bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined treatment of primary vitreoretinal lymphomas significantly prolongs the time to first relapse
Authors: Klimova Aneta , Heissigerova Jarmila , Rihova Eva , Brichova Michaela , Pytlik Robert , Spicka Ivan , Mrazova Katerina , Karolova Jana , Svozilkova Petra 
Published: January 2018

BackgroundVitreoretinal lymphomas belong to the family of central nervous system (CNS) lymphomas. The optimal approach for the treatment of isolated primary vitreoretinal lymphoma is unclear because of the lack of large comparative clinical series. Combination of intravitreal and systemic chemotherapy is recommended in many reports. The aim of our retrospective study was to compare the survival rate and prognosis of patients with vitreoretinal lymphoma with and without CNS involvement.MethodsTwenty patients with vitreoretinal lymphomas were observed between the years 2004and2016, 10 patients with primary vitreoretinal lymphoma and 10 with primary CNS lymphoma. To compare survival rates, we included 53 patients diagnosed with primary CNS lymphoma without vitreoretinal involvement between the years 2002and2011 from our haemato-oncology department.ResultsThe 5-year survival rate was estimated 71% in patients with vitreoretinal lymphoma in our observation. Significantly longer 5-year overall survival (P˂0.01) was observed in patients with vitreoretinal lymphoma compared with patients with primary CNS lymphoma without vitreoretinal involvement. Progression-free survival was almost equal in both groups of patients with primary vitreoretinal lymphoma and primary CNS lymphoma (P=0.363). The relapse of lymphoma was frequent (50%–60%) with the median time to first relapse of 31 months. Combined treatment (local and systemic) in patients without CNS involvement significantly prolonged progression-free survival in our study (P˂0.05).ConclusionCombined treatment of primary vitreoretinal lymphoma significantly delays the relapse of lymphoma compared with local therapy alone. Intraocular involvement brings significant positive prognostic value when overall survival is compared.
Protocol for Compass: a randomised controlled trial of primary HPV testing versus cytology screening for cervical cancer in HPV-unvaccinated and vaccinated women aged 25–69 years living in Australia
Authors: Canfell Karen , Saville Marion , Caruana Michael , Gebski Val , Darlington-Brown Jessica , Brotherton Julia , Heley Stella , Castle Philip E 
Published: January 2018

IntroductionAustralia’s National Cervical Screening Program (NCSP) currently recommends 2-year cytology in women aged 18–69 years. Following a review of the NCSP prompted by the implementation of human papillomavirus (HPV) vaccination, the programme will transition in 2017 to 5-year primary HPV screening with partial genotyping for HPV16/18 in women aged 25–74 years. Compass is a sentinel experience for the renewed NCSP and the first prospectively randomised trial of primary HPV screening compared with cytology to be conducted in a population with high uptake of HPV vaccination. This protocol describes the main Compass trial, which commenced after a pilot study of ~5000 women completed recruitment.Methods and analysisWomen aged 25–69 years will be randomised at a 1:2 allocation to (1) 2.5-year image-read, liquid-based cytology (LBC) screening with HPV triage of low-grade smears (active control Arm A) or (2) 5-year HPV screening with partial genotyping and referral of HPV16/18-positive women to colposcopy (intervention Arm B). Women in Arm B positive for other oncogenic HPV (not 16/18) will undergo secondary randomisation at a 1:1 allocation to either LBC or dual-stained (p16INK4aand Ki-67) cytology testing (dual-stained cytology). The primary outcome is cumulative CIN3+ (CIN3, adenocarcinoma in situ and invasive cervical cancer) following a 5-year HPV exit testing round in both arms, in women randomised to the HPV arm versus women randomised to the LBC arm, based on an intention-to-treat analysis. The primary outcome will first be tested for non-inferiority and if declared, the primary outcome will be tested for superiority. A total of 36 300 women in birth cohorts not offered vaccination and 84 700 women in cohorts offered vaccination will be recruited, bringing the final sample size to 121 000. The trial is powered for the secondary outcome of cumulative CIN3+ in screen-negative women, adjusted for censoring after CIN2+ treatment and hysterectomy.Ethics and disseminationApproved by the Bellberry Ethics Committee (2014-11-592). Findings will be reported in peer-reviewed journals and presented at scientific meetings.Trial registration numberNCT02328872; Pre-results.
Blood-based biomarkers of cancer-related cognitive impairment in non-central nervous system cancer: protocol for a scoping review
Authors: Mayo Samantha J , Kuruvilla John , Laister Rob C , Ayala Ana Patricia , Alm Mark , Byker Will , Kelly Debra Lynch , Saligan Leorey 
Published: January 2018

