bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilisation of anti-TNF levels in a UK tertiary IBD centre
Authors: Johnston E L , Warner B D , Digby-Bell J L , Unsworth N , Anderson S , Sanderson J D , Arkir Z , Irving P M 
Published: November 2016

ObjectiveTo ascertain how anti-tumour necrosis factor (TNF) drug and anti-drug antibody levels testing is used in a ‘real-world’ setting to optimise inflammatory bowel disease (IBD) treatment.DesignRetrospective cohort study of prospectively collected patient data.SettingTertiary IBD centre in London, UK.PatientsAll patients at Guy's and St Thomas' Hospitals on anti-TNF who had levels measured between the start of testing in 2012 and October 2014.InterventionsAnti-TNF drug and anti-drug antibody levels as part of routine monitoring.Main outcome measuresIndication for measuring levels and changes in management made as a result of the levels.Results330 infliximab levels were carried out in 199 patients and 143 adalimumab levels were carried out in 103 patients. Levels were primarily done in those with evidence of loss of response; 37% of infliximab levels and 52% of adalimumab levels. Levels resulted in a change in management in 26% of patients in infliximab group and 25% of patients in adalimumab group; however, this was greater in those with loss of response, 62% and 61% respectively. Anti-drug antibodies were detected in 7% of patients.ConclusionsOur early experience has demonstrated that measuring anti-TNF drug and anti-drug antibody levels can be useful in the optimisation of IBD management. In an increasing number of patients, particularly those with evidence of loss of response, it allows early decisions to be made regarding changing therapy. It also offers the potential for significant cost-saving by preventing pointless dose escalation in the context of therapeutic levels or when high-level anti-drug antibodies are present.
‘Repeat abortion’, a phrase to be avoided? Qualitative insights into labelling and stigma
Authors: Hoggart Lesley , Newton Victoria Louise , Bury Louise 
Published: November 2016

BackgroundIn recent years there has been growing international interest in identifying risk factors associated with ‘repeat abortion’, and developing public health initiatives that might reduce the rate. This article draws on a research study looking at young women's abortion experience in England and Wales. The study was commissioned with a specific focus on women who had undergone more than one abortion. We examine what may influence women's post-abortion reproductive behaviour, in addition to exploring abortion-related stigma, in the light of participants' own narratives.Study designMixed-methods research study: a quantitative survey of 430 women aged 16–24 years, and in-depth qualitative interviews with 36 women who had undergone one or more abortions. This article focuses on the qualitative data from two subsets of young women: those we interviewed twice (n=17) and those who had experienced more than one unintended/unwanted pregnancy (n=15).ResultsThe qualitative research findings demonstrate the complexity of women's contraceptive histories and reproductive lives, and thus the inherent difficulty of establishing causal patterns for more than one abortion, beyond the obvious observation that contraception was not used, or not used effectively. Women who had experienced more than one abortion did, however, express intensified abortion shame.ConclusionsThis article argues that categorising women who have an abortion in different ways depending on previous episodes is not helpful. It may also be damaging, and generate increased stigma, for women who have more than one abortion.
Variable MR and pathologic patterns of hemorrhage after iodinated contrast infusion in MCA occlusion/reperfusion model
Authors: Morales Humberto , Lu Aigang , Kurosawa Yuko , Clark Joseph F , Tomsick Thomas 
Published: November 2016

