bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cessation of oral anticoagulants in antiphospholipid syndrome
Authors: Comarmond C , Jego P , Veyssier-Belot C , Marie I , Mekinian A , Elmaleh-Sachs A , Leroux G , Saadoun D , Oziol E , Fraisse T , Hyvernat H , Thiercein-Legrand M-F , Sarrot-Reynauld F , Ferreira-Maldent N , de Menthon M , Goujard C , Khau D , Nguen Y , Monnier S , Michon A , Castel B , Decaux O , Piette J-C , Cacoub P 
Published: March 2017

Objective To study the outcome of patients with antiphospholipid syndrome (APS) after oral anticoagulant treatment cessation. Methods We performed a retrospective study of patients with APS experiencing cessation of oral anticoagulant and enrolled in a French multicentre observational cohort between January 2014 and January 2016. The main outcome was the occurrence of recurrent thrombotic event after oral anticoagulation cessation. Results Forty four APS patients interrupted oral anticoagulation. The median age was 43 (27–56) years. The median duration of anticoagulation was 21 (9–118) months. Main causes of oral anticoagulant treatment cessation were switch from vitamin K antagonists to aspirin in 15 patients, prolonged disappearance of antiphospholipid antibodies in ten, bleeding complications in nine and a poor therapeutic adherence in six. Eleven (25%) patients developed a recurrent thrombotic event after oral anticoagulation cessation, including three catastrophic APS and one death due to lower limb ischemia. Antihypertensive treatment required at time of oral anticoagulants cessation seems to be an important factor associated with recurrent thrombosis after oral anticoagulant cessation (15.2% in patients with no relapse versus 45.5% in patients with recurrent thrombosis, p = 0.038). Oral anticoagulant treatment was re-started in 18 (40.9%) patients. Conclusion The risk of a new thrombotic event in APS patients who stopped their anticoagulation is high, even in those who showed a long lasting disappearance of antiphospholipid antibodies. Except for the presence of treated hypertension, this study did not find a particular clinical or biological phenotype for APS patients who relapsed after anticoagulation cessation. Any stopping of anticoagulant in such patients should be done with caution.
Cellulitis Secondary to Liquid Nitrogen Cryotherapy: Case Report and Literature Review
Authors: Huang Christina M. , Lu Emily Y. , Kirchhof Mark G. 
Published: March 2017

Background: Liquid nitrogen cryotherapy is a commonly used technique to treat a wide variety of dermatologic conditions including actinic keratoses, non-melanoma skin cancers, verrucae, and seborrheic keratoses. The risks associated with liquid nitrogen cryotherapy are important to know and discuss with patients prior to treatment. Objective: We report a case of cellulitis secondary to liquid nitrogen cryotherapy for actinic keratosis. We sought to review the literature for an estimate of secondary infection rates following cryotherapy treatment. Methods: We searched Pubmed using the terms cryotherapy and infection or cellulitis. We then looked at articles classified as clinical trials where cryotherapy was used to treat skin conditions. We then selected clinical trials that listed cellulitis or infection as an adverse event. Results and Conclusion: There were no case reports, case series, or review articles detailing the risk of infection from liquid nitrogen cryotherapy. We found 8 articles classified as clinical trials on Pubmed that did list infection as an adverse event. The risk of infection from these studies varied from approximately 2% to 30%. There was a great degree of heterogeneity in treatment sites, length of treatment, and treatment targets. While it is difficult to determine the true incidence of infection from liquid nitrogen cryotherapy, clinicians should endeavor to inform patients of this potential risk.
Preventive effects of multiple domain interventions on lifestyle and risk factor changes in stroke survivors: Evidence from a two-year randomized trial
Authors: Teuschl Yvonne , Matz Karl , Firlinger Bernadette , Dachenhausen Alexandra , Tuomilehto Jaakko , Brainin Michael ,   for the ASPIS Study Group
Published: March 2017

