bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metastatic Melanoma Patient Had a Complete Response with Clonal Expansion after Whole Brain Radiation and PD-1 Blockade
Authors: Haymaker Cara L. , Kim DaeWon , Uemura Marc , Vence Luis M. , Phillip Ann , McQuail Natalie , Brown Paul D. , Fernandez Irina , Hudgens Courtney W. , Creasy Caitlin , Hwu Wen-Jen , Sharma Padmanee , Tetzlaff Michael T. , Allison James P. , Hwu Patrick , Bernatchez Chantale , Diab Adi 
Published: January 2017

Abstract
We report here on a patient with metastatic melanoma who had extensive brain metastases. After being treated with the sequential combination of whole brain radiation therapy followed by the PD-1–inhibitory antibody, pembrolizumab, the patient had a durable complete response. Retrospective laboratory studies of T cells revealed that, after treatment with anti-PD-1 commenced, effector CD8+ T cells in the blood expanded and the ratio of CD8+:Treg T cells increased. A CD8+ T-cell clone present in the initial brain metastases was expanded in the blood after anti-PD-1 treatment, which suggested an antitumor role for this clone. Immunohistochemical analysis confirmed the presence of CD8+ T cells and low PD-L1 expression in the brain metastases before immunotherapy initiation. This sequence of therapy may provide an option for melanoma patients with unresponsive brain metastases. Cancer Immunol Res; 5(2); 100–5. ©2017 AACR.
Performance Analysis of Quantized Feedback JLS Precoder in CoMP transmission
Authors: Fahmy Yasmine 
Published: January 2017

Joint Processing (JP) in Coordinated Multi-Point (CoMP) transmission allows user data to be jointly processed by several interfering base stations to achieve high performance and large capacity gain. This is achieved by making use of timing advance mechanisms; to ensure that the desired signals from the cooperating cells reach the mobile station at exactly the same time. The Joint Leakage Suppression (JLS) precoder is a suitable linear precoding scheme in this scenario. In this paper, JLS performance analysis is considered under real assumptions such as the presence of asynchronous reception of the interfering signals and the effect of the finite capacity backhaul links. The effect of quantizing the feedback channel on the sum rate is derived, and a tight upper bound of the rate loss due to quantization is obtained. Simulation results are provided to validate these results.
Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not Different
Authors: Abilleira Sònia , Ribera Aida , Cardona Pedro , Rubiera Marta , López-Cancio Elena , Amaro Sergi , Rodríguez-Campello Ana , Camps-Renom Pol , Cánovas David , de Miquel Maria Angels , Tomasello Alejandro , Remollo Sebastian , López-Rueda Antonio , Vivas Elio , Perendreu Joan , Gallofré Miquel , Martí-Fàbregas J. , Delgado-Mederos R. , Martínez-Domeño A. , Marín R. , Roquer J. , Ois Á. , Jiménez-Conde J. , Guimaraens L. , Chamorro Á. , Obach V. , Urra X. , Macho J.M. , Blasco J. , San Roman L. , Martínez-Yélamos A. , Quesada H. , Lara B , Cayuela N. , Aja L. , Mora P. , Molina C. , Ribó M. , Pagola J. , Rodríguez-Luna D. , Muchada M. , Coscojuela P. , Dávalos A. , Millán M. , Pérez de la Ossa N. , Gomis M. , Dorado L. , Castaño C. , Garcia M.C. , Estela J. , Krupinski J. , Huertas-Folch S. , Nicolás-Herrerias M.C. , Gómez-Choco M. , García S. , Martínez R. , Sanahuja J. , Purroy F. , Serena J. , Castellanos M. , Silva Y. , Marés R. , Pellisé A. , Ustrell X. , Baiges J.J. , Garcés M. , Saura J. , Soler-Insa J.M. , Aragonés J.M. , Cocho D. , Palomeras E. 
Published: January 2017

Background and Purpose—
Whether intravenous thrombolysis adds a further benefit when given before endovascular thrombectomy (EVT) is unknown. Furthermore, intravenous thrombolysis delays time to groin puncture, mainly among drip and ship patients.

