bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cachexia in cancer: what is in the definition?
Authors: Vanhoutte Greetje , van de Wiel Mick , Wouters Kristin , Sels Michaël , Bartolomeeussen Linda , De Keersmaecker Sven , Verschueren Caroline , De Vroey Veronique , De Wilde Annemieke , Smits Elke , Cheung Kin Jip , De Clerck Liesbeth , Aerts Petra , Baert Didier , Vandoninck Caroline , Kindt Sofie , Schelfhaut Sofie , Vankerkhoven Marc , Troch Annelies , Ceulemans Lore , Vandenbergh Hanne , Leys Sven , Rondou Tim , Dewitte Elke , Maes Kristel , Pauwels Patrick , De Winter Benedicte , Van Gaal Luc , Ysebaert Dirk , Peeters Marc 
Published: October 2016

ObjectiveThis study aimed to provide evidence-based results on differences in overall survival (OS) rate to guide the diagnosis of cancer cachexia.DesignData collection and clinical assessment was performed every 3 months (5 visits): baseline data, muscle strength, nutritional and psychosocial status. 2 definitions on cachexia using different diagnostic criteria were applied for the same patient population. Fearonet al's definition is based on weight loss, body mass index (BMI) and sarcopenia. Evanset alnuances the contribution of sarcopenia and attaches additional attention to abnormal biochemistry parameters, fatigue and anorexia. The mean OS rates were compared between patients with and without cachexia for both definitions.ResultsBased on the population of 167 patients who enrolled, 70% developed cachexia according to Fearonet al's definition and 40% according to Evanset al's definition. The OS in the cachectic population is 0.97 and 0.55 years, respectively. The difference in OS between patients with and without cachexia is more significant using the diagnostic criteria of Evanset al. The focus of Fearonet alon weight loss and sarcopenia over-rates the assignment of patients to the cachectic group and OS rates have less prognostic value.ConclusionThis study presents a correlation with prognosis in favour of Evanset al’ definition as a tool for cachexia diagnosis. This means that weight loss and BMI decline are both key factors in patients with cancer leading to cachexia but less decisive as stated by Fearonet al. Instead, extra factors gain importance in order to predict survival, such as chronic inflammation, anaemia, protein depletion, reduced food intake, fatigue, decreased muscle strength and lean tissue depletion.Trial registration numberB300201112334.
Clinical Implications of Brief Device-Detected Atrial Tachyarrhythmias in a Cardiac Rhythm Management Device Population
Authors: Swiryn Steven , Orlov Michael V. , Benditt David G. , DiMarco John P. , Lloyd-Jones Donald M. , Karst Edward , Qu Fujian , Slawsky Mara T. , Turkel Melanie , Waldo Albert L. 
Published: October 2016

Background:
The RATE Registry (Registry of Atrial Tachycardia and Atrial Fibrillation Episodes) is a prospective, outcomes-oriented registry designed to document the prevalence of atrial tachycardia and/or fibrillation (AT/AF) of any duration in patients with pacemakers and implantable cardioverter defibrillators (ICDs) and evaluate associations between rigorously adjudicated AT/AF and predefined clinical events, including stroke. The appropriate clinical response to brief episodes of AT/AF remains unclear.

Methods:

Rigorously adjudicated electrogram (EGM) data were correlated with adjudicated clinical events with logistic regression and Cox models.
Long episodes of AT/AF
were defined as episodes in which the onset and/or offset of AT/AF was not present within a single EGM recording.
Short episodes of AT/AF
were defined as episodes in which both the onset and offset of AT/AF were present within a single EGM recording.

Results:

We enrolled 5379 patients with pacemakers (N=3141) or ICDs (N=2238) at 225 US sites (median follow-up 22.9 months). There were 359 deaths. There were 478 hospitalizations among 342 patients for clinical events. We adjudicated 37 531 EGMs; 50% of patients had at least one episode of AT/AF. Patients with clinical events were more likely than those without to have long AT/AF (31.9% vs. 22.1% for pacemaker patients and 28.7% vs. 20.2% for ICD patients;
P
<0.05 for both groups). Only short episodes of AT/AF were documented in 9% of pacemaker patients and 16% of ICD patients. Patients with clinical events were no more likely than those without to have short AT/AF (5.1% vs. 7.9% for pacemaker patients and 11.5% vs. 10.4% for ICD patients;
P
=0.21 and 0.66, respectively).

