bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a Model Performance Metric and Its Application to Assess Summer Precipitation over the U.S. Great Plains in Downscaled Climate Simulations
Authors: Tian Baijun , Lee Huikyo , Waliser Duane E. , Ferraro Robert , Kim Jinwon , Case Jonathan , Iguchi Takamichi , Kemp Eric , Wu Di , Putman William , Wang Weile 
Published: August 2017

Abstract
Several dynamically downscaled climate simulations with various spatial resolutions (24, 12, and 4 km) and spectral nudging strengths (0, 600, and 2000 km) have been run over the contiguous United States from 2000 to 2009 using the high-resolution NASA Unified Weather and Research Forecasting (NU-WRF) regional model initialized and constrained by the Modern-Era Retrospective Analysis for Research and Applications, version 2 (MERRA-2). This paper summarizes the authors’ efforts on the development of a model performance metric and its application to assess summer precipitation over the U.S. Great Plains (USGP) in these downscaled climate simulations. A new model performance metric T was first developed that uses both the linear correlation coefficient and mean square error and is consistent with other commonly used metrics, but gives a bigger separation between good and bad simulations. This metric T was then applied to the summer mean precipitation spatial pattern, diurnal Hovmöller diagram, and diurnal spatial pattern over the USGP from the simulations focusing on the summer precipitation diurnal cycle related to mesoscale convective systems (MCSs). The metric T skill scores increase significantly from the control simulation to the nudged simulations and from the nudged simulations with shorter wavelengths to the nudged simulations with longer wavelengths, but do not change much from MERRA-2 to the downscaled simulations or between the various downscaled simulations with different spatial resolutions. Thus, there is some credibility, but no significant value added compared to MERRA-2, of the downscaled climate simulations of the summer precipitation over the USGP.
Prediction of high-stage liver fibrosis using ADC value on diffusion-weighted imaging and quantitative enhancement ratio at the hepatobiliary phase of Gd-EOB-DTPA–enhanced MRI at 1.5 T
Authors: Harada Taiyo L , Saito Kazuhiro , Araki Yoichi , Matsubayashi Jun , Nagao Toshitaka , Sugimoto Katsutoshi , Tokuuye Koichi 
Published: August 2017

Background Recently, diffusion-weighted imaging (DWI) and quantitative enhancement ratio measured at the hepatobiliary phase (HBP) of Gd-EOB-DTPA–enhanced magnetic resonance imaging (MRI) has been established as an effective method for evaluating liver fibrosis. Purpose To evaluate which is a more favorable surrogate marker in predicting high-stage liver fibrosis, apparently diffusion coefficient (ADC) value or quantitative enhancement ratio measured on HBP. Material and Methods Eighty-three patients with 99 surgically resected hepatic lesions were enrolled in this study. DWI was performed with b-values of 100 and 800 s/mm2. Regions of interest were set on ADC map, and the HBP of Gd-EOB-DTPA–enhanced MRI, to calculate ADC value, liver-to-muscle ratio (LMR), liver-to-spleen ratio (LSR), and contrast enhancement index (CEI) of liver. We compared these parameters between low-stage fibrosis (F0, F1, and F2) and high-stage fibrosis (F3 and F4). Receiver operating characteristic analysis was performed to compare the diagnostic performance when distinguishing low-stage fibrosis from high-stage fibrosis. Results LMR and CEI were significantly lower at high-stage fibrosis than at the low stage ( P < 0.01 and P = 0.04, respectively), whereas LSR did not show a significant difference ( P = 0.053). No significant difference was observed in diagnostic performance between LMR and CEI ( P = 0.185). The best sensitivity and specificity, when an LMR of 2.80 or higher was considered to be low-stage fibrosis, were 82.4% and 75.6%, respectively. ADC value showed no significant differences among fibrosis grades ( P = 0.320). Conclusion LMR and CEI were both adequate surrogate parameters to distinguish high-stage fibrosis from low-stage fibrosis.
In vitro and in vivo evaluation of hypothermia on pharmacokinetics and pharmacodynamics of nimodipine in rabbits
Authors: Fei Yu-xing , Zhang Tian-hong , Zhao Jing , Ren He , Du Ya-nan , Yu Chun-ling , Wang Qiang , Li Shu , Ren Ting-lin , Jian Qiang , Fei Shu-yang , Zhang Zhen-qing , Zhang Yi 
Published: August 2017

