bluuebunny/crossref_metadata_2025_split huggingface dataset:
International survey on high‐ and low‐dose synacthen test and assessment of accuracy in preparing low‐dose synacthen
Authors: Cross Alexandra S. , Helen Kemp E. , White Anne , Walker Leanne , Meredith Suzanne , Sachdev Pooja , Krone Nils P. , Ross Richard J. , Wright Neil P. , Elder Charlotte J. 
Published: February 2018

SummaryObjectiveThe short synacthen test (SST) is widely used to assess patients for adrenal insufficiency, but the frequency and protocols used across different centres for the low‐dose test (LDT) are unknown. This study aimed to survey centres and test the accuracy of ten different synacthen preparation strategies used for the LDT.MethodsMembers of 6 international endocrine societies were surveyed regarding diagnostic tests used for adrenal insufficiency, and in particular the SST. Synacthen was diluted for the LDT and concentrations measured using a synacthen ELISA.ResultsSurvey responses were received from 766 individuals across 60 countries (52% adult, 45% paediatric endocrinologists). The SST is used by 98% of centres: 92% using high‐dose (250 μg), 43% low‐dose and 37% both. Ten low‐dose dilution methods were assessed and variation in synacthen concentration was demonstrated with intramethod coefficients of variation (CV) ranging from 2.1% to 109%. The method using 5% dextrose as a diluent was the least variable (CV of 2.1%). The variation in dilution methods means that the dose of synacthen administered in a LDT may vary between 0.16 and 0.81 μg.ConclusionsThe high‐dose SST is the most popular diagnostic test of adrenal insufficiency, but up to 72% of paediatric endocrinologists use a LDT. There is considerable variation observed both within and between low‐dose synacthen dilution methods creating considerable risk of inaccurate dosing and thereby invalid results.
Genetics in multiple sclerosis: Updates in the era of big data
Authors: Isobe Noriko 
Published: February 2018

AbstractMultiple sclerosis is a complex disease where both genetics and environmental factors play critical roles in its susceptibility. The contribution of genetics has been proven by familial studies, but there still exists missing heritability. Big data science has been a novel approach in research, including multiple sclerosis genetics, and multiple tools to handle those big data have been developed for researchers in different fields: from tools with a user‐friendly graphical user interface to more professional tools with a text user interface. In this era of big data, it is important to accelerate collaborative studies with researchers of distinct professions, such as bioinformaticians, statisticians, geneticists and computational biologists.
Metastasis to the extraocular muscles: a case report, literature review and pooled data analysis
Authors: Leung Vannessa , Wei Michael , Roberts Timothy V 
Published: February 2018

AbstractMetastasis to the extraocular muscles (EOM) is rare. The existing literature comprises only of isolated case reports therefore a summative description of these lesions is lacking. This study presents a case of bilateral rectus muscle metastasis from malignant melanoma. Furthermore a literature review and pooled data analysis is undertaken with 43 articles encompassing 77 patients and 101 eyes. Mean age was 53 years, 54% were male, 66% had unilateral involvement and 34% had bilateral involvement. The primary malignancies were melanoma (n = 17, 22%), breast (n = 15, 15%) and carcinoid (n = 11, 14%). A single muscle was involved in 56 eyes (67%) and multiple muscles in 27 eyes (33%). Lateral rectus was most commonly affected (n = 44, 53%). Presenting symptoms included restricted eye movements (n = 48, 62%), proptosis (n = 45, 58%), diplopia (n = 27, 35%) and pain (n = 18, 23%). Scattered case reports have previously made it difficult to characterise this phenomenon thus a pooled data analysis is presented.
The association of discharge decisions after deceased donor kidney transplantation with the risk of early readmission: Results from the deceased donor study
Authors: Harhay Meera Nair , Jia Yaqi , Thiessen‐Philbrook Heather , Besharatian Behdad , Gumber Ramnika , Weng Francis L. , Hall Isaac E. , Doshi Mona , Schroppel Bernd , Parikh Chirag R. , Reese Peter P. 
Published: February 2018