Conclusions:
In the RATE Registry, rigorously adjudicated short episodes of AT/AF, as defined, were not associated with increased risk of clinical events compared with patients without documented AT/AF.

Clinical Trial Registration:

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00837798.
Use of Chronic Oral Anticoagulation and Associated Outcomes Among Patients Undergoing Percutaneous Coronary Intervention
Authors: Secemsky Eric A. , Butala Neel M. , Kartoun Uri , Mahmood Sadiqa , Wasfy Jason H. , Kennedy Kevin F. , Shaw Stanley Y. , Yeh Robert W. 
Published: October 2016

Background

Contemporary rates of oral anticoagulant (
OAC
) therapy and associated outcomes among patients undergoing percutaneous coronary intervention (
PCI
) have been poorly described.

Methods and Results

Using data from an integrated health care system from 2009 to 2014, we identified patients on
OAC
s within 30 days of
PCI
. Outcomes included in‐hospital bleeding and mortality. Of 9566
PCI
s, 837 patients (8.8%) were on
OAC
s, and of these, 7.9% used non–vitamin K antagonist agents.
OAC
use remained stable during the study (8.1% in 2009, 9.0% in 2014;
P
=0.11), whereas use of non–vitamin K antagonist agents in those on
OAC
s increased (0% in 2009, 16% in 2014;
P
<0.01). Following
PCI
,
OAC
‐treated patients had higher crude rates of major bleeding (11% versus 6.5%;
P
<0.01), access‐site bleeding (2.3% versus 1.3%;
P
=0.017), and non–access‐site bleeding (8.2% versus 5.2%;
P
<0.01) but similar crude rates of in‐hospital stent thrombosis (0.4% versus 0.3%;
P
=0.85), myocardial infarction (2.5% versus 3.0%;
P
=0.40), and stroke (0.48% versus 0.52%;
P
=0.88). In addition, prior to adjustment,
OAC
‐treated patients had longer hospitalizations (3.9±5.5 versus 2.8±4.6 days;
P
<0.01), more transfusions (7.2% versus 4.2%;
P
<0.01), and higher 90‐day readmission rates (22.1% versus 13.1%;
P
<0.01). In adjusted models,
OAC
use was associated with increased risks of in‐hospital bleeding (odds ratio 1.50;
P
<0.01), 90‐day readmission (odds ratio 1.40;
P
<0.01), and long‐term mortality (hazard ratio 1.36;
P
<0.01).

Conclusions

Chronic
OAC
therapy is frequent among contemporary patients undergoing
PCI
. After adjustment for potential confounders,
OAC
‐treated patients experienced greater in‐hospital bleeding, more readmissions, and decreased long‐term survival following
PCI
. Efforts are needed to reduce the occurrence of adverse events in this population.
Impacts of Anomalous Midlatitude Cyclone Activity over East Asia during Summer on the Decadal Mode of East Asian Summer Monsoon and Its Possible Mechanism
Authors: Chen Haishan , Teng Fangda , Zhang Wanxin , Liao Hong 
Published: October 2016

AbstractBy using an objective identification and tracking algorithm of the cyclone, the statistics of midlatitude cyclone activity in East Asia during summer for the period 1979–2013 were analyzed. The impact of the midlatitude summer cyclone anomalies in East Asia on the decadal mode of East Asian summer monsoon (EASM) was investigated and possible mechanisms were proposed. The possible reasons for the anomalous cyclone activity from the perspective of land surface thermal forcing were also explored. Results indicate that the midlatitude summer cyclone activity over East Asia exhibits decadal changes in the period of 1979–2013 and is significantly weakened after early 1990s. Further analysis indicates that there is a close relationship between the midlatitude summer cyclone activity over East Asia and the decadal variation of EASM; when the midlatitude summer cyclone activity over East Asia is strong (weak), EASM tends to be intensified (weakened), and the weak cyclone activity after 1993 generally coincides with the decadal weakening of EASM. Moreover, there is a close linkage between the weakening of cyclonic activity after the early 1990s and the nonuniform surface warming of the Eurasian continent. Significant warming to the west of Mongolia tends to weaken the north–south temperature gradient and the atmospheric baroclinicity to its south and eventually can lead to weakening of the midlatitude cyclone activity over East Asia.
Quantifying Uncertainties in Extreme Flood Predictions under Climate Change for a Medium-Sized Basin in Northeastern China
Authors: Qi Wei , Zhang Chi , Fu Guangtao , Zhou Huicheng , Liu Junguo 
Published: October 2016

