bluuebunny/crossref_metadata_2025_split huggingface dataset:
A clinical audit on the efficacy and safety of uterine artery embolisation for symptomatic adenomyosis: Results in 117 women
Authors: Liang Eisen , Brown Bevan , Rachinsky Maxim 
Published: January 2018

BackgroundUterine artery embolisation (UAE) is a possible uterine‐sparing treatment option for women with unsuccessful conservative management for adenomyosis‐related heavy menstrual bleeding (HMB) and dysmenorrhoea.AimTo conduct a clinical audit on the efficacy and safety of UAE for symptomatic adenomyosis.Materials and MethodsRetrospective review of 309 women who underwent UAE identified 117 women with magnetic resonance imaging features of adenomyosis (junctional zone thickness ≥ 12 mm). Overall success and HMB control were rated by women. Visual analogue scale (VAS) pain score, Uterine Fibroid Symptom and health‐related Quality of Life (UFS‐QoL) symptoms score and quality of life score were also used to measure outcome.ResultsOne hundred and fifteen women (98%) were available for outcome evaluation. The mean follow‐up was 22.5 months. Overall clinical success was achieved in 102/115 (89%) women; HMB control was achieved in 91/104 (88%); dysmenorrhea relief was achieved in 94/104 (90%), with VAS reduction of 6.13 (P < 0.001), Mean symptoms score was reduced from 58 to 17 at 12 months (P < 0.001) and QoL score increased from 42 to 88 at 12 months (P < 0.001). Hysterectomy was performed on six (5%) women. There were three (3%) mild groin haematomatas and three (3%) mild subacute complications (one possible endometritis, two urinary tract infections; all responded to oral antibiotics). Two women had unintended pregnancies which were complicated.ConclusionsIn this clinical audit UAE was found to be an effective uterine‐sparing option for women who had unsuccessful conservative treatments for adenomyosis‐related HMB and dysmenorrhoea. There were no major complications. Two women had unintended pregnancies that were complicated.
Refractory Pulmonary Edema and Upper Body Hypoxemia During Veno‐Arterial Extracorporeal Membrane Oxygenation—A Case for Atrial Septostomy
Authors: Prasad Amit , Ghodsizad Ali , Brehm Christoph , Kozak Mark , Körner Michael , El Banayosy Aly , Singbartl Kai 
Published: January 2018

AbstractVeno‐arterial extracorporeal membrane oxygenation (VA‐ECMO) provides mechanical circulatory support for patients with advanced cardiogenic shock, facilitating myocardial recovery and limiting multi‐organ failure. In patients with severely limited left ventricular ejection, peripheral VA‐ECMO can further increase left ventricular and left atrial pressures (LAP). Failure to decompress the left heart under these circumstances can result in pulmonary edema and upper body hypoxemia, that is, myocardial and cerebral ischemia. Atrial septostomy can decrease LAP in these situations. However, the effects of atrial septostomy on upper body oxygenation remain unknown. After IRB approval, we identified 9 out of 242 adult VA‐ECMO patients between January 2011 and June 2016 who also underwent atrial septostomy for refractory pulmonary edema/upper body hypoxemia. We analyzed LAP/pulmonary capillary wedge pressure (PCWP), right atrial pressures (RAPs), PaO2/FiO2 ratios (blood samples from right radial artery), intrathoracic volume status, and resolution of pulmonary edema before and up to 48 h after septostomy. There were no procedure‐related complications. Thirty‐day survival was 44%. LAP/PCWP decreased by approximately 40% immediately following septostomy and remained so for at least 24 h. PaO2/FiO2 ratios significantly increased from 0.49 (0.38–2.12) before to 5.35 (3.01–7.69) immediately after septostomy and continued so for 24 h, 6.6 (4.49–10.93). Radiographic measurements also indicated a significant improvement in thoracic intravascular volume status after atrial septostomy. Atrial septostomy reduces LAP and improves upper body oxygenation and intrathoracic vascular volume status in patients developing severe refractory pulmonary edema while undergoing peripheral VA‐ECMO. Atrial septostomy therefore appears safe and suitable to reduce the risk of upper body ischemia under these circumstances.
A Weaning Protocol for Venovenous Extracorporeal Membrane Oxygenation With a Review of the Literature
Authors: Grant April A. , Hart Valerie J. , Lineen Edward B. , Badiye Amit , Byers Patricia M. , Patel Amit , Vianna Rodrigo , Koerner Michael M. , El Banayosy Aly , Loebe Matthias , Ghodsizad Ali 
Published: January 2018

