bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of early and late quality of life between left anterior thoracotomy and median sternotomy off-pump coronary artery bypass surgery
Authors: Nesbitt Julian J. , Mori George , Mason-Apps Charlotte , Asimakopoulos George 
Published: July 2016

Objective: Minimally invasive coronary artery bypass surgery performed through a left thoracotomy has potential benefits over conventional sternotomy, including reduced surgical trauma, faster recovery and potential improvement in quality of life. This study is a prospective assessment of quality of life in patients undergoing off-pump coronary bypass by median sternotomy and left anterior thoracotomy. Methods: Quality of life was assessed by the EuroQoL questionnaire, with additional questions on dyspnoea, angina, wound pain and scar aesthetics. Outcomes were compared across the data sets at pre-operation, three weeks and three months post-operation. Results: Sixty-six (17 minimally invasive and 49 off-pump) patients (mean age 65±12, 7 females and 59 males) were included. Significant differences in mean EuroQol outcomes were observed for activities, F(1,64) = 5.86, (p<0.05), pain scores, F(1,64) = 4.658 (p=0.035) and scar aesthetics, F(1,64) = 16.83 (p<0.05). There was an additional significant interaction, F(1.898, 121.49) = 3.282, (p<0.05), between time and group for activity levels; exploring this further indicated no significant difference at baseline, but significantly greater improvement observed in the minimally invasive group over time. At 3 weeks, 50% of minimally invasive patients compared to 82% of sternotomy patients (p<0.001) required oral analgesia. At 3 months, 8% of minimally invasive patients and 21% of sternotomy patients (p<0.001) required oral analgesia. Conclusions: Off-pump coronary artery bypass performed with a minimally invasive approach through a left thoracotomy appears to result in earlier improvement in quality of life outcomes compared to conventional sternotomy. These results are important when counselling patients regarding the benefits and difference between a left anterior thoractomy MIDCABG and conventional OPCAB and can be used as pilot data for a larger trial examining differences in the MIDCABG and conventional full sternotomy OPCAB procedures.
Extramural venous invasion detected by MDCT as an adverse imaging feature for predicting synchronous metastases in T4 gastric cancer
Authors: Cheng Jin , Wu Jing , Ye Yingjiang , Zhang Chunfang , Zhang Yinli , Wang Yi 
Published: July 2016

Background Extramural venous invasion (EMVI) is defined histologically as the active invasion of tumor cells to the lumens of mesenteric vessels beyond the muscularis propria in advanced gastrointestinal cancer, resulting in distant metastases. Purpose To determine the association between synchronous metastatic disease in patients with T4 gastric cancer and EMVI detected on contrast-enhanced multiple-row detector computed tomography (MDCT). Material and Methods A total of 152 patients with T4 gastric carcinoma were retrospectively reviewed and divided into EMVI-positive and EMVI-negative groups where EMVI, as detected on MDCT, was defined as a tubular or nodular soft tissue thickening extending from the tumor along the vessels of the mesentery. Synchronous metastases were detected by MDCT and/or confirmed by postoperative diagnosis. Logistic regression analyses were performed to analyze the predictive factors of synchronous metastases in gastric cancer. Results Synchronous metastases were found in 47 of 152 (30.9%) patients with T4 gastric cancer. Thirty-one of 77 (40.3%) patients in the EMVI-positive group had evidence of metastases compared to 16 (21.3%) of 75 patients in the EMVI-negative group ( P = 0.019). Synchronous metastases were significantly associated with EMVI with an odds ratio (OR) of 2.250 (95% CI, 1.072–4.724). Conclusion EMVI-positive tumors, as an adverse imaging feature, were significantly associated with synchronous metastases in patients with T4 gastric cancer.
Length of capsular contact on prostate MRI as a predictor of extracapsular extension: which is the most optimal sequence?
Authors: Woo Sungmin , Kim Sang Youn , Cho Jeong Yeon , Kim Seung Hyup 
Published: July 2016