AbstractBackgroundKidney transplant (KT) recipients experience high rates of early (≤30 days) hospital readmission (EHR) after KT, and existing studies provide limited data on modifiable discharge factors that may mitigate EHR risk.MethodsWe performed a retrospective cohort study of 468 adult deceased donor KT recipients transplanted between 4/2010 and 11/2013 at 5 United States transplant centers. We fit multivariable mixed effects models to assess the association of two potentially modifiable discharge factors with the probability of EHR after KT: (i) weekend discharge and (ii) days to first scheduled follow‐up.ResultsAmong 468 KT recipients, 38% (n = 178) experienced EHR after KT. In fully adjusted analyses, compared to weekday discharges, KT recipients discharged on the weekend had a 29% lower risk of EHR (adjusted odds ratio [aOR] 0.71, 95% confidence interval [CI] 0.41‐0.94). Compared to follow‐up within 2 days of discharge, KT recipients with follow‐up within 3 to 6 days had a 28% higher probability of EHR (aOR 1.28, 95% CI 1.13‐1.45).ConclusionsThese findings suggest that clinical decisions related to the timing of discharge and follow‐up modify EHR risk after KT, independent of traditional risk factors.
Angioplasty vs stent in the treatment of transplant renal artery stenosis
Authors: Chen Ling‐Xin , De Mattos Angelo , Bang Heejung , Vu Catherine T. , Gandhi Mehul , Alnimri Muna , Gallay Brian , Fananapazir Ghaneh 
Published: February 2018

AbstractObjectiveTo compare outcomes between percutaneous transluminal angioplasty and stent placement in the treatment of transplant renal artery stenosis (TRAS).MethodsWe retrospectively studied patients who underwent angiography for TRAS between 1/1/2008 and 9/20/2016 at 1 center. We compared the rates of restenosis in patients who were treated with angioplasty alone vs those who were treated with stenting. Secondary outcomes included serum creatinine and blood pressure after intervention and graft and patient survival.ResultsA total of 82 patients were identified as having TRAS after angiography. Restenosis occurred in 28% (16 of 58) of the angioplasty patients compared with 8% (2 of 24) of the stented patients (P = .04). Repeat angiography occurred in 14% (8 of 58) of angioplasty patients vs 13% (3 of 24) of stented patients (P = .9). The stented group had significantly higher pre‐intervention stenosis (71% vs 64%, P = .01) and lower postintervention stenosis (4% vs 30%, P < .001). Serum creatinine and blood pressures were not significantly different between the 2 groups at 30, 90, or 360 days postintervention. There was no statistically significant difference in graft or patient survival between groups (P = .37).ConclusionsStent placement resulted in fewer cases of restenosis compared with angioplasty alone, although no benefit in terms of serum creatinine, blood pressure, or patient and graft survival was shown.
PTH, vitamin D, and the FGF‐23–klotho axis and heart: Going beyond the confines of nephrology
Authors: Navarro‐García José Alberto , Fernández‐Velasco María , Delgado Carmen , Delgado Juan F. , Kuro‐o Makoto , Ruilope Luis M. , Ruiz‐Hurtado Gema 
Published: February 2018

AbstractBackgroundProfound disturbances in mineral metabolism are closely linked to the progression of chronic kidney disease. However, increasing clinical and experimental evidence indicates that alterations in phosphate homoeostasis could have an even stronger impact on the heart.AimThe aim of this review is to provide the reader with an update of how alterations in mineral metabolism are related to direct and indirect cardiotoxic effects beyond the nephrology setting.ResultsEvidence exists that alterations in mineral metabolism that are related to changes in parathyroid hormone (PTH), vitamin D, and the FGF‐23–klotho axis have direct pathological consequences for the heart. Alterations in plasma PTH levels are associated with cardiac dysfunction and detrimental cardiac remodelling. Several clinical studies have associated vitamin D deficiency with the prevalence of cardiovascular disease (CV) and its risk factors. Recent evidences support deleterious direct and nonphosphaturic effects of FGF‐23 on the heart as hypertrophy development. In contrast, reduced systemic klotho levels are related to CV damage, at least when advanced age is present. In addition, we discuss how these mineral metabolism molecules can counteract each other in some situations, in the context of failed clinical trials on cardiac protection as is the case of vitamin D supplementation.ConclusionsAmong all mineral components, an increase in systemic FGF‐23 levels is considered to have the greatest CV impact and risk. However, it is quite possible that many intracellular mechanisms mediated by FGF‐23, especially those related to cardiomyocyte function, remain to be discovered.
The question of land access and the Spanish land reform of 1932
Authors: Carmona Juan , Rosés Joan R. , Simpson James 
Published: February 2018