ObjectiveTo examine the hypothesis that IA reperfusion with iso-osmolar iodixanol, low-osmolar iopamidol, or saline causes different effects on MR signal changes and pathologic cut-brain section related to hemorrhagic transformation (HT) or iodinated radiographic contrast media (IRCM) deposition.MethodsInfarct was induced in 30 rats by middle cerebral artery suture occlusion. Reperfusion was performed after 5 hours with iso-osmolar iodixanol (n=9), low-osmolar iopamidol (n=12) or saline (n=9). MR images were obtained immediately after reperfusion and rats were sacrificed at 24 hours. Hypointense areas within the infarction on T2-weighted (T2-WI) or gradient echo (GRE) images were recorded and compared with HT on pathology. Fisher's exact test was used for proportions, and receiver operator curve analysis to evaluate MRI discrimination of hemorrhage.ResultsTwo types of HT were noted on pathology: confluent >0.2 mm petechial hemorrhage (PeH, 78%) or well-defined ≤0.2 mm hemorrhagic focus (HF, 22%). PeH was least common in the iodixanol subgroup (p<0.02). HF was more common in the IRCM group. Hypointense areas on T2-WI but not on GRE were significantly more common in the IRCM group (p<0.05). Hypointense areas on T2-WI and GRE discriminated HT (area under the curve: 0.714, p<0.002).ConclusionsIRCM and saline induced different MRI signal and pathologic patterns in our sample. We postulate that T2 hypointensity with no GRE hypointensity might be associated with IRCM deposition; and decreased frequency of PeH after iodixanol infusion and the presence of HF almost exclusively in the IRCM group might represent a direct/indirect effect of contrast infusion/deposition in the brain parenchyma after reperfusion. Our results support previous observations in IMS III and are hypothesis generating.
Techniques to identify and temporally correlate calcium transients between multiple regions of interest in vertebrate neural circuits
Authors: Sorensen Julian , Wiklendt Lukasz , Hibberd Tim , Costa Marcello , Spencer Nick J. 
Published: November 2016

Calcium imaging is commonly used to record dynamic changes in excitability from axons or cell bodies in the nervous system of vertebrates. These recordings often reveal discrete calcium transients that have variable amplitudes, durations, and rates of rise and decay, all of which can arise from an unstable or “noisy” baseline. This often leads to considerable ambiguity about how to discriminate and quantify calcium transients. We describe an analytical methodology that objectively identifies multiple calcium transients from multiple recording sites and quantifies the degree of temporal synchrony between each event. The methodology consists of multiple steps. The first step involves baselining, to either preserve the underlying shape of calcium transients or remove unwanted frequency components and transform the peaks of calcium transients into more easily detectable patterns. The second step is the application of at least one of two different spike detection algorithms, one based on a gradient estimate and the other on template matching. The third step is the quantification of synchrony between pairs of recordings using at least one of two time lag correlation measures. The fourth step is the identification of statistically significant coincident firing patterns. This allows discrimination of neuronal firing patterns between different sites that appear to occur simultaneously and that statistically could not be attributed to chance. The analytical methods we have demonstrated can be applied not only to calcium imaging but also to many other physiological recordings, where discrimination and temporal correlation of biological signals from multiple sites is required, particularly when arising from unstable baselines, with variable signal-to-noise ratios. NEW & NOTEWORTHY Dynamic imaging of intracellular calcium is commonly used to record changes in excitability in central and peripheral neurons. We describe a novel analytical methodology that objectively discriminates calcium transients from low signal-to-noise recordings from multiple sites and quantifies the degree of temporal synchrony between events. These new methods can be applied not only to calcium imaging but also to many other physiological recordings where discrimination and temporal correlation of biological signals from multiple sites is required.
A Metastatic Mouse Model Identifies Genes That Regulate Neuroblastoma Metastasis
Authors: Seong Bo Kyung A. , Fathers Kelly E. , Hallett Robin , Yung Christina K. , Stein Lincoln D. , Mouaaz Samar , Kee Lynn , Hawkins Cynthia E. , Irwin Meredith S. , Kaplan David R. 
Published: November 2016

Abstract
Metastatic relapse is the major cause of death in pediatric neuroblastoma, where there remains a lack of therapies to target this stage of disease. To understand the molecular mechanisms mediating neuroblastoma metastasis, we developed a mouse model using intracardiac injection and in vivo selection to isolate malignant cell subpopulations with a higher propensity for metastasis to bone and the central nervous system. Gene expression profiling revealed primary and metastatic cells as two distinct cell populations defined by differential expression of 412 genes and of multiple pathways, including CADM1, SPHK1, and YAP/TAZ, whose expression independently predicted survival. In the metastatic subpopulations, a gene signature was defined (MET-75) that predicted survival of neuroblastoma patients with metastatic disease. Mechanistic investigations demonstrated causal roles for CADM1, SPHK1, and YAP/TAZ in mediating metastatic phenotypes in vitro and in vivo. Notably, pharmacologic targeting of SPHK1 or YAP/TAZ was sufficient to inhibit neuroblastoma metastasis in vivo. Overall, we identify gene expression signatures and candidate therapeutics that could improve the treatment of metastatic neuroblastoma. Cancer Res; 77(3); 696–706. ©2017 AACR.
Patent Foramen Ovale and Cryptogenic Strokes in the Stroke in Young Fabry Patients Study
Authors: Huber Roman , Grittner Ulrike , Weidemann Frank , Thijs Vincent , Tanislav Christian , Enzinger Christian , Fazekas Franz , Wolf Markus , Hennerici Michael G. , McCabe Dominick J.H. , Putaala Jukaa , Tatlisumak Turgut , Kessler Christoph , von Sarnowski Bettina , Martus Peter , Kolodny Edwin , Norrving Bo , Rolfs Arndt 
Published: November 2016

