bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost‐effectiveness analysis of consolidation with brentuximab vedotin for high‐risk Hodgkin lymphoma after autologous stem cell transplantation
Authors: Hui Lucy , von Keudell Gottfried , Wang Rong , Zeidan Amer M. , Gore Steven D. , Ma Xiaomei , Davidoff Amy J. , Huntington Scott F. 
Published: June 2017

BACKGROUNDIn a recent randomized, placebo‐controlled trial, consolidation treatment with brentuximab vedotin (BV) decreased the risk of Hodgkin lymphoma (HL) progression after autologous stem cell transplantation (ASCT). However, the impact of BV consolidation on overall survival, quality of life, and health care costs remain unclear.METHODSA Markov decision‐analytic model was constructed to measure the costs and clinical outcomes for BV consolidation therapy compared with active surveillance in a cohort of patients aged 33 years who were at risk for HL relapse after ASCT. Life‐time costs, quality‐adjusted life‐years (QALYs), and incremental cost‐effectiveness ratios (ICERs) were calculated for each post‐ASCT strategy.RESULTSAfter quality‐of‐life adjustments and standard discounting, upfront BV consolidation was associated with an improvement of 1.07 QALYs compared with active surveillance plus BV as salvage. However, the strategy of BV consolidation led to significantly higher health care costs ($378,832 vs $219,761), resulting in an ICER for BV consolidation compared with active surveillance of $148,664/QALY. If indication‐specific pricing was implemented, then the model‐estimated BV price reductions of 18% to 38% for the consolidative setting would translate into ICERs of $100,000 and $50,000 per QALY, respectively. These findings were consistent on 1‐way and probabilistic sensitivity analyses.CONCLUSIONSBV as consolidation therapy under current US pricing is unlikely to be cost effective at a willingness‐to‐pay threshold of $100,000 per QALY. However, indication‐specific price reductions for the consolidative setting could reduce ICERs to widely acceptable values. Cancer 2017. © 2017 American Cancer Society. Cancer 2017;123:3763–3771. © 2017 American Cancer Society
A phase 2 study of the efficacy and biomarker on the combination of transarterial chemoembolization and axitinib in the treatment of inoperable hepatocellular carcinoma
Authors: Chan Stephen L. , Yeo Winnie , Mo Frankie , Chan Anthony W.H. , Koh Jane , Li Leung , Hui Edwin P. , Chong Charing C.N. , Lai Paul B.S , Mok Tony S.K. , Yu Simon C.H. 
Published: June 2017

BACKGROUNDA surge of vascular endothelial growth factor (VEGF) after transarterial chemoembolization (TACE) may contribute to tumor progression. Axitinib is a potent antiangiogenic agent with main activity against VEGF receptors 1 to 3. To the authors' knowledge, its role in combination with TACE for the treatment of patients with inoperable hepatocellular carcinoma (HCC) is unclear.METHODSA phase 2 clinical trial (ClinicalTrials.gov identifier NCT01352728) was conducted to evaluate the combination treatment. Patients with inoperable HCC who were potential candidates for TACE initiated treatment with axitinib at a dose of 5 mg twice daily and were evaluated for the need for TACE every 8 weeks. Axitinib was withheld 24 hours before TACE, and resumed 24 hours afterward when fulfilling predefined criteria. Radiologic assessment was conducted every 8 weeks. The primary endpoint was the 2‐year overall survival (OS) rate.RESULTSA total of 50 patients were recruited from March 2011 to April 2014. The mean age of the patients was 61.8 years, and 46 patients (92%) had hepatitis B infection. The Barcelona Clinic Liver Cancer stage B/C percentage was 76% (38 cases)/24% (12 cases). The 2‐year OS rate was 43.7%, and the median OS was 18.8 months in the intention‐to‐treat population. Among the evaluable population (44 patients), 40.9% (18 patients) and 27.3% (12 patients) achieved complete and partial responses, respectively. Common grade 3 or above axitinib‐related complications included hand‐foot skin reaction (14%) and hypertension (24%). The presence of hypertension during treatment was found to be an independent prognosticator (hazard ratio, 0.563; P = .0073) suggestive of a contributory role of axitinib to efficacy.CONCLUSIONSThe combination of axitinib and TACE was potentially efficacious for patients with inoperable HCC with a high radiologic response rate. Cancer 2017;123:3977‐85. © 2017 American Cancer Society.
Efficacy and safety of recombinant human lymphotoxin‐α derivative with cisplatin and fluorouracil in patients with metastatic esophageal squamous cell carcinoma: A randomized, multicenter, open‐label, controlled, phase 2b trial
Authors: Wang Feng‐hua , Wang Yun , Sun Guo‐ping , Chen Jian‐hua , Lin Ying‐cheng , Liu Wei , Zheng Rong‐sheng , Chen Jia , Zhang He‐long , Lan Hai‐tao , Qi Jun , Liu Yang‐qing , Deng Yan‐ming , Zhao Heng , Xiong Jian‐ping , Xu Qing , Jiang Wen‐qi , Li Yu‐hong 
Published: June 2017

