bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmaceutical assistance programs for cancer patients in the era of orally administered chemotherapeutics
Authors: Mitchell Aaron , Muluneh Benyam , Patel Rachana , Basch Ethan 
Published: July 2017

Introduction The rising cost of cancer drugs may make treatment unaffordable for some patients. Patients often rely on drug manufacturer-administered Pharmaceutical Assistance Programs (PAPs) to obtain drugs and reduced or no cost. The overall usage of PAPs within cancer care delivery is unknown. Methods We included all cancer patients across an academically affiliated, integrated health system in North Carolina during 2014 ( N = 8591). We identified the subset of patients receiving PAP assistance to afford one or more cancer drugs, in order to calculate the proportion of patients receiving PAP assistance, and the retail value of the assistance. Results Among 8591 cancer patients, 215 unique patients submitted a total of 478 successful PAP requests for cancer drugs. 40% of PAP-utilizing patients were uninsured, 23% had Medicaid coverage, 20% had Medicare coverage, 2% were dual Medicare/Medicaid eligible, and 14% were commercially insured. Among all cancer patients who received medical treatment, 6.0% required PAP assistance, whereas 10.6% receiving an oral agent required PAP assistance. The proportion receiving PAP assistance varied substantially by drug, ranging from <1% of patients (e.g. carboplatin, methotrexate) to 50% of patients (e.g. ponatinib, temsirolimus). The majority of the retail value obtained was for oral agents, including $1,556,575 of imatinib and $1,449,633 of dasatinib, which were the two drugs with the highest aggregate retail value. Conclusions A substantial proportion of cancer patients receive private charitable assistance to obtain standard-of-care treatments. This includes patients with federal and private insurance, suggesting an inability of patients to meet cost-sharing requirements.
CD36-positive B-lymphoblasts Predict Poor Outcome in Children With B-lymphoblastic Leukemia
Authors: Newton Joanna G , Horan John T , Newman Scott , Rossi Michael R , Ketterling Rhett P , Park Sunita I 
Published: July 2017

Objective We observed that pediatric patients with B lymphoblastic leukemia which expressed CD36 at diagnosis seemed to have worse outcome than patients whose blasts did not. Here, we describe the patient, disease characteristics, pathological, molecular, and genetic features and outcomes of patients with CD36+ B-LL compared to patients with CD36− B-LL. Methods We retrospectively reviewed all flow cytometry reports from September 2008 to December 2015 to identify patients diagnosed at our institution with CD36 expression on B lymphoblasts. CD36− control patients were chosen from our leukemia database and matched 2:1 to CD36+ patients for National Cancer Institute (NCI) risk group at diagnosis. We reviewed diagnostic marrow slides for cytoplasmic granules and abstracted clinical data from patient charts. To identify underlying genetic abnormalities, clinical FISH testing and RNA sequencing was performed on 5 of our CD36+ patients, and RNA-seq data from the NIH Therapeutically Applicable Research to Generate Effective Treatments (TARGET) ALL Expansion Phase 2 data set were examined. Results Twenty-five of 366 (6.83%) patients diagnosed at our institution in the study period had CD36+ blasts. With a median follow-up of 5.32 years, 5-year event-free survival (EFS) and overall survival (OS) were significantly worse for CD36+ patients compared to CD36− patients who were NCI Standard Risk at diagnosis (EFS: 60% ± 15.49 vs 95% ± 4.87, P = .016; OS: 90% ± 9.5 vs 100%, P = .019). NCI Standard Risk patients whose blasts were both CD36+ and had granules had the worst survival compared to CD36− patients without granules (EFS 25% ± 21.65 vs 95% ± 4.87, P = .0004). From our CD36+ patients and the TARGET database, we found 2 ABL2 mutations, 1 PDGFRB mutation, and 2 NRAS mutations. Conclusions For NCI Standard Risk patients, CD36 expression on B-lymphoblasts identifies patients with B-LL who have especially poor outcome. This may be due to underlying genetic abnormalities that may be amenable to targeted therapy.
Distinguishing Epidermolysis Bullosa Acquisita From Bullous Pemphigoid Without Direct Immunofluorescence
Authors: Gardner Kerry M. , Crawford Richard I. 
Published: July 2017