Background and Purpose—
A patent foramen ovale (PFO) is disproportionately prevalent in patients with cryptogenic stroke. Without alternative explanations, it is frequently considered to be causative. A detailed stratification of these patients may improve the identification of incidental PFO.

Methods—
We investigated the PFO prevalence in 3497 transient ischemic attack and ischemic stroke patients aged 18 to 55 years in the prospective multicenter SIFAP1 study (Stroke in Young Fabry Patients 1) using the ASCO classification. Patients without an obvious cause for transient ischemic attack/stroke (ASCO 0) were divided into subgroups with and without vascular risk factors (ASCO 0+ and 0−). In addition, we looked for PFO-related magnetic resonance imaging lesion patterns.

Results—

PFO was identified in 25% of patients. Twenty percent of patients with a definite or probable cause of transient ischemic attack/stroke (≥1 grade 1 or 2 ASCO criterion; n=1769) had a PFO compared with 29% of cryptogenic stroke patients (ASCO 0 and 3; n=1728;
P
<0,001); subdivision of cryptogenic strokes revealed a PFO in 24% of 978 ASCO 3 patients (n.s. versus ASCO 1 and 2) and a higher prevalence of 36% in 750 ASCO 0 cases (
P
<0.001 versus ASCO 3 and versus ASCO 1 and 2). PFO was more commonly observed in ASCO 0− (n=271) than in ASCO 0+ patients (n=479; 48 versus 29%;
P
<0.001). There was no PFO-associated magnetic resonance imaging lesion pattern.

Conclusions—
Cryptogenic stroke patients demonstrate a heterogeneous PFO prevalence. Even in case of less conclusive diseases like nonstenotic arteriosclerosis, patients should preferentially be considered to have a non-PFO-mediated stroke.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00414583.
The Anatomic Centers of the Femoral and Tibial Insertions of the Anterior Cruciate Ligament: A Systematic Review of Imaging and Cadaveric Studies Reporting Normal Center Locations
Authors: Parkar Anagha P. , Adriaensen Miraude E.A.P.M. , Vindfeld Søren , Solheim Eirik 
Published: November 2016

Background: The anterior cruciate ligament (ACL) is regularly reconstructed if knee joint function is impaired. Anatomic graft tunnel placement, often assessed with varying measurement methods, in the femur and tibia is considered important for an optimal clinical outcome. A consensus on the exact location of the femoral and tibial footprint centers is lacking. Purpose: To systematically review the literature regarding anatomic centers of the femoral and tibial ACL footprints and assess the mean, median, and percentiles of normal centers. Study Design: Systematic review. Methods: A systematic literature search was performed in the PubMed/Medline database in November 2015. Search terms were the following: “ACL” and “insertion anatomy” or “anatomic footprint” or “radiographic landmarks” or “quadrant methods” or “tunnel placement” or “cadaveric femoral” or “cadaveric tibial.” English-language articles that reported the location of the ACL footprint according to the Bernard and Hertel grid in the femur and the Stäubli and Rauschning method in the tibia were included. Weighted means, weighted medians, and weighted 5th and 95th percentiles were calculated. Results: The initial search yielded 1393 articles. After applying the inclusion and exclusion criteria, 16 studies with measurements on cadaveric specimens or a healthy population were reviewed. The weighted mean of the femoral insertion center based on measurements in 218 knees was 29% in the deep-shallow (DS) direction and 35% in the high-low (HL) direction. The weighted median was 26% for DS and 34% for HL. The weighted 5th and 95th percentiles for DS were 24% and 37%, respectively, and for HL were 28% and 43%, respectively. The weighted mean of the tibial insertion center in the anterior-posterior direction based on measurements in 300 knees was 42%, and the weighted median was 44%; the 5th and 95th percentiles were 39% and 46%, respectively. Conclusion: Our results show slight differences between the weighted means and medians in the femoral and tibial insertion centers. We recommend the use of the 5th and 95th percentiles when considering postoperative placement to be “in or out of the anatomic range.”
Performance Against WELCOA’s Worksite Health Promotion Benchmarks Across Years Among Selected US Organizations
Authors: Weaver GracieLee M. , Mendenhall Brandon N. , Hunnicutt David , Picarella Ryan , Leffelman Brittanie , Perko Michael , Bibeau Daniel L. 
Published: November 2016

Purpose: The purpose of this study was to quantify the performance of organizations’ worksite health promotion (WHP) activities against the benchmarking criteria included in the Well Workplace Checklist (WWC). Design: The Wellness Council of America (WELCOA) developed a tool to assess WHP with its 100-item WWC, which represents WELCOA’s 7 performance benchmarks. Setting: Workplaces. Participants: This study includes a convenience sample of organizations who completed the checklist from 2008 to 2015. The sample size was 4643 entries from US organizations. Measures: The WWC includes demographic questions, general questions about WHP programs, and scales to measure the performance against the WELCOA 7 benchmarks. Analysis: Descriptive analyses of WWC items were completed separately for each year of the study period. Results: The majority of the organizations represented each year were multisite, multishift, medium- to large-sized companies mostly in the services industry. Despite yearly changes in participating organizations, results across the WELCOA 7 benchmark scores were consistent year to year. Across all years, benchmarks that organizations performed the lowest were senior-level support, data collection, and programming; wellness teams and supportive environments were the highest scoring benchmarks. Conclusion: In an era marked with economic swings and health-care reform, it appears that organizations are staying consistent in their performance across these benchmarks. The WWC could be useful for organizations, practitioners, and researchers in assessing the quality of WHP programs.
Lisfranc Injuries in the Athlete
Authors: Lewis John S. , Anderson Robert B. 
Published: November 2016

Lisfranc injuries to the tarsometatarsal complex of the midfoot have become increasingly recognized in the athletic population. Regardless of mechanism, any injury that results in instability in the midfoot requires operative stabilization to preserve function and enable return to sport. In this manuscript, the anatomy, etiology, prevalence, current treatment modalities, and clinical outcomes of patients who suffer Lisfranc injuries are reviewed, with a special focus on the unique characteristics surrounding such an injury in an athlete. Level of Evidence: Level V, expert opinion.
e-ASPECTS software is non-inferior to neuroradiologists in applying the ASPECT score to computed tomography scans of acute ischemic stroke patients
Authors: Nagel Simon , Sinha Devesh , Day Diana , Reith Wolfgang , Chapot René , Papanagiotou Panagiotis , Warburton Elizabeth A , Guyler Paul , Tysoe Sharon , Fassbender Klaus , Walter Silke , Essig Marco , Heidenrich Jens , Konstas Angelos A , Harrison Michael , Papadakis Michalis , Greveson Eric , Joly Olivier , Gerry Stephen , Maguire Holly , Roffe Christine , Hampton-Till James , Buchan Alastair M , Grunwald Iris Q 
Published: November 2016

