bluuebunny/crossref_metadata_2025_split huggingface dataset:
Status of environment in Chotanagpur-Santal Pargana region of Jharkhand
Authors: Kumar Uday , Prasad Kalpana , Kumar Binay 
Published: August 2017

The Chotanagpur-Santal Pargana (CSP), the ‘Ruhr of India’ has been the cradle of mineral exploitation and mineral based industries since the dawn of 20th century. The post-Independence era witnessed a rapid growth in heavy industries and subsequent urbanisation. To cater the energy need, coal based power stations were installed in Damodar valley. Such economic ventures were concentrated mainly in the Damodar and Subernarekha river valleys. These anthropogenic activities triggered a series of environmental degradation. Large scale deforestation led to wide spread soil erosion due to which loss of valuable topsoil and lowering of water table has taken place. The preference for open cast mining practice for more mineral exploitation especially coal, iron ore and bauxite has further aggravated the problem in this fragile eco-system. The discharge of large volume of untreated or semi-treated industrial effluents has literally turned the river Damodar into an “industrial effluent channel.’ Besides being unethical and inhumane, these acts are a gross violation of environmental laws. Ironically, the major culprit industries are public sector undertakings. Even the highly polluted ambient air in the mining and associated industrial areas, especially in the Damodar valley has made the region a virtual gas chamber gradually pushing the local populace towards ‘extinction’. The vast surface water resources are trapped or are in a process to be trapped leading to submergence of large agricultural and forest area and displacement of local inhabitants which are mostly tribals. Almost all such act of ‘development’ has led to delinking of tribals from their root as well as distortion of socio-cultural fabric.
Estimating the Prevalence of Serious Mental Illness and Dementia Diagnoses Among Medicare Beneficiaries in the Health and Retirement Study
Authors: Brown Maria Teresa , Wolf Douglas A. 
Published: August 2017

Objective: To estimate the prevalence of serious mental illness and dementia among Medicare beneficiaries in the Health and Retirement Study (HRS). Methods: This study utilizes HRS-linked Medicare claims data sets and inverse probability weighting to estimate overall and age-specific cumulative prevalence rates of dementia and serious mental illnesses among 18,740 Medicare beneficiaries. Two-way tabulations determine conditional probabilities of dementia diagnoses among beneficiaries diagnosed with specific mental illnesses, and binary logistic regressions determine conditional probabilities of dementia diagnoses among beneficiaries diagnosed with specific mental illnesses, controlling for covariates. Results: Weighted prevalence estimates for dementia, schizophrenia (SZP), bipolar disorder (BPD), and major depressive disorder (MDD) are similar to previous studies. Odds of dementia diagnosis are significantly greater for beneficiaries diagnosed with SZP, BPD, or MDD. Conclusions: Co-occurring mental disabilities require further investigation, as in the near future increasing numbers of mentally ill older adults will need appropriate and affordable community-based services and supports.
Efficacy of ondansetron for spinal anesthesia during cesarean section: a meta-analysis of randomized trials
Authors: Zhou Chengmao , Zhu Yu , Bao Zeqing , Wang Xianxue , Liu Qili 
Published: August 2017

Objective To investigate the efficacy and safety of ondansetron during cesarean section under spinal anesthesia. Methods We sought randomized controlled trials (RCTs) on ondansetron during spinal anesthesia for cesarean section in The Cochrane Library, PubMed, MEDLINE, and Web of Science from their inception to September 2016. Results Altogether, 21 RCTs were included in this study. Meta-analysis showed that the ondansetron group had a lower incidence of nausea/vomiting and bradycardia than the placebo group during cesarean section under spinal anesthesia [relative risk (RR) = 0.43, 95% confidence interval (CI) (0.36, 0.51) and RR = 0.45, 95% CI (0.26, 0.80), respectively]. There were no significant differences in the incidences of pruritus, hypotension, or shivering during cesarean section under spinal anesthesia [RR = 0.92, 95% CI (0.83, 1.02); RR = 0.72 (0.50, 1.06), 95% CI (0.50, 1.06); and RR = 0.89, 95% CI (0.71, 1.11), respectively]. Conclusion Ondansetron effectively reduces the incidences of nausea/vomiting and bradycardia under spinal anesthesia during cesarean section.
Total flavonoids from Astragalus alleviate endothelial dysfunction by activating the Akt/eNOS pathway
Authors: Liu Qian , Zhang Ling , Shan Qiyuan , Ding Yuxia , Zhang Zhaocai , Zhu Meifei , Mao Yuanjie 
Published: August 2017