Abstract
This study develops a new variance-based uncertainty assessment framework to investigate the individual and combined impacts of various uncertainty sources on future extreme floods. The Long Ashton Research Station Weather Generator (LARS-WG) approach is used to downscale multiple general circulation models (GCMs), and the dynamically dimensioned search approximation of uncertainty approach is used to quantify hydrological model uncertainty. Extreme floods in a region in northeastern China are studied for two future periods: near term (2046–65) and far term (2080–99). Six GCMs and three emission scenarios (A1B, A2, and B1) are used. Results obtained from this case study show that the 500-yr flood magnitude could increase by 4.5% in 2046–65 and by 6.4% in 2080–99 in terms of median values; in worst-case scenarios, it could increase by 63.0% and 111.8% in 2046–65 and 2080–99, respectively. It is found that the combined effect of GCMs, emission scenarios, and hydrological models has a larger influence on the discharge uncertainties than the individual impacts from emission scenarios and hydrological models. Further, results show GCMs are the dominant contributor to extreme flood uncertainty in both 2046–65 and 2080–99 periods. This study demonstrates that the developed framework can be used to effectively investigate changes in the occurrence of extreme floods in the future and to quantify individual and combined contributions of various uncertainty sources to extreme flood uncertainty, which can guide future efforts to reduce uncertainty.
Evidence of Sea-State Dependence of Aerosol Concentration in the Marine Atmospheric Boundary Layer
Authors: Lenain Luc , Melville W. Kendall 
Published: October 2016

AbstractSea spray aerosols represent a large fraction of the aerosols present in the maritime environment. Despite evidence of the importance of surface wave– and wave breaking–related processes in coupling the ocean with the atmosphere, sea spray source generation functions are traditionally parameterized by the 10-m wind speed U10 alone. It is clear that unless the wind and wave field are fully developed, the source function will be a function of both wind and wave parameters. This study reports primarily on the aerosol component of an air–sea interaction experiment, the phased-resolved High-Resolution Air–Sea Interaction Experiment (HIRES), conducted off the coast of northern California in June 2010. Detailed measurements of aerosol number concentration in the marine atmospheric boundary layer (MABL) at altitudes ranging from as low as 30 m up to 800 m above mean sea level (MSL) over a broad range of environmental conditions (significant wave height Hs of 2 to 4.5 m and U10 from 10 to 18 m s−1) collected from an instrumented research aircraft are presented. Aerosol number densities and volume are computed over a range of particle diameters from 0.1 to 200 μm, while the sea surface conditions, including Hs, moments of the breaker length distribution Λ(c), and wave breaking dissipation, were measured by a suite of electro-optical sensors that included the NASA Airborne Topographic Mapper (ATM). The sea-state dependence of the aerosol concentration in the MABL is evident, stressing the need to incorporate wave parameters in the spray source generation functions that are traditionally parameterized by surface winds alone.
Minimally symptomatic hypocalcaemia unmasking celiac disease
Authors: Lazaridis A , Drosou ME , Fontalis A , Prousali E , Hadwe SE , Giouleme O , Petidis K 
Published: October 2016

Introduction Celiac disease is an autoimmune disease of the small intestine which occurs in genetically predisposed people of all ages. A large clinical spectrum of manifestations accompanies the onset of the disease with diarrhoea, flatulence and weight loss being the most common. However, findings like osteoporosis, iron deficiency, anaemia and hypocalcaemia could also insinuate the existence of the disease. Case presentation We report the case of a 55-year-old man with numbness and tingling of the upper extremities due to hypocalcaemia that proved to be an uncommon case of celiac disease. Conclusion A non-negligible number of adult patients with celiac disease can present with only minor and subclinical manifestations of the disease. As such, hypocalcaemia may be the sole manifestation of celiac disease. A high index of suspicion is needed for prompt diagnosis.
MR and mammographic imaging features of HER2-positive breast cancers according to hormone receptor status: a retrospective comparative study
Authors: Song Sung Eun , Bae Min Sun , Chang Jung Min , Cho Nariya , Ryu Han Suk , Moon Woo Kyung 
Published: October 2016