Background Length of capsular contact (LCC) is a promising biomarker for predicting extracapsular extension (ECE), but the most optimal magnetic resonance imaging (MRI) sequence for measuring LCC is yet to be determined. Purpose To evaluate LCC using different MRI sequences for determining ECE in prostate cancer. Material and Methods A total of 185 patients underwent prostate MRI followed by radical prostatectomy. LCC was measured separately on T2-weighted (T2W) images, apparent diffusion coefficient (ADC) maps, and dynamic contrast-enhanced (DCE) MRI. LCCs (LCCT2, LCCADC, LCCDCE, and LCCmax [greatest value of 3 LCCs]) were compared between sequences using Wilcoxon signed rank test and was tested for determining ECE using the Mann–Whitney U test, ROC curve analysis, and logistic regression analysis. Results There were no significant differences among LCCs ( P = 0.333–0.837). All LCCs were significantly greater in patients with ECE ( P < 0.001). The optimal threshold value for predicting ECE was >14, >13, >12, and >14 mm for LCCT2, LCCADC, LCCDCE, and LCCmax, respectively. LCCmax yielded the highest area under the curve (0.895) which was significantly greater than that by LCCADC (0.858, P = 0.030). Otherwise, there were no significant difference between LCCs ( P = 0.052–0.985). At univariate analysis, age, clinical stage, PSA, Gleason score, and all LCCs were significantly associated with ECE ( P < 0.001–0.040). At multivariate analysis, GS ( P ≤ 0.008) and all LCCs ( P < 0.001) were independently predictive factors. Conclusion LCC measured on any sequence was significantly different in patients with and without ECE and was independently associated with the presence of ECE. Although LCCmax showed the greatest ability to predict ECE, there was relatively equivalent performance among different MRI sequences.
Thiamine Levels During Intensive Insulin Therapy in Critically Ill Patients
Authors: van Snippenburg Wouter , Reijnders Mariet G. J. , Hofhuis Jose G. M. , de Vos Rien , Kamphuis Stephan , Spronk Peter E. 
Published: July 2016

Introduction: Thiamine is an essential cofactor in carbohydrate metabolism, and deficiency can therefore cause various organ dysfunctions. Little is known about the prevalence and possible worsening of thiamine deficiency in critically ill patients. In this study, we investigated the prevalence of thiamine deficiency at admission to the intensive care unit (ICU) and hypothesized that intensive insulin therapy, aimed at regulating glucose levels, increases thiamine utilization and therefore might cause or worsen deficiency in patients with limited thiamine stores. Materials and Methods: An observational prospective cohort study was carried out in a medical–surgical ICU in a general teaching hospital in Apeldoorn, the Netherlands. All adults who were treated during that time with intensive insulin therapy were included. Deficiency was defined as a thiamine level <100 nmol/L. No thiamine supplementation was administered except for normal amounts present in standard enteral feeding. Results: A total of 58 patients were available for analysis. Median thiamine level at admission was 111 nmol/L. Deficiency was present in 39.7% of patients and was significantly associated with the presence of gastrointestinal pathology and with recent surgery. Thiamine levels increased a median of 14 nmol/L in 48 hours. Only 3.4% of patients showed a predefined relevant decline in thiamine levels. Conclusion: Intensive insulin therapy does not appear to cause or worsen thiamine deficiency. However, based on the high prevalence of deficiency at admission, it might be warranted to supplement thiamine in all patients admitted to the ICU, especially when there is an underlying gastrointestinal disease or recent surgery.
Benchmarks for Outpatient Dialectical Behavioral Therapy in Adults With Borderline Personality Disorder
Authors: Washburn Micki , Rubin Allen , Zhou Shu 
Published: July 2016

Purpose: This article provides benchmark data on within-group effect sizes from published randomized clinical trials supporting the efficacy of dialectical behavioral therapy (DBT) for borderline personality disorder (BPD) in adults aged 18–65 years. Method: Within-group effect sizes were calculated via the Glass approach and adjusted for sample size using Hedges’s g then aggregated to produce benchmarks for symptoms commonly associated with BPD, such as self-harm, depression, and anger. Results: Aggregate within-group effect sizes are presented separately for treatment (DBT) and control (treatment as usual) groups and for interviewer assessed and self-reported outcome measures. Discussion: Community-based practitioners can use these benchmarks as a comparison tool to evaluate the ways in which they are adopting or adapting the DBT intervention and to determine if the intervention should be modified or replaced, given their unique practice setting and client population.
Clinical ethics committees – also for mental health care? The Norwegian experience
Authors: Syse Irene , Førde Reidun , Pedersen Reidar 
Published: July 2016