AbstractSeveral articles have discussed the weaning process for venoarterial extracorporeal membrane oxygenation; however, there is no published report to outline a standardized approach for weaning a patient from venovenous extracorporeal membrane oxygenation (ECMO). This complex process requires an organized approach and a thorough understanding of ventilator management and ECMO physiology. The purpose of this article is to describe the venovenous ECMO weaning protocol used at our institution as well as provide a review of the literature.
First‐in‐human study to assess the safety, pharmacokinetics and pharmacodynamics of BMS‐962212, a direct, reversible, small molecule factor XIa inhibitor in non‐Japanese and Japanese healthy subjects
Authors: Perera Vidya , Luettgen Joseph M. , Wang Zhaoqing , Frost Charles E. , Yones Cynthia , Russo Cesare , Lee John , Zhao Yue , LaCreta Frank P. , Ma Xuewen , Knabb Robert M. , Seiffert Dietmar , DeSouza Mary , Mugnier Pierre , Cirincione Brenda , Ueno Takayo , Frost Robert J. A. 
Published: January 2018

AimsThe aims of the present study were to assess the safety, pharmacokinetics (PK) and pharmacodynamics (PD) of BMS‐962212, a first‐in‐class factor XIa inhibitor, in Japanese and non‐Japanese healthy subjects.MethodsThis was a randomized, placebo‐controlled, double‐blind, sequential, ascending‐dose study of 2‐h (part A) and 5‐day (part B) intravenous (IV) infusions of BMS‐962212. Part A used four doses (1.5, 4, 10 and 25 mg h−1) of BMS‐962212 or placebo in a 6:2 ratio per dose. Part B used four doses (1, 3, 9 and 20 mg h−1) enrolling Japanese (n = 4 active, n = 1 placebo) and non‐Japanese (n = 4 active, n = 1 placebo) subjects per dose. The PK, PD, safety and tolerability were assessed throughout the study.ResultsBMS‐962212 was well tolerated; there were no signs of bleeding, and adverse events were mild. In parts A and B, BMS‐962212 demonstrated dose proportionality. The mean half‐life in parts A and B ranged from 2.04 to 4.94 h and 6.22 to 8.65 h, respectively. Exposure‐dependent changes were observed in the PD parameters, activated partial thromboplastin time (aPTT) and factor XI clotting activity (FXI:C). The maximum mean aPTT and FXI:C change from baseline at 20 mg h−1 in part B was 92% and 90%, respectively. No difference was observed in weight‐corrected steady‐state concentrations, aPTT or FXI:C between Japanese and non‐Japanese subjects (P > 0.05).ConclusionBMS‐962212 has tolerability, PK and PD properties suitable for investigational use as an acute antithrombotic agent in Japanese or non‐Japanese subjects.
Hypoalbuminaemia segregates different prognostic subgroups within the refined standard risk acute graft‐versus‐host disease score
Authors: Kharfan‐Dabaja Mohamed A. , Sheets Kyle , Kumar Ambuj , Murthy Hemant S. , Nishihori Taiga , Tsalatsanis Athanasios , Mina Alain , Mathews John , Ayala Ernesto , Chavez Julio , Perez Lia E. , Betts Brian C. , Anasetti Claudio , Pidala Joseph 
Published: January 2018

SummaryHypoalbuminaemia has been previously described to predict worse non‐relapse mortality (NRM) and inferior overall survival (OS) in allogeneic haematopoietic cell transplant (allo‐HCT) recipients. Here, we evaluate the role of hypoalbuminaemia (<35 g/l) at time of onset of acute graft‐versus‐host disease (aGVHD) when incorporated into the refined aGVHD score. The study population consisted of 522 patients, median age 53 (18–75) years, who underwent an allo‐HCT mostly for haematological malignancies. Standard risk (SR) aGVHD comprised 467 patients (89%) and the number of high risk (HR) cases was 55 (11%). Median follow‐up for all surviving patients was 26 (3–55) months. Two‐year OS was significantly better in patients with SR aGVHD with a serum albumin ≥35 g/l compared to SR with albumin <35 g/l [70% (95% CI = 64–76%) vs. 49% (95% CI = 42–56%), P < 0·0001]. Also, patients with SR aGVHD and a serum albumin level of ≥35 g/l had a significantly lower NRM at 1‐year post‐transplantation [6% (95% CI = 3–10%) vs. 25% (95% CI = 20–32%), P < 0·0001]. After our findings are validated in a large cohort of patients, we propose that hypoalbuminaemia should be incorporated into the refined aGVHD risk score to further its ability to predict outcomes within this group.
Palbociclib in combination with letrozole as first‐line treatment for advanced breast cancer: A Japanese phase II study
Authors: Masuda Norikazu , Nishimura Reiki , Takahashi Masato , Inoue Kenichi , Ohno Shinji , Iwata Hiroji , Mori Yuko , Hashigaki Satoshi , Muramatsu Yasuaki , Nagasawa Takashi , Umeyama Yoshiko , Toi Masakazu 
Published: January 2018