Background and aim Behavioral and lifestyle interventions in stroke patients need to be intense enough to result in sustainable treatment differences among groups of a randomized trial. Therefore, we report the effects of multidomain interventions on lifestyle and laboratory parameters after 12 and 24 months from a trial that examined whether intensive risk factor management can prevent cognitive decline in ischemic stroke patients. Methods This prospective randomized, open-label, blinded endpoint trial recruited patients within three months after acute stroke in five Austrian neurological clinics during June 2010 and November 2012. One hundred and one patients were randomized into multidomain intervention and 101 into standard care. Lifestyle interventions were individualized to match predefined targets of regular physical activity, healthy diet, and adequate physiological risk factor control. Results A total of 167 participants (80 intervention, 87 control) completed the 12-month visit and 155 (76 intervention, 79 control) the 24-month visit. During the first 12 months, adherence to healthy lifestyle and adequately controlled physiological parameters (measured by summary scores) improved significantly in the intervention group compared to controls (p < 0.01). The consumption of reduced-fat milk (p = 0.031), reduced-fat spreads (p = 0.007), and fish (p = 0.021) increased in the intervention group from baseline to 12 months but not in controls. After 24 months, the group difference was significant for the lifestyle summary score but no longer for the combined laboratory lifestyle score. Conclusions These results demonstrate that intensified individualized multidomain lifestyle interventions in stroke patients are effective in promoting healthy lifestyle in stroke care.
Does national expenditure on research and development influence stroke outcomes?
Authors: Kim Young Dae , Jung Yo Han , Norrving Bo , Ovbiagele Bruce , Saposnik Gustavo 
Published: March 2017

Background Expenditure on research and development is a macroeconomic indicator representative of national investment. International organizations use this indicator to compare international research and development activities. Aim We investigated whether differences in expenditures on research and development at the country level may influence the incidence of stroke and stroke mortality. Methods We compared stroke metrics with absolute amount of gross domestic expenditure on R&D (GERD) per-capita adjusted for purchasing power parity (aGERD) and relative amount of GERD as percent of gross domestic product (rGERD). Sources included official data from the UNESCO, the World Health Organization, the World Bank, and population-based studies. We used correlation analysis and multivariable linear regression modeling. Results Overall, data on stroke mortality rate and GERD were available from 66 countries for two periods (2002 and 2008). Age-standardized stroke mortality rate was associated with aGERD (r = −0.708 in 2002 and r = −0.730 in 2008) or rGERD (r = −0.545 in 2002 and r = −0.657 in 2008) (all p < 0.001). Multivariable analysis showed a lower aGERD and rGERD were independently and inversely associated with higher stroke mortality (all p < 0.05). The estimated prevalence of hypertension, diabetes, or obesity was higher in countries with lower aGERD. The analysis of 27 population-based studies showed consistent inverse associations between aGERD or rGERD and incident risk of stroke and 30-day case fatality. Conclusions There is higher stroke mortality among countries with lower expenditures in research and development. While this study does not prove causality, it suggests a potential area to focus efforts to improve global stroke outcomes.
Coding of significant comorbidities and complications for stroke in rehabilitation
Authors: Murray Joanne , Pfeiffer Rhonda , Scholten Ingrid 
Published: March 2017

Background: Comorbidities and complications of stroke have implications for level of care and hospital resources. It is critical, therefore, that hospital morbidity data accurately reflect the prevalence of these additional diagnoses. Objective: This study aimed to measure and describe the concordance between stroke clinicians/researchers and medical record coders when recording stroke and related diagnoses. Method: Diagnoses recorded prospectively, according to defined criteria by a clinical research team, were compared with the coding of stroke comorbidities and complications as per the Australian Coding Standards (ACS) from the separations of 100 inpatients from three rehabilitation facilities in South Australia. Percentage agreement, kappa coefficient, sensitivity and specificity values were calculated. Results: Kappa coefficients for agreement of prospective diagnoses with coding ranged from 0.08 to 0.819. The diagnoses with the highest agreement were stroke, aspiration pneumonia (nil cases), aphasia and dysphagia. The diagnoses with the lowest agreement were apraxia, cognitive impairment, constipation and dehydration. Conclusion: Not all stroke comorbidities are represented accurately in hospital morbidity datasets. Education of stroke clinicians about the current ACS may clarify expectations about medical record documentation for coding purposes which in turn may result in more accurate morbidity data and therefore costings for the rehabilitation sector.
Subcutaneous dirofilariasis caused by Dirofilaria (Nochtiella) repens in Sri Lanka: A potential risk of transmitting human dirofilariasis
Authors: Gunathilaka Nayana , Siriwardana Shirom , Wijesooriya Lakmini , Gunaratne Gayana , Perera Nilanga 
Published: March 2017