Background The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is an established 10-point quantitative topographic computed tomography scan score to assess early ischemic changes. We performed a non-inferiority trial between the e-ASPECTS software and neuroradiologists in scoring ASPECTS on non-contrast enhanced computed tomography images of acute ischemic stroke patients. Methods In this multicenter study, e-ASPECTS and three independent neuroradiologists retrospectively and blindly assessed baseline non-contrast enhanced computed tomography images of 132 patients with acute anterior circulation ischemic stroke. Follow-up scans served as ground truth to determine the definite area of infarction. Sensitivity, specificity, and accuracy for region- and score-based analysis, receiver-operating characteristic curves, Bland-Altman plots and Matthews correlation coefficients relative to the ground truth were calculated and comparisons were made between neuroradiologists and different pre-specified e-ASPECTS operating points. The non-inferiority margin was set to 10% for both sensitivity and specificity on region-based analysis. Results In total 2640 (132 patients × 20 regions per patient) ASPECTS regions were scored. Mean time from onset to baseline computed tomography was 146 ± 124 min and median NIH Stroke Scale (NIHSS) was 11 (6–17, interquartile range). Median ASPECTS for ground truth on follow-up imaging was 8 (6.5–9, interquartile range). In the region-based analysis, two e-ASPECTS operating points (sensitivity, specificity, and accuracy of 44%, 93%, 87% and 44%, 91%, 85%) were statistically non-inferior to all three neuroradiologists (all p-values <0.003). Both Matthews correlation coefficients for e-ASPECTS were higher (0.36 and 0.34) than those of all neuroradiologists (0.32, 0.31, and 0.3). Conclusions e-ASPECTS was non-inferior to three neuroradiologists in scoring ASPECTS on non-contrast enhanced computed tomography images of acute stroke patients.
The Elimination of Transfer Distances Is an Important Part of Hospital Design
Authors: Karvonen Sauli , Nordback Isto , Elo Jussi , Havulinna Jouni , Laine Heikki-Jussi 
Published: November 2016

Objective: The objective of the present study was to describe how a specific patient flow analysis with from-to charts can be used in hospital design and layout planning. Background: As part of a large renewal project at a university hospital, a detailed patient flow analysis was applied to planning the musculoskeletal surgery unit (orthopedics and traumatology, hand surgery, and plastic surgery). Method: First, the main activities of the unit were determined. Next, the routes of all patients treated over the course of 1 year were studied, and their physical movements in the current hospital were calculated. An ideal layout of the new hospital was then generated to minimize transfer distances by placing the main activities with close to each other, according to the patient flow analysis. The actual architectural design was based on the ideal layout plan. Finally, we compared the current transfer distances to the distances patients will move in the new hospital. Results: The methods enabled us to estimate an approximate 50% reduction in transfer distances for inpatients (from 3,100 km/year to 1,600 km/year) and 30% reduction for outpatients (from 2,100 km/year to 1,400 km/year). Conclusions: Patient transfers are nonvalue-added activities. This study demonstrates that a detailed patient flow analysis with from-to charts can substantially shorten transfer distances, thereby minimizing extraneous patient and personnel movements. This reduction supports productivity improvement, cross-professional teamwork, and patient safety by placing all patient flow activities close to each other. Thus, this method is a valuable additional tool in hospital design.
Adverse drug reactions in therapeutic hypothermia after cardiac arrest
Authors: Witcher Robert , Dzierba Amy L. , Kim Catherine , Smithburger Pamela L. , Kane-Gill Sandra L. 
Published: November 2016

Background: Therapeutic hypothermia (TH) improves survival and neurologic function in comatose survivors of cardiac arrest. Many medications used to support TH have altered pharmacokinetics and pharmacodynamics during this treatment. It is unknown if or at what frequency the medications used during TH cause adverse drug reactions (ADRs). Methods: A retrospective chart review was conducted for patients admitted to an intensive care unit (ICU) after cardiac arrest and treated with TH from January 2009 to June 2012 at two urban, university-affiliated, tertiary-care medical centres. Medications commonly used during TH were screened for association with significant ADRs (grade 3 or greater per Common Terminology Criteria for Adverse Events) using three published ADR detection instruments. Results: A total of 229 patients were included, the majority being males with median age of 62 presenting with an out-of-hospital cardiac arrest in pulseless electrical activity or asystole. The most common comorbidities were hypertension, coronary artery disease, and diabetes mellitus. There were 670 possible ADRs and 69 probable ADRs identified. Of the 670 possible ADRs, propofol, fentanyl, and acetaminophen were the most common drugs associated with ADRs. Whereas fentanyl, insulin, and propofol were the most common drugs associated with a probable ADR. Patients were managed with TH for a median of 22 hours, with 38% of patients surviving to hospital discharge. Conclusions: Patients undergoing TH after cardiac arrest frequently experience possible adverse reactions associated with medications and the corresponding laboratory abnormalities are significant. There is a need for judicious use and close monitoring of drugs in the setting of TH until recommendations for dose adjustments are available to help prevent ADRs.