This single‐arm, open‐label, phase II study in 42 Japanese postmenopausal patients with estrogen receptor‐positive/human epidermal growth factor receptor 2‐negative (ER+/HER2−) advanced breast cancer evaluated the efficacy, safety, and pharmacokinetics of first‐line palbociclib (125 mg once daily, 3 weeks on/1 week off) coadministered with letrozole (2.5 mg once daily). Primary endpoint of investigator‐assessed 1‐year progression‐free survival (PFS) probability was 75.0% (90% CI, 61.3%‐84.4%), far surpassing the 40% lower limit of the 90% CI supporting efficacy. Median duration of treatment was 438 days. Among secondary efficacy measures, median PFS was not reached (95% CI, 16.7: not estimable), 17/42 patients (40.5%) had an objective response, 36/42 (85.7%) maintained disease control, and 27/42 (64.3%) remained in follow‐up. Median overall survival was not reached, and 1‐year survival probability was 92.9% (95% CI, 79.5%‐97.6%). Results of intensive pharmacokinetics in a subset of 6 patients showed palbociclib steady‐state mean area under the plasma concentration‐time curve over the dosing interval [τ] and mean maximum plasma concentration were 1979 ng·h/mL and 124.7 ng/mL, respectively. For day 15 plasma samples from cycles 1 and 2, geometric mean of the within‐patient mean trough concentration was 90.1 ng/mL. The most common treatment‐related adverse events were neutropenia (100%) and stomatitis (73.8%). There was 1 case of treatment‐related febrile neutropenia. Toxicities were generally tolerated and manageable by dose modifications and/or medical care. Efficacy and safety of first‐line palbociclib plus letrozole therapy is supported in Japanese postmenopausal patients with treatment‐naive ER+/HER2− advanced breast cancer.
Long‐term follow‐up after full‐split liver transplantation and its applicability in the recent transplant era
Authors: Herden Uta , Fischer Lutz , Sterneck Martina , Grabhorn Enke , Nashan Bjoern 
Published: January 2018

AbstractIntroductionFull‐split liver transplantation (LTX) offers the possibility to expand the donor pool by utilization of one liver for two adults. The aim of our study was to analyze the long‐term outcome in a large series and its applicability in the recent transplant era.MethodsWe performed a retrospective analysis of all full‐split LTX from deceased donors (1999‐2015). Additionally, the potential of full‐split LTX was retrospectively analyzed in all whole organ LTX recipients between 2006 and 2015 (after introduction of the MELD allocation).ResultsWe performed 44 full‐split LTX, thereof 82% before introduction of the MELD‐based allocation system in Germany. Analysis showed highly selected recipients (median MELD score 8 points) and organ data (median donor age 30 years). 5‐ and 10‐year patient survival rates after full‐left and full‐right LTX were 90.7%/90.7% and 85.2%/56.8% (P = .301), corresponding graft survival rates were 80.5%/80.5% in full‐left grafts and 73.7%/36.8% in full‐right graft (P = .198).ConclusionIn the past, in case of strict donor and recipient selection, full‐split LTX was a feasible method with a good outcome. Due to introduction of the national waiting list with a patient‐oriented allocation based on the MELD score in 2006, full‐split LTX seems to be not any longer applicable.
Individual variability in response to renin angiotensin aldosterone system inhibition predicts cardiovascular outcome in patients with type 2 diabetes: A primary care cohort study
Authors: Apperloo Ellen M. , Pena Michelle J. , de Zeeuw Dick , Denig Petra , Heerspink Hiddo J. L. 
Published: January 2018