Objective: Dirofilariasis is a parasitic infection caused by filarial nematodes belonging to the genus Dirofilaria. Human dirofilariasis due to Dirofilaria repens has been widely reported from European countries. Sri Lanka is the most affected country in Asia with an infection rate of almost 60% in dog population. However, human infection of D. repens remains undiagnosed and many of the cases are not scientifically documented. Therefore, the objective of the present investigation is to document the presence of dirofilariasis infections in humans. Method: A 1 year and 10 months old boy from Ragama, Gampaha District, Western Province of Sri Lanka, was presented to a private hospital with a painless, non-pruritic and ill-defined subcutaneous nodule on his right hypochondrial region of the anterior abdominal wall for 1 week. On examination, there was a non-tender swelling measuring 2 cm × 2 cm in the anterior abdominal wall, with surrounding mild redness. The patient was referred for ultrasound confirmation. Results: The ultrasound scan revealed a hypoechoic nodular lesion measuring 11 mm × 6 mm in the anterior abdominal wall. Parasitological examination on the excised nodule confirmed the presence of D. repens measuring 10.5 cm in length having characteristic cuticle with longitudinal ridges. Conclusion: It is essential to record the human infections and increase the awareness about this infection, diagnostic tests and vector controlling measures, in order to reduce the disease prevalence through suppressing vector densities, proper diagnosis and patient care.
Medical management of chronic thromboembolic pulmonary hypertension
Authors: Pepke-Zaba Joanna , Ghofrani Hossein-Ardeschir , Hoeper Marius M. 
Published: March 2017

Chronic thromboembolic pulmonary hypertension (CTEPH) results from incomplete resolution of acute pulmonary emboli, organised into fibrotic material that obstructs large pulmonary arteries, and distal small-vessel arteriopathy. Pulmonary endarterectomy (PEA) is the treatment of choice for eligible patients with CTEPH; in expert centres, PEA has low in-hospital mortality rates and excellent long-term survival. Supportive medical therapy consists of lifelong anticoagulation plus diuretics and oxygen, as needed.An important recent advance in medical therapy for CTEPH is the arrival of medical therapies for patients with inoperable disease or persistent/recurrent pulmonary hypertension after PEA. The soluble guanylate cyclase stimulator riociguat is licensed for the treatment of CTEPH in patients with inoperable disease or with recurrent/persistent pulmonary hypertension after PEA. Clinical trials of this agent have shown improvements in patients' haemodynamics and exercise capacity. Phosphodiesterase-5 inhibitors, endothelin receptor antagonists and prostanoids have been used in the treatment of CTEPH, but evidence of benefit is limited. Challenges in the future development of medical therapy for CTEPH include better understanding of the underlying pathology, end-points to monitor the condition's progress, and the optimisation of pulmonary arterial hypertension therapies in relation to diverse patient characteristics and emerging options such as balloon pulmonary angioplasty.
24h-gene variation effect of combined bevacizumab/erlotinib in advanced non-squamous non-small cell lung cancer using exon array blood profiling
Authors: Baty Florent , Joerger Markus , Früh Martin , Klingbiel Dirk , Zappa Francesco , Brutsche Martin 
Published: March 2017

Abstract
Background
The SAKK 19/05 trial investigated the safety and efficacy of the combined targeted therapy bevacizumab and erlotinib (BE) in unselected patients with advanced non-squamous non-small cell lung cancer (NSCLC). Although activating EGFR mutations were the strongest predictors of the response to BE, some patients not harboring driver mutations could benefit from the combined therapy. The identification of predictive biomarkers before or short after initiation of therapy is therefore paramount for proper patient selection, especially among EGFR wild-types. The first aim of this study was to investigate the early change in blood gene expression in unselected patients with advanced non-squamous NSCLC treated by BE. The second aim was to assess the predictive value of blood gene expression levels at baseline and 24h after BE therapy.