Background: It has been postulated that periodic acid–Schiff staining of basement membrane can predict direct immunofluorescence patterns seen in epidermolysis bullosa acquisita and bullous pemphigoid. It has also been suggested that the type of inflammatory infiltrate or presence of fraying of basal keratinocytes may differentiate these two conditions. Objective: In this study, we aimed to confirm these observations. Methods: We reviewed 13 cases of direct immunofluorescence-confirmed epidermolysis bullosa acquisita and 19 cases of direct immunofluorescence-confirmed bullous pemphigoid, all with a subepidermal blister in the routinely processed specimen. The gold standard for diagnosis of epidermolysis bullosa acquisita vs bullous pemphigoid was taken to be identification of immune deposits on the dermal side (‘floor’ for epidermolysis bullosa acquisita) or the epidermal side (‘roof’ for bullous pemphigoid) of the salt-split direct immunofluorescence specimen. Our tests to distinguish epidermolysis bullosa acquisita from bullous pemphigoid on the routinely processed biopsy included periodic acid–Schiff basement membrane on the blister roof, neutrophilic infiltrate, lack of eosinophilic infiltrate, and absence of keratinocyte fraying. Results: Sensitivity and specificity for each test were as follows: periodic acid–Schiff staining of roof (sensitivity 25%, specificity 95%), neutrophilic infiltrate (sensitivity 54%, specificity 74%), lack of eosinophilic infiltrate (sensitivity 92%, specificity 68%), and absence of keratinocyte fraying (sensitivity 62%, specificity 58%). Conclusions: Features in the routinely processed biopsy were unable to reliably distinguish between epidermolysis bullosa acquisita and bullous pemphigoid. Direct immunofluorescence on salt-split skin remains the standard for differentiation.
Thoracic Aortic Aneurysm Repair with Endovascular Stent-Grafts
Authors: Semba Charles P , Mitchell R Scott , Miller D Craig , Kato Noriyuki , Kee Stephen T , Chen Jason T , Dake Michael D 
Published: July 2017

The purpose of the study was to describe the clinical experience in using endoluminal stent-grafts for the treatment of thoracic aortic aneurysms in high-risk patients. Patients with aneurysms of the descending thoracic aorta who were considered high surgical risks underwent evaluation for endoluminal repair. The prosthesis was constructed from Z stents covered with polyester fabric using dimensions based upon preprocedural computed tomography scans and angiography. Through a femoral arteriotomy or left retroperitoneal flank incision, a 22–24 Fr delivery catheter was inserted and advanced through the aorta to the target site under fluoroscopic guidance in the operating suite. The stent-graft prosthesis was deployed at the site of the aneurysm. 44 patients (36 male, 8 female; mean age 36 years) underwent stent-graft repair for thoracic aneurysms (mean diameter 6.3 cm). The deployment was technically successful in all cases, with complete aneurysm thrombosis in 88%. The 30-day perioperative mortality rate was 6.8% and 35-month actuarial survival was 82%. There were no cases of stent migration, surgical conversion or intraprocedural death. Paraplegia occurred in two patients who underwent simultaneous surgical infrarenal aortic aneurysm repair immediately followed by stent-graft placement for a coexisting thoracic aneurysm. The conclusion was that placement of endoluminal stent-grafts for repair of thoracic aortic aneurysms is technically feasible in high-risk patients in whom conventional surgery is contraindicated. Long-term studies are needed to determine protection against aneurysm rupture and patient survival.
Fifty years of hemodialysis access literature: The fifty most cited publications in the medical literature
Authors: Skripochnik Edvard , O’Connor David J , Trestman Eric B , Lipsitz Evan C , Scher Larry A 
Published: July 2017

Objectives The modern era of hemodialysis access surgery began with the publication in 1966 by Brescia et al. describing the use of a surgically created arteriovenous fistula. Since then, the number of patients on chronic hemodialysis and the number of publications dealing with hemodialysis access have steadily increased. We have chronicled the increase in publications in the medical literature dealing with hemodialysis access by evaluating the characteristics of the 50 most cited articles. Methods We queried the Science Citation Index from the years 1960–2014. Articles were selected based on a subject search and were ranked according to the number of times they were cited in the medical literature. Results The 50 most frequently cited articles were selected for further analysis and the number of annual publications was tracked. The landmark publication by Dr Brescia et al. was unequivocally the most cited article dealing with hemodialysis access (1109 citations). The subject matter of the papers included AV fistula and graft (9), hemodialysis catheter (9), complications and outcomes (24), and other topics (8). Most articles were published in nephrology journals (33), with fewer in surgery (7), medicine (7), and radiology (3) journals. Of the 17 journals represented, Kidney International was the clear leader, publishing 18 articles. There has been an exponential rise in the frequency of publications regarding dialysis access with 42 of 50 analyzed papers being authored after 1990. Conclusion As the number of patients on hemodialysis has increased dramatically over the past five decades, there has been a commensurate increase in the overall number of publications related to hemodialysis access
Relationship between neck circumference, insulin resistance and arterial stiffness in overweight and obese subjects
Authors: Fantin Francesco , Comellato Gabriele , Rossi Andrea P , Grison Elisa , Zoico Elena , Mazzali Gloria , Zamboni Mauro 
Published: July 2017