Background Human epidermal growth factor receptor 2-positive (HER2+) breast cancer has two distinct subtypes according to hormone receptor (HR) status. Survival, pattern of recurrence, and treatment response differ between HR–/HER2+ and HR+/HER2+ cancers. Purpose To investigate imaging and clinicopathologic features of HER2+ cancers and their correlation with HR expression. Material and Methods Between 2011 and 2013, 252 consecutive patients with 252 surgically confirmed HER2+ cancers (125 HR– and 127 HR+) were included. Two experienced breast radiologists blinded to the clinicopathologic findings reviewed the mammograms and magnetic resonance (MR) images using the BI-RADS lexicon. Tumor kinetic features were acquired by computer-aided detection (CAD). The imaging and clinicopathologic features of 125 HR–/HER2+ cancers were compared with those of 127 HR+/HER2+ cancers. Association between the HR status and each feature was assessed. Results Multiple logistic regression analysis showed that circumscribed mass margin (odds ratio [OR], 4.73; P < 0.001), associated non-mass enhancement (NME) on MR images (OR, 3.29; P = 0.001), high histologic grade (OR, 3.89; P = 0.002), high Ki-67 index (OR, 3.06; P = 0.003), and older age (OR, 2.43; P = 0.006) remained independent indicators associated with HR–/HER2+ cancers. Between the two HER2+ subtypes, there were no differences in mammographic imaging presentations and calcification features and MR kinetic features by a CAD. Conclusion HER2+ breast cancers have different MR imaging (MRI) phenotypes and clinicopathologic feature according to HR status. MRI features related to HR and HER2 status have the potential to be used for the diagnosis and treatment decisions in HER2+ breast cancer patients.
Incidence of combined cranial and cervical spine injuries in patients with blunt minor trauma: are combined CT examinations of the head and cervical spine justified?
Authors: Vahldiek Janis L , Thieme Stefan , Hamm Bernd , Niehues Stefan M 
Published: October 2016

BackgroundThe use of computed tomography (CT) scans of the head and cervical spine has markedly increased in patients with blunt minor trauma. The actual likelihood of a combined injury of head and cervical spine following a minor trauma is estimated to be low.PurposeTo determine the incidence of such combined injuries in patients with a blunt minor trauma in order to estimate the need to derive improved diagnostic guidelines.Material and MethodsA total of 1854 patients were retrospectively analyzed. All cases presented to the emergency department and in all patients combined CT scans of head and cervical spine were conducted. For the following analysis, only 1342 cases with assured blunt minor trauma were included. Data acquisition covered age, sex, and presence of a head injury as well as presence of a cervical spine injury or both.ResultsOf the 1342 cases, 46.9% were men. The mean age was 65.6 years. CT scans detected a head injury in 116 patients; of these, 70 cases showed an intracranial hemorrhage, 11 cases a skull fracture, and 35 cases an intracranial hemorrhage as well as a skull fracture. An injury of the cervical spine could be detected in 40 patients. A combined injury of the head and cervical spine could be found in one patient.ConclusionThe paradigm of the coincidence of cranial and cervical spine injuries should be revised in patients with blunt minor trauma. Valid imaging decision algorithms are strongly needed to clinically detect high-risk patients in order to save limited resources.
Plugged percutaneous biopsy of the liver in living-donor liver transplantation recipients suspected to have graft rejection
Authors: Kim Sung Jung , Won Je Hwan , Kim Young Bae , Wang Hee-Jung , Kim Bong-Wan , Kim Haeryoung , Kim Jinoo 
Published: October 2016

Background Percutaneous biopsy is a widely-accepted technique for acquiring histologic samples of the liver. When there is concern for bleeding, plugged percutaneous biopsy (PPB) may be performed, which involves embolization of the biopsy tract. Purpose To evaluate the efficacy and safety of PPB of the liver in patients suspected to have graft rejection after living-donor liver transplantation (LDLT). Material and Methods During January 2007 and December 2013, 51 patients who underwent PPB of the liver under the suspicion of post-LDLT graft rejection were retrospectively analyzed. A total of 73 biopsies were performed. Biopsy was performed with a 17-gauge core needle and 18-gauge cutting needle. The needle tract was embolized using gelatin sponge (n = 44) or N-butyl cyanoacrylate (NBCA) (n = 29). The specimens were reviewed to determine their adequacy for histologic diagnosis. We reviewed all medical records after PPB. Results Specimens were successfully acquired in all procedures (100%). They were adequate for diagnosis in 70 cases (95.9%) and inadequate in three (1.3%). Average of 9.8 complete portal tracts was counted per specimen. One minor complication (1.4%) occurred where the patient had transient fever after the procedure. Conclusion PPB is easy and safe to perform in LDLT recipients and provides high diagnostic yield.
Clinical Relevance of Classifying Massive Rotator Cuff Tears: Results Based on Functional and Radiological Findings After Arthroscopic Repair
Authors: Ok Hyun Soo , Kim Byung Guk , Choi Won Chul , Hong Chul Gie , Kim Jee Woong , Kim Jae Hwa 
Published: October 2016

