bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of the Publication of Appropriate Use Criteria on Utilization Rates of Myocardial Perfusion Imaging Studies in Ontario, Canada: A Population‐Based Study
Authors: Roifman Idan , Austin Peter C. , Qiu Feng , Wijeysundera Harindra C. 
Published: June 2017

Background

Concern regarding overutilization of cardiac imaging has led to the development of appropriate use criteria (
AUC
). Myocardial perfusion imaging (
MPI
) is one of the most commonly used cardiac imaging modalities worldwide. Despite multiple iterations of AUC, there is currently no evidence regarding their real‐world impact on population‐based utilization rates of
MPI
. Our goal was to assess the impact of the AUC on rates of
MPI
in Ontario, Canada. We hypothesized that publication of the AUC would be associated with a significant reduction in
MPI
rates.

Methods and Results

We conducted a retrospective cohort study of the adult population of Ontario from January 1, 2000, to December 31, 2015. Age‐ and sex‐standardized rates were compared from 4 different periods intersected by 3 published iterations of the AUC. Overall, 3 072 611
MPI
scans were performed in Ontario during our study period. The mean monthly rate increased from 14.1/10 000 in the period from January 2000 to October 2005 to 18.2/10 000 between November 2005 and June 2009. After this point in time, there was a reduction in rates, falling to a mean monthly rate of 17.1/10 000 between March 2014 and December 2015. Time series analysis revealed that publication of the 2009
AUC
was associated with a significant reduction in
MPI
rates (
P
<0.001). This translated into ≈88 849 fewer
MPI
scans at a cost savings of ≈72 million Canadian dollars.

Conclusions

Our results reflect a potential real‐world impact of the 2009
MPI AUC
by demonstrating evidence of a significant effect on population‐based rates of
MPI
.
Differences in Characteristics and Outcomes Between Asian and Non-Asian Patients in the TIAregistry.org
Authors: Hoshino Takao , Uchiyama Shinichiro , Wong Lawrence K.S. , Sissani Leila , Albers Gregory W. , Bornstein Natan M. , Caplan Louis R. , Donnan Geoffrey A. , Ferro José M. , Hennerici Michael G. , Labreuche Julien , Lavallée Philippa C. , Molina Carlos , Rothwell Peter M. , Steg Philippe Gabriel , Touboul Pierre-Jean , Vicaut Éric , Amarenco Pierre 
Published: June 2017

Background and Purpose—
This study provides the contemporary causes and prognosis of transient ischemic attack (TIA) and minor stroke in Asians and the direct comparisons with non-Asians.

Methods—
The TIAregistry.org enrolled 4789 patients (1149 Asians and 3640 non-Asians) with a TIA or minor ischemic stroke within 7 days of onset. Every participating facility had systems dedicated to urgent intervention of TIA/stroke patients by specialists. The primary outcome was a composite of cardiovascular death, nonfatal stroke, and nonfatal acute coronary syndrome.

Results—

Approximately 80% of patients were evaluated within 24 hours of symptom onset. At 1 year, there were no differences in the rates of composite cardiovascular events (6.8% versus 6.0%;
P
=0.38) and stroke (6.0% versus 4.8%;
P
=0.11) between Asians and non-Asians. Asians had a lower risk of cerebrovascular disease (stroke or TIA) than non-Asians (adjusted hazard ratio, 0.79; 95% confidence interval, 0.63–0.98;
P
=0.03); the difference was primarily driven by a lower rate of TIA in Asians (4.2% versus 8.3%;
P
<0.001). Moderately severe bleeding was more frequent in Asians (0.8% versus 0.3%;
P
=0.02). In multivariable analysis, multiple acute infarcts (
P
=0.005) and alcohol consumption (
P
=0.02) were independent predictors of stroke recurrence in Asians, whereas intracranial stenosis (
P
<0.001), ABCD
2
score (
P
<0.001), atrial fibrillation (
P
=0.008), extracranial stenosis (
P
=0.03), and previous stroke or TIA (
P
=0.03) were independent predictors in non-Asians.