Abstract

Background
Only a few studies have investigated the relationship between neck circumference and cardiometabolic risk. The aim of this study was to assess the relationships between neck circumference, waist circumference, metabolic variables and arterial stiffness in a group of overweight and obese subjects evaluating a possible independent role of neck circumference in determining arterial stiffness.

Methods and results
We studied 95 subjects (53 women) with an age range of 20–77 years and body mass index range from 25.69 to 47.04 kg/m2. In each subject we evaluated body mass index, waist, hip and neck circumference, systolic and diastolic blood pressure, insulin, fasting glucose, cholesterol, low-density lipoprotein and high-density lipoprotein cholesterol and triglycerides. Arterial stiffness was assessed by carotid-femoral pulse wave velocity (PWVcf) and carotid-radial pulse wave velocity (PWVcr). Both PWVcf and PWVcr were higher in subjects with high values of neck circumference compared with subjects with normal values of neck circumference. Subjects with high values of neck circumference and abdominal obesity presented higher values of mean arterial pressure, PWVcr and homeostasis model assessment (HOMA) index and lower values of high-density lipoprotein than subjects with only abdominal obesity. Two models of stepwise multiple regression were performed in order to evaluate the combined effect of independent variables on arterial stiffness. In the first model PWVcf was considered a dependent variable, and age, gender, systolic blood pressure, triglycerides, high-density lipoprotein cholesterol, waist circumference, neck circumference, HOMA index and the use of anti-hypertensive medications were considered independent variables. Age, systolic blood pressure, triglycerides and waist circumference were significant predictors of PWVcf, explaining 65% of its variance. In the second model, in which PWVcr was considered a dependent variable, neck circumference and gender were significant predictors of PWVcr, explaining 24% of its variance.

Conclusions
These findings emphasise the need to measure not only waist but even neck circumference to better stratify and identify individuals at increased cardiometabolic risk, as upper-body subcutaneous fat is a novel, easily measured fat depot.
Clinical value of ST-segment change after return of spontaneous cardiac arrest and emergent coronary angiography in patients with out-of-hospital cardiac arrest: Diagnostic and therapeutic importance of vasospastic angina
Authors: Tateishi Kazuya , Abe Daisuke , Iwama Tooru , Hamabe Yuichi , Aonuma Kazutaka , Sato Akira 
Published: July 2017

Background: We investigated the association between initial ST-segment change after return of spontaneous circulation (ROSC) and the incidence of acute coronary lesions in patients with out-of-hospital cardiac arrest (OHCA), and clinical outcomes of patients with OHCA caused by vasospastic angina pectoris (VSA). Methods: Among 2779 OHCA patients in our institution, all patients with ROSC underwent emergent coronary angiography (CAG) except for those with an obvious extra-cardiac cause of OHCA. Initial ST-segment changes after ROSC were reviewed, and 30-day survival and neurological outcome (Cerebral Performance Category) were evaluated. Results: Of the 155 patients, 52 (34%) had ST-segment elevation (STE) and 103 (66%) had non-STE. Significant coronary culprit lesions were present in 81% of patients with STE and in 33% of patients with non-STE ( P<.001). Percutaneous coronary intervention (PCI) was successful in 60 patients (93.8%) and failed in 4 patients (6.2%). Among 155 patients, 74 patients (47.7%) had favorable neurological prognosis, and 104 patients (67.1%) were alive at 30 days. ST-segment analysis showed good positive predictive value (81%) but low negative predictive value (68%) in diagnosing the presence of acute coronary lesions. VSA was found in 5 patients (9.6%) in the STE group and in 12 patients (11.7%) in the non-STE group. Of these 17 patients, 9 (52.9%) had favorable neurological outcome and 14 (82.4%) were alive at 30 days. Conclusion: An acute culprit lesion may be the cause of OHCA even in the absence of STE. In survivors of OHCA with normal coronary arteries, spasm provocation testing should be performed to detect VSA as a cause of the arrest.
Intra- and inter-observer agreement and reliability of bone mineral density measurements around acetabular cup: a porcine ex-vivo study using single- and dual-energy computed tomography
Authors: Mussmann Bo , Overgaard Søren , Torfing Trine , Bøgehøj Morten , Gerke Oke , Andersen Poul Erik 
Published: July 2017