BACKGROUNDRecombinant human lymphotoxin‐α derivative (rhLTα‐Da) is a lymphotoxin‐α derivative that is missing 27 N‐terminal amino acid residues. Previous studies indicated a benefit from the addition of rhLTα‐Da to cisplatin‐based treatment in patients with metastatic esophageal squamous cell carcinoma. The current study was conducted to evaluate the efficacy and safety of rhLTα‐Da plus cisplatin and fluorouracil (PF) in patients with mESCC.METHODSPatients from 15 centers in China were randomly assigned (1:1:1) to 3 arms (arm A, PF plus 10 μg/m2 daily rhLTα‐Da; arm B, PF plus 20 μg/m2 daily rhLTα‐Da; arm C, PF alone). The primary endpoints included progression‐free survival (PFS) and the confirmed overall response rate (ORR). An exploratory analysis was performed to evaluate the role of serum tumor necrosis factor receptor II (TNFR II) in predicting the efficacy of rhLTα‐Da.RESULTSBetween September 2010 and May 2013, 150 patients were enrolled. No significant differences in either PFS or ORR were observed between the 3 arms. However, in a small subset of patients who had low serum TNFR II levels, the median PFS was significantly longer for those in arm B than for these in other 2 arms (7.2 months [95% confidence interval, 5.1‐8.6 months] for arm B vs 3.5 months [95% confidence interval, 1.7‐5.5 months] for arm A [P = .022] and 4.0 months [95% confidence interval, 3.2‐6.3 months] for arm C [P = .027]). The addition of rhLTα‐Da significantly increased the incidence of chills (P < .001).CONCLUSIONSrhLTα‐Da combined with the PF regimen failed to improve PFS and ORR in patients with mESCC, except in a small subset that had low serum TNFR II concentrations. Cancer 2017;123:3986‐94. © 2017 American Cancer Society.
Decision‐support networks of women newly diagnosed with breast cancer
Authors: Wallner Lauren P. , Li Yun , McLeod M. Chandler , Hamilton Ann S. , Ward Kevin C. , Veenstra Christine M. , An Lawrence C. , Janz Nancy K. , Katz Steven J. , Hawley Sarah T. 
Published: June 2017

BACKGROUNDLittle is known about the size and characteristics of the decision‐support networks of women newly diagnosed with breast cancer and whether their involvement improves breast cancer treatment decisions.METHODSA population‐based sample of patients newly diagnosed with breast cancer in 2014 and 2015, as reported to the Georgia and Los Angeles Surveillance, Epidemiology, and End Results registries, were surveyed approximately 7 months after diagnosis (N = 2502; response rate, 68%). Network size was estimated by asking women to list up to 3 of the most important decision‐support persons (DSPs) who helped them with locoregional therapy decisions. Decision deliberation was measured using 4 items assessing the degree to which patients thought through the decision, with higher scores reflecting more deliberative breast cancer treatment decisions. The size of the network (range, 0‐3 or more) was compared across patient‐level characteristics, and adjusted mean deliberation scores were estimated across levels of network size using multivariable linear regression.RESULTSOf the 2502 women included in this analysis, 51% reported having 3 or more DSPs, 20% reported 2, 18% reported 1, and 11% reported not having any DSPs. Married/partnered women, those younger than 45 years, and black women all were more likely to report larger network sizes (all P < .001). Larger support networks were associated with more deliberative surgical treatment decisions (P < .001).CONCLUSIONSMost women engaged multiple DSPs in their treatment decision making, and involving more DSPs was associated with more deliberative treatment decisions. Future initiatives to improve treatment decision making among women with breast cancer should acknowledge and engage informal DSPs. Cancer 2017;123:3895‐903. © 2017 American Cancer Society.
Factors Influencing CO2 and Energy Penalties of CO2 Mineralization Processes
Authors: Naraharisetti Pavan Kumar , Yeo Tze Yuen , Bu Jie 
Published: June 2017