Background The aim was to explore how the clinical ethics committees in Norway have worked and functioned within mental health care and addiction treatment services. Methods Analysis of 256 annual reports from clinical ethics committees from 2003 to 2012 and a survey to clinicians who had used a clinical ethics committee. Results Dilemmas related to coercion, confidentiality, information, and patient autonomy dominated. The committees established only for psychiatric hospitals, had received more cases from mental health and addiction services than the committees also serving somatic services. Many of the case discussions involved both somatic and mental health care, complicated legal issues as well as ethical dilemmas. Mental health care professionals that have used the clinical ethics committees evaluated the clinical ethics committees deliberation as useful. Conclusion Given the many difficult ethical dilemmas in mental health care ethics work need to be strengthened. The complexity of the cases requires varied and interdisciplinary competence and training among the clinical ethics committee members.
Non-factorial analyses of two-by-two factorial trial designs
Authors: Korn Edward L , Freidlin Boris 
Published: July 2016

Background/aims Factorial analyses of 2 × 2 trial designs are known to be problematic unless one can be sure that there is no interaction between the treatments ( A and B). Instead, we consider non-factorial analyses of a factorial trial design that addresses clinically relevant questions of interest without any assumptions on the interaction. Primary questions of interest are as follows: (1) is A better than the control treatment C, (2) is B better than C, (3) is the combination of A and B ( AB) better than C, and (4) is AB better than A, B, and C. Methods A simple three-step procedure that tests the first three primary questions of interest using a Bonferroni adjustment at the first step is proposed. A Hochberg procedure on the four primary questions is also considered. The two procedures are evaluated and compared in limited simulations. Published results from three completed trials with factorial designs are re-evaluated using the two procedures. Results Both suggested procedures (that answer multiple questions) require a 50%–60% increase in per arm sample size over a two-arm design asking a single question. The simulations suggest a slight advantage to the three-step procedure in terms of power (for the primary and secondary questions). The proposed procedures would have formally addressed the questions arising in the highlighted published trials arguably more simply than the pre-specified factorial analyses used. Conclusion Factorial trial designs are an efficient way to evaluate two treatments, alone and in combination. In situations where a statistical interaction between the treatment effects cannot be assumed to be 0, simple non-factorial analyses are possible that directly assess the questions of interest without the zero interaction assumption.
Nigerian (Yoruba) version of Disabilities of the Arm, Shoulder and Hand questionnaire (DASH-Y): Cross-cultural adaptation and initial validation
Authors: Odole Adesola C , Odunaiya Nse A , Mbaike Chidinma F , Ibikunle Peter O , Akinseloyin Adefemi A , Olaseinde Oluseyi R 
Published: July 2016

Introduction The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is a widely used upper extremity outcome measure. However, it is yet to be translated into any of the major languages in Nigeria, thus limiting its utility in the Nigerian clinical setting. The aim of this study was to cross-culturally adapt the DASH questionnaire into Yoruba, a major Nigerian language and investigate its initial validation. Methods The English version of DASH was adapted into Yoruba through forward–back translations, experts’ committee meetings, pretesting and cognitive debriefing interview in accordance with the guidelines recommended by the developers of DASH. Fifty-two purposively selected patients with upper extremity musculoskeletal disorders participated in a cross-sectional survey. Factor analysis was performed to ensure structural validity of Yoruba version, and construct validity was investigated with Spearman rank correlation coefficient. Results The Yoruba version of DASH has semantic, idiomatic, linguistic and conceptual equivalence with the English DASH. Thirty linear components were identified within the data set. Principal factor analysis of the Yoruba DASH revealed a seven factor scale, having fulfilled all the necessary conditions. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.61, and Barlett’s test of Sphericity was adequate and significant (χ2 (1066) = 435, p = 0.001). Significant correlation (r = 0.994, p = 0.001) exists between scores obtained on English and Yoruba versions of DASH. Conclusion A cross-culturally adapted, valid Yoruba version of DASH is available for use in in south western Nigeria and other similar populations.
Magnitude and variability of effect sizes for the associations between chronic pain and cognitive test performances: a meta-analysis
Authors: Rathbone Michél , Parkinson William , Rehman Yasir , Jiang Shucui , Bhandari Mohit , Kumbhare Dinesh 
Published: July 2016

