bluuebunny/crossref_metadata_2025_split huggingface dataset:
Renal Effects of DPP-4 Inhibitor Sitagliptin or GLP-1 Receptor Agonist Liraglutide in Overweight Patients With Type 2 Diabetes: A 12-Week, Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Tonneijck Lennart , Smits Mark M. , Muskiet Marcel H.A. , Hoekstra Trynke , Kramer Mark H.H. , Danser A.H. Jan , ter Wee Piet M. , Diamant Michaela , Joles Jaap A. , van Raalte Daniël H. 
Published: September 2016

OBJECTIVE
To investigate effects of dipeptidyl peptidase-4 inhibitor (DPP-4I) sitagliptin or glucagon-like peptide 1 (GLP-1) receptor agonist liraglutide treatment on renal hemodynamics, tubular functions, and markers of renal damage in overweight patients with type 2 diabetes without chronic kidney disease (CKD).

RESEARCH DESIGN AND METHODS
In this 12-week, randomized, double-blind trial, 55 insulin-naïve patients with type 2 diabetes (mean ± SEM: age 63 ± 7 years, BMI 31.8 ± 4.1 kg/m2, glomerular filtration rate [GFR] 83 ± 16 mL/min/1.73 m2; median [interquartile range]: albumin-to-creatinine ratio (ACR) 1.09 mg/mmol [0.47–3.31]) received sitagliptin (100 mg/day), liraglutide (1.8 mg/day), or matching placebos. GFR (primary end point) and effective renal plasma flow (ERPF) were determined by inulin and para-aminohippuric acid clearance, respectively. Intrarenal hemodynamic variables were estimated. Absolute and fractional excretions of sodium (FENa), potassium, and urea (FEU) and renal damage markers (ACR, neutrophil gelatinase–associated lipocalin [NGAL], and kidney injury molecule-1 [KIM-1]) were measured. Plasma renin concentration (PRC) and glycated hemoglobin (HbA1c) were assessed. At weeks 2 and 6, estimated GFR and fractional electrolyte excretions were determined.

RESULTS
At week 12, GFR was not affected by sitagliptin (−6 mL/min/1.73 m2 [95% CI −14 to 3], P = 0.17) or liraglutide (+3 mL/min/1.73 m2 [−5 to 11], P = 0.46), compared with placebo. Sitagliptin modestly reduced estimated glomerular hydraulic pressure (PGLO; P = 0.043). ERPF, other intrarenal hemodynamic variables, renal damage markers, and PRC did not change for both treatments. Both agents reduced HbA1c. Only at week 2, sitagliptin increased FENa and FEU (P = 0.005).

CONCLUSIONS
Twelve-week treatment with sitagliptin or liraglutide does not affect measured renal hemodynamics. No sustained changes in tubular functions or alteration in renal damage markers were observed. The validity and clinical relevance of the slight sitagliptin-induced PGLO reduction remains speculative.
Factors associated with spinal fusion after posterior fossa decompression in pediatric patients with Chiari I malformation and scoliosis
Authors: Mackel Charles E. , Cahill Patrick J. , Roguski Marie , Samdani Amer F. , Sugrue Patrick A. , Kawakami Noriaki , Sturm Peter F. , Pahys Joshua M. , Betz Randal R. , El-Hawary Ron , Hwang Steven W. 
Published: September 2016

OBJECTIVE
The authors performed a study to identify clinical characteristics of pediatric patients diagnosed with Chiari I malformation and scoliosis associated with a need for spinal fusion after posterior fossa decompression when managing the scoliotic curve.

METHODS
The authors conducted a multicenter retrospective review of 44 patients, aged 18 years or younger, diagnosed with Chiari I malformation and scoliosis who underwent posterior fossa decompression from 2000 to 2010. The outcome of interest was the need for spinal fusion after decompression.

RESULTS
Overall, 18 patients (40%) underwent posterior fossa decompression alone, and 26 patients (60%) required a spinal fusion after the decompression. The mean Cobb angle at presentation and the proportion of patients with curves > 35° differed between the decompression-only and fusion cohorts (30.7° ± 11.8° vs 52.1° ± 26.3°, p = 0.002; 5 of 18 vs 17 of 26, p = 0.031). An odds ratio of 1.0625 favoring a need for fusion was established for each 1° of increase in Cobb angle (p = 0.012, OR 1.0625, 95% CI 1.0135–1.1138). Among the 14 patients older than 10 years of age with a primary Cobb angle exceeding 35°, 13 (93%) ultimately required fusion. Patients with at least 1 year of follow-up whose curves progressed more 10° after decompression were younger than those without curve progression (6.1 ± 3.0 years vs 13.7 ± 3.2 years, p = 0.001, Mann-Whitney U-test). Left apical thoracic curves constituted a higher proportion of curves in the decompression-only group (8 of 16 vs 1 of 21, p = 0.002).