AbstractCarbon mineralization is one of the carbon capture utilization, and storage (CCUS) technologies that can be used to capture large quantities of CO2 and convert it into stable carbonate products that can be stored easily. Several CO2 mineralization processes have been proposed; however, there are no commercial‐scale projects because there are still significant issues that need to be improved before commercialization can take place. In this work, we evaluate the CO2 and energy penalties related to the most well‐known types of mineralization processes developed to date, in which the mineralization reaction takes place directly under aqueous conditions, high pressures and temperatures, and compared these with newer T‐P swing processes and ball‐mill reactor processes, which are under development. The data used in the evaluation are taken from published literature. By comparing the three processes, we identify important variables that contribute to high CO2 and energy penalties so that future research can focus on optimization of these variables. It is observed that slurry concentration (heating) and particle size (grinding) are critical factors, with mineral calcination and operating pressure constituting other important factors.
Evaluating intrusion prevention systems with evasions
Authors: Särelä Mikko , Kyöstilä Tomi , Kiravuo Timo , Manner Jukka 
Published: June 2017

SummaryIntrusion prevention systems have become a common security measure in the past 20 years. Their promise is the possibility to prevent known attacks against vulnerable, unpatched devices inside enterprise networks. However, evasion techniques that enable the attacker to evade the eye of the intrusion prevention system are a potential problem for this capability. These techniques take advantage of the robustness principle that has guided designers to create systems that will try to recreate protocol content from any input they receive.In this work, we evaluated the effectiveness of 35 well‐known evasions against 9 commercial and 1 free, state‐of‐the‐art, intrusion prevention systems. We conducted 4 experiments with one million attacks against each device. Each system lets a significant amount (0.1%‐45%) of attacks pass through unrecognized. Our results show that most existing intrusion prevention systems are vulnerable against evasions.
Serum Derived Transfer Factor Stimulates the Innate Immune System to Improve Survival Traits in High Risk Pathogen Scenarios
Authors: Willeford Bridget V. , Shapiro‐Dunlap Trudy , Willeford Kenneth O. 
Published: June 2017

ABSTRACT

Preclinical Research

Transfer Factors (TFs) are low molecular weight (<5,000 daltons) biological response mediators. In the present study, a serum derived TF improved the ability of the recipient animal to survive high‐risk infectious challenges (salmonellosis and canine parvoviral enteritis (CPV)) by altering the host's cytokine response profile. Mice mortally challenged with 5,000 colony‐forming units of Salmonella experienced a group mortality of 73% while mice treated with a single 5 mg dose of the TF demonstrated a significant decrease in morbidity (7%, p ≤ 0.01). The splenic bacterial load in untreated mice was over 10,000 times higher than that in the TF treated mice. Twenty‐four hours post‐administration, the treated murine population expressed a rapid temporal increase in serum IL‐6 (26‐fold) and INF‐γ (77‐fold) concentrations. IL‐6 can act as a critical signal regulating action against bacterial pathogens. A comparative double‐blind study performed using dogs confirmed to be undergoing a canine parvovirus challenge showed that when conventional supportive therapy was supplemented with a single 5 mg TF dose there was a reduction (p ≤ 0.01) in group mortality (68% of the TF treated group survived versus 32% of the placebo group), an observation consistent with the observed increase in INF‐γ, a cytokine associated with promoting antiviral activity. Drug Dev Res 78 : 189–195, 2017. © 2017 Wiley Periodicals, Inc.
An improved SPH model for multiphase flows with large density ratios
Authors: Zhu G.X. , Zou L. , Chen Z. , Wang A.M. , Liu M.B. 
Published: June 2017