Objectives and Methods: A systematic review and meta-analysis were performed to estimate the size and variability of the association between chronic pain (CP) and poorer cognitive test performances as a function of individual tests, pain sub-types, and study sources on 22 studies having (1) a control group, (2) reported means and standard deviations (SDs) and (3) tests studied at least 3 times. Results: CP patients performed significantly poorer with small to moderate effects (d = −.31 to −.57) on Digit Span Backward; STROOP Word; Color and Color-Word; Digit Symbol; Trail Making A and B; Rey Auditory Learning Immediate and Delayed Recall and Recognition. For these 10 measures, single effects (no interaction) were supported (I2 = 0%–8%) and Random and Fixed models yielded similar results. No group differences were found for Corsi Blocks Forward or Wisconsin Cart Sorting Test Categories Achieved, or Perseveration. Effects for the Rey Complex Figure Immediate and Delayed Recall were significant, but effect size was inconclusive, given moderate to high heterogeneity and lack of consistency between Random and Fixed models. For the Paced Auditory Serial Addition Test, there was a homogeneous (I2 = 0%) and significantly lower performance in fibromyalgia (d = −.47), but no effect in diagnostically undifferentiated pain samples, and wide variability across studies of whiplash (d = −.15 to −1.04, I2 = 60%). Conclusion: The magnitude and consistency of the CP – cognition effect depended on the test, pain subgroup and study source. Summary points Among tests showing a chronic pain (CP) – cognition effect, the magnitude of this association was consistently small to moderate across tests. Effect size estimation was inconclusive for Digit Span Forwards, the Paced Auditory Serial Addition Test and the Rey Complex Figure Test. Variance was too heterogeneous for testing cognitive domain specificity of the CP – cognition effect.
IL-10+ regulatory B cells are enriched in cord blood and may protect against cGVHD after cord blood transplantation
Authors: Sarvaria Anushruti , Basar Rafet , Mehta Rohtesh S. , Shaim Hila , Muftuoglu Muharrem , Khoder Ahmad , Sekine Takuye , Gokdemir Elif , Kondo Kayo , Marin David , Daher May , Alousi Amin M. , Alsuliman Abdullah , Liu Enli , Oran Betul , Olson Amanda , Jones Roy B. , Popat Uday , Hosing Chitra , Champlin Richard , Shpall Elizabeth J. , Rezvani Katayoun 
Published: July 2016

Key PointsCord blood is a rich source of B cells with immunoregulatory function. IL-10–producing B cells may protect against cGVHD after cord blood transplantation.
Carfilzomib significantly improves the progression-free survival of high-risk patients in multiple myeloma
Authors: Avet-Loiseau Hervé , Fonseca Rafael , Siegel David , Dimopoulos Meletios A. , Špička Ivan , Masszi Tamás , Hájek Roman , Rosiñol Laura , Goranova-Marinova Vesselina , Mihaylov Georgi , Maisnar Vladimír , Mateos Maria-Victoria , Wang Michael , Niesvizky Ruben , Oriol Albert , Jakubowiak Andrzej , Minarik Jiri , Palumbo Antonio , Bensinger William , Kukreti Vishal , Ben-Yehuda Dina , Stewart A. Keith , Obreja Mihaela , Moreau Philippe 
Published: July 2016

Key Points
KRd has a favorable benefit-risk profile compared with Rd, regardless of baseline cytogenetic risk status, in patients with relapsed MM. KRd improves but does not abrogate the poor prognosis associated with high-risk cytogenetics in patients with relapsed MM.
The effect of age at school entry on college admission and earnings: a regression-discontinuity approach
Authors: Matta Rafael , Ribas Rafael P. , Sampaio Breno , Sampaio Gustavo R. 
Published: July 2016

Abstract
This paper provides evidence of the effect of age at school entry on college admission and earnings. It does so by exploiting a number of features in the application process to one of the major flagship universities in Brazil. By comparing applicants with different ages at school entry depending on whether they were born on December 31 or on January 1, our estimates show that applicants who delayed first-grade enrollment present higher aptitude test scores and probability of admission. Our results further suggest that advantaged applicants also earn more early in their careers.