Background: Studies on the results of arthroscopic repair of massive rotator cuff tears have reported widely varied prognoses. Among other factors, the sizable discrepancy can be attributable to the fact that the current definition of massive rotator cuff tears covers an extensive area of tendons. Hypothesis: Functional and radiological results according to subgroups would show significant inter-subgroup differences preoperatively and postoperatively. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 104 patients who required arthroscopic repair for massive rotator cuff tears were prospectively evaluated. The patients were allocated into 3 groups according to tendon involvement as diagnosed by preoperative magnetic resonance imaging: group 1 (anterosuperior type involving the subscapularis and supraspinatus), group 2 (posterosuperior type involving the infraspinatus and supraspinatus), and group 3 (anteroposterior type involving the subscapularis, supraspinatus, and infraspinatus). We compared functional results (at 2 years postoperatively) and radiological findings (at 1 year postoperatively) for each group. Results: There were 34 patients in group 1, 54 in group 2, and 16 in group 3. In all 3 groups, functional results significantly improved after surgery. There were no statistically significant intergroup differences in functional results among the 3 groups. On the radiological evaluations, each group (groups 1, 2, and 3) showed a significantly different result in the preoperative acromiohumeral distance (AHD) (7.19, 5.44, and 5.22 mm, respectively), tear size (38.8, 39.3, and 46.4 mm, respectively), extent of retraction (33.9, 40.0, and 41.4 mm, respectively), postoperative AHD (8.92, 7.37, and 6.71 mm, respectively), and retear rate (23.5%, 51.9%, and 56.2%, respectively) ( P < .001 for all). Conclusion: Massive rotator cuff tears can be divided into 3 types: anterosuperior (group 1), posterosuperior (group 2), and anteroposterior (group 3). Each group has distinctive characteristics and shows different results in the preoperative AHD, tear size, extent of retraction, postoperative AHD, and retear rate, which provide a reasonable basis for categorization. So far, massive rotator cuff tears have only been broadly defined, consequently being understood as a single category by many. However, to clearly understand and evaluate this injury, we suggest identifying differences within the category through proper subclassification.
A Prospective Randomized Study Comparing the Interference Screw and Suture Anchor Techniques for Biceps Tenodesis
Authors: Park Ji Soon , Kim Sae Hoon , Jung Ho Jin , Lee Ye Hyun , Oh Joo Han 
Published: October 2016

Background: Several methods are used to perform biceps tenodesis in patients with superior labrum-biceps complex (SLBC) lesions accompanied by a rotator cuff tear. However, limited clinical data are available regarding the best technique in terms of clinical and anatomic outcomes. Purpose: To compare the clinical and anatomic outcomes of the interference screw (IS) and suture anchor (SA) fixation techniques for biceps tenodesis performed along with arthroscopic rotator cuff repair. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A total of 80 patients who underwent arthroscopic rotator cuff repair with SLBC lesions were prospectively enrolled and randomly divided according to the tenodesis method: the IS and SA groups. Functional outcomes were evaluated with the visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST), Constant score, Korean Shoulder Score (KSS), and long head of the biceps (LHB) score at least 2 years after surgery. The anatomic status of tenodesis was estimated using magnetic resonance imaging or ultrasonography, and the anatomic failure of tenodesis was determined when the biceps tendon was not traced in the intertubercular groove directly from the insertion site of the IS or SA. Results: Thirty-three patients in the IS group and 34 in the SA group were monitored for more than 2 years. All postoperative functional scores improved significantly compared with the preoperative scores (all P < .001) and were not significantly different between the groups, including the LHB score (all P > .05). Nine anatomic failures of tenodesis were observed: 7 in the IS group and 2 in the SA group ( P = .083). In a multivariate analysis using logistic regression, IS fixation ( P = .003) and a higher (ie, more physically demanding) work level ( P = .022) were factors associated with the anatomic failure of tenodesis significantly. In patients with tenodesis failure, the LHB score ( P = .049) and the degree of Popeye deformity by the patient and examiner ( P = .004 and .018, respectively) were statistically different compared with patients with intact tenodeses. Conclusion: Care must be taken while performing biceps tenodesis in patients with a higher work level; IS fixation appears to pose a higher risk in terms of the anatomic failure of tenodesis than SA fixation, although functional outcomes were not different.