BackgroundPeriprosthetic bone loss is considered to be a potentially contributing factor in aseptic loosening of acetabular hip components, but no studies have shown this association. The lack of association might be caused by insufficient image quality because of metal artifacts and challenges in measuring bone density (BMD) in complex anatomic structures which might be overcome using dual-energy computed tomography (DECT).PurposeTo test inter- and intra-observer agreement and reliability of in-house segmentation software measuring BMD adjacent to acetabular cup and to compare measurements performed with single-energy CT (SECT) and DECT in cemented and cementless cups.Material and MethodsTwenty-four acetabular cups inserted in porcine hip specimens were scanned with SECT and DECT. Bone density was measured in a three-dimensional volume adjacent to the cup. Double measurements were performed.ResultsBMD derived from SECT was approximately four times higher than that of DECT. In both scan modes, intraclass correlation coefficient (ICC) was >0.90 with no differences between repeated measurements, except for uncemented cups where a statistically significant difference of 11 mg/cm3was found with DECT. DECT showed narrower limits of agreement than SECT. Inter-observer analysis showed small differences.ConclusionBMD can be estimated with high intra- and inter-observer reliability with SECT and DECT around acetabular cups using custom software. The intra- and inter-observer agreement of DECT is superior to that of SECT and better in the cementless concept. Good intra- and inter-observer reliability can be obtained in both cemented and cementless cups using the segmentation software. SECT and DECT cannot be used interchangeably.
Hypoxic vascular response and ventilation/perfusion matching in end-stage COPD may depend on p22phox
Authors: Nagaraj Chandran , Tabeling Christoph , Nagy Bence M. , Jain Pritesh P. , Marsh Leigh M. , Papp Rita , Pienn Michael , Witzenrath Martin , Ghanim Bahil , Klepetko Walter , Weir E. Kenneth , Heschl Stefan , Kwapiszewska Grazyna , Olschewski Andrea , Olschewski Horst 
Published: July 2017

Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease in which the amount of emphysema and airway disease may be very different between individuals, even in end-stage disease. Emphysema formation may be linked to the involvement of the small pulmonary vessels. The NAPDH oxidase (Nox) family is emerging as a key disease-related factor in vascular diseases, but currently its role in hypoxia-induced pulmonary remodelling in COPD remains unclear.Here we investigate the role of p22phox, a regulatory subunit of Nox, in COPD lungs, hypoxic pulmonary vasoconstriction (HPV), hypoxia-induced pulmonary vascular remodelling and pulmonary hypertension.In COPD, compared to control lungs, p22phox expression was significantly reduced. The expression was correlated positively with mean pulmonary arterial pressure and oxygenation index and negatively with the diffusing capacity of the lung for carbon monoxide (p<0.02). This suggests a role of p22phox in ventilation/perfusion ratio matching, vascular remodelling and loss of perfused lung area. In p22phox-/-mice, HPV was significantly impaired. In the chronic hypoxic setting, lack of p22phox was associated with improved right ventricular function and decreased pulmonary vascular remodelling.p22phox-dependent Nox plays an important role in the COPD phenotype, by its action on phase II HPV and chronic vascular remodelling.
The role of macrophages in interstitial lung diseases
Authors: Rossi Giulio , Cavazza Alberto , Spagnolo Paolo , Bellafiore Salvatore , Kuhn Elisabetta , Carassai Pierpaolo , Caramanico Laura , Montanari Gloria , Cappiello Gaia , Andreani Alessandro , Bono Francesca , Nannini Nazarena 
Published: July 2017