CONCLUSIONS
The need for fusion after posterior fossa decompression reflected the curve severity at clinical presentation. Patients presenting with curves measuring > 35°, as well as those greater than 10 years of age, may be at greater risk for requiring fusion after posterior fossa decompression, while patients less than 10 years of age may require routine monitoring for curve progression. Left apical thoracic curves may have a better response to Chiari malformation decompression.
Risk factors associated with venous thromboembolism in patients undergoing spine surgery
Authors: Piper Keaton , Algattas Hanna , DeAndrea-Lazarus Ian A. , Kimmell Kristopher T. , Li Yan Michael , Walter Kevin A. , Silberstein Howard J. , Vates G. Edward 
Published: September 2016

OBJECTIVE
Patients undergoing spinal surgery are at risk for developing venous thromboembolism (VTE). The authors sought to identify risk factors for VTE in these patients.

METHODS
The American College of Surgeons National Surgical Quality Improvement Project database for the years 2006–2010 was reviewed for patients who had undergone spinal surgery according to their primary Current Procedural Terminology code(s). Clinical factors were analyzed to identify associations with VTE.

RESULTS
Patients who underwent spinal surgery (n = 22,434) were identified. The rate of VTE in the cohort was 1.1% (pulmonary embolism 0.4%; deep vein thrombosis 0.8%). Multivariate binary logistic regression analysis revealed 13 factors associated with VTE. Preoperative factors included dependent functional status, paraplegia, quadriplegia, disseminated cancer, inpatient status, hypertension, history of transient ischemic attack, sepsis, and African American race. Operative factors included surgery duration > 4 hours, emergency presentation, and American Society of Anesthesiologists Class III–V, whereas postoperative sepsis was the only significant postoperative factor. A risk score was developed based on the number of factors present in each patient. Patients with a score of ≥ 7 had a 100-fold increased risk of developing VTE over patients with a score of 0. The receiver-operating-characteristic curve of the risk score generated an area under the curve of 0.756 (95% CI 0.726–0.787).

CONCLUSIONS
A risk score based on race, preoperative comorbidities, and operative characteristics of patients undergoing spinal surgery predicts the postoperative VTE rate. Many of these risks can be identified before surgery. Future protocols should focus on VTE prevention in patients who are predisposed to it.
Thyroid imaging reporting and data system in assessment of cytological Bethesda Category III thyroid nodules
Authors: Mao Feng , Xu Hui-Xiong , Zhao Chong-Ke , Bo Xiao-Wan , Li Xiao-Long , Li Dan-Dan , Liu Bo-Ji , Zhang Yi-Feng , Xu Jun-Mei , Qu Shen 
Published: September 2016

OBJECTIVE: To assess the usefulness of thyroid imaging reporting and data system (TI-RADS) for cytological Bethesda Category III thyroid nodules (TNs). METHODS: This retrospective study included 121 patients with 121 TNs classified as Bethesda Category III at fine needle aspiration (FNA) cytology and thereafter underwent surgery. The TNs were classified according to US TI-RADS category and the malignancy risk of each category was calculated. RESULTS: Surgical pathology confirmed 43 (35.5%) malignant and 78 (64.5%) benign TNs. The malignancy risks of categories 3, 4a, 4b, 4c, and 5 TNs were 0%, 4.0%, 12.5%, 62.2%, and 100%, respectively. For those >10 mm ( n = 55), the malignancy risks were 0%, 6.2%, 12.5%, 73.3%, and 100%, respectively, whereas for those ≤10 mm ( n = 66), the risks were 0%, 0%, 12.5%, 56.7%, and 100%, respectively. CONCLUSION: Bethesda Category III TNs without suspicious US features or those ≤10 mm with only one suspicious US feature can be followed up with US.
An Ambulatory Tremor Score for Parkinson’s Disease
Authors: Braybrook Michelle , O’Connor Sam , Churchward Philip , Perera Thushara , Farzanehfar Parisa , Horne Malcolm 
Published: September 2016

Background: While tremor in Parkinson’s Disease (PD) can be characterised in the consulting room, its relationship to treatment and fluctuations can be clinically helpful. Objective: To develop an ambulatory assessment of tremor of PD. Methods: Accelerometry data was collected using the Parkinson’s KinetiGraph System (PKG, Global Kinetics). An algorithm was developed, which could successfully distinguish been subjects with a resting or postural tremor that involved the wrist whose frequency was greater than 3 Hz. Percent of time that tremor was present (PTT) between 09 : 00 and 18 : 00 was calculated. Results: This algorithm was applied to 85 people with PD who had been assessed clinically for the presence and nature of tremor. The Sensitivity and Selectivity of a PTT ≥0.8% was 92.5% and 92.9% in identifying tremor, providing that the tremor was not a fine kinetic and postural tremor or was not in the upper limb. A PTT >1% provide high likely hood of the presence of clinical meaningful tremor. These cut-offs were retested on a second cohort ( n = 87) with a similar outcome. The Sensitivity and Selectivity of the combined group was 88.7% and 89.5% respectively. Using the PTT, 50% of 22 newly diagnosed patients had a PTT >1.0%. The PKG’s simultaneous bradykinesia scores was used to find a threshold for the emergence of tremor. Tremor produced artefactual increase in the PKG’s dyskinesia score in 1% of this sample. Conclusions: We propose this as a means of assessing the presence of tremor and its relationship to bradykinesia.
A Factor Analysis Approach for Clustering Patient Reported Outcomes
Authors: Thor Maria , Olsson Caroline , Skokic Viktor , Jörnsten Rebecka , Alsadius David , Pettersson Niclas , Steineck Gunnar , Deasy Joseph , Oh Jung Hun 
Published: September 2016

SummaryBackground: In the field of radiation oncology, the use of extensive patient reported outcomes is increasingly common to meas -ure adverse side effects after radiotherapy in cancer patients. Factor analysis has the potential to identify an optimal number of latent factors (i.e., symptom groups). However, the ultimate goal of treatment response modeling is to understand the relationship between treatment variables such as radiation dose and symptom groups resulting from FA. Hence, it is crucial to identify clinically more relevant symptom groups and improved response variables from those symptom groups for a quantitative analysis. Objectives: The goal of this study is to design a computational method for finding clinically relevant symptom groups from PROs and to test associations between symptom groups and radiation dose. Methods: We propose a novel approach where exploratory factor analysis is followed by confirmatory factor analysis to determine the relevant number of symptom groups. We also propose to use a combination of symptoms in a symptom group identified as a new response variable in linear regression analysis to investigate the relationship between the symptom group and dose-volume variables. Results: We analyzed patient-reported gastrointestinal symptom profiles from 3 datasets in prostate cancer patients treated with radiotherapy. The final structural model of each dataset was validated using the other two datasets and compared to four other existing FA methods. Our systematic EFA-CFA approach provided clinically more relevant solutions than other methods, resulting in new clinically relevant outcome variables that enabled a quantitative analysis. As a result, statistically significant correlations were found between some dose- volume variables to relevant anatomic structures and symptom groups identified by FA. Conclusions: Our proposed method can aid in the process of understanding PROs and provide a basis for improving our understanding of radiation-induced side effects.
CHANDRA OBSERVATIONS OF OUTFLOWS FROM PSR J1509–5850
Authors: Klingler Noel , Kargaltsev Oleg , Rangelov Blagoy , Pavlov George G. , Posselt Bettina , Ng C.-Y. 
Published: September 2016

ABSTRACT
PSR J1509–5850 is a middle-aged pulsar with a period of P ≈ 89 ms and spin-down power of

erg s−1, at a distance of about 3.8 kpc. We report on deep Chandra X-ray Observatory observations of this pulsar and its pulsar wind nebula (PWN). In addition to the previously detected tail extending up to 7′ southwest from the pulsar (the southern outflow), the deep images reveal similarly long, faint, diffuse emission stretched toward the north (the northern outflow) and the fine structure of the compact nebula (CN) in the pulsar vicinity. The CN is resolved into two lateral tails and one axial tail pointing southwest (a morphology remarkably similar to that of the Geminga PWN), which supports the assumption that the pulsar moves toward the northeast. The luminosities of the southern and northern outflows are about

and

erg s−1, respectively. The spectra extracted from four regions of the southern outflow do not show any softening with increasing distance from the pulsar. The lack of synchrotron cooling suggests a high flow speed or in situ acceleration of particles. The spectra extracted from two regions of the northern outflow show a hint of softening with distance from the pulsar, which may indicate slower particle propagation. We speculate that the northern outflow is associated with particle leakage from the bow-shock apex into the ISM, while the southern outflow represents the tail of the shocked pulsar wind behind the moving pulsar. We estimate the physical parameters of the observed outflows and compare the J1509–5850 PWN with PWNe of other supersonically moving pulsars.
Dolutegravir Monotherapy as Treatment De-Escalation in HIV-Infected Adults with Virological Control: DoluMono Cohort Results
Authors: Oldenbuettel Celia , Wolf Eva , Ritter Ayla , Noe Sebastian , Heldwein Silke , Pascucci Rita , Wiese Carmen , Krosigk Ariane Von , Jaegel-Guedes Eva , Jaeger Hans , Balogh Annamaria , Koegl Christine , Spinner Christoph D 
Published: September 2016

Background The potential toxicity of long-term anti-retroviral therapy (ART) requires ongoing investigation of novel strategies for treatment of HIV-infected patients. Monotherapy with the integrase inhibitor (INSTI) dolutegravir (DTG) may offer a favourable safety profile. Additionally, DTG has a high barrier of resistance, crucial for successful maintenance of virological control. However, published data is sparse. Methods Retrospective, single-centre cohort study. We enrolled patients on suppressive ART who were switched to DTG monotherapy in routine clinical practice and fulfilled the following inclusion criteria: HIV RNA level <50 copies/ml for ≥6 months at time of switch (one blip <200 copies/ml with re-suppression accepted), no known INSTI resistance or prior INSTI failure, no replicative HBV infection and no history of AIDS. Results We identified 31 patients with 24-weeks of follow-up data. Previous ART included a non-nucleoside reverse transcriptase inhibitor, a boosted protease inhibitor or an INSTI in 32%, 6% and 61% of patients, respectively. At week 24, HIV RNA remained <50 copies/ml in all but two patients (94%). One patient chose to discontinue DTG monotherapy and another developed confirmed virological failure (HIV RNA 538 copies/ml) with new INSTI mutations (Q148H/G140S). Immune status and renal and metabolic function showed no statistically significant changes, apart from a significant decrease in gamma-glutamyl transferase. Conclusions De-escalating to DTG monotherapy in selected patients might be a safe and feasible option. However, in one case evolution of INSTI resistance was observed. Further studies should assess particular risk factors for DTG mono-therapy failure. In the meanwhile, caution is warranted.
Development and Alpha-testing of a Stepped Decision Aid for Patients Considering Nonsurgical Options for Knee and Hip Osteoarthritis Management
Authors: Toupin April Karine , Rader Tamara , Hawker Gillian A. , Stacey Dawn , O’Connor Annette M. , Welch Vivian , Lyddiatt Anne , McGowan Jessie , Thorne J. Carter , Bennett Carol , Pardo Pardo Jordi , Wells George A. , Tugwell Peter 
Published: September 2016

Objective.To develop an innovative stepped patient decision aid (StDA) comparing the benefits and harms of 13 nonsurgical treatment options for managing osteoarthritis (OA) and to evaluate its acceptability and effects on informed decision making.Methods.Guided by the Ottawa Decision Support Framework and the International Patient Decision Aid Standards, the process involved (1) developing a decision aid with evidence on 13 nonsurgical treatments from the 2012 American College of Rheumatology OA clinical practice guidelines; and (2) interviewing patients with OA and healthcare providers to test its acceptability and effects on knowledge and decisional conflict.Results.The StDA helped make the decision explicit, and presented evidence on 13 OA treatments clustered into 5 steps or levels according to their benefits and harms. Probabilities of benefits and harms were presented using pictograms of 100 faces formatted to allow comparisons across sets of options. It also included a values clarification exercise and knowledge test. Feedback was obtained from 49 patients and 7 healthcare providers. They found that the StDA presented evidence in a clear manner, and helped patients clarify their values and make an informed decision. Some participants found that there was too much information and others said that there was not enough on each treatment option.Conclusion.This innovative StDA allows patients to consider both the evidence and their values for multiple options. The findings are being used to revise and plan future evaluation. The StDA is an example of how research evidence in guidelines can be implemented in practice.
The Association of HLA-class I Genes and the Extent of Atherosclerotic Plaques in Patients with Psoriatic Disease
Authors: Eder Lihi , Abji Fatima , Rosen Cheryl F. , Chandran Vinod , Cook Richard J. , Gladman Dafna D. 
Published: September 2016

Objective.To investigate the association between HLA susceptibility and disease severity markers and the extent of atherosclerosis in patients with psoriatic disease.Methods.White patients with psoriatic arthritis (PsA) and psoriasis without PsA (PsC) were recruited. An ultrasound of the carotid arteries was performed and the size of each atherosclerotic plaque was measured. The resulting score, the total plaque area (TPA), represented the extent of atherosclerosis. HLA genotyping was performed using sequence-specific oligonucleotide probes. The association between 10 HLA susceptibility and severity markers of PsC and PsA and the severity of atherosclerosis was assessed by ordinal logistic regression models adjusted for age, sex, and cardiovascular (CV) risk factors.Results.The study involved 411 patients (273 PsA, 138 PsC). Of them, 61.8% had at least 1 atherosclerotic plaque. HLA-B*13:02 and HLA-C*06:02 were associated with more severe atherosclerosis (age- and sex-adjusted OR 2.31, 95% CI 1.23–4.32 and OR 1.68, 95% CI 1.12–2.52, respectively). HLA-B*38:01 was associated with less severe atherosclerosis (OR 0.49, 95% CI 0.28–0.86). These associations remained statistically significant after adjusting for CV risk factors. Higher levels of erythrocyte sedimentation rate (ESR) were associated with more severe atherosclerosis (age- and sex-adjusted OR 1.33, p = 0.02). HLA-B*13:02–positive (p = 0.01) as well as HLA-C*06:02–positive (p = 0.008) patients had higher levels of ESR over time.Conclusion.HLA-C*06:02 and B*13:02 alleles are associated with a higher burden of atherosclerosis in patients with psoriatic disease. This association may be mediated by a higher level of systemic inflammation.
Are AR shopping services valued the same way throughout Europe? A four-country Q-investigation
Authors: Gautier Stéphanie , Gauzente Claire , Aikala Maiju 
Published: September 2016

La réalité augmentée permet aux consommateurs d’interagir avec un produit dans le contexte de leur choix et d’une manière personnalisée avant l’achat, créant de nouvelles affordances. Il est nécessaire d’évaluer le potentiel de cette technologie et de ses caractéristiques pour pouvoir l’intégrer de manière stratégique dans les activités de commerce en ligne et commerce mobile. Etant donné que le développement des technologies s’effectue à une échelle globale, une approche investiguant différents pays doit être privilégiée. Cet article apporte un éclairage sur la perception de la réalité augmentée dans 4 pays européens et offre un guide pour mener des études comparatives avec la méthode Q. Les résultats suggèrent que des phénomènes de divergence et de convergence sont à l’œuvre, appelant à une approche différenciée pour les différents utilisateurs européens dans le cadre du développement et de la promotion d’applications de réalité augmentée.
Evaluating the performance of land surface model ORCHIDEE-CAN v1.0 on water and energy flux estimation with a single- and multi-layer energy budget scheme
Authors: Chen Yiying , Ryder James , Bastrikov Vladislav , McGrath Matthew J. , Naudts Kim , Otto Juliane , Ottlé Catherine , Peylin Philippe , Polcher Jan , Valade Aude , Black Andrew , Elbers Jan A. , Moors Eddy , Foken Thomas , van Gorsel Eva , Haverd Vanessa , Heinesch Bernard , Tiedemann Frank , Knohl Alexander , Launiainen Samuli , Loustau Denis , Ogée Jérôme , Vessala Timo , Luyssaert Sebastiaan 
Published: September 2016

Abstract. Canopy structure is one of the most important vegetation characteristics for land–atmosphere interactions, as it determines the energy and scalar exchanges between the land surface and the overlying air mass. In this study we evaluated the performance of a newly developed multi-layer energy budget in the ORCHIDEE-CAN v1.0 land surface model (Organising Carbon and Hydrology In Dynamic Ecosystems – CANopy), which simulates canopy structure and can be coupled to an atmospheric model using an implicit coupling procedure. We aim to provide a set of acceptable parameter values for a range of forest types. Top-canopy and sub-canopy flux observations from eight sites were collected in order to conduct this evaluation. The sites crossed climate zones from temperate to boreal and the vegetation types included deciduous, evergreen broad-leaved and evergreen needle-leaved forest with a maximum leaf area index (LAI; all-sided) ranging from 3.5 to 7.0. The parametrization approach proposed in this study was based on three selected physical processes – namely the diffusion, advection, and turbulent mixing within the canopy. Short-term sub-canopy observations and long-term surface fluxes were used to calibrate the parameters in the sub-canopy radiation, turbulence, and resistance modules with an automatic tuning process. The multi-layer model was found to capture the dynamics of sub-canopy turbulence, temperature, and energy fluxes. The performance of the new multi-layer model was further compared against the existing single-layer model. Although the multi-layer model simulation results showed few or no improvements to both the nighttime energy balance and energy partitioning during winter compared with a single-layer model simulation, the increased model complexity does provide a more detailed description of the canopy micrometeorology of various forest types. The multi-layer model links to potential future environmental and ecological studies such as the assessment of in-canopy species vulnerability to climate change, the climate effects of disturbance intensities and frequencies, and the consequences of biogenic volatile organic compound (BVOC) emissions from the terrestrial ecosystem.