JEL Classification: I21, J24
Epidermal Growth Factor Receptor Mutational Status and Brain Metastases in Non–Small-Cell Lung Cancer
Authors: Bhatt Vijaya Raj , D’Souza Sanyo P. , Smith Lynette M. , Cushman-Vokoun Allison M. , Noronha Vanita , Verma Vivek , Joshi Amit , Chougule Anuradha , Jambhekar Nirmala , Kessinger Anne , Marr Alissa , Patil Vijay , Banavali Sripad D. , Ganti Apar Kishor , Prabhash Kumar 
Published: July 2016

Introduction Epidermal growth factor receptor ( EGFR) mutations in non–small-cell lung cancers (NSCLC) may be more common in patients with brain metastases. Previous studies, however, did not adjust for effects of confounding variables. Methods This retrospective study included 1,522 consecutive patients with NSCLC, whose tumors were diagnosed and tested for EGFR mutations at the University of Nebraska Medical Center (Omaha, NE) and Tata Memorial Hospital (Mumbai, India). Multivariate logistic regression was used to identify any association between EGFR status and clinical factors. Results EGFR mutations were more common in females than males (38.7% v 24.8%), Asians than whites (31.3% v 13.4%), nonsmokers than smokers (40.2% v 14.6%), alcohol nonconsumers than users (32.4% v 15.8%), adenocarcinoma than other histology types (32.7% v 10.3%), and patients with brain metastases than extracranial or no metastases (39.4% v 29.8% v 15.1%; P < .001 for all comparisons). There was a higher likelihood of an EGFR mutation among patients with brain metastases (odds ratio, 1.8; P < .001). The median overall survival (OS) was 19.8 months. Patients with brain metastases had a shorter median OS (15 v 20.6 months; P = .02). However, in the cohort of EGFR mutation–positive patients, there was no difference in median OS between patients with and without brain metastases (20.8 v 25.1 months; P = .11). Conclusion There is a nearly two-fold higher incidence of EGFR mutations in NSCLC among patients with brain metastases at diagnosis. EGFR mutations did not predict for outcomes from brain metastases.
A Case-Control Study to Evaluate the Etiology of Esophageal Cancer in Tanzania
Authors: Mmbaga Elia , Deardorff Katrina , Mushi Beatrice , Zhang Li , Mgisha William , Parikh Aparna , Hiatt Robert A. , Mwaiselage Julius , Van Loon Katherine 
Published: July 2016

Abstract 75 Objective: East Africa has been previously reported as a geographic area with a disproportionately high incidence of squamous cell esophageal cancer (EC). In the setting of an apparent geographic cluster, we sought to identify specific etiologic factors contributing to the high incidence of EC in Tanzania (TZ). Methods: We performed a case-control study to examine possible associations between EC and selected environmental, dietary, and lifestyle factors. Newly diagnosed EC cases were recruited at Muhimbili National Hospital and Ocean Road Cancer Institute during 2014-2015. Hospital controls were identified from patients with non-malignant conditions and matched 1:1 for gender and age ±10 years. The study team conducted in-person interviews. A matched case-control analysis used McNemar’s test with a Mantel-Haenszel estimate for odds ratios (OR). Results: 375 cases and 375 controls were enrolled. 71% of cases and controls were male. Median age was 58 years (range 30-91) for cases and 55 years (range 31-88) for controls. Among cases with a confirmed pathologic diagnosis, squamous cell carcinoma was the most common histology (85%). Liquor consumption (OR 1.84, 95% CI: 1.05-3.22, p=0.04), burning firewood (OR 2.66, 95% CI: 1.88-3.76, p<0.001), use of kerosene (OR 3.29, 95% CI: 2.36-4.59, p<0.001), and use of surface water as a primary source of drinking water (OR 2.3, 95% CI: 1.41-3.76, p=0.001) were associated with increased risk of EC. Running water, gas, and electric utilities in the household were protective. Conclusion: Alcohol consumption, firewood and kerosene use as fuel, and surface water consumption merit further investigation as potential etiologic factors contributing to high EC incidence in TZ. Future research will include conducting multivariate analysis with these and other potential risk factors and a genome-wide analysis study using DNA extracted from saliva specimens obtained from cases and controls. Funding: Research support provided by the National Cancer Institute, National Institutes of Health Contract No. HH5N261200800001E. AUTHORS’ DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: Elia Mmbaga No relationship to disclose Katrina Deardorff No relationship to disclose Beatrice Mushi No relationship to disclose Li Zhang No relationship to disclose William Mgisha No relationship to disclose Aparna Parikh Employment: Genentech Stock or Other Ownership: Genentech Travel, Accommodations, Expenses: Genentech Robert A. Hiatt No relationship to disclose Julius Mwaiselage No relationship to disclose Katherine Van Loon Consulting or Advisory Role: Bayer Company: OncoPlex Diagnostics