AbstractSpanish land reform, involving the breakup of the large southern estates, was a central issue during the first decades of the twentieth century, and was justified on economic and political grounds. This article employs new provincial data on landless workers, land prices, and agrarian wages to consider whether government intervention was needed because of the failure of the free action of markets to redistribute land. Our evidence shows that the relative number of landless workers decreased significantly from 1860 to 1930, before the approval of the 1932 Land reform during the Second Republic (1931–6). This was due to two interrelated market forces: the falling ratio between land prices and rural wages, which made plots of land cheaper for landless workers to rent and buy; and structural change that drained the rural population from the countryside Given that shifts in factor prices were already helping workers gain access to land by the 1930s, the economic arguments for introducing reform at that time remain unclear.
Rituximab in combination with chemotherapy for the treatment of chronic lymphocytic leukaemia in clinical practice
Authors: Reiser Marcel , Dörfel Steffen , Hensel Manfred , Hoesl Mark , Jordan Wolf‐Oliver , Koenigsmann Michael , Meyer Dirk , Reichert Dietmar , Schwarzer Andreas , Marquardt Moritz , Kellershohn Kerstin , Jentsch‐Ullrich Kathleen 
Published: February 2018

AbstractObjectivesThis study was conducted to investigate the real‐world effectiveness and tolerability of rituximab‐containing chemoimmunotherapies, which have become the standard of care for chronic lymphocytic leukaemia (CLL), particularly for physically fit patients. Furthermore, current treatment patterns in clinical practice were documented, and an unselected real‐life population was compared with older, comorbid patients.MethodsProspective, multicentre, observational study with rituximab‐containing chemoimmunotherapy in CLL patients.ResultsOf 681 patients in total, 485 were enroled in cohort 1 (unselected) and 196 in cohort 2 (comorbid “slow‐go” patients). The median patient age was higher than in most randomised controlled trials (cohort 1: 70 years and cohort 2: 75 years). The most common treatment regimen in both first‐line and relapsed patients was rituximab‐bendamustine. Two‐year progression‐free survival rate for first‐line therapy was 84.1% for cohort 1 and 69.8% for cohort 2 (with best overall response rate 81.8% for cohort 1 and 76.6% for cohort 2). General and B‐symptoms declined during treatment and remained at low level or decreased further until study end. The safety profile observed in randomised clinical trials was confirmed.ConclusionChemoimmunotherapy with rituximab is feasible and safe in a wide variety of clinical settings in CLL, including the treatment of older patients with comorbidities (ClinicalTrials.gov NCT01178086).
Laser ablation is effective for temporal lobe epilepsy with and without mesial temporal sclerosis if hippocampal seizure onsets are localized by stereoelectroencephalography
Authors: Youngerman Brett E. , Oh Justin Y. , Anbarasan Deepti , Billakota Santoshi , Casadei Camilla H. , Corrigan Emily K. , Banks Garret P. , Pack Alison M. , Choi Hyunmi , Bazil Carl W. , Srinivasan Shraddha , Bateman Lisa M. , Schevon Catherine A. , Feldstein Neil A. , Sheth Sameer A. , McKhann Guy M. ,   the Columbia Comprehensive Epilepsy Center Co‐Authors
Published: February 2018

SummaryObjectiveSelective laser amygdalohippocampotomy (SLAH) using magnetic resonance–guided laser interstitial thermal therapy (MRgLITT) is emerging as a treatment option for drug‐resistant mesial temporal lobe epilepsy (MTLE).SLAHis less invasive than open resection, but there are limited series reporting its safety and efficacy, particularly in patients without clear evidence of mesial temporal sclerosis (MTS).MethodsWe report seizure outcomes and complications in our first 30 patients who underwentSLAHfor drug‐resistantMTLEbetween January 2013 and December 2016. We compare patients who required stereoelectroencephalography (SEEG) to confirm mesial temporal onset with those treated based on imaging evidence ofMTS.ResultsTwelve patients withSEEG‐confirmed, non‐MTS MTLEand 18 patients withMRI‐confirmedMTSunderwentSLAH.MTSpatients were older (median age 50 vs 30 years) and had longer standing epilepsy (median 40.5 vs 5.5 years) than non‐MTSpatients. Engel class I seizure freedom was achieved in 7 of 12 non‐MTSpatients (58%, 95%confidence interval [CI] 30%‐86%) and 10 of 18MTSpatients (56%, 95%CI33%‐79%), with no significant difference between groups (odds ratio [OR]1.12, 95%CI0.26‐4.91,P = .88). Length of stay was 1 day for most patients (range 0‐3 days). Procedural complications were rare and without long‐term sequelae.SignificanceWe report similar rates of seizure freedom followingSLAHin patients withMTSandSEEG‐confirmed, non‐MTS MTLE. Consistent with early literature, these rates are slightly lower than typically observed with surgical resection (60%‐80%). However,SLAHis less invasive than open surgery, with shorter hospital stays and recovery, and severe procedural complications are rare.SLAHmay be a reasonable first‐line surgical option for patients with bothMTSandSEEGconfirmed, non‐MTS MTLE.
Insulo‐opercular cortex generates oroalimentary automatisms in temporal seizures
Authors: Aupy Jerome , Noviawaty Ika , Krishnan Balu , Suwankpakdee Piradee , Bulacio Juan , Gonzalez‐Martinez Jorge , Najm Imad , Chauvel Patrick 
Published: February 2018