Methods—
Using region-wide registry data, we selected cases that received direct EVT or combined intravenous thrombolysis+EVT for anterior circulation strokes between January 2011 and October 2015. Treatment effect was estimated by stratification on a propensity score. The average odds ratios for the association of treatment with good outcome and death at 3 months and symptomatic bleedings at 24 hours were calculated with the Mantel–Haenszel test statistic.

Results—
We included 599 direct EVT patients and 567 patients with combined treatment. Stratification through propensity score achieved balance of baseline characteristics across treatment groups. There was no association between treatment modality and good outcome (odds ratio, 0.97; 95% confidence interval, 0.74–1.27), death (odds ratio, 1.07; 95% confidence interval, 0.74–1.54), or symptomatic bleedings (odds ratio, 0.56; 95% confidence interval, 0.25–1.27).

Conclusions—
This observational study suggests that outcomes after direct EVT or combined intravenous thrombolysis+EVT are not different. If confirmed by a randomized controlled trial, it may have a significant impact on organization of stroke systems of care.
Ewing Sarcoma of the Head and Neck
Authors: Ellis Mark A. , Gerry Daniel R. , Neskey David M. , Lentsch Eric J. 
Published: January 2017

Objectives: Ewing sarcoma is a rare tumor of the head and neck. Previous efforts to characterize Ewing sarcoma of the head and neck (ES-HN) have been limited to small retrospective series. The objective of this study was to analyze the demographic, clinicopathologic, treatment, and survival characteristics of ES-HN compared to Ewing sarcoma at other locations (ES-other). Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, we compared 183 patients with ES-HN to 3177 patients with ES-other. Patient characteristics were analyzed with chi-square or t test. Ten-year disease-specific survival (DSS) and overall survival (OS) were estimated via the Kaplan-Meier method and compared using the log-rank test. Multivariate Cox regression analysis was used to determine if HN location was an independent prognosticator. Results: The ES-HN displayed a lower tumor size ( P < .001) and metastatic rate ( P < .001) compared to ES-other. The ES-HN had a better 10-year DSS and OS than ES-other ( P = .001, P = .015, respectively). The HN location did not achieve statistical significance on multivariate Cox regression analysis ( P = .88). Conclusion: ES-HN does not appear to be a separate clinical entity compared to ES-other; rather, its associated improved prognosis is likely secondary to its smaller size and lower metastatic rate compared to ES-other.
Mucosal Sparing Radiation Therapy in Resected Oropharyngeal Cancer
Authors: Gamez Mauricio E. , Halyard Michele Y. , Hinni Michael L. , Hayden Richard E. , Nagel Thomas H. , Vargas Carlos E. , Wong William W. , Curtis Kelly K. , Zarka Matthew A. , Ma Daniel , Patel Samir H. 
Published: January 2017

Purpose: To report the outcomes of patients with favorable risk oropharyngeal cancer that underwent adjuvant radiation therapy with omission of the primary site from the clinical target volume (CTV). Material/Methods: A retrospective study of 40 patients treated with transoral surgery (TOS) followed by neck only radiation using intensity modulated radiation therapy (IMRT) with exclusion of the primary site. For all patients, a CTV of the primary surgical bed was contoured to obtain the estimated incidental dose to the primary site. Results: Median follow-up was 51 months (range, 13-155 months). The median radiation therapy (RT) dose to the neck was 6000 cGy (range, 5400-6400 cGy). The mean incidental dose to the primary tonsillar site was 4320 cGy (SD ± 480 cGy) and to the primary base of tongue site was 4060 cGy (SD ± 420 cGy). There were no local failures and only 1 regional failure, resulting in 97.5% locoregional control rate at 4 years. Two patients developed distant metastases, without evidence of locoregional recurrence, for a 4-year overall survival rate of 97%. Conclusions: Our analysis suggests that mucosal sparing RT after TOS in favorable risk oropharyngeal cancer patients may provide comparable oncologic and improved functional outcomes compared to conventional treatment in selected patients.
Personalized Medicine Approach for an Exceptional Response to Multiple-recurrent and Metastatic HER2-positive Oropharyngeal Squamous Cell Carcinoma
Authors: Seim Nolan B. , Kang Stephen Y. , Bhandari Milan , Jones Riley G. , Teknos Theodoros N. 
Published: January 2017