IntroductionCancer-related cognitive impairment (CRCI) can have detrimental effects on quality of life, even among patients with non-central nervous system (CNS) cancers. Several studies have been conducted to explore different markers associated with CRCI to understand its pathobiology. It is proposed that the underlying mechanisms of CRCI are related to a cascade of physiological adaptive events in response to cancer and/or treatment. Hence, peripheral blood would be a logical source to observe and identify these physiological events. This paper outlines the protocol for a scoping review being conducted to summarise the extant literature regarding blood-based biomarkers of CRCI among patients with non-CNS cancer.Methods/analysisMethods will be informed by the updated guidelines of Arksey and O’Malley. The systematic search for literature will include electronic databases, handsearching of key journals and reference lists, forward citation tracking and consultation with content experts. Study selection will be confirmed by duplicate review and calculation of inter-rater reliability. Data to be charted will include study design, sample size, cancer and treatment characteristics, demographic characteristics, cognitive variable/s and biomarkers assessed, associations between cognitive functioning and biomarkers (including statistics used), and rigour in biomarker sample collection and processing. Results will be presented through: (1) a descriptive numerical summary of studies, including a flow diagram based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement, (2) a list of blood-based biomarkers associated with CRCI and (3) a narrative overview developed through collaboration among the research team and consultation with content experts.DisseminationThe findings of this review will highlight current directions and gaps in the current body of evidence that may lead to improved rigour in future CRCI investigations. The dissemination of this work will be facilitated through the involvement of clinicians and researchers on the research team, an external consultation process and the presentation of the results through scholarly publication and presentation.
Epidurals in Pancreatic Resection Outcomes (E-PRO) study: protocol for a randomised controlled trial
Authors: Pak Linda Ma , Haroutounian Simon , Hawkins William G , Worley Lori , Kurtz Monika , Frey Karen , Karanikolas Menelaos , Swarm Robert A , Bottros Michael M 
Published: January 2018

IntroductionEpidural analgesia provides an important synergistic method of pain control. In addition to reducing perioperative opioid consumption, the deliverance of analgesia into the epidural space, effectively creating a sympathetic blockade, has a multitude of additional potential benefits, from decreasing the incidence of postoperative delirium to reducing the development of persistent postsurgical pain (PPSP). Prior studies have also identified a correlation between the use of epidural analgesia and improved oncological outcomes and survival. The aim of this study is to evaluate the effect of epidural analgesia in pancreatic operations on immediate postoperative outcomes, the development of PPSP and oncological outcomes in a prospective, single-blind, randomised controlled trial.MethodsThe Epidurals in Pancreatic Resection Outcomes (E-PRO) study is a prospective, single-centre, randomised controlled trial. 150 patients undergoing either pancreaticoduodenectomy or distal pancreatectomy will be randomised to receive an epidural bupivacaine infusion following anaesthetic induction followed by continued epidural bupivacaine infusion postoperatively in addition to the institutional standardised pain regimen of hydromorphone patient-controlled analgesia (PCA), acetaminophen and ketorolac (intervention group) or no epidural infusion and only the standardised postoperative pain regimen (control group). The primary outcome was the postoperative opioid consumption, measured in morphine or morphine-equivalents. Secondary outcomes include patient-reported postoperative pain numerical rating scores, trend and relative ratios of serum inflammatory markers (interleukin (IL)-1β, IL-6, tumour necrosis factor-α, IL-10), occurrence of postoperative delirium, development of PPSP as determined by quantitative sensory testing, and disease-free and overall survival.Ethics and disseminationThe E-PRO trial has been approved by the institutional review board. Recruitment began in May 2016 and will continue until the end of May 2018. Dissemination plans include presentations at scientific conferences and scientific publications.Trial registration numberNCT02681796.
Trends and determinants of length of stay and hospital reimbursement following knee and hip replacement: evidence from linked primary care and NHS hospital records from 1997 to 2014
Authors: Burn Edward , Edwards Christopher J , Murray David W , Silman Alan , Cooper Cyrus , Arden Nigel K , Pinedo-Villanueva Rafael , Prieto-Alhambra Daniel 
Published: January 2018