Methods
Blood samples from 43 advanced non-squamous NSCLC patients taken at baseline and 24h after initiation of therapy were profiled using Affymetrix’ exon arrays. The 24h gene dysregulation was investigated in the light of gene functional annotations using gene set enrichment analysis. The predictive value of blood gene expression levels was assessed and validated using an independent dataset.

Results
Significant gene dysregulations associated with the 24h-effect of BE were detected from blood-based whole-genome profiling. BE had a direct effect on “Pathways in cancer”, by significantly down-regulating genes involved in cytokine–cytokine receptor interaction, MAPK signaling pathway and mTOR signaling pathway. These pathways contribute to phenomena of evasion of apoptosis, proliferation and sustained angiogenesis. Other signaling pathways specifically reflecting the mechanisms of action of erlotinib and the anti-angiogenesis effect of bevacizumab were activated. The magnitude of change of the most dysregulated genes at 24h did not have a predictive value regarding the patients’ response to BE. However, predictive markers were identified from the gene expression levels at 24h regarding time to progression under BE.

Conclusions
The 24h-effect of the combined targeted therapy BE could be accurately monitored in advanced non-squamous NSCLC blood samples using whole-genome exon arrays. Putative predictive markers at 24h could reflect patients’ response to BE after adjusting for their mutational status.
Trial registration ClinicalTrials.gov: NCT00354549
How blockchain-timestamped protocols could improve the trustworthiness of medical science
Authors: Irving Greg , Holden John 
Published: March 2017

Trust in scientific research is diminished by evidence that data are being manipulated. Outcome switching, data dredging and selective publication are some of the problems that undermine the integrity of published research. Methods for using blockchain to provide proof of pre-specified endpoints in clinical trial protocols were first reported by Carlisle. We wished to empirically test such an approach using a clinical trial protocol where outcome switching has previously been reported. Here we confirm the use of blockchain as a low cost, independently verifiable method to audit and confirm the reliability of scientific studies.
Competing and contested discourses of citizenship and civic praxis
Authors: Koyama Jill 
Published: March 2017

In this paper, I utilize complementary features of critical discourse analysis (CDA) and Actor-Network Theory (ANT) to trace and investigate issues of power, materiality, and reproduction embedded within notions of citizenship and civic engagement. I interrogate the often narrow and conservative political and public discourses in Arizona, as well as the xenophobic-driven civics education policy. To these, I juxtapose the enactment of citizenship by youth who use, produce, and share language materials and counter authoritative citizenship and civic discourses, especially, but not exclusively, in online contexts. I explore the questions: In what ways are discourses of civic engagement and citizenship assembled, interpreted, understood, enacted, and contested in Arizona? What are the relationships between the civics education policy, discursive enactments of citizenship, and the youth of Mexican descent’s online civic practices? I draw on a mixture of textual (language materials) and discursive (events, acts, and practices) data collected in Arizona to argue that youth are doing critical, yet unrecognized and undervalued, forms of civic engagement online, which could be incorporated in the formal civics education curriculum.
The influence of implant body and thread design of mini dental implants on the loading of surrounding bone: a finite element analysis
Authors: Toth Arpad , Hasan Istabrak , Bourauel Christoph , Mundt Torsten , Biffar Reiner , Heinemann Friedhelm 
Published: March 2017