SummaryThis paper presents a new smoothed particle hydrodynamics (SPH) model for simulating multiphase fluid flows with large density ratios. The new SPH model consists of an improved discretization scheme, an enhanced multiphase interface treatment algorithm, and a coupled dynamic boundary treatment technique. The presented SPH discretization scheme is developed from Taylor series analysis with kernel normalization and kernel gradient correction and is then used to discretize the Navier‐Stokes equation to obtain improved SPH equations of motion for multiphase fluid flows. The multiphase interface treatment algorithm involves treating neighboring particles from different phases as virtual particles with specially updated density to maintain pressure consistency and a repulsive interface force between neighboring interface particles into the pressure gradient to keep sharp interface. The coupled dynamic boundary treatment technique includes a soft repulsive force between approaching fluid and solid particles while the information of virtual particles are approximated using the improved SPH discretization scheme. The presented SPH model is applied to 3 typical multiphase flow problems including dam breaking, Rayleigh‐Taylor instability, and air bubble rising in water. It is demonstrated that inherent multiphase flow physics can be well captured while the dynamic evolution of the complex multiphase interfaces is sharp with consistent pressure across the interfaces.
Plasma cytokine IL‐6 levels and subjective cognitive decline: preliminary findings
Authors: Keegan Andrew P. , Paris Daniel , Luis Cheryl A. , Abdullah Laila , Ait‐Ghezala Ghania , Beaulieu‐Abdelahad David , Pryor Makenzie , Chaykin Jillian , Crynen Gogce , Crawford Fiona , Mullan Michael 
Published: June 2017

ObjectiveDetection of Alzheimer's disease (AD) prior to clinical inception will be paramount for introducing disease modifying treatments. We have begun collecting baseline characteristics of a community cohort for longitudinal assessment and testing of antecedent blood‐based biomarkers. We describe the baseline visit from the first 131 subjects in relationship to a commonly described cytokine, interleukin 6 (IL‐6).MethodsSubjects from the community presented for a free memory screening with varying degrees of memory concern. We quantified the baseline plasma levels of the cytokine IL‐6 and assessed cognition (Montreal Cognitive Assessment, MoCA) and mood (Geriatric Depression Scale, GDS) in relationship to their memory concern.ResultsBaseline MoCA scores were inversely related to age, and this association was influenced by an AD risk factor, Apolipoprotein E (APOE4) carrier status. The degree of subjective cognitive decline correlated with GDS and was inversely related to MoCA scores. Interleukin 6 levels were related to age, body mass index, and years of education.ConclusionsIt will be important to assess how these baseline IL‐6 levels and forthcoming novel biomarkers relate to future cognitive decline. Copyright © 2017 John Wiley & Sons, Ltd.
Provision and perceived quality of mental health services for older care home residents in England: a national survey
Authors: Stewart Karen , Hargreaves Claire , Jasper Rowan , Challis David , Tucker Sue , Wilberforce Mark 
Published: June 2017

ObjectiveThis study examined the nature, extent and perceived quality of the support provided by community mental health teams for older people (CMHTsOP) to care home residents.MethodsA postal survey was sent to all CMHTsOP in England. Information was collected about teams' staffing and their involvement in case finding, assessment, medication reviews, care planning and training as well as team managers' rating of the perceived quality of the service they provided for care home residents. Data were analysed using chi‐squared tests of association and ordinal regression.ResultsResponses were received from 225 (54%) CMHTsOP. Only 18 per cent of these teams contained staff with allocated time for care home work. Services for care home residents varied considerably between teams. Two‐fifths of teams provided formal training to care home staff. Team managers were more likely to perceive the quality of their service to care homes as good if they had a systematic process in place for reviewing antipsychotic drugs or routine mental health reviews, including contact with a GP.ConclusionThe findings suggested that more evidence is needed on the best approach for supporting care home residents with mental health needs. Areas to consider are the potential benefits of training to care home staff and regular mental health reviews, utilising links between GPs and CMHTsOP. Copyright © 2017 John Wiley & Sons, Ltd.
Persistently low lymphocyte counts after FCR therapy for chronic lymphocytic leukemia are associated with longer overall survival
Authors: Joffe Erel , Ariela Arad N. , Bairey Osnat , Fineman Riva , Ruchlemer Rosa , Rahimi‐Levene Naomi , Shvidel Lev , Greenbaum Uri , Aviv Ariel , Tadmor Tamar , Braester Andrei , Goldschmidt Neta , Polliack Aaron , Herishanu Yair 
Published: June 2017