SummaryObjectiveOroalimentary automatisms (OAAs) resembling normal alimentary behavior are stereotyped complex movements that may occur during epileptic seizures. They are considered common clinical signs in temporal lobe seizures, but their anatomofunctional mechanisms are not established. We took the opportunity of presurgical intracerebral recordings to study the relations between the occurrence of OAAs and temporal/spatial features of ictal activities.MethodsWe retrospectively reviewed patients with medically intractable medial temporal lobe epilepsy who underwent stereoelectroencephalography (SEEG) at Cleveland Clinic between 2009 and 2016. Patients presenting oroalimentary automatisms during seizures, with intracerebral electrodes spanning temporal and extratemporal areas, were selected. SEEG‐clinical correlations with latency measurements were done. Coherence analyses were performed on regions of interest as defined by the areas involved at the onset of oroalimentary automatisms.ResultsFifteen patients (115 seizures) were analyzed. Sixty‐nine seizures exhibited overt oroalimentary automatisms. Only insulo‐opercular cortex ictal involvement was consistently related to the occurrence of OAAs, with a linear correlation between OAA onset and ictal oscillatory activity onset in the insulo‐opercular cortex. SEEG signal processing showed an increase in theta coherence preceding oroalimentary automatism onset between mediobasal‐temporal structures and insulo‐opercular cortex, as well as between the 2 insulo‐opercular regions.SignificanceThe underlying mechanism for the production of oroalimentary automatisms in medial temporal seizures is based on temporal‐insulo‐opercular theta coherence leading to a synchronous state generating rhythmic patterned outputs from the cortical masticatory area.
Arthroscopic treatment for cervical articular process joint osteochondrosis in a Thoroughbred horse
Authors: Tucker R. , Piercy R. J. , Dixon J. J. , Muir C. F. , Smith K. C. , Potter K. E. , Leaman T. R. , Smith R. K. W. 
Published: February 2018

SummaryA yearling Thoroughbred colt was presented for investigation of neck stiffness and episodes of intermittent neck pain without neurological signs. Osteochondrosis (OCD) of the cervical articular process joints (APJs) was diagnosed with the aid of radiography and computed tomography. An articular osteochondral fragment of the left fourth caudal cervical articular process was removed arthroscopically following a cut down approach to the joint capsule of the affected APJ. Surgical removal resulted in resolution of clinical signs at 4 weeks. However, subsequently the horse was markedly ataxic 6 weeks post surgery after being found cast in its stable. Cervical stenotic myelopathy was considered the most likely cause based on clinical and radiographic signs and the horse was subjected to euthanasia due to a poor prognosis for racing. Post‐mortem examination identified atypical cartilage within several cervical APJs with histological changes consistent with OCD. This case report supports OCD of the APJs as a cause of neck pain and confirms the clinical practicality and short‐term effectiveness of arthroscopic fragment removal. Surgical treatment for cervical OCD should be considered in horses without neurological signs, although case selection is important and the underlying pathology remains a risk factor for the development of subsequent neurological signs.
“It is the innocence which constitutes the crime”: Political geographies of white supremacy, the construction of white innocence, and the Flint water crisis
Authors: Inwood Joshua F.J. 
Published: February 2018

AbstractUsing the Flint, Michigan water crisis as a backdrop, this review piece explores the concept of white innocence. The concept of white innocence presents us with an analytic tool to understand the frustrating endurance of white supremacy within the U.S. settler state and how white supremacy operates through a range of geographically grounded practices. This paper makes an explicit link between work on settler colonialism and white innocence outlining how the burgeoning work on settler societies opens space to a productive engagement with the concept of innocence. I contend that white innocence as a concept needs to be more fully grounded in work that engages with settler colonialism and within the United States specifically. White innocence also inculcates the agency of whites in a society that is built through the explicit exploitation of persons of color as well as the way white institutions continue to expose persons of color to a range of negative impacts. This paper begins with a review of the literature on whiteness within geographic research. The last several years has seen a series of important interventions in the literature and geographers are increasingly turning to the concept of white supremacy to explain racism in 21st century U.S. society.
Quantitative estimation of progression of chronic liver disease using gadoxetate disodium‐enhanced magnetic resonance imaging
Authors: Yamada Akira , Fujinaga Yasunari , Suzuki Takeshi , Komatsu Daisuke , Kitoh Yoshihiro , Iwadate Yuji , Nozaki Atsushi , Ueda Kazuhiko , Kadoya Masumi 
Published: February 2018

AimThe purpose of this study was to determine whether the liver stiffness (LS) measured on magnetic resonance (MR) elastography can be estimated by a combination of gadoxetate disodium‐enhanced MR imaging (EOB‐MRI) and ordinary blood tests.MethodsWe evaluated 33 consecutive patients with suspected liver disease who underwent EOB‐MRI using a Differential Subsampling with Cartesian Ordering MR sequence and MR elastography using a 1.5‐T MR system in this prospective study. A stepwise multiple linear regression model analysis of LS was performed using various predictive values obtained from two‐in‐one‐uptake, two‐compartment model analysis of EOB‐MRI (velocity constants of arterial inflow [K1a], portal venous inflow [K1p], hepatocellular uptake [Ki]), and ordinary blood test results (blood platelet count, serum albumin level [ALB], total serum bilirubin level [T‐BIL], and prothrombin time [PT%]).ResultsMultiple linear regression model analysis revealed that hepatic perfusion‐uptake index (HPUI = –K1a + K1p + Ki) (P < 0.0001), albumin‐bilirubin linear predictor (ALBI‐LP = 0.66 × log10T‐BIL – 0.085 × ALB) (P = 0.034), and blood platelet count (P = 0.046) were significant independent predictors of LS (r = 0.863). The area under receiver operator characteristics curve of multiple linear regression model in prediction of the liver stiffness corresponding to higher (LS > 5.0 kPa) and lower (LS < 4.2 kPa) risk for developing hepatocellular carcinoma were 0.956 and 0.938, respectively.ConclusionLS can be estimated quantitatively with the use of HPUI obtained from compartment model analysis of EOB‐MRI combined with ALBI‐LP and blood platelet count.
Diagnosis of a severe congenital anomaly: A qualitative analysis of parental decision making and the implications for healthcare encounters
Authors: Lotto Robyn , Smith Lucy K. , Armstrong Natalie 
Published: February 2018

AbstractObjectiveTo explore parental decision making following diagnosis of a severe congenital anomaly, and implications for healthcare encounters.DesignQualitative semi‐structured interviews with 38 parents‐to‐be were collated and triangulated with data generated from consultation recordings.AnalysisData were analysed using a constant comparative‐based approach.SettingRecruitment was undertaken across four fetal medicine sites in two tertiary referral trusts.ParticipantsParents‐to‐be whose pregnancy was suspected or diagnosed as being affected by a severe congenital anomaly. This sample was purposive to include known factors affecting the decision to terminate or continue the affected pregnancy.FindingsIn trying to make a decision about how to proceed with their pregnancy, parents‐to‐be typically had to work hard to negotiate multiple uncertainties around the diagnosis and prognosis of the suspected anomaly. This was influenced by parents’ capacity to cope with uncertainty and the way in which uncertainty was managed by the clinical team. This negotiation of uncertainty was enacted within a fluid, nonlinear three‐phase process: “information seeking,” reflecting the way parents‐to‐be face the uncertainty associated with a fetal diagnosis and associated prognosis; “implications,” where consideration is given to future consequences of the decision; and “decision making,” which reflects the way in which the decision is made (head‐ or heart‐led). Spectrums of responses were apparent within each phase.ConclusionsThis study provides important insights into how parents‐to‐be make decisions following diagnosis or suspicion of a severe congenital anomaly. The impact of these on healthcare encounters is discussed, alongside recommendations for clinical practice.