Objective To investigate the effect of hypothermia on the pharmacokinetics and pharmacodynamics of nimodipine in rabbits using in vivo and in vitro methods. Methods Five healthy New Zealand rabbits received a single dose of nimodipine (0.5 mg/kg) intravenously under normothermic and hypothermic conditions. Doppler ultrasound was used to monitor cerebral blood flow, vascular resistance, and heart rate. In vitro evaluations of protein binding, hepatocyte uptake and intrinsic clearance of liver microsomes at different temperatures were also conducted. Results Plasma concentrations of nimodipine were significantly higher in hypothermia than in normothermia. Nimodipine improved cerebral blood flow under both conditions, but had a longer effective duration during the hypothermic period. Low temperature decreased the intrinsic clearance of liver microsomes, with no change in protein binding or hepatocyte uptake of nimodipine. Conclusion Nimodipine is eliminated at a slower rate during hypothermia than during normothermia, mainly due to the decreased activity of cytochrome P450 enzymes. This results in elevated system exposure with little enhancement in pharmacological effect.
Effect of hypercortisolism on bone mineral density and bone metabolism: A potential protective effect of adrenocorticotropic hormone in patients with Cushing’s disease
Authors: Guo Weihong , Li Fengao , Zhu Chonggui , Wang Baoping , Wang Kunling , Dai Chenlin , Jia Hongwei , Wei Hongyan , He Qing , Cui Jin , Yuan Menghua , Tang Shaofang , Liu Wei , Zhu Tiehong , Gao Zhihong , Zheng Fangqiu , Ma Zhongshu , Qu Huiqi , Zhu Mei 
Published: August 2017

Objective To investigate the effects of Cushing’s disease (CD) and adrenal-dependent Cushing’s syndrome (ACS) on bone mineral density (BMD) and bone metabolism. Methods Data were retrospectively collected for 55 patients with hypercortisolism (CD, n = 34; ACS n = 21) from January 1997 to June 2014. BMD was examined in all patients, and bone turnover markers were tested in some patients. Healthy controls (n = 18) were also recruited. Results The lumbar spine and femoral neck BMD were significantly lower in the ACS and CD groups than in the control group. Lumbar BMD was significantly lower in the ACS than CD group. The collagen breakdown product (CTX) concentrations were significantly higher while the osteocalcin and procollagen type I N-terminal propeptide (PINP) concentrations were significantly lower in the ACS and CD groups than in the control group. The PINP concentration was significantly lower while the CTX concentration was significantly higher in the ACS than CD group. In the CD group only, lumbar BMD and serum adrenocorticotropic hormone had a significant positive correlation. Conclusions Bone turnover markers indicated suppressed osteoblast and enhanced osteoclast activities. PINP and CTX changes might indicate bone mass deterioration. Adrenocorticotropic hormone might be protective for lumbar BMD in patients with CD.
Innovative Treatment Strategies in Locally Advanced and/or Unresectable Non-Small Cell Lung Cancer
Authors: Movsas Benjamin 
Published: August 2017

Background While small improvements in outcome have occurred for patients with locally advanced non-small cell lung cancer (NSCLC), 5-year survival results remain low, ranging from 5% to 20%. Distant metastases and local-regional progression remain significant patterns of failure. Methods Trials investigating innovative treatment strategies for patients with locally advanced and/or unresectable NSCLC are reviewed, including altered radiation fractionation schema, conformal 3-dimensional radiotherapy, and combined chemoradiotherapy regimens. Results Whereas hyperfractionated radiation therapy (HFRT) alone does not appear to be beneficial, combined HFRT and chemotherapy appears promising in several trials. Patients treated with accelerated RT compared with standard RT have an improved survival. As higher radiation doses appear to enhance local tumor control, strategies involving 3-dimensional conformal radiotherapy merit further investigation. RT plus chemotherapy is superior to RT alone, albeit with greater toxicity. Amifostine is currently being investigated as a radioprotector. The optimal chemotherapy agents and their integration with radiotherapy are the subject of randomized trials. Conclusions Ongoing investigations are warranted to combat both local-regional and systemic failures for patients with locally advanced NSCLC. Treatment strategies need to consider not only the traditional endpoints of survival and local control, but also quality of life.
Evaluation and Treatment of Aerodigestive Tract Invasion by Well-Differentiated Thyroid Carcinoma
Authors: McCaffrey Judith Czaja 
Published: August 2017