AbstractDecreased absolute lymphocyte counts (ALCs) following frontline therapy for chronic lymphocytic leukemia may be associated with disease control, even in patients without evidence of minimal residual disease. We studied the prognostic significance of ALCs during the first year following treatment with fludarabine, cyclophosphamide, and rituximab (FCR).We evaluated 99 patients who achieved a partial response without lymphocytosis (<4.0 × 103cells/μL) or better after FCR. Absolute lymphocyte counts were recorded at 3‐, 6‐, 9‐, and 12‐month posttreatment and correlated with overall survival (OS) and event‐free survival (EFS). For each time point, analyses were limited to patients without lymphocytosis, so as to avoid possible biases from undocumented disease progressions.Lymphopenia (ALC < 1.0 × 103cells/μL) at 3 m after FCR (69% of patients n = 68), was associated with a longer OS (5y OS 91% vs 64%, P = .001), as were ALC ≤ 2 × 103 cells/μL at 6 m (5y OS 85% vs 48%, P = .004) and ALC ≤ 1.8 × 103 cells/μL at 9 m (5y OS 93% vs 54%, P = .009). A normal‐range ALC (≤4 × 103 cells/μL) at 12 m was also associated with a 91% 5y OS. Higher ALCs (but without lymphocytosis) were associated with shorter EFS (median EFS 27 months for ALC > 1.8 vs not reached for ALC ≤ 0.7 at 9 months, P < .0001).In conclusion, lower ALC levels in the first few months following frontline FCR therapy were associated with longer OS and EFS. Possible explanations may be that lower ALCs reflect deeper clonal suppression or protracted Treg depletion. Absolute lymphocyte count levels may be a cheap and widely available prognostic marker, though the added value for clinical practice is the minimal residual disease era needs to be explored.
Changes in chronic disease management among community health centers (CHCs) in China: Has health reform improved CHC ability?
Authors: Wang Zhaoxin , Shi Jianwei , Wu Zhigui , Xie Huiling , Yu Yifan , Li Ping , Liu Rui , Jing Limei 
Published: June 2017

SummarySince the 1980s, China has been criticized for its mode of chronic disease management (CDM) that passively provides treatment in secondary and tertiary hospitals but lacks active prevention in community health centers (CHCs). Since there are few systematic evaluations of the CHCs' methods for CDM, this study aimed to analyze their abilities. On the macroperspective, we searched the literature in China's largest and most authoritative databases and the official websites of health departments. Literature was used to analyze the government's efforts in improving CHCs' abilities to perform CDM. At the microlevel, we examined the CHCs' longitudinal data after the New Health Reform in 2009, including financial investment, facilities, professional capacities, and the conducted CDM activities. A policy analysis showed that there was an increasing tendency towards government efforts in developing CDM, and the peak appeared in 2009. By evaluating the reform at CHCs, we found that there was an obvious increase in fiscal and public health subsidies, large‐scale equipment, general practitioners, and public health physicians. The benefited vulnerable population in this area also rose significantly. However, rural centers were inferior in their CDM abilities compared with urban ones, and the referral system is still not effective in China. This study showed that CHCs are increasingly valued in managing chronic diseases, especially after the New Health Reform in 2009. However, we still need to improve collaborative management for chronic diseases in the community and strengthen the abilities of CHCs, especially in rural areas.
Headwater stream length dynamics across four physiographic provinces of theAppalachianHighlands
Authors: Jensen Carrie K. , McGuire Kevin J. , Prince Philip S. 
Published: June 2017

AbstractUnderstanding patterns of expansion, contraction, and disconnection of headwater stream length in diverse settings is invaluable for the effective management of water resources as well as for informing research in the hydrology, ecology, and biogeochemistry of temporary streams. More accurate mapping of the stream network and quantitative measures of flow duration in the vast headwater regions facilitate implementation of water quality regulation and other policies to protect waterways. We determined the length and connectivity of the wet stream and geomorphic channel network in 3 forested catchments (<75 ha) in each of 4 physiographic provinces of the Appalachian Highlands: the New England, Appalachian Plateau, Valley and Ridge, and Blue Ridge. We mapped wet stream length 7 times at each catchment to characterize flow conditions between exceedance probabilities of <5% and >90% of the mean daily discharge. Stream network dynamics reflected geologic controls at both regional and local scales. Wet stream length was most variable at two Valley and Ridge catchments on a shale scarp slope and changed the least in the Blue Ridge. The density and source area of flow origins differed between the crystalline and sedimentary physiographic provinces, as the Appalachian Plateau and Valley and Ridge had fewer origins with much larger contributing areas than New England and the Blue Ridge. However, the length and surface connectivity of the wet stream depended on local lithology, geologic structure, and the distribution of surficial deposits such as boulders, glacially derived material, and colluival debris or sediment valley fills. Several proxies indicate the magnitude of stream length dynamics, including bankfull channel width, network connectivity, the base flow index, and the ratio of geomorphic channel to wet stream length. Consideration of geologic characteristics at multiple spatial scales is imperative for future investigations of flow intermittency in headwaters.