Conclusions—
The short-term stroke risk after a TIA or minor stroke was lower than expected when urgent evidence-based care was delivered, irrespective of race/ethnicity or region. However, the predictors of stroke were different for Asians and non-Asians.
A new species of iguana Brachylophus Cuvier 1829 (Sauria: Iguania: Iguanidae) from Gau Island, Fiji Islands
Authors: FISHER ROBERT N. , NIUKULA JONE , WATLING DICK , HARLOW PETER S. 
Published: June 2017

The south Pacific iguanas (Brachylophus) currently have three recognized living species in Fiji. Recent surveys have uncovered more specific variation (morphological and genetic) within the genus and have better defined the geographic ranges of the named species. One of these recent discoveries is a strikingly different iguana from all other island populations in Fiji which is restricted to Gau Island of the Lomaiviti Province. Gau is the fifth largest island in Fiji and maintains excellent upland forests in the higher elevations. We describe this population from Gau Island as a new species, Brachylophus gau sp. nov., in recognition of its type locality.
Validation of a Syndromic Case Definition for Detecting Emergency Department Visits Potentially Related to Marijuana
Authors: DeYoung Kathryn , Chen Yushiuan , Beum Robert , Askenazi Michele , Zimmerman Cali , Davidson Arthur J. 
Published: June 2017

Objectives: Reliable methods are needed to monitor the public health impact of changing laws and perceptions about marijuana. Structured and free-text emergency department (ED) visit data offer an opportunity to monitor the impact of these changes in near-real time. Our objectives were to (1) generate and validate a syndromic case definition for ED visits potentially related to marijuana and (2) describe a method for doing so that was less resource intensive than traditional methods. Methods: We developed a syndromic case definition for ED visits potentially related to marijuana, applied it to BioSense 2.0 data from 15 hospitals in the Denver, Colorado, metropolitan area for the period September through October 2015, and manually reviewed each case to determine true positives and false positives. We used the number of visits identified by and the positive predictive value (PPV) for each search term and field to refine the definition for the second round of validation on data from February through March 2016. Results: Of 126 646 ED visits during the first period, terms in 524 ED visit records matched ≥1 search term in the initial case definition (PPV, 92.7%). Of 140 932 ED visits during the second period, terms in 698 ED visit records matched ≥1 search term in the revised case definition (PPV, 95.7%). After another revision, the final case definition contained 6 keywords for marijuana or derivatives and 5 diagnosis codes for cannabis use, abuse, dependence, poisoning, and lung disease. Conclusions: Our syndromic case definition and validation method for ED visits potentially related to marijuana could be used by other public health jurisdictions to monitor local trends and for other emerging concerns.
Preoperative Tracheostomy Is Associated with Poor Disease‐Free Survival in Recurrent Laryngeal Cancer
Authors: Birkeland Andrew C. , Rosko Andrew J. , Beesley Lauren , Bellile Emily , Chinn Steven B. , Shuman Andrew G. , Prince Mark E. , Wolf Gregory T. , Bradford Carol R. , Brenner J. Chad , Spector Matthew E. 
Published: June 2017

ObjectivesIt is unknown if preoperative tracheostomy for persistent/recurrent laryngeal squamous cell carcinoma (LSCC) plays a role in unrecognized local disease spread and disease recurrence after salvage laryngectomy. The goals of this study were to determine the effect of preoperative tracheostomy on disease‐free survival (DFS) in patients with recurrent/persistent LSCC undergoing salvage laryngectomy.Study DesignRetrospective case series derived from prospectively maintained database.SettingTertiary care academic center.SubjectsPatients with recurrent/persistent LSCC after radiation/chemoradiation (RT/CRT) who underwent salvage laryngectomy at the University of Michigan from 1997 to 2015.MethodsDemographic, clinical, pathologic, and survival data were collected. Kaplan‐Meier survival estimates were performed.ResultsDFS was worse for patients with tracheostomy prior to laryngectomy than patients without a tracheostomy (5 year: 39% vs 67%; P <. 001). Patients with tracheostomy prior to RT/CRT compared to patients with tracheostomy after RT/CRT or patients without a tracheostomy had worse DFS (5‐year: 25%, 49%, and 67%, respectively; P <. 001). In bivariable analyses controlling for T classification, N classification, or overall stage, preoperative tracheostomy was associated with worse DFS. In multivariable analysis, presence of a preoperative tracheostomy had a worse DFS (hazard ratio, 1.63; 95% confidence interval, 1.00‐2.67; P =. 048).ConclusionPreoperative tracheostomy is associated with disease recurrence in patients with persistent/recurrent LSCC undergoing salvage laryngectomy, particularly in patients who had tracheostomy prior to completion of initial RT/CRT. Notably, preoperative tracheostomy as a causal factor vs marker for disease recurrence is difficult to ascertain. Nevertheless, clinicians should be aware of the increased risk of locoregional recurrence in patients with preoperative tracheostomy when counseling on surgical salvage and when considering the role of additional therapy.
Volatile Organic Compounds in the Breath of Oral Squamous Cell Carcinoma Patients: A Pilot Study
Authors: Hartwig Stefan , Raguse Jan D. , Pfitzner Dorothee , Preissner Robert , Paris Sebastian , Preissner Saskia 
Published: June 2017

ObjectiveTo assess the feasibility of detecting signature volatile organic compounds in the breath of patients with oral squamous cell carcinoma.Study DesignProspective cohort pilot study.SettingUniversity hospital.Subjects and MethodsUsing gas chromatography and mass spectrometry, emitted volatile organic compounds in the breath of patients before and after curative surgery (n = 10) were compared with those of healthy subjects (n = 4). It was hypothesized that certain volatile organic compounds disappear after surgical therapy. A characteristic signature of these compounds for diseased patients was compiled and validated.ResultsBreath analyses revealed 125 volatile organic compounds in patients with oral cancer. A signature of 8 compounds that were characteristic for patients with oral cancer could be detected: 3 from this group presented were absent after surgery.ConclusionThe presented results confirmed the hypothesis of an absence of cancer‐associated volatile organic compounds in the breath after therapy. In this pilot study, we proved the feasibility of this test approach. Further studies should be initiated to establish protocols for usage in a clinical setting.
Antibody Profile of Colostrum and the Effect of Processing in Human Milk Banks: Implications in Immunoregulatory Properties
Authors: Rodríguez-Camejo Claudio , Puyol Arturo , Fazio Laura , Rodríguez Analía , Villamil Emilia , Andina Eliana , Cordobez Vanira , Díaz Hernán , Lemos Mary , Siré Gabriela , Carroscia Lilián , Castro Mara , Panizzolo Luis , Hernández Ana 
Published: June 2017

Background: When feeding preterm infants, donor milk is preferred if the mother’s own milk is unavailable. Pasteurization may have detrimental effects on bioactivity, but more information is needed about its effects on the immunological compounds. Research aim: This work has two main aims: evaluate the antibody profile of colostrum and study the quantitative variations in the antibodies’ level and specific reactivity after undergoing Holder pasteurization. The authors focused on immunoregulatory components of colostrum (antidietary antibodies and TGF-β2) in the neonatal gut. Methods: This is a descriptive cross-sectional study of a convenience sample of 67 donated colostrum samples at different days after delivery, both raw and pasteurized. Antibody profiles were analyzed at different times during breastfeeding, and total and specific antibodies (IgM, IgA, and IgG subclasses) were compared with tetanus toxoid and ovalbumin using enzyme-linked immunosorbent assay. The processing effect on total and specific antibodies, as well as TGF-β2, was evaluated by paired analyses. Results: No variations in immunological compounds were observed throughout the colostrum stage. The TGF-β2, antibodies’ concentrations, and antibodies’ specific reactivity after pasteurization did not vary significantly as days of lactation varied. Changes in antibody levels were dependent on isotype and IgG subclass, and IgG4 showed remarkable resistance to heating. Moreover, the effect of the pasteurization on specific reactivity was antigen dependent. Conclusion: The supply of relevant immunological components is stable throughout the colostrum stage. The effects of pasteurization on antibodies depend on isotype, subclass, and specificity. This information is relevant to improving the immunological quality of colostrum, especially for preterm newborns.
In vivo Portal Imaging Dosimetry Identifies Delivery Errors in Rectal Cancer Radiotherapy on the Belly Board Device
Authors: Peca Stefano , Sinha Richie Siddhartha , Brown Derek Wilson , Smith Wendy Lani 
Published: June 2017

Purpose: We recently developed a novel, open-source in vivo dosimetry that uses the electronic portal imaging device to detect dose delivery discrepancies. We applied our method on patients with rectal cancer treated on a belly board device. Methods: In vivo dosimetry was performed on 10 patients with rectal cancer treated prone on the belly board with a 4-field box arrangement. Portal images were acquired approximately once per week from each treatment beam. Our dosimetry method used these images along with the planning CT to reconstruct patient planar dose at isocenter depth. Results: Our algorithm proved sensitive to dose discrepancies and detected discordances in 7 patients. The majority of these were due to soft tissue differences between planning and treatment, present despite matching to bony anatomy. As a result of this work, quality assurance procedures have been implemented for our immobilization devices. Conclusion: In vivo dosimetry is a powerful quality assurance tool that can detect delivery discrepancies, including changes in patient setup and position. The added information on actual dose delivery may be used to evaluate equipment and process quality and to guide for adaptive radiotherapy.
Egyptian experience in increasing utilization of reperfusion therapies in acute ischemic stroke
Authors: Zakaria Magd Fouad , Aref Hany , Abd ElNasser Azza , Fahmy Nagia , Tork Mohamed Amir , Fouad Mohamed Mahmoud , ElBokl Ahmed , Roushdy Tamer , ElFaramawy Sara , El-Shiekh Mohammad Abdullah , Moustafa Ramez Reda 
Published: June 2017

Background The rate of alteplase (tPA) thrombolysis utilization in acute stroke in Egypt is <1%. We report on the causes of this low rate of reperfusion therapies and take corrective action to improve it. Methods Two prospective observational studies were conducted at Ain Shams University hospitals. The first included 269 acute stroke patients admitted to the hospital over a six-month period. Obstacles to reperfusion therapy were identified, and based on the results, a corrective action plan was implemented including making alteplase(tPA) available, training, and establishing a standardized local protocol for reperfusion therapy. A second study was then conducted that included 284 acute ischemic stroke patients over another six-month period. Results In the first study, 53/269 patients (19.7%) arrived at hospital within 4.5 h and were eligible for reperfusion therapy. Of those, seven (13.2%) received alteplase(tPA), representing 2.6% of the total ischemic stroke patients admitted. The main causes for not giving thrombolytic therapy was unavailability of alteplase(tPA) (56.5%), wrong treatment decision (17.4%), missed window while performing brain imaging (15%), and unavailability of intermediate care bed (10.9%). The second study showed that out of 284 cases admitted with acute ischemic stroke, 37 were eligible for thrombolysis and 35 received alteplase(tPA) (94.3%), representing 12.3% of the total ischemic stroke admissions. Conclusion A comprehensive action plan that centers around making the drug available and training resulted in a significant improvement of reperfusion therapy utilization in Egypt.
Shoulder-specific outcomes 1 year after nontraumatic full-thickness rotator cuff repair: a systematic literature review and meta-analysis
Authors: Gurnani Navin , van Deurzen Derek F. P. , van den Bekerom Michel P. J. 
Published: June 2017

Background Nontraumatic full-thickness rotator cuff tears are commonly initially treated conservatively. If conservative treatment fails, rotator cuff repair is a viable subsequent option. The objective of the present meta-analysis is to evaluate the shoulder-specific outcomes one year after arthroscopic or mini-open rotator cuff repair of nontraumatic rotator cuff tears. Methods A literature search was conducted in PubMed and EMBASE within the period January 2000 to January 2017. All studies measuring the clinical outcome at 12 months after nontraumatic rotator cuff repair of full-thickness rotator cuff tears were listed. Results We included 16 randomized controlled trials that met our inclusion criteria with a total of 1.221 shoulders. At 12 months after rotator cuff repair, the mean Constant score had increased 29.5 points; the mean American Shoulder and Elbow Score score increased by 38.6 points; mean Simple Shoulder Test score was 5.6 points; mean University of California Los Angeles score improved by 13.0 points; and finally, mean Visual Analogue Scale score decreased by 4.1 points. Conclusions Based on this meta-analysis, significant improvements in the shoulder-specific indices are observed 12 months after nontraumatic arthroscopic or mini-open rotator cuff repair.
In-depth PtdIns(3,4,5)P3 signalosome analysis identifies DAPP1 as a negative regulator of GPVI-driven platelet function
Authors: Durrant Tom N. , Hutchinson James L. , Heesom Kate J. , Anderson Karen E. , Stephens Len R. , Hawkins Phillip T. , Marshall Aaron J. , Moore Samantha F. , Hers Ingeborg 
Published: June 2017

Key PointsWe present the first in-depth analysis of platelet PtdIns(3,4,5)P3-binding proteins, providing a valuable resource for future studies. The PtdIns(3,4,5)P3-binding protein, DAPP1, negatively regulates glycoprotein VI–driven platelet activation and thrombus formation.
The effects of basal insulin peglispro vs. insulin glargine on lipoprotein particles by NMR and liver fat content by MRI in patients with diabetes
Authors: Orchard Trevor J. , Cariou Bertrand , Connelly Margery A. , Otvos James D. , Zhang Shuyu , Antalis Caryl J. , Ivanyi Tibor , Hoogwerf Byron J. 
Published: June 2017

Abstract
Background
In Phase 2/3 studies of basal insulin peglispro (BIL) compared to insulin glargine, patients with type 1 or type 2 diabetes previously treated with insulin and randomized to BIL had an increase in serum triglycerides (TGs). To further understand lipoprotein changes, a lipid substudy which included liver fat content was designed to assess relationships among the measured variables for each diabetes cohort and compare the hepato-preferential insulin BIL to glargine.

Methods
In three cohorts of patients with diabetes (type 1, type 2 insulin naïve, and type 2 previously on insulin; n = 652), liver fat content (LFC) was determined by magnetic resonance imaging (MRI) and blood lipids were analyzed by nuclear magnetic resonance (NMR) spectroscopy at baseline, 26 and 52 weeks of treatment. Apolipoproteins, adiponectin, and other lipid parameters were also measured. Descriptive statistics were done, as well as correlation analyses to look for relationships among LFC and lipoproteins or other lipid measures.

Results
In patients with type 1 diabetes treated with BIL, but not glargine, small LDL and medium and large VLDL subclass concentrations increased from baseline. In patients with type 2 diabetes previously on insulin and treated with BIL, large VLDL concentration increased from baseline. In insulin naïve patients with type 2 diabetes treated with BIL, there were very few changes, while in those treated with glargine, small LDL and large VLDL decreased from baseline. Baseline LFC correlated significantly in one or more cohorts with baseline large VLDL, small LDL, VLDL size, and Apo C3. Changes in LFC by treatment showed generally weak correlations with lipoprotein changes, except for positive correlations with large VLDL and VLDL size. Adiponectin was higher in patients with type 1 diabetes compared to patients with type 2 diabetes, but decreased with treatment with both BIL and glargine.

Conclusions
The lipoprotein changes were in line with the observed changes in serum TGs; i.e., the cohorts experiencing increased TGs and LFC with BIL treatment had decreased LDL size and increased VLDL size. These data and analyses add to the currently available information on the metabolic effects of insulins in a very carefully characterized cohort of patients with diabetes.
Clinicaltrials.gov registration numbers and dates NCT01481779 (2011), NCT01435616 (2011), NCT01454284 (2011), NCT01582451 (2012)
Frontline Science: Aspirin-triggered resolvin D1 controls herpes simplex virus-induced corneal immunopathology
Authors: Rajasagi Naveen K , Bhela Siddheshvar , Varanasi Siva Karthik , Rouse Barry T 
Published: June 2017

Abstract
Stromal keratitis (SK) is a chronic immunopathological lesion of the eye, caused by HSV-1 infection, and a common cause of vision impairment in humans. The inflammatory lesions in the cornea are primarily caused by neutrophils with the active participation of CD4+ T cells. Therefore, the targeting of these immune cell types and their products represents a potentially valuable form of therapy to reduce the severity of disease. Resolvin D1 (RvD1) and its epimer aspirin-triggered RvD1 (AT-RvD1) are lipid mediators derived from docosahexaenoic acid (DHA) and were shown to promote resolution in several inflammatory disease models. In this report, we examined whether AT-RvD1 administration, begun before infection or at a later stage after ocular infection of mice with HSV-1, could control the severity of SK lesions. Treatment with AT-RvD1 significantly diminished the extent of corneal neovascularization and the severity of SK lesions. AT-RvD1-treated mice had fewer numbers of inflammatory cells that included neutrophils as well as Th1 and Th17 cells in the infected cornea. The mechanisms by which AT-RvD1 acts appear to be multiple. These include inhibitory effects on proinflammatory mediators, such as IL-1β, IL-6, IL-12, CXCL1, MCP-1, MIP-2, vascular endothelial growth factor (VEGF)-A, matrix metalloproteinase 9 (MMP-9), and proinflammatory miRNA, such as miR-155, miR-132, and miR-223, which are involved in SK pathogenesis and corneal neovascularization. In addition, AT-RvD1 attenuated STAT1, which plays an important role in Th1 cell differentiation and IFN-γ expression. These findings demonstrate that AT-RvD1 treatment could represent a useful strategy for the management of virus-induced immunopathological lesions.
Failure of the Ricardian Equivalence Theory in Economies with Incomplete Markets
Authors: Divino José Angelo , Orrillo Jaime 
Published: June 2017

We investigate whether or not the Ricardian Equivalence Theorem (RET) holds in a naive economy with incomplete financial markets. Even in this artificially favorable environment, where public debt has a perfect substitute, the RET fails if we allow the payoff matrix to vary. For the RET to hold, we need to assume that the risk-free payoff belongs to the asset span of the economy and the law of one price is valid. Given that these are strong assumptions, we show that the failure of the RET is robust, in the sense that there exists an open set of payoff matrices such that the RET fails.