AimsTo assess variability in systolic blood pressure (SBP) and albuminuria (urinary albumin creatinine ratio [UACR]) responses in patients with type 2 diabetes mellitus initiating renin angiotensin aldosterone system (RAAS) inhibition, and to assess the association of response variability with cardiovascular outcomes.Material and MethodsWe performed an observational cohort study in patients with type 2 diabetes who started RAAS inhibition between 2007 and 2013 (n = 1600). Patients were identified from general practices in the Netherlands. Individual response in SBP and UACR was assessed during 15 months’ follow‐up. Patients were categorized as: good responders (∆SBP <0 mm Hg and ∆UACR <0%); intermediate responders (∆SBP <0 mm Hg and ∆UACR >0% or ∆SBP >0 mm Hg and ∆UACR <0%); or poor responders (∆SBP >0 mm Hg and ∆UACR >0%). Multivariable Cox regression was performed to test the association between initial RAAS inhibition response and subsequent cardiovascular outcomes.ResultsAfter starting RAAS inhibition, the mean SBP change was −13.2 mm Hg and the median UACR was −36.6%, with large between‐individual variability, both in SBP [5th to 95th percentile: 48.5‐20] and UACR [5th to 95th percentile: −87.6 to 171.4]. In all, 812 patients (51%) were good responders, 353 (22%) had a good SBP but poor UACR response, 268 (17%) had a good UACR but poor SBP response, and 167 patients (10%) were poor responders. Good responders had a lower risk of cardiovascular events than poor responders (hazard ratio 0.51, 95% confidence interval 0.30‐0.86; P = .012).ConclusionsSBP and UACR response after RAAS inhibition initiation varied between and within individual patients with type 2 diabetes treated in primary care. Poor responders had the highest risk of cardiovascular events, therefore, more efforts are needed to develop personalized treatment plans for these patients.
Investment beliefs of endowments
Authors: Ang Andrew , Ayala Andrés , Goetzmann William N. 
Published: January 2018

AbstractUnited States university and college endowments now hold close to one‐third of their portfolios in private equity and hedge funds. We estimate the implied beliefs of endowments on these alternative assets’ returns relative to equities and bonds. At the end of 2012, the typical endowment believes that its private equity investments will outperform a portfolio of conventional assets by 3.9% per year, and hedge funds will outperform by 0.7% per year. Taking into account the implied equity exposures in alternative asset positions, the effective equity holding of endowments is approximately 60%.
Analytical validation of a new point‐of‐care assay for serum amyloid A in horses
Authors: Schwartz D. , Pusterla N. , Jacobsen S. , Christopher M. M. 
Published: January 2018

SummaryBackgroundSerum amyloid A (SAA) is a major acute phase protein in horses. A new point‐of‐care (POC) test for SAA (Stablelab) is available, but studies evaluating its analytical accuracy are lacking.ObjectivesTo evaluate the analytical performance of the SAA POC test by 1) determining linearity and precision, 2) comparing results in whole blood with those in serum or plasma, and 3) comparing POC results with those obtained using a previously validated turbidimetric immunoassay (TIA).Study designAssay validation.MethodsAnalytical validation of the POC test was done in accordance with American Society of Veterinary Clinical Pathology guidelines using residual equine serum/plasma and whole blood samples from the Clinical Pathology Laboratory at the University of California‐Davis. A TIA was used as the reference method. We also evaluated the effect of haematocrit (HCT).ResultsThe POC test was linear for SAA concentrations of up to at least 1000 μg/mL (r = 0.991). Intra‐assay CVs were 13, 18 and 15% at high (782 μg/mL), intermediate (116 μg/mL) and low (64 μg/mL) concentrations. Inter‐assay (inter‐batch) CVs were 45, 14 and 15% at high (1372 μg/mL), intermediate (140 μg/mL) and low (56 μg/mL) concentrations. SAA results in whole blood were significantly lower than those in serum/plasma (P = 0.0002), but were positively correlated (r = 0.908) and not affected by HCT (P = 0.261); proportional negative bias was observed in samples with SAA>500 μg/mL. The difference between methods exceeded the 95% confidence interval of the combined imprecision of both methods (15%).Main limitationsAnalytical validation could not be performed in whole blood, the sample most likely to be used stall side.ConclusionThe POC test has acceptable accuracy and precision in equine serum/plasma with SAA concentrations of up to at least 1000 μg/mL. Low inter‐batch precision at high concentrations may affect serial measurements, and the use of the same test batch and sample type (serum/plasma or whole blood) is recommended. Comparison of results between the POC test and the TIA is not recommended.
Anti‐inflammatory effect of 4‐methylcyclopentadecanone in rats submitted to ischemic stroke
Authors: Jin Yan , Wei Fang , Dai Xiaoli , Qi Min , Ma Yukui 
Published: January 2018

AbstractThis study aimed to investigate the anti‐inflammatory effect of 4‐methylcyclopentadecanone (4‐MCPC) in rats suffering from a cerebral ischemia/reperfusion (I/R) injury. In this study, the focal cerebral ischemia in rats was induced by middle cerebral artery occlusion (MCAO) for 2 h, and the rats were treated with 4‐MCPC (8 mg/kg) just 0.5 h before reperfusion. The ischemic infarct volume was recorded 24 h after the MCAO. In addition, myeloperoxidase (MPO) activity and TNF‐α and IL‐1β levels in the ischemic cerebral cortex were determined by ELISA, while nuclear translocation of NF‐κB p65 subunit and expression of p‐IκBα were investigated by Western blotting. Our results showed that 4‐MCPC treatment decreased infarct volume significantly, compared with I/R group (16.8%±7.5% vs. 39.7%±10.9%); it reduced MPO activity (0.43 ± 0.10 vs. 1.00 ± 0.51 U/g) and expression levels of TNF‐α (18.90 ± 3.65 vs. 35.87 ± 4.87 ng/g) and IL‐1β (1.68 ± 0.23 vs. 2.67 ± 0.38 ng/g) in ischemic brain tissues of rats. Further study revealed that 4‐MCPC treatment markedly reduced nuclear translocation of NF‐κB p65 subunit and expression of p‐IκBα in ischemic cerebral cortex. Taken together, our results suggest that 4‐MCPC protects against cerebral I/R injury and displays anti‐inflammatory actions through inhibition of the NF‐κB signal pathway.
Observation and quantification of two incidents of mass fish kill of Icelandic summer spawning herring (Clupea harengus) in the winter 2012/2013
Authors: Óskarsson Guđmundur J. , Ólafsdóttir Sólveig R. , Sigurđsson Þorsteinn , Valdimarsson Héđinn 
Published: January 2018

AbstractThe Icelandic summer‐spawning herring (Clupea harengus) stock overwinters in large, dense schools like other herring stocks. In the winter of 2012/2013 around 300 thousand tonnes, or ~70% of the spawning stock, overwintered in a fjord west of Iceland. The inner part of the fjord, where the herring was located, is separated from the outer part with a natural barrier and a built‐up road with a 210 m long bridge. This creates strong tidal currents under the bridge. On 14 December and again on 1 February mass mortalities of herring took place in this location, and the sea floor and the shores were covered with dead herring. Fieldwork, including camera and video recordings on the shore and on a small boat, was conducted 3 and 4 days after the incidents. Results from this indicated that a total of 55 thousand tonnes had died during these two incidents, an amount nearly equal to the total catch from the stock that year. Measurements of environmental conditions in the days following the incidents showed that the oxygen saturation was generally 20%–40% but was as low as 15% (1.1 ml/L). The most likely explanation for the mortalities was oxygen depletion resulting from respiration of the large herring biomass, limited atmospheric‐water gas exchange due to calm and cold weather prior to both incidents and sea ice on part of the fjord, and limited renewal of water coming in and out via tidal currents. Aerobic decomposition of dead herring came additionally in the latter incident.
Precipitation frequency alters peatland ecosystem structure and CO2 exchange: Contrasting effects on moss, sedge, and shrub communities
Authors: Radu Danielle D. , Duval Tim P. 
Published: January 2018

AbstractClimate projections forecast a redistribution of seasonal precipitation for much of the globe into fewer, larger events spaced between longer dry periods, with negligible changes in seasonal rainfall totals. This intensification of the rainfall regime is expected to alter near‐surface water availability, which will affect plant performance and carbon uptake. This could be especially important in peatland systems, where large stores of carbon are tightly coupled to water surpluses limiting decomposition. Here, we examined the role of precipitation frequency on vegetation growth and carbon dioxide (CO2) balances for communities dominated by a Sphagnum moss, a sedge, and an ericaceous shrub in a cool temperate poor fen. Field plots and laboratory monoliths received one of three rainfall frequency treatments, ranging from one event every three days to one event every 14 days, while total rain delivered in a two‐week cycle and the entire season to each treatment remained the same. Separating incident rain into fewer but larger events increased vascular cover in all peatland communities: vascular plant cover increased 6× in the moss‐dominated plots, nearly doubled in the sedge plots, and tripled in the shrub plots in Low‐Frequency relative to High‐Frequency treatments. Gross ecosystem productivity was lowest in moss communities receiving low‐frequency rain, but higher in sedge and shrub communities under the same conditions. Net ecosystem exchange followed this pattern: fewer events with longer dry periods increased CO2 flux to the atmosphere from the moss while vascular plant‐dominated communities became more of a sink for CO2. Results of this study suggest that changes to rainfall frequency already occurring and predicted to continue will lead to increased vascular plant cover in peatlands and will impact their carbon‐sink function.