Background Although rare, invasion of the upper aerodigestive tract by well-differentiated thyroid carcinoma can be a source of significant morbidity as well as mortality for the patient. Effective management of patients with invasive thyroid carcinoma requires an understanding of the patterns of invasion and methods of treatment, including surgical resection and adjuvant therapy. Methods The author reports on experience with invasive well-differentiated thyroid carcinoma, discussing diagnosis (based on physical examination, imaging studies, and endoscopy) as well as treatment options (based on degree of aerodigestive tract invasion). Results Direct intraluminal invasion of thyroid carcinoma requires definitive resection of aerodigestive tract lumen to remove all gross disease. However, when the lumen is not involved, “shaving” tumor from airway or esophagus is an acceptable treatment with a similar locoregional control rate and minimal morbidity when compared to definitive aerodigestive tract resection. Conclusions Successful treatment of invasive thyroid carcinoma should improve survival and reduce not only the morbidity of the disease, but also the morbidity of the surgical procedure.
Observation in the Management of Localized Prostate Cancer
Authors: Hoff Bryan , Pow-Sang Julio M. 
Published: August 2017

Background The widespread use of the prostate-specific antigen test, the availability of ultrasound, and improved techniques for prostate biopsy have led to the diagnosis of organ-confined prostate cancers at an earlier stage. An unknown number of these cancers will be incidental and will not impact the patient's quality or length of life. Methods The most recent published reports and decision analysis studies on observation management were reviewed. We also analyzed our own series of observed patients. Results Three contemporary series on observation and three reports on decision analysis for treatment of early prostate cancer define a group of patients who may be treated with observation. Our own preliminary experience, however, demonstrates that a significant number undergo definitive treatment within 3 years from diagnosis. The optimal treatment for men with early prostate cancer is currently unknown. Conclusions A subset of patients with newly diagnosed prostate cancer may be managed by observation. Standard protocols for selection and follow-up of patients on observation need to be developed.
Laboratory Testing for HER2/neu in Breast Carcinoma: An Evolving Strategy to Predict Response to Targeted Therapy
Authors: Diaz Nils M. 
Published: August 2017

Background Laboratory testing of HER2/neu in breast carcinoma has become vital to patient care following the approval of trastuzumab as the first therapy to target the HER2/neu oncoprotein. Initial clinical trials used immunohistochemistry (IHC) to test for HER2/neu overexpression in order to select patients for therapy. Fluorescence in situ hybridization (FISH), which tests for gene amplification, is more specific and sensitive than IHC when either assay is compared with HER2/neu overexpression as determined by Northern or Western blot analysis. Many weak overexpressors on IHC testing are not gene amplified on FISH analysis. Such weak overexpressors may be considered false-positives and raise the question of how best to test for HER2/neu. Methods The literature was surveyed regarding testing for HER2/neu overexpression in breast carcinomas and alternative testing strategies. Results False-positive results are a significant problem when IHC is exclusively used to test for HER2/neu overexpression. The false-positives are overwhelmingly confined to the group of 2+ positives and do not respond to targeted therapy. In contrast, concordance between IHC and FISH is high when immunostaining is interpreted as either negative or strongly positive (3+). Whereas some recent studies have suggested that FISH may better predict response to anti-HER2/neu therapy than IHC, others have indicated that IHC is as effective a predictor as FISH. IHC is less technically demanding and costly than FISH. Conclusions IHC analysis of HER2/neu in breast carcinoma is a useful predictor of response to therapy with trastuzumab when strongly positive. Negative immunostaining is highly concordant with a lack of gene amplification by FISH. Most weakly positive overexpressors are false-positives on testing with FISH. Thus, screening of breast carcinomas with IHC and confirmation of weakly positive IHC results by FISH is an effective evolving strategy for testing HER2/neu as a predictor of response to targeted therapy.
The Treatment Challenge of Hormone-Refractory Prostate Cancer
Authors: Kish Julie A. , Bukkapatnam Raviender , Palazzo Felipe 
Published: August 2017

Background Both the demographics and treatment of hormone-refractory prostate cancer (HRPC) are changing. Patients are younger and healthier, with fewer comorbidities. The “no treatment until symptoms” approach is disappearing. Chemotherapy is increasingly being utilized. Methods The authors review the steps involved in hormone management before chemotherapy is considered. The roles for chemotherapy in current clinical trials are examined. Results Effective hormonal management of the prostate cancer patient incorporates an understanding of the stages of hormone sensitivity and prescribing additional interventions beyond simple castration. Once hormone refractoriness is established, the combination of mitoxantrone and prednisone has become a standard chemotherapeutic approach. New agents such as docetaxel are being tested in phase III trials against mitoxantrone plus prednisone. Conclusions HRPC is now regarded as a chemotherapy-sensitive tumor. The goals of chemotherapy in HRPC are to decrease PSA level and improve quality of life. New agents and combinations are needed to improve survival.
Radical Prostatectomy in the Management of Clinically Localized Prostate Cancer
Authors: Bukkapatnam Raviender , Pow-Sang Julio M. 
Published: August 2017

Background Several management options are available when prostate cancer is diagnosed at an early stage. However, the optimal treatment for localized prostate cancer is unknown, and reports in the literature are controversial regarding the best treatment modality for this early presentation. Methods The authors review improvements in surgical technique that have decreased complications, and they address long-term outcomes of surgery related to cancer control. Results Improvements in surgical techniques allow for decreased intraoperative complications. The incidence of long-term complications such as incontinence and impotency is also reduced. The 5- and 10-year progression-free survival with radical prostatectomy has improved. Conclusions Surgery today is safer with improvements in techniques. The long-term outcomes with surgery are excellent and, in several series, better than outcomes achieved with other treatment modalities.
High-Dose-Rate Brachytherapy in the Treatment of Carcinoma of the Prostate
Authors: Syed A.M. Nisar , Puthawala Ajmel , Sharma Anil , Gamie Sherief , Londrc Adina , Cherlow Joel M. , Damore Steven J. , Nazmy Nashwa , Sheikh Khalid M. , Ko Stephen J. 
Published: August 2017

Background Although radical prostatectomy for localized disease is considered as a standard of care, external-beam radiotherapy and brachytherapy are equally effective. We report on the technique and preliminary results of high-dose-rate (HDR) brachytherapy using a temporary iridium-192 implant technique. Methods The authors reviewed the literature on the techniques, treatment protocols, and results of HDR brachytherapy in the treatment of carcinoma of the prostate, and they report their own protocols, technique, and results. Results The combination of HDR brachytherapy and external irradiation has been well tolerated by all 200 patients in our series, with less than 3% grade 3 late complications and with 95% PSA relapse-free survival with a median follow-up of 24 months. Conclusions HDR brachytherapy may be the most conformal type of irradiation in the treatment of carcinoma of the prostate regardless of tumor size, anatomical distortion, and organ mobility.
Management of Erectile Dysfunction Secondary to Treatment for Localized Prostate Cancer
Authors: Telöken Cláudio 
Published: August 2017

Background Management options for localized prostate cancer include radical prostatectomy, external radiation therapy, brachytherapy, and watchful waiting. Improvements in treatment techniques have resulted in fewer side effects. Nevertheless, long-term complications such as erectile dysfunction (ED) continue to affect a significant percentage of men treated for prostate cancer and can have a distressing and debilitating effect on the patient's quality of life. Methods The author reviews both the prevalence and the current options for the management of ED secondary to treatment for clinically localized prostate cancer. Results The ability to preserve potency after prostate cancer treatment is controversial, with reports ranging from 10%-90%. For patients complaining of impotence, efficacious alternatives are available such as oral drugs, intraurethral alprostadil, vacuum devices, intracavernous injections, and penile prostheses. Conclusions Sexual function is an integral part of patient satisfaction and quality of life. Although ED is a frequent complication of definitive treatment of localized prostate cancer, a variety of treatment options are now available to maximize quality of life despite age and other comorbidities.
Lymphatic Mapping in Solid Neoplasms: State of the Art
Authors: Zervos Emmanuel E. , Burak William E. 
Published: August 2017

Background Lymphatic mapping and sentinel lymph node biopsy is an established technique for the staging and treatment of melanoma. The success of lymphatic mapping in this realm has broadened its application to other solid neoplasms. This update reviews the status of sentinel lymph node biopsy in its most widely cited applications. Methods Seminal manuscripts on lymphatic mapping in melanoma, breast, colon, vulvar, cervical, lung, gastric, and head and neck cancers are reviewed. Results Studies suggest that the application of lymphatic mapping as a staging tool in breast cancer and melanoma is justified when applied by trained surgeons. Additional validation is necessary before sentinel node biopsy is advocated in gynecologic, colon, lung, and head and neck cancer. Conclusions As in breast cancer and melanoma, validation of the sentinel node concept in other solid tumors must occur in institutions other than those in which the technique is being developed before it is generally applied to other neoplasms.
Hypopituitarism in Childhood
Authors: Geffner Mitchell E. 
Published: August 2017

Background Childhood hypopituitarism may be present at birth or may be acquired. Early diagnosis and treatment promote the best possible outcomes. Methods The anatomy, etiologies, clinical presentation, diagnostic testing strategies, and current treatments relevant to childhood hypopituitarism are reviewed. Results Children with congenital hypopituitarism may present with life-threatening hypoglycemia, abnormal serum sodium concentrations, shock, microphallus in males, and, only later, growth failure. Causes of congenital hypopituitarism include septo-optic dysplasia, other midline syndromes, and mutations of transcription factors involved in pituitary gland development. Children with acquired hypopituitarism typically present with growth failure and may have other complaints depending on the etiology and the extent of missing pituitary hormones. Acquired hypopituitarism may result from tumors (most commonly craniopharyngioma), radiation, infection, hydrocephalus, vascular anomalies, and trauma. Conclusions An MRI of the head is critical in determining the etiology. Testing for pituitary hormone deficiencies is undertaken along with appropriate hormonal replacement and, in some cases, direct treatment of the cause of the hypopituitarism. All children with hypopituitarism require coordination of medical care by a pediatric endocrinologist and, when older, transition to the care of an internist endocrinologist. Referrals to a reproductive endocrinologist may be required as fertility issues arise.
Treatment of Locally Advanced Head and Neck Cancer: Historical and Critical Review
Authors: Al-Sarraf Muhyi 
Published: August 2017

Background Advanced squamous cell cancers of the head and neck have traditionally been associated with high rates of morbidity and mortality. Advances in management have improved outcomes for most of these patients. Methods The author reviews the historical progress in management of these difficult tumors and adds his own wide experience to describe and evaluate newer approaches to management. Results Over the last 10 years, overall survival rates for patients with head and neck cancers have improved as has quality of life. New standards of care have been defined for patients with nasopharyngeal cancer and for those with advanced unresectable disease. Organ preservation is more commonly achieved. Conclusions Newer targeted therapies are likely to add to the progress that has already been achieved in the multimodality management of patients with head and neck cancers.
Ethical Considerations in the Treatment of Head and Neck Cancer
Authors: Schenck David P. 
Published: August 2017

BackgroundThe second half of the 20th century saw not only important developments in medical science and technology, but also a rapid growth in the application of biomedical ethics in medical decision making. Withdrawal of treatment, allowing to die, informed consent, and patient autonomy are concerns that now comprise a part of the overall medical treatment, particularly in patients with head and neck cancers.MethodsThe author discusses ethical issues relating to disfigurement/dysfunction in head and neck cancer patients and examines the aspects of “principlism” — autonomy, nonmaleficence, beneficence, and justice. Two case reports are presented to illustrate the ethical challenges that may confront physicians who treat head and neck cancer patients.ResultsHead and neck oncology generates unique problems relating to disfigurement and dysfunction. An algorithm that considers the patient's medical good and greater good, as well as the goods of others, can assist in arriving at appropriate ethical decisions.ConclusionsBioethical decision making requires the integration of virtues with principles, followed by the application of these standards to each patient.