bluuebunny/crossref_metadata_2025_split huggingface dataset:
Costs of cancer care in children and adolescents in Ontario, Canada
Authors: de Oliveira Claire , Bremner Karen E. , Liu Ning , Greenberg Mark L. , Nathan Paul C. , McBride Mary L. , Krahn Murray D. 
Published: May 2017

AbstractBackgroundCancer in children and adolescents presents unique issues regarding treatment and survivorship, but few studies have measured economic burden. We estimated health care costs by phase of cancer care, from the public payer perspective, in population‐based cohorts.MethodsChildren newly diagnosed at ages 0 days–14.9 years and adolescents newly diagnosed at 15–19.9 years, from January 1, 1995 to June 30, 2010, were identified from Ontario cancer registries, and each matched to three noncancer controls. Data were linked with administrative records describing resource use for cancer and other health care. Total and net (patients minus controls) resource‐specific costs ($CAD2012) were estimated using generalized estimating equations for four phases of care: prediagnosis (60 days), initial (360 days), continuing (variable), final (360 days).ResultsMean ages at diagnosis were 6 years for children (N = 4,606) and 17 years for adolescents (N = 2,443). Mean net prediagnosis phase 60‐day costs were $6,177 for children and $1,018 for adolescents. Costs for initial, continuing, and final phases were $138,161, $15,756, and $316,303 per 360 days for children, and $62,919, $7,071, and $242,008 for adolescents. The highest initial phase costs were for leukemia patients ($156,225 per 360 days for children and $171,275 for adolescents). The final phase was the most costly ($316,303 per 360 days for children and $242,008 for adolescents).ConclusionsCosts for children with cancer are much higher than for adolescents and much higher than those reported in adults. Comprehensive population‐based long‐term estimates of cancer costs are useful for health services planning and cost‐effectiveness analysis.
Predictors of Response in Emergency Department Patients Receiving Intravenous Opioids for Severe Pain
Authors: Radcliff Jacob A. , Rafeq Rachel M. , Bowen Jane F. , Pontiggia Laura , Sen Sanchita 
Published: May 2017

The primary objective of this study was to identify significant environmental and patient characteristics of emergency department (ED) patients who responded to intravenous (IV) hydromorphone and IV morphine for severe pain. Secondary objectives were to investigate the individual effect of the significant environmental and patient characteristics of responders, and to assess the nature and strength of the correlation of initial dose and change in pain score from arrival to pre‐administration. A retrospective chart review was performed in patients who received IV hydromorphone or morphine in the ED for severe pain. Key evaluated patient characteristics included patient demographics, recent opioid use, history of drug or alcohol abuse, and pain location, among others. Key evaluated environmental characteristics included initial opioid administered, time to first dose, initial pain score, and initial dose of opioid administered, among others. Environmental and patient characteristics associated with response to pain management were first identified using bivariate analyses and then entered into a multiple stepwise logistic regression mode. Patients were excluded if they were younger than 18 years, did not have a follow‐up pain score within 2 hours of drug administration, or if they were discharged from the ED within 1 hour of administration. Patients meeting the inclusion criteria were grouped into two cohorts based on response and lack of response to treatment. A total of 200 patients were included. A decrease in pain score from arrival until pre‐administration pain score and an inactive tobacco history had a positive association with response (odds ratio [OR] 1.488, 95% confidence interval [CI] 1.088–2.036, p=0.013, and OR 1.835, 95% CI 0.801–4.200, overall p=0.022, respectively). A higher initial dose and an active tobacco history had a negative association with response (OR 0.715, 95% CI 0.580–0.881, p=0.002, and OR 0.582, 95% CI 0.296–1.144, overall p=0.022, respectively). Two characteristics were associated with response to IV opioid pain management in the ED, inactive tobacco history and an increase in pain score from arrival until pre‐administration, and two characteristics were associated with nonresponse to IV opioid pain management in the ED, active tobacco history and a higher initial dose. Previous literature supports both characteristics identified as risk factors but does not support either characteristic identified as protective factors, prompting the need for further research.
Triple responsive block copolymers combining pH‐responsive, thermoresponsive, and glucose‐responsive behaviors
Authors: Brooks William L. A. , Vancoillie Gertjan , Kabb Christopher P. , Hoogenboom Richard , Sumerlin Brent S. 
Published: May 2017

ABSTRACTPolymers with multiple tunable responses were achieved by incorporating boronic acid functionality along the backbone of a thermoresponsive polymer. The inherent Lewis acidity and diol‐sensitivity of boronic acid moieties allowed these polymers to respond to changes in pH and glucose concentration. Through reversible addition‐fragmentation chain transfer copolymerization of boronic acid‐containing monomers with N‐isopropylacrylamide, well‐defined block copolymers were synthesized containing a hydrophilic N,N‐dimethylacrylamide block and a second, responsive block with temperature‐dependent water solubility, making the resulting polymers capable of self‐assembly into nanostructures upon heating. By incorporating boronic acids within the thermoresponsive block, the cloud point of the polymer depended on the solution conditions, including pH and diol concentration, allowing tunable cloud point ranges. © 2017 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2017, 55, 2309–2317
Fundamental trade-offs between information flow in single cells and cellular populations
Authors: Suderman Ryan , Bachman John A. , Smith Adam , Sorger Peter K. , Deeds Eric J. 
Published: May 2017

Significance
The function of signal transduction networks is to detect changes in the extracellular environment and combine this with information on intracellular state and thereby control cell-fate decisions. Recent evidence suggests that high levels of biochemical noise in eukaryotic signaling networks interfere with information transmission, making it unclear how cell fate is correctly controlled. Here, we show that high noise levels are advantageous when a system needs to regulate the behavior of populations of cells using noisy biological signals. In contrast, when the key biological unit is a single cell, we show that the impact of noise on cellular responses is much less pronounced. Understanding how noise is generated and exploited advances our understanding of information processing in cells.
Combined HMG-COA reductase and prenylation inhibition in treatment of CCM
Authors: Nishimura Sayoko , Mishra-Gorur Ketu , Park JinSeok , Surovtseva Yulia V. , Sebti Said M. , Levchenko Andre , Louvi Angeliki , Gunel Murat 
Published: May 2017

Significance
Cerebral cavernous malformations (CCMs) are common vascular anomalies of the central nervous system that can lead to seizures, focal neurological deficits, and brain hemorrhage. Clinical options are limited mainly to treatment of symptoms or surgical resection, and targeted pharmacological therapy is lacking. Here we undertake a high-throughput screen and identify fluvastatin and zoledronate, two drugs already approved for clinical use for other indications, which act synergistically to reverse outcomes of CCM3 loss. Used in combination, fluvastatin and zoledronate effectively attenuate neural and vascular deficits in mouse models of CCM in vivo, significantly reducing formation of lesions and extending longevity. Our studies suggest that combined therapy targeting the mevalonate pathway might have therapeutic effects in CCM disease.
Impact of an Integrated Antibiotic Allergy Testing Program on Antimicrobial Stewardship: A Multicenter Evaluation
Authors: Trubiano Jason A , Thursky Karin A , Stewardson Andrew J , Urbancic Karen , Worth Leon J , Jackson Cheryl , Stevenson Wendy , Sutherland Michael , Slavin Monica A , Grayson M Lindsay , Phillips Elizabeth J 
Published: May 2017

SummaryAn integrated antibiotic allergy testing program resulted in increased prescribing of narrow-spectrum β-lactams and reduction in restricted antibiotics and inappropriate prescriptions. The program effectively and safely de-labeled patients, with >80% of antibiotic allergy labels removed following testing.
Association Between Neurotrophic Factor Expression and Pain-Related Behavior Induced by Nucleus Pulposus Applied to Rat Nerve Root
Authors: Seki Shinobu , Sekiguchi Miho , Konno Shin-ichi 
Published: May 2017

Study Design.
An experimental animal study.

Objective.
To investigate the relationship between pain-related behavior and the expression of neurotrophic factors in the dorsal root ganglion (DRG) and spinal cord (SC) using a nucleus pulposus (NP) rat model.

Summary of Background Data.
Neurotrophic factors are released from activated glial cells and are associated with pain-related behavior. Nerve growth factor (NGF) is a neurotrophic factor that is induced by inflammation.

Methods.
Rats were divided into an NP group (n = 94) and a sham-operated group (n = 46). NP harvested from the tail was applied to the left L5 DRG. Rats in the NP group were then divided into five subgroups: one non-treatment and four treatment groups. In the treatment groups, a dose of anti-NGF antibody or phosphate-buffered saline was administered into the DRG. Behavioral testing was performed to investigate the mechanical withdrawal threshold of the left hind paw for all groups. Immunohistochemical localization of NGF, phosphorylated p38 (p38), and brain-derived neurotrophic factor (BDNF) in the DRGs and SCs was performed, and the numbers of immunoreactive (IR) cells were counted.

Results.
The withdrawal threshold in the nontreatment NP group was significantly decreased for 35 days, and that of the middle- and high-dose treatment rats was significantly higher than the phosphate-buffered saline group values. In the DRG, NGF-IR, p38-IR, and BDNF-IR cells were increased for days 21. In the SC, BDNF-IR, and p38-IR cells were increased from days 7 to 21.

Conclusion.
In the DRG, NGF expression increased, mechanical thresholds were reduced, and p38 and BDNF expression was increased in the NP group. p38 and BDNF expression was increased in SC neurons during the same period. Inhibition of NGF may be a potential treatment for neuropathic pain due to lumbar disc herniation.

Level of Evidence: 5
T1D Autoantibodies: room for improvement?
Authors: Yu Liping , Zhao Zhiyuan , Steck Andrea K. 
Published: May 2017

Purpose of review
Type 1 diabetes (T1D) is now predictable by measuring major islet autoantibodies (IAbs) against insulin and other pancreatic β cells proteins including GAD65 (GADA), islet antigen 2 (IA-2A), and zinc transporter 8 (ZnT8A). The assay technology for IAbs has made great progress; however, several important aspects still need to be addressed and improved.

Recent findings
Currently a radio-binding assay has been well established as the ‘gold’ standard assay for all four IAbs. New generation of nonradioactive IAb assay with electrochemiluminescence technology has been shown to further improve sensitivity and disease specificity. Recently, multiplexed assays have opened the possibility of more efficient screening in large populations. Identification of potential new autoantibodies to neo-antigens or neo-epitopes posttranslational modification is a new important field to be explored.

Summary
Individuals having a single positive autoantibody are at low risk for progression to T1D, whereas individuals expressing two or more positive autoantibodies, especially on multiple tests over time, have nearly 100% risk of developing clinical T1D when followed for over two decades. More efficient and cost effective IAb assays will hopefully lead to point-of-care screening in the general population.
Cosmetic bone contouring
Authors: Rodman Regina 
Published: May 2017

Purpose of review
In recent years, cosmetic bone contouring surgery has become increasingly popular, especially in East Asian countries. These procedures are also being requested by patients in the United States at an increasing rate. The purpose of this study is to provide an overview of what is involved with these procedures and their potential complications.

Recent findings
In some cultures, a wide jaw and a square face are aesthetically unpleasing, whereas an ovoid or ‘melon seed face’ is thought to be feminine, delicate and beautiful. Mandibular angloplasty, mandibular lateral cortex excision, reduction malarplasty, as well as genioplasty may be performed to alter the facial contour and bring about dramatic results.

Summary
Whether a surgeon choses to incorporate these procedures into practice or not, the craniofacial surgeons should be familiar with the procedures as well as the potential complications.
Update on injectables in the nose
Authors: Wang Leo L. , Friedman Oren 
Published: May 2017

Purpose of review
The use of injectable fillers for nonsurgical rhinoplasty has increased tremendously over the past decade. This review describes the most commonly used fillers and their indications in the context of recent reports of both their successes and failures.

Recent findings
Hyaluronic acid and calcium hydroxylapatite are the two most commonly used fillers for injection. Recent studies have found that most injectable fillers are met with success and patient satisfaction, but vascular complications are still a serious problem of which physicians should be wary.

Summary
Injectable fillers should continue to be considered for patients on a case-by-case basis, but physicians should be knowledgeable of the various filler types, their indications, and injection technique to prevent serious complications.
An update on the impact of food allergy on anxiety and quality of life
Authors: Shaker Marcus S. , Schwartz Jonathan , Ferguson Morgan 
Published: May 2017

Purpose of review
Food allergies have become more common, and management involves dietary avoidance that can impair quality of life. Patients and families must manage the daily risk of anaphylaxis at each meal. The purpose of this review is to describe the impact of food allergies on quality of life and to provide an update on new developments in food allergy management, particularly peanut allergy.

Recent findings
Food allergy requires careful avoidance of common and ubiquitous dietary allergens. Living with food allergy is associated with annual economic costs in excess of $4000 per child, in addition to risks of anxiety and depressive symptoms. An expert panel sponsored by the 2017 National Institute of Allergy and Infectious Diseases published addendum guidelines for the prevention of peanut allergy, which suggest three separate approaches to peanut protein introduction for infants at various levels of risk.

Summary
Clinicians must be aware of underappreciated burdens faced by children and families with food allergies. Management involves a partnership between primary and specialty care. Mitigation strategies to improve quality of life for patients include efforts to avoid overdiagnosis in synergy with balanced counseling about the risks of food allergies. Experimental food allergen desensitization can improve quality of life but remains investigational at this time. For patients with significant anxiety, interdisciplinary management involving professional counseling may be helpful. Risk stratification and early introduction of peanut protein can help prevent the development of peanut allergy.
The opioid epidemic and national guidelines for opioid therapy for chronic noncancer pain: a perspective from different continents
Authors: Häuser Winfried , Schug Stephan , Furlan Andrea D. 
Published: May 2017

Abstract

Introduction:
A marked rise in opioid prescriptions for patients with chronic noncancer pain (CNCP) with a parallel increase in opioid abuse/misuse, and resulting deaths was noted in the Unites states in the past decade (opioid epidemic). In response, the US Center of Diseases Control (CDC) developed a guideline for prescribing of opioids for patients with CNCP.

Objectives:
To assess (1) if there is an opioid epidemic in Australia, Canada, and Germany (2) to compare Australian, Canadian, German, and Center of Diseases Control guidelines recommendations for long-term opioid therapy for CNCP.

Methods:
National evidence-based guidelines and PubMed were searched for recommendations for opioid prescriptions for CNCP.

Results:
There are signs of an opioid epidemic in Australia and Canada, but not in Germany. Guidelines in all 4 countries provide similar recommendations: opioids are not the first-line therapy for patients with CNCP; regular clinical assessments of benefits and harms are necessary; excessive doses should be avoided (recommended morphine equivalent daily doses range from 50 to 200 mg/d); stopping rules should be followed. All guidelines do not recommend the use of opioids in chronic pain conditions without an established nociceptive or neuropathic cause such as fibromyalgia and primary headache.

Conclusion:
Implementation of opioid prescribing guidelines should ensure that physicians prescribe opioids only for appropriate indications in limited doses for selected patients and advice patients on their safe use. These measures could contribute to reduce prescription opioid misuse/abuse and deaths.
Cytomegalovirus disease in hematopoietic stem cell transplant patients: current and future therapeutic options
Authors: Fuji Shigeo , Einsele Hermann , Kapp Markus 
Published: May 2017

Purpose of review
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has become one of the standard treatment for hematological diseases. Although the clinical outcome has improved significantly during the last decades, the morbidity and mortality after allo-HSCT are still obstacles to cure. Out of major morbidities, opportunistic virus infections such as cytomegalovirus (CMV) infection are important complications, in particular in patients who received human leukocyte antigen-mismatched HSCT. Here, we aim to summarize information about current and future therapeutic options in CMV disease after allo-HSCT.

Recent findings
Recently, not only new drugs but also adoptive T-cell therapy are tested in the setting of clinical trials. CMV prophylaxis using letermovir significantly reduced the incidence of CMV disease in comparison to placebo in a phase III clinical trial. Meanwhile, adoptive T-cell therapies which are fully adapted to good manufacturing practice (GMP) conditions are now available. A recent multicenter study in Germany showed a promising result using Streptamer-isolated T-cell therapy.

Summary
With the recent development of CMV-targeted therapy, treatment strategies of CMV infection would be further sophisticated in the near future.

Video abstract

http://links.lww.com/COID/A19.
Automated surveillance of healthcare-associated infections: state of the art
Authors: Sips Meander E. , Bonten Marc J.M. , van Mourik Maaike S.M. 
Published: May 2017

Purpose of review
This review describes recent advances in the field of automated surveillance of healthcare-associated infections (HAIs), with a focus on data sources and the development of semiautomated or fully automated algorithms.

Recent findings
The availability of high-quality data in electronic health records and a well-designed information technology (IT) infrastructure to access these data are indispensable for successful implementation of automated HAI surveillance. Previous studies have demonstrated that reliance on stand-alone administrative data is generally unsuited as sole case-finding strategy. Recent attempts to combine multiple administrative and clinical data sources in algorithms yielded more reliable results. Current surveillance practices are mostly limited to single healthcare facilities, but future linkage of multiple databases in a network may allow interfacility surveillance. Although prior surveillance algorithms were often straightforward decision trees based on structured data, recent studies have used a wide variety of techniques for case-finding, including logistic regression and various machine learning methods. In the future, natural language processing may enable the use of unstructured narrative data.

Summary
Developments in healthcare IT are rapidly changing the landscape of HAI surveillance. The electronic availability and incorporation of routine care data in surveillance algorithms enhances the reliability, efficiency and standardization of surveillance practices.
Oral diseases: a 14-year experience of a Chilean institution with a systematic review from eight countries
Authors: Rivera César , Jones-Herrera Carolina , Vargas Pablo , Venegas Bernardo , Droguett Daniel 
Published: May 2017

ABSTRACTBACKGROUNDRetrospective studies to assess the distribution of oral diseases (ODs) are helpful in estimating the prevalence of oral diagnoses in the population, and thus help in preventive and curative services. Prevalence and frequency data for ODs are available from many countries, but information from Chile is scarce.METHODSThis study investigated the frequency of ODs in a Chilean population. For this, we included all patients treated at the University of Talca (UTALCA, Chile) between 2001 and 2014. Patient characteristics were retrieved from medical files. To contextualize our results, we conducted a systematic review (SystRev) using Publish or Perish software (PoP), Google Scholar and MEDLINE/PubMed.RESULTSOne hundred sixty-six ODs were diagnosed, and the most prevalent groups were soft tissue tumours, epithelial pathology and salivary gland pathology. Individually, irritation fibroma, oral lichen planus (OLP) and mucocele were the most common diagnoses. ODs frequently affected unspecified parts of the mouth (including cheek, vestibule and retromolar area), gum, lips, tongue and palate. In the SystRev, the more studied diagnoses were leukoplakia, OLP and recurrent aphthous stomatitis; prevalent lesions included Fordyce’s spots, recurrent aphthous stomatitis and fissured tongue. Chilean patients and SistRev shared almost all ODs.CONCLUSIONThe results reflect ODs diagnosed in a specialized service of oral pathology and medicine in Chile and will allow the establishment of preventive/curative policies, adequate health services and dentistry curriculum.