Objective To investigate the vasodilative and endothelial-protective effects and the underlying mechanisms of total flavonoids from Astragalus (TFA). Methods The vasodilative activities of TFA were measured with a myograph ex vivo using rat superior mesenteric arterial rings. The primary human umbilical vein endothelial cell (HUVEC) viabilities were assayed using the cell counting kit-8 after hypoxia or normoxia treatment with or without TFA. Akt, P-Akt, eNOS, P-eNOS, Erk, P-Erk, Bcl-2 and Bax expression were analyzed using western blotting. Results TFA showed concentration-dependent vasodilative effects on rat superior mesenteric arterial rings, but had no effects on normal or potassium chloride precontracted arterial rings. TFA did not affect HUVEC viabilities in normoxia, but dramatically promoted cell proliferation in the concentration range of 1 to 30 µg/mL under hypoxia. Moreover, TFA significantly increased the ratios of P-Akt/Akt and P-eNOS/eNOS in vascular endothelial cells under hypoxic conditions, but did not change the P-Erk/Erk or Bcl-2/Bax ratios. Conclusions TFA might exhibit vasorelaxant and endothelial-protective effects via the Akt/eNOS signaling pathway.
Serum long noncoding RNA urothelial carcinoma-associated 1: A novel biomarker for diagnosis and prognosis of hepatocellular carcinoma
Authors: Zheng Zhi-kun , Pang Cui , Yang Yang , Duan Qiong , Zhang Ju , Liu Wen-chao 
Published: August 2017

Objective Long noncoding RNAs (lncRNAs) offer great potential as cancer biomarkers. This study was performed to assess the applicability of serum lncRNA urothelial carcinoma-associated 1 (UCA1) as a diagnostic and/or prognostic biomarker for hepatocellular carcinoma (HCC). Methods We examined UCA1 expression in serum samples from 105 patients with HCC, 105 patients with benign liver disease (BLD), and 105 healthy volunteers using reverse-transcription polymerase chain reaction and analyzed the relationship between serum UCA1 and clinicopathological parameters of HCC as well as survival. Results Expression of serum UCA1 was significantly higher in patients with HCC and allowed for discrimination of HCC from BLD and healthy controls. High expression of serum UCA1 was significantly associated with a high tumor grade, large tumor size, positive vascular invasion, and advanced TNM stage. Multivariate analysis revealed that a high serum UCA1 level was an independent unfavorable prognostic factor for HCC. Conclusions Our results confirm the upregulation of serum UCA1 expression in HCC and indicate its clinical value as a noninvasive biomarker for HCC screening and prognostic prediction.
An exploration of fall-related, psychosocial variables in people with multiple sclerosis who have fallen
Authors: Comber Laura , Coote Susan , Finlayson Marcia , Galvin Rose , Quinn Gillian , Peterson Elizabeth 
Published: August 2017

Introduction Psychosocial contributors to fall risk for people with multiple sclerosis are often overlooked in falls prevention practice. This study explored several fall-related, psychosocial variables and their association with falls self-efficacy in a sample of people with multiple sclerosis reporting a fall. Method A cross-sectional, structured telephone survey was employed. The survey explored socio-demographics, multiple sclerosis characteristics, and fall-related psychosocial variables. Multiple linear regression was employed to investigate associations with Falls Efficacy Scale – International scores. Results The mean Falls Efficacy Scale – International score for 140 participants was 38.14(SD = 10.16), and the mean Falls Control Scale score was 5.38(SD = 2.22). Fear of falling was expressed by 129 (92%) participants, with 111 (79%) reporting associated activity curtailment. A regression model including six predictors explained 47% of the variance in the Falls Efficacy Scale – International scores. Results of the multiple linear regression showed that fear of falling, associated activity curtailment, balance interference, falls control, and health status were associated with falls self-efficacy. Conclusion Fear of falling and associated activity curtailment, low falls self-efficacy, and compromised falls control are common among people with multiple sclerosis who have fallen. These fall-related psychosocial variables are distinct and each warrants attention during assessment. Findings suggest that falls self-efficacy among people with multiple sclerosis who have fallen is a complex construct associated with physical and psychosocial factors.
Ten years of follow-up in a large family with familial hemiplegic migraine type 1: Clinical course and implications for treatment
Authors: Indelicato Elisabetta , Nachbauer Wolfgang , Eigentler Andreas , Donnemiller Evelin , Wagner Michaela , Unterberger Iris , Boesch Sylvia 
Published: August 2017