The finding of collections of macrophages/histiocytes in lung biopsy and bronchoalveolar lavage is relatively common in routine practice. This morphological feature in itself is pathological, but the exact clinical significance and underlying disease should be evaluated together with clinical data, functional respiratory and laboratory tests and imaging studies.Morphological characteristics of macrophages and their distribution along the different pulmonary structures should be examined carefully by pathologists. Indeed, haemosiderin-laden macrophages are associated with smoking-related diseases when pigment is fine and distribution is bronchiolocentric, while alveolar haemorrhage or pneumoconiosis are the main concerns when pigment is chunky or coarse and the macrophages show an intra-alveolar or perilymphatic location, respectively. In the same way, pulmonary accumulation of macrophages with foamy cytoplasm is generally associated with pathologies leading to broncho-bronchiolar obstruction (e.g.diffuse panbronchiolitis, hypersensitivity pneumonia or cryptogenic organising pneumonia) or alternatively to exogenous lipoid pneumonia, some drug toxicity (e.g.amiodarone exposure or toxicity) and metabolic disorders (e.g.type B Niemann–Pick disease).This pathology-based perspectives article is aimed at concisely describing the diagnostic possibilities when faced with collection of macrophages in lung biopsy and cytology.
Efficacy of whip roller setting on physical attributes of denim fabric
Authors: Farha Farial Islam , Siddiqa Fahmida , Islam Md. Rashedul 
Published: July 2017

AbstractWhip roller settings in a weaving machine is one of the vital factor to adjust warp yarn tension properly as well as delivering fault free fabric. The present study was undertaken with an aim to explore the influence of whip roller settings on various physical and mechanical properties of both grey and finished 100% cotton denim fabric in order to select suitable position of whip roller for producing particular (3/1 twill) denim fabric. For this purpose total eight positions of whip roller were selected keeping constant depth with variable height in five cases and constant height with variable depth in three cases. The samples were produced in an air jet loom and some prominence like EPcm, PPcm, areal density, tensile strength, dimensional stability, air permeability, crimp% and skewness were checked. Data analysis of all the results showed that with the ascendance of whip roller, crimp% of warp yarn was decreased whereas crimp% of weft yarn was increased both in grey and finished state. Decreasing the depth of whip roller caused increment of both warp and weft crimp% in both state. Tensile strength in warp way direction was found to increase gradually up to a certain roller height and then decreased whereas air permeability showed reverse trend in both state. Warp density, Weft density as well as areal density was also affected by the alteration in settings of whip roller. Due to reduction of roller depth, warp way tensile strength and lengthwise shrinkage were reduced but air permeability had improved.
Potential role of cyclophilin A in regulating cytokine secretion
Authors: Dawar Farman Ullah , Xiong Yang , Khattak Muhammad Nasir Khan , Li Jun , Lin Li , Mei Jie 
Published: July 2017

Abstract
Cyclophilin A (CypA), a peptidylprolyl cis-trans isomerase, is a ubiquitous and multifunctional protein. In addition to its role as a host-cell receptor for cyclosporine A, CypA has diverse functions in inflammatory conditions and diseases. CypA secreted in response to inflammatory stimuli binds to the cell surface via its receptor CD147 and induces secretion of various inflammatory cytokines. However, silencing and inhibition of either CypA or CD147 inhibits inflammatory cytokine expression and inflammation. This report reviews the literature related to the mechanism of CypA-dependent cytokine secretion and discusses this factor as a possible therapeutic target in inflammatory diseases.
Results of early warning indicators for HIV/AIDS in 42 outpatient clinics in 25 northern provinces of Vietnam
Authors: Le Huong Thi , Doan Linh Thuy Thi , Pham Dung Kim , Phuc Do Huyen , Nguyen Huong Lan Thi 
Published: July 2017

Background: The emergence of HIV drug resistance (HIVDR) is an unavoidable consequence of antiretroviral therapy (ART), and HIVDR early warning indicators (EWIs) could specifically assess factors at individual clinics associated with HIVDR. Thus, the present study aimed to collect data on EWIs for HIV/AIDS at 42 outpatient clinics (OPCs) in 25 northern provinces and cities of Vietnam in 2012. Methods: A retrospective cohort study was conducted. Data was collected from 42 OPCs in 25 northern provinces between October and December 2012. The information was collected retrospectively from outpatient records from 2008 to 2011. Results: In total, 99.8% ART patients were prescribed the correct regimen when starting ART treatment. All facilities met the target of under 20% patients lost to follow-up at 12 months. A total of 31/42 facilities reached the goal for on-time appointment keeping and 37/42 facilities achieved the target of first-line retention after 12-month ARV treatment. Conclusions: EWIs should be performed routinely in HIV/AIDS facilities. The data collected will contribute to monitoring, supervision, periodic assessment, and future plans for HIV/AIDS care and treatment programs in the area.