AbstractMini dental implants (MDI) were once thought of as transitional implants for treatment in selected clinical situations. Their reduced diameter makes them a very attractive option for patients with poor tolerance to maxillary and mandibular prostheses. Using the method of finite element analysis, a series of different designed MDI prototypes have been investigated. The prototypes differed in the geometry of implant body and/or design of implant head. The load transfer of the implant prototypes to the idealised alveolar bone has been regarded and the prototypes have been compared to each other and to a number of standard commercial implants. The prototype models have been virtually placed in the idealised bone with a cortical thickness of 1.5 mm and loaded laterally 30° from the implant's long axis. The condition of immediate loading was assumed for the numerical analyses through defining a contact interface between the implant and bone bed. The numerical analysis in this study showed that the design of the investigated prototype MDI of group 3 (mini-ball head) is the most advantageous design.
Coalescence and contraction of V-to-Vinf sequences in American English – Evidence from spoken language
Authors: Lorenz David , Tizón-Couto David 
Published: March 2017

Abstract
This paper addresses the issue of coalescence of frequent collocations and its consequences for their realization and mental representation. The items examined are ‘semi-modal’ instantiations of the type V-to-Vinf, namely have to, used to, trying to and need to, in American English. We explore and compare their realization variants in speech, considering the effects of speech-internal and extra-linguistic factors (speech rate, stress accent, phonological context, speech situation, age of the speaker), as well as possible effects of analogy with established contractions like gonna, wanna. Our findings show a high degree of coalescence in the items under study, but no clear pattern of contraction. The propensity for contraction in analogy to gonna/wanna is strongly affected by phonological properties – it is inhibited by the presence of a fricative in have/used to. Moreover, the most frequent reduced realizations are conservative in terms of transparency and still allow morphological parsing of the structure. More radical contractions are restricted to rapid and informal speech, and less entrenched as variants. This shows the limitations of reduction as a frequency effect in light of the balance between articulatory ease and explicitness in speaker–hearer interaction. Even in highly frequent and strongly coalesced items, reduction (articulatory ease) is restricted by a tendency to retain cues to morphological structure (explicitness). Finally, we propose a network of pronunciation variants that includes representation strengths as well as analogy relations across constructional types.
On the Yang-Baxter-like matrix equation for rank-two matrices
Authors: Zhou Duanmei , Chen Guoliang , Ding Jiu 
Published: March 2017

Abstract
Let A = PQT, where P and Q are two n × 2 complex matrices of full column rank such that QTP is singular. We solve the quadratic matrix equation AXA = XAX. Together with a previous paper devoted to the case that QTP is nonsingular, we have completely solved the matrix equation with any given matrix A of rank-two.
Are There Scattered Objects?
Authors: Biro John 
Published: March 2017

Abstract
“That there are scattered material objects seems … beyond reasonable doubt.” Many have agreed with this confident assertion by Richard Cartwright. I give reasons to doubt it. While there is an uninteresting sense in which there are scattered material objects, what makes Cartwright’s claim startling is that he makes it clear that by ‘a material object’ he means ‘a body.’ I argue that the every-day examples Cartwright gives – and similar ones offered by others who endorse his claim – are not both material objects in that sense and scattered. There are no scattered bodies.
A Bayesian semiparametric factor analysis model for subtype identification
Authors: Sun Jiehuan , Warren Joshua L. , Zhao Hongyu 
Published: March 2017

Abstract:Disease subtype identification (clustering) is an important problem in biomedical research. Gene expression profiles are commonly utilized to infer disease subtypes, which often lead to biologically meaningful insights into disease. Despite many successes, existing clustering methods may not perform well when genes are highly correlated and many uninformative genes are included for clustering due to the high dimensionality. In this article, we introduce a novel subtype identification method in the Bayesian setting based on gene expression profiles. This method, called BCSub, adopts an innovative semiparametric Bayesian factor analysis model to reduce the dimension of the data to a few factor scores for clustering. Specifically, the factor scores are assumed to follow the Dirichlet process mixture model in order to induce clustering. Through extensive simulation studies, we show that BCSub has improved performance over commonly used clustering methods. When applied to two gene expression datasets, our model is able to identify subtypes that are clinically more relevant than those identified from the existing methods.