Background Familial hemiplegic migraine (FHM) is a rare, genetic form of migraine with aura. The severity of the aura imposes an effective prophylaxis that is currently based on standard anti-migraine drugs. To this concern, only short-term reports are currently available. Methods Eight patients from a multigenerational FHM type 1 family harbouring a T666M mutation in the CACNA1A gene were referred to our ataxia outpatient clinic. Medical history, general and neurological examination as well as therapeutic approaches were recorded regularly on a routine basis for an average period of 13 years (range 9–15 years). Brain imaging studies and EEG data were also collected. Results Our long-term follow-up revealed that ictal manifestations, which usually improve after the adolescence, may reoccur later in the adulthood. Permanent neurological signs as assessed by means of clinical evaluation as well as follow-up MRIs, EEGs and neuropsychological testing remained stable. Interval therapy with non-selective calcium antagonists reduced the burden of migraine attacks and was well tolerated in the long term.
Sustained complete renal remission is a predictor of reduced mortality, chronic kidney disease and end-stage renal disease in lupus nephritis
Authors: Pakchotanon R , Gladman D D , Su J , Urowitz M B 
Published: August 2017

Objective The objective of this paper is to identify the relationship between patients with lupus nephritis (LN) who achieve sustained complete renal remission (CR) and renal outcome and survival. Methods From a longitudinal cohort study we identified patients with LN with CR. We compared the outcomes of patients who achieved sustained CR for at least five years (Group A) with those less than five years (Group B). The outcomes were death, SLICC/ACR damage index (SDI), renal flare, end-stage renal disease (ESRD) or estimated glomerular filtration rate (eGFR) < 50 ml/min, and doubling of serum creatinine. Regression analyses were used to identify predictors of the outcomes. Results A total of 345 patients were identified, 132 patients in Group A and 213 patients in Group B. The duration of CR in Group A was 11.76 ± 7.34 years but only 1.24 ± 1.24 years in Group B ( p < 0.001). Death, increasing renal SDI, renal flare, renal transplantation, ESRD or eGFR < 50 ml/min, and doubling of serum creatinine in Group A were significantly lower than Group B. Multivariable analysis revealed that Group A patients were at a lower risk of death (hazard ratio (HR) = 0.20; 95% confidence interval (CI), 0.07–0.61; p = 0.004), increasing renal SDI (HR = 0.41; 95% CI, 0.21–0.76; p = 0.01), developing ESRD or eGFR < 50 ml/min (HR = 0.27; 95% CI, 0.12–0.61; p = 0.001), and doubling of serum creatinine (HR = 0.29; 95% CI, 0.14–0.61; p = 0.001) compared with Group B. Conclusion Sustained CR for at least five years is a predictor of better prognosis in patients with LN.
Cladribine versus fingolimod, natalizumab and interferon β for multiple sclerosis
Authors: Kalincik Tomas , Jokubaitis Vilija , Spelman Tim , Horakova Dana , Havrdova Eva , Trojano Maria , Lechner-Scott Jeannette , Lugaresi Alessandra , Prat Alexandre , Girard Marc , Duquette Pierre , Grammond Pierre , Solaro Claudio , Grand’Maison Francois , Hupperts Raymond , Prevost Julie , Sola Patrizia , Ferraro Diana , Terzi Murat , Butler Ernest , Slee Mark , Kermode Allan , Fabis-Pedrini Marzena , McCombe Pamela , Barnett Michael , Shaw Cameron , Hodgkinson Suzanne , Butzkueven Helmut ,   on behalf of the MSBase Study Group
Published: August 2017

Objective: This propensity score–matched analysis from MSBase compared the effectiveness of cladribine with interferon β, fingolimod or natalizumab. Methods: We identified all patients with relapse-onset multiple sclerosis, exposure to the study therapies and ⩾1-year on-treatment follow-up from MSBase. Three pairwise propensity score–matched analyses compared treatment outcomes over 1 year. The outcomes were hazards of first relapse, disability accumulation and disability improvement events. Sensitivity analyses were completed. Results: The cohorts consisted of 37 (cladribine), 1940 (interferon), 1892 (fingolimod) and 1410 patients (natalizumab). The probability of experiencing a relapse on cladribine was lower than on interferon ( p = 0.05), similar to fingolimod ( p = 0.31) and higher than on natalizumab ( p = 0.042). The probability of disability accumulation on cladribine was similar to interferon ( p = 0.37) and fingolimod ( p = 0.089) but greater than natalizumab ( p = 0.021). The probability of disability improvement was higher on cladribine than interferon ( p = 0.00017), fingolimod ( p = 0.0025) or natalizumab ( p = 0.00099). Sensitivity analyses largely confirmed the above results. Conclusion: Cladribine is an effective therapy for relapse-onset multiple sclerosis. Its effect on relapses is comparable to fingolimod and its effect on disability accrual is comparable to interferon β and fingolimod. Cladribine may potentially associate with superior recovery from disability relative to interferon, fingolimod and natalizumab.
Natalizumab during pregnancy and lactation
Authors: Proschmann Undine , Thomas Katja , Thiel Sandra , Hellwig Kerstin , Ziemssen Tjalf 
Published: August 2017

Background: Managing medication during pregnancy and lactation in multiple sclerosis (MS) patients needs to balance potential risks to the newborn with the substantial risks of ongoing disease activity. Objective: To evaluate the potential transfer of natalizumab (NAT) into breast milk and into the serum of newborn babies in women who continued NAT treatment during pregnancy and lactation. Methods: Serum samples of 11 mother–infant pairs and mother milk samples of a further 4 women were analyzed for free NAT using a HL60 cell-based fluorescence-activated cell sorting (FACS) assay. Two mother–baby pairs were analyzed for cell-bound NAT, very-late-antigen (VLA)-4 expression, and saturation with NAT on immune cells by FACS analysis. Results: In the majority of the mother–infant serum pairs (6/11) and in all breast milk samples, free NAT was detectable. Cell-bound NAT was measurable in both mother–baby pairs with significant higher levels in babies. VLA-4 expression seems to be higher in newborns. Saturation with NAT was comparable between newborns and mothers. Conclusion: NAT can pass placental barrier before delivery and into breast milk. Measurable NAT on neonatal lymphocytes may have functional impact. Further investigations are needed to clarify safety and risk of NAT exposure during pregnancy and lactation.
Stroke while driving: Frequency and association with automobile accidents
Authors: Inamasu Joji , Nakatsukasa Masashi , Tomiyasu Kazuhiro , Mayanagi Keita , Nishimoto Masaaki , Oshima Takeo , Yoshii Masami , Miyatake Satoru , Imai Akira 
Published: August 2017

Background Cardiovascular events while driving have occasionally been reported. In contrast, there have been few studies on stroke while driving. Aim The objectives of this study were to (1) report the frequency of stroke while driving and (2) evaluate its association with automobile accidents. Methods Clinical data prospectively acquired between January 2011 and December 2016 on 2145 stroke patients (1301 with ischemic stroke, 585 with intracerebral hemorrhage, and 259 with subarachnoid hemorrhage) were reviewed to identify patients who sustained a stroke while driving. The ratio of driving to performing other activities was evaluated for each stroke type. Furthermore, the drivers’ response to stroke was reviewed to understand how automobile accidents occurred. Results Among the 2145 patients, 85 (63 ischemic stroke, 20 intracerebral hemorrhage, and 2 subarachnoid hemorrhage) sustained a stroke while driving. The ratio of driving to performing other activities was significantly higher in ischemic stroke (4.8%) than in intracerebral hemorrhage (3.4%) or subarachnoid hemorrhage (0.8%). A majority of drivers either continued driving or pulled over to the roadside after suffering a stroke. However, 14 (16%) patients were involved in automobile accidents. In most patients, an altered mental status due to severe stroke was the presumed cause of the accident. Conclusion Stroke occurred while driving in 4.0% of all strokes and accidents occurred in 16% of these instances.
Changes in delta ADC reflect intracranial pressure changes in craniosynostosis
Authors: Takahashi Yuko , Hori Masaaki , Shimoji Kazuaki , Miyajima Masakazu , Akiyama Osamu , Arai Hajime , Aoki Shigeki 
Published: August 2017

Background In patients with craniosynostosis, intracranial pressure (ICP) has been reported to increase even in the absence of overt symptoms. The early and non-invasive detection of intracranial hypertension is important for reducing the risk of abnormal brain development in pediatric patients. Purpose To assess whether the apparent diffusion coefficient (ADC) of white matter during the cardiac cycle (ΔADC) would change after surgery to relieve ICP in children with craniosynostosis. Material and Methods This prospective study included ten patients diagnosed with craniosynostosis and four normal controls. All ten patients underwent magnetic resonance (MR) examinations before and after surgical treatment. Single-shot diffusion MR imaging (MRI) triggered by an electrocardiogram was performed, with regions of interest (ROIs) placed on frontal white matter and basal ganglia. Results In all ten patients, ΔADC values after surgery were higher than those before surgery. This difference was statistically significant (Wilcoxon signed-rank test, P = 0.005). Conclusion The change in ΔADC in the frontal white matter before and after surgery in patients with craniosynostosis indicates that it might reflect the change in ICP. Measurements of ΔADC could be a promising tool for non-invasive monitoring of ICP.
Implementation of Surgeon-Initiated Gene Expression Profile Testing (Oncotype DX) Among Patients With Early-Stage Breast Cancer to Reduce Delays in Chemotherapy Initiation
Authors: Losk Katya , Freedman Rachel A. , Lin Nancy U. , Golshan Mehra , Pochebit Stephen M. , Lester Susan C. , Natsuhara Kelsey , Camuso Kristen , King Tari A. , Bunnell Craig A. 
Published: August 2017

Purpose: Delays to adjuvant chemotherapy initiation in breast cancer may adversely affect clinical outcomes and patient satisfaction. We previously identified an association between genomic testing (Onco type DX) and delayed chemotherapy initiation. We sought to reduce the interval between surgery and adjuvant chemotherapy initiation by developing standardized criteria and workflows for Onco type DX testing. Methods: Criteria for surgeon-initiated reflex Onco type DX testing, workflows for communication between surgeons and medical oncologists, and a streamlined process for receiving and processing Onco type DX requests in pathology were established by multidisciplinary consensus. Criteria for surgeon-initiated testing included patients ≤ 65 years old with T1cN0 (grade 2 or 3), T2N0 (grade 1 or 2), or T1/T2N1 (grade 1 or 2) breast cancer on final surgical pathology. Medical oncologists could elect to initiate Onco type testing for cases falling outside the criteria. We then examined 720 consecutive patients with breast cancer who underwent Onco type DX testing postoperatively between January 1, 2014 and November 28, 2016 and measured intervals between date of surgery, Onco type DX order date, result received date, and chemotherapy initiation date (if applicable) before and after intervention implementation. Results: The introduction of standardized criteria and workflows reduced time between surgery and Onco type DX ordering, and time from surgery to receipt of result, by 7.3 days ( P < .001) and 6.3 days ( P < .001), respectively. The mean number of days between surgery and initiation of chemotherapy was also reduced by 6.4 days ( P = .004). Conclusion: Developing consensus on Onco type DX testing criteria and implementing streamlined workflows has led to clinically significant reductions in wait times to chemotherapy decision making and initiation.
Is it safe to preserve the deltoid when resecting the proximal humerus for a primary malignant bone tumour?
Authors: Cladière-Nassif V. , Bourdet C. , Audard V. , Babinet A. , Anract P. , Biau D. 
Published: August 2017

AimsResection of the proximal humerus for the primary malignant bone tumour sometimes requires en bloc resection of the deltoid. However, there is no information in the literature which helps a surgeon decide whether to preserve the deltoid or not. The aim of this study was to determine whether retaining the deltoid at the time of resection would increase the rate of local recurrence. We also sought to identify the variables that persuade expert surgeons to choose a deltoid sparing rather than deltoid resecting procedure.Patients and MethodsWe reviewed 45 patients who had undergone resection of a primary malignant tumour of the proximal humerus. There were 29 in the deltoid sparing group and 16 in the deltoid resecting group. Imaging studies were reviewed to assess tumour extension and soft-tissue involvement. The presence of a fat rim separating the tumour from the deltoid on MRI was particularly noted. The cumulative probability of local recurrence was calculated in a competing risk scenario.ResultsThere was no significant difference (adjusted p = 0.89) in the cumulative probability of local recurrence between the deltoid sparing (7%, 95% confidence interval (CI) 1 to 20) and the deltoid resecting group (26%, 95% CI 8 to 50). Patients were more likely to be selected for a deltoid sparing procedure if they presented with a small tumour (p = 0.0064) with less bone involvement (p = 0.032) and a continuous fat rim on MRI (p = 0.002) and if the axillary nerve could be identified (p = 0.037).ConclusionA deltoid sparing procedure can provide good local control after resection of the proximal humerus for a primary malignant bone tumour. A smaller tumour, the presence of a continuous fat rim and the identification of the axillary nerve on pre-operative MRI will persuade surgeons to opt for a deltoid resecting procedure. Cite this article: Bone Joint J 2017;99-B:1244–9.