analyzed. Forty-four of the patients had serous carcinoma; 13, mucinous carcinoma; 53, clear cell carcinoma; and 15, endometrioid carcinoma. We studied the bilateralism, morphological type, tumor diameter, solid portion ratio, relative signal intensity on T2WI and DWI, contrast ratio, and endometriosis on MRI and the calcification, peritoneal dissemination and lymph node metastasis, clinical staging, and thromboembolism on CT. We also studied the tumor markers and serum calcium concentrations. Each parameter was statistically analyzed by univariate and multivariate analyses.

Results
Serous carcinoma showed a significantly higher incidence of bilateral disease, smaller tumor size, higher signal intensity on DWI, and less frequent hypercalcemia. The CA19-9 level was significantly higher in mucinous carcinoma, in which most of the tumors appeared as multilocular cystic masses. Clear cell carcinoma appeared as unilateral disease with a larger solid portion and hypercalcemia in younger patients. Endometrioid carcinoma only showed a lower incidence of intraperitoneal dissemination.

Conclusions
CT and MRI combined with clinical data especially tumor markers and presence of paraneoplastic syndrome could partly predict epithelial ovarian cancer subtypes.
ReCAP: Feasibility and Accuracy of Extracting Cancer Stage Information From Narrative Electronic Health Record Data
Authors: Warner Jeremy L. , Levy Mia A. , Neuss Michael N. , Warner Jeremy L. , Levy Mia A. , Neuss Michael N. 
Published: February 2016

QUESTION ASKED: Cancer stage, one of the most important prognostic factors for cancer-specific survival, is often documented in narrative form in electronic health records (EHRs), and as such is difficult to abstract by registrars and other secondary data users, including clinicians participating in quality reporting activities. Can the cancer stage be accurately extracted by natural language processing (NLP) of the text from EHRs? SUMMARY ANSWER: In a combined dataset of N = 2,323 patients with lung cancer (training set: n = 1,103; validation set n = 1,220), we analyzed 751,880 documents and discovered at least one stage statement for 98.6% of patients (median of 24 documents with stage statements per patient). Despite a high degree of discordance in patient records (83.6% of patients had conflicting stage statements in their HER; Fig 2 ), algorithmically derived stage accuracy was very high in the validation set, κ = 0.906 (95% CI, 0.873 to 0.939), as compared with the gold standard of tumor registrar–derived stage. METHODS: We developed an NLP algorithm to extract stage statements from machine-readable EHR documents, including automated rules to choose the most likely stage when discordance was present in the EHR; the algorithm was developed on a training set of patients with lung cancer and independently validated on a test set of patients with lung cancer who were seen at our institution. BIAS, CONFOUNDING FACTOR(S), DRAWBACKS: An exact stage (eg, stage I, stage IV) could be calculated for only 72% of the patients; the remainder were assigned an inexact stage (eg, “early stage”). In an exploratory analysis, we were able to distinguish stage IIIA from stage IIIB, but the accuracy was not as good, in the 64% to 79% range. The experiments were carried out only on patients with lung cancer, so it is unknown whether other tumor types would have a similar level of performance. We did not explicitly consider the provenance of the information, (eg, was the stage documented by a medical student, an attending oncologist, etc). Finally, given that this was performed at a single tertiary care institution, there may be significant differences in documentation patterns at other institutions that could affect the reproducibility of the results. REAL-LIFE IMPLICATIONS: This new approach to the determination of summary stage in patients with lung cancer can be applied rapidly and broadly to a patient population with large amounts of EHR data. Despite the presence of significant discordance in documentation, the results were highly accurate. This proof-of-concept suggests that NLP may augment and enhance manual abstraction efforts and may even replace them for certain targeted applications. [Figure: see text]
ReCAP: Feasibility and Effectiveness of a Pilot Program to Facilitate Quality Improvement Learning in Oncology: Experience of the American Society of Clinical Oncology Quality Training Program
Authors: Kamal Arif H. , Quinn Doris , Gilligan Timothy D. , Davis Barbara Corning , Dalby Carole K. , Bretsch Jennifer , McNiff Kristen K. , Jacobson Joseph O. , Kamal Arif H. , Quinn Doris , Gilligan Timothy D. , Corning Davis Barbara , Dalby Carole K. , Bretsch Jennifer , McNiff Kristen K. , Jacobson Joseph O. 
Published: February 2016

CONTEXT AND QUESTION ASKED: Improving quality of oncology delivery is an important responsibility for busy oncology practices. Is it feasible to construct a training program for oncology professionals to teach quality improvement that is applicable to practice? SUMMARY ANSWER: Using a longitudinal, project-based program with a mix of in-person and distance-learning components, the ASCO Quality Training Program is a highly feasible method to facilitate quality improvement learning in oncology. METHODS: The ASCO Quality Training Program (QTP) consisted of three in-person Learning Sessions and four phases: pre-work, planning, implementation, and sustain and spread. We measured two primary outcomes: program feasibility and effectiveness. BIAS, CONFOUNDING FACTOR(S), DRAWBACKS: Although we observed high participation, satisfaction, and applicability of content to the needs of the oncology learners, it should be noted that this represents a small, pilot project. REAL-LIFE IMPLICATIONS: Even busy oncology clinicians find a structured program to learn and practice quality improvement skills valuable. Conclusions regarding long-term applicability effectiveness and feasibility among non-early adopters require further study.
ReCAP: Comparison of Independent Error Checks for Oral Versus Intravenous Chemotherapy
Authors: Griffin Melissa C. , Gilbert Rachel E. , Broadfield Larry H. , Easty Anthony E. , Trbovich Patricia L. , Griffin Melissa C. , Gilbert Rachel E. , Broadfield Larry H. , Easty Anthony E. , Trbovich Patricia L. 
Published: February 2016

QUESTION ASKED:In the United States, research has found that oral chemotherapy is subject to fewer safeguards than are in routine use for intravenous (IV) chemotherapy; however, less is known about the Canadian context. The objective of this study was to determine whether similar safeguards, in the form of independent checks, existed to identify potential errors related to IV and oral chemotherapy formulations in a particular cancer system.SUMMARY ANSWER:In the cancer system studied, a total of 57 systematic checks were identified for IV chemotherapy, whereas only six systematic checks were identified for oral chemotherapy. Community pharmacists were the only qualified professionals involved in independent, systematic checking of oral chemotherapy, which occurred during ordering and dispensing.METHODS:Human factors specialists conducted observations and interviews in cancer center clinics, a cancer center pharmacy, and four community pharmacies across Nova Scotia. Processes were analyzed to determine whether an independent check was performed, which qualified provider completed the check, and at what point of the process the check occurred.BIAS, CONFOUNDING FACTOR(S), DRAWBACKS:This study had some limitations. Although there are many forms of safeguards (eg, preprinted orders), only one type of safeguard (ie, independent checks) was examined in the cancer system studied. We chose to focus on independent checks because they were observable and were defined in the cancer center’s policies. Another limitation was that just a single jurisdiction (Nova Scotia), and four community pharmacies were examined. We examined each community pharmacy in detail, and sites were chosen to be representative (eg, rural versus urban). Further, the model used to deliver oral chemotherapy in Nova Scotia is not unique; a number of other provinces share similar models.REAL-LIFE IMPLICATIONS:There is an enormous opportunity for pharmacists and other qualified professionals to take on an expanded role in improving patient safety for oral chemotherapy. Oral chemotherapy, like IV chemotherapy, is known to be potentially hazardous, but in the cancer system studied, there were dramatically fewer independent checks associated with all aspects of oral chemotherapy–related processes. Greater involvement of pharmacists, both in the clinic environment and the community, would facilitate increased systematic checking, which could improve patient safety related to oral chemotherapy. [Figure: see text]
ReCAP: Detection of Potentially Avoidable Harm in Oncology From Patient Medical Records
Authors: Lipitz-Snyderman Allison , Weingart Saul N. , Anderson Christopher , Epstein Andrew S. , Killen Aileen , Classen David , Sima Camelia S. , Fortier Elizabeth , Atoria Coral L. , Pfister David , Lipitz-Snyderman Allison , Weingart Saul N. , Anderson Christopher , Epstein Andrew S. , Killen Aileen , Classen David , Sima Camelia S. , Fortier Elizabeth , Atoria Coral L. , Pfister David 
Published: February 2016

QUESTION ASKED: Although medical record–based measurement of adverse events (AEs) associated with cancer care is desirable, condition-specific triggers in oncology care are needed. We sought to develop a screening tool to facilitate efficient detection of AEs across settings of cancer care via medical record review. We hope to use this tool to understand the frequency, spectrum, and preventability of AEs with the goal of helping improve the quality and safety of cancer care. SUMMARY ANSWER: We developed a cancer-specific screening tool to help identify candidate preventable AEs that occur during cancer care from patients’ medical records. Our oncology screening tool consists of 76 triggers—readily identifiable findings to screen for possible AEs that occur during cancer care ( Table 1 ). METHODS: We sought to develop a screening tool to facilitate the detection of AEs across settings of cancer care via medical record review. We obtained structured and unstructured input from clinical experts to develop our tool, using a modified Delphi process. BIAS, CONFOUNDING FACTOR(S), DRAWBACKS: Our oncology tool requires further evaluation in order to understand its usefulness for population-based assessments of AEs in oncology and quality improvement. REAL-LIFE IMPLICATIONS: Information obtained from structured record reviews using an oncology trigger tool could help to prioritize quality improvement activities, identify high-risk groups, and generate cancer-focused quality measures. Ultimately, the goals of this work are to prevent AEs and allow timely, automated identification of these events so that clinicians can intervene promptly to improve patient outcomes. [Table: see text]