Introduction: Advanced stage squamous cell carcinoma of the head and neck carries an overall poor prognosis, and survivorship gains have remained relatively stagnant compared to other malignancies due to its complex tumor biology and lack of proven effective targeting agents. Methods: We present a case of an exceptional responder to molecular-targeted therapy for metastatic oropharyngeal squamous cell carcinoma using a chemotherapeutic agent FDA approved for breast cancer and targeting the HER2/Neu receptor in order to discuss the larger clinical implications. Results: The National Cancer Institute (NCI) has recently instituted the Exceptional Responders Initiative in order to identify such patients with unexpected outcomes in order to expedite the development of additional targeted therapies. This case illustrates the opportunity for cure using targeted oncogene identification in a scenario of recurrent squamous cell carcinoma with lung metastasis typically considered fatal. Conclusions: Molecular tumor analysis is an infrequently utilized tool in head and neck squamous cell carcinoma; however, as understanding of biologic mechanisms improves, additional molecular targets will become available and expand treatment opportunities such as HER2/Neu targeting. The Exceptional Responders Initiative is a unique strategy with potential to expedite progress.
Is Domain Highlighting Actually Helpful in Identifying Phishing Web Pages?
Authors: Xiong Aiping , Proctor Robert W. , Yang Weining , Li Ninghui 
Published: January 2017

Objective: To evaluate the effectiveness of domain highlighting in helping users identify whether Web pages are legitimate or spurious. Background: As a component of the URL, a domain name can be overlooked. Consequently, browsers highlight the domain name to help users identify which Web site they are visiting. Nevertheless, few studies have assessed the effectiveness of domain highlighting, and the only formal study confounded highlighting with instructions to look at the address bar. Method: We conducted two phishing detection experiments. Experiment 1 was run online: Participants judged the legitimacy of Web pages in two phases. In Phase 1, participants were to judge the legitimacy based on any information on the Web page, whereas in Phase 2, they were to focus on the address bar. Whether the domain was highlighted was also varied. Experiment 2 was conducted similarly but with participants in a laboratory setting, which allowed tracking of fixations. Results: Participants differentiated the legitimate and fraudulent Web pages better than chance. There was some benefit of attending to the address bar, but domain highlighting did not provide effective protection against phishing attacks. Analysis of eye-gaze fixation measures was in agreement with the task performance, but heat-map results revealed that participants’ visual attention was attracted by the highlighted domains. Conclusion: Failure to detect many fraudulent Web pages even when the domain was highlighted implies that users lacked knowledge of Web page security cues or how to use those cues. Application: Potential applications include development of phishing prevention training incorporating domain highlighting with other methods to help users identify phishing Web pages.
Formative Research in Occupational Health and Safety Intervention for Diverse, Underserved Worker Populations: A Homecare Worker Intervention Project
Authors: Gong Fang , Baron Sherry , Stock Laura , Ayala Linda 
Published: January 2017

Objective. The increasing numbers of minority, low-income, and contingent workers in the U.S. labor force present new challenges to occupational safety and health interventions. Formative research can be used to help researchers better understand target populations and identify unanticipated barriers to safety changes. The National Institute for Occupational Safety and Health initiated an intervention project to improve health and safety among homecare workers in Alameda County, California. Investigators conducted systematic formative research to gather information to guide intervention development. Methods. Various qualitative methods were used including 11 focus groups (conducted in English, Spanish, and Chinese) and 10 key informant interviews. This article focuses on two picture-based focus group activities that explored workers' views on their relationships with consumers and their perceived barriers to interventions. Results. Findings indicated cultural differences regarding workers' perceptions of their relationships with consumers. Chinese homecare workers mostly focused on respecting elders rather than initiating changes. Some English- and Spanish-speaking workers described efforts to negotiate with consumers. Results also identified workers' perceived barriers to interventions, such as consumers' resistance to changes and lack of resources. These findings played important roles in shaping the intervention materials. For example, given the lack of resources among consumers, the project tried to tap into community-level resources by collaborating with local stakeholders and developing community resource guides. Conclusion. Formative research can be a valuable step to inform the development of occupational health and safety interventions for diverse, underserved worker populations.
Intervention to Increase Adoption of Safer Dairy Farming Production Practices
Authors: Chapman Larry J. , Karsh Ben-Tzion , Taveira Alvaro D. , Josefsson K. Gunnar , Brunette Christopher M. , Pereira Kathryn M. 
Published: January 2017

Objectives. We conducted an intervention to increase adoption of three dairy farming practices shown to reduce certain traumatic and musculoskeletal injury hazards. Methods. The intervention disseminated information to 4,300 Wisconsin dairy farm managers about three safer, more profitable production practices (barn lights, bag silos, and calf feed mixing sites) using information channels upon which these managers were known to rely. We evaluated rolling, independent, community-based samples at baseline and after each of two intervention years. We also evaluated a single sample after the intervention's second year from 1,200 Maryland dairy farm managers who were exposed only to the intervention's nationally distributed print publications, as a “partially exposed” comparison group. Results. In before/after comparisons, Wisconsin managers reported getting more information from print media, public events, and resource people for barn lights and bag silos. Also, Wisconsin managers, in comparison with Maryland managers after the intervention's second year, reported getting more barn lights and bag silo information from public events and resource people, but not from print media. Analyses that adjusted for farm manager, farm operation, and herd variables associated the intervention with increased Wisconsin manager adoption of all three practices after the second intervention year: barn lights (odds ratio [OR] = 2.268, 95% confidence interval [CI] 1.476, 3.485), bag silos (OR=3.561, 95% CI 2.684, 4.728), and calf feeding sites (OR=2.433, 95% CI 1.059, 5.591). There were also increases in awareness of barn lights and calf feeding sites. Conclusion. Disseminating information to managers through well-known information channels was associated with increased reports of information gathering, adoption, and awareness of safer, profit-enhancing work practices in a high-hazard industry.
Evaluation of the Immediate Impact of the Washington, D.C., Smoke-Free Indoor Air Policy on Bar Employee Environmental Tobacco Smoke Exposure
Authors: Pearson Jennifer , Windsor Richard , El-Mohandes Ayman , Perry David C. 
Published: January 2017

Objective. On January 2, 2007, the Washington, D.C., City Council banned smoking in restaurants and bars. We sought to determine the immediate impact of the ban on cotinine-confirmed environmental tobacco smoke (ETS) levels and respiratory symptom reports of a random sample of bar employees. Methods. We conducted an assessment of 66 employees from 41 randomly selected bars in December 2006, a month before the ban went into effect. After analyses of baseline data, 52 employees were eligible and 49 of them (94%) had a post-ban assessment in February 2007. Three participants were excluded due to high cotinine levels at the post-ban assessment, yielding a final sample size of 46 bar employees. ETS exposure levels were documented using saliva cotinine analyses by tandem liquid chromatography and mass spectrometry. Employee respiratory and sensory symptoms reports were assessed by a standardized, validated form: the International Union Against Tuberculosis and Lung Disease Bronchial Symptoms Questionnaire. Employee ETS exposure reports at work were eliminated after the ban. Results. Sensory symptoms reports (at ≤4 weeks) declined significantly by 70% to 100% ( p=0.0016); respiratory symptoms results were inconclusive due to a lack of data. Saliva cotinine medians declined significantly by 70% ( p<0.0001), from a pre-ban mean of 2.11 nanograms per millileter (ng/mL) to a post-ban mean of 0.29 ng/mL, confirming reports of no ETS exposure at work. Conclusion. We concluded that the indoor air law was effective, eliminating employee ETS exposure reports, dramatically reducing their cotinine levels, and almost eliminating reports of sensory symptoms.
Farmworkers at the Border: A Bilingual Initiative for Occupational Health and Safety
Authors: Acosta Martha Soledad Vela , Sechrest Lee , Chen Mei-Kuang 
Published: January 2017

Objective. Bilingual and bicultural occupational health and safety interventions for Hispanic farmworkers are extremely rare and, because of language barriers and cultural differences, issues important to their health and safety on the job remain unaddressed. We designed, conducted, and assessed the first bilingual occupational health and safety education program for farmworkers attending High School Equivalency Programs (HEPs). Methods. We took an interdisciplinary participatory approach by integrating educators and researchers with a community advisory board to guide development, evaluation, and implementation of Work Safely–Trabaje con Cuidado Curriculum (Curriculum), a bilingual occupational health and safety curriculum. We created a quasi-experimental design using mixed-method evaluation (quantitative and qualitative elements) via pre- and posttest comparisons, follow-up surveys, and focus groups assessing the Curriculum effect on knowledge, safety risk perception (SRP), and safety behavior. Focus groups and follow-up surveys reflected success and acceptance of the Curriculum among participating farmworkers under the study's logic model. Results. Completion of the Curriculum resulted in statistically significant improvements in the combined score of knowledge and SRP at the posttest ( p=0.001) and follow-up survey ( p=0.02) in the intervention group. After completing this study, the Curriculum was permanently adopted by the two high school equivalency sites involved. Conclusion. The participatory approach resulted in integration of community and applied research partnership. The potential to expand use of this Curriculum by other HEP sites can further assess effectiveness and external validity among underserved minority groups.
An Intervention Effectiveness Study of Hazard Awareness Training in the Construction Building Trades
Authors: Sokas Rosemary K. , Jorgensen Emile , Nickels Leslie , Gao Weihua , Gittleman Janie L. 
Published: January 2017

Objective. We evaluated knowledge, attitudes, and self-reported work practices among apprentice and journeyman trainees in two construction trades at baseline and three months after participation in two training sessions as part of a 10-hour Occupational Safety and Health Administration hazard awareness training program. We developed preliminary assessment of prior and current training impact, accounting for demographics, trade, and construction site safety climate. Methods. Participants were recruited prior to union-delivered safety training, self-completed a baseline survey prior to class, and completed a follow-up interviewer-administered telephone survey three months later. Discrimination (D) testing evaluated knowledge questions, paired t-tests examined differences in pre- and post-intervention knowledge, and attitude responses were tested with the Wilcoxon signed rank test. Linear regression analysis and logistic regression were used to assess the contribution of different categorical responses to specific sub-questions. Results. Of 175 workers completing the baseline survey, 127 were born in the U.S. and 41 were born in Mexico; 40% of those who reported ethnicity were Hispanic. Follow-up surveys were completed by 92 (53%) respondents and documented significant increases in both fall safety and electrical safety knowledge. The most recent safety climate was associated with improvement in fall safety attitudes (slope = 0.49, p<0.005) when adjusted by country of birth (slope = 0.51, p<0.001). Workers born in Mexico had less formal education than U.S.-born workers and lower baseline knowledge scores, but more positive attitude scores at baseline and greater improvements in attitude at follow-up. Conclusion. Knowledge and attitude improvement following a one-hour safety class was measurable at three months in both U.S.-born and Mexican-born construction workers.
Hands-Free Technique in the Operating Room: Reduction in Body Fluid Exposure and the Value of a Training Video
Authors: Stringer Bernadette , Haines Ted , Goldsmith Charles H. , Blythe Jennifer , Berguer Ramon , Andersen Joel , de Gara Christopher J. 
Published: January 2017

Objectives. This study sought to determine if ( 1) using a hands-free technique (HFT)—whereby no two surgical team members touch the same sharp item simultaneously—≥75% of the time reduced the rate of percutaneous injury, glove tear, and contamination (incidents); and ( 2) if a video-based intervention increased HFT use to ≥75%, immediately and over time. Methods. During three and four periods, in three intervention and three control hospitals, respectively, nurses recorded incidents, percentage of HFT use, and other information in 10,596 surgeries. The video was shown in intervention hospitals between Periods 1 and 2, and in control hospitals between Periods 3 and 4. HFT, considered used when ≥75% passes were done hands-free, was practiced in 35% of all surgeries. We applied logistic regression to ( 1) estimate the rate reduction for incidents in surgeries when the HFT was used and not used, while adjusting for potential risk factors, and ( 2) estimate HFT use of about 75% and 100%, in intervention compared with control hospitals, in Period 2 compared with Period 1, and Period 3 compared with Period 2. Results. A total of 202 incidents (49 injuries, 125 glove tears, and 28 contaminations) were reported. Adjusted for differences in surgical type, length, emergency status, blood loss, time of day, and number of personnel present for ≥75% of the surgery, the HFT-associated reduction in rate was 35%. An increase in use of HFT of ≥75% was significantly greater in intervention hospitals, during the first post-intervention period, and was sustained five months later. Conclusion. The use of HFT and the HFT video were both found to be effective.