ObjectivesTo measure changes in length of stay following total knee and hip replacement (TKR and THR) between 1997 and 2014 and estimate the impact on hospital reimbursement, all else being equal. Further, to assess the degree to which observed trends can be explained by improved efficiency or changes in patient profiles.DesignCross-sectional study using routinely collected data.SettingNational Health Service primary care records from 1995 to 2014 in the Clinical Practice Research Datalink were linked to hospital inpatient data from 1997 to 2014 in Hospital Episode Statistics Admitted Patient Care.ParticipantsStudy participants had a diagnosis of osteoarthritis or rheumatoid arthritis.InterventionsPrimary TKR, primary THR, revision TKR and revision THR.Primary outcome measuresLength of stay and hospital reimbursement.Results10 260 primary TKR, 10 961 primary THR, 505 revision TKR and 633 revision THR were included. Expected length of stay fell from 16.0 days (95% CI 14.9 to 17.2) in 1997 to 5.4 (5.2 to 5.6) in 2014 for primary TKR and from 14.4 (13.7 to 15.0) to 5.6 (5.4 to 5.8) for primary THR, leading to savings of £1537 and £1412, respectively. Length of stay fell from 29.8 (17.5 to 50.5) to 11.0 (8.3 to 14.6) for revision TKR and from 18.3 (11.6 to 28.9) to 12.5 (9.3 to 16.8) for revision THR, but no significant reduction in reimbursement was estimated. The estimated effect of year of surgery remained similar when patient characteristics were included.ConclusionsLength of stay for joint replacement fell substantially from 1997 to 2014. These reductions have translated into substantial savings. While patient characteristics affect length of stay and reimbursement, patient profiles have remained broadly stable over time. The observed reductions appear to be mostly explained by improved efficiency.
Maternal and birth cohort studies in the Gulf Cooperation Council countries: protocol for a systematic review and narrative evaluation
Authors: Al-Rifai Rami H. , Ali Nasloon , Barigye Esther T. , Al Haddad Amal H. I. , Loney Tom , Al-Maskari Fatima , Ahmed Luai A. 
Published: January 2018

IntroductionCohort studies have revealed that genetic, socioeconomic, communicable and non-communicable diseases, and environmental exposures during pregnancy may influence the mother and her pregnancy, birth delivery and her offspring. Numerous studies have been conducted in the Gulf Cooperation Council (GCC) countries to examine maternal and birth health. The objectives of this protocol for a systematic review are to systematically review and characterise the exposures and outcomes that have been examined in the mother and birth cohort studies in the GCC region, and to summarise the strength of association between key maternal exposures during pregnancy (ie, body mass index) and different health-related outcomes (ie, mode of birth delivery). The review will then synthesise and characterise the consequent health implications and will serve as a platform to help identify areas that are overlooked, point out limitations of studies and provide recommendations for future cohort studies.Methods and analysisMedline, Embase, Cochrane Library and Web of Science electronic databases will be comprehensively searched. Two reviewers will independently screen each study for eligibility, and where discrepancies arise they will be discussed and resolved; otherwise a third reviewer will be consulted. The two reviewers will also independently extract data into a predefined Excel spreadsheet. The included studies will be categorised on the basis of whether the participant is a mother, infant or mother–infant dyad. Outcome variables will be divided along two distinctions: mother or infant. Exposure variables will be divided into six domains: psychosocial, biological, environmental, medical/medical services, maternal/reproductive and perinatal/child. Studies are expected to be of heterogeneous nature; therefore, quantitative syntheses might be limited.Ethics and disseminationThere is no primary data collection; therefore, ethical review is not necessary. The findings of this review will be disseminated in a peer-reviewed journal and presented at relevant conferences.PROSPERO registration numberCRD42017068910.
Residual cardiovascular risk in individuals on lipid-lowering treatment: quantifying absolute and relative risk in the community
Authors: Lieb Wolfgang , Enserro Danielle M , Larson Martin G , Vasan Ramachandran S 
Published: January 2018

ObjectiveThe residual cardiovascular disease (CVD) risk in individuals on long-term lipid-lowering treatment (LLT) in the general population is not well described.MethodsWe estimated absolute CVD risks by age and sex for different categories of low-density lipoprotein cholesterol (LDL-C) levels, stratified by LLT status, and assessed subclinical carotid atherosclerosis in 3012 Framingham Study participants (mean age, 58.4 years; 55% women) free of CVD. Individuals were categorised into five groups: (1) LDL-C <100 mg/dL without LLT; (2) LDL-C ≥100 mg/dL to <130 mg/dL without LLT; (3) LDL-C <130 mg/dL on LLT; (4) LDL-C ≥130 mg/dL without LLT; and (5) LDL-C ≥130 mg/dL on LLT.ResultsIndividuals in groups 3–5 had significantly more carotid atherosclerosis compared with group 1. During follow-up (median, 13.7 years), 548 CVD events occurred. Individuals on LLT (groups 3 and 5) had substantial residual CVD risk (26.7 (95% CI 19.5 to 34.0) and 24.1 (95% CI 16.2 to 31.9) per 1000 person-years, respectively), representing approximately three times the risk for untreated individuals with LDL <100 mg/dL (group 1: 9.0 (95% CI 6.8 to 11.3) per 1000 person-years). Absolute CVD risks rose with age and were slightly greater in men than in women. After adjustment for traditional risk factors, groups 3–5 displayed increased hazards for CVD (HR=1.47, 1.42 and 1.54, respectively) compared with group 1. Further adjustment for carotid atherosclerosis modestly attenuated these results.ConclusionsThere is substantial residual CVD risk in individuals on LLT, compared with participants with optimal LDL-C (<100 mg/dL), even when LDL-C levels <130 mg/dL are reached.
Optimal antiplatelet strategy after transcatheter aortic valve implantation: a meta-analysis
Authors: Ahmad Yousif , Demir Ozan , Rajkumar Christopher , Howard James P , Shun-Shin Matthew , Cook Christopher , Petraco Ricardo , Jabbour Richard , Arnold Ahran , Frame Angela , Sutaria Nilesh , Ariff Ben , Kanaganayagam Gajen , Francis Darrel , Mayet Jamil , Mikhail Ghada , Malik Iqbal , Sen Sayan 
Published: January 2018

ObjectiveInternational guidelines recommend the use of dual antiplatelet therapy (DAPT) after transcatheter aortic valve implantation (TAVI). The recommended duration of DAPT varies between guidelines. In this two-part study, we (1) performed a structured survey of 45 TAVI centres from around the world to determine if there is consensus among clinicians regarding antiplatelet therapy after TAVI; and then (2) performed a systematic review of all suitable studies (randomised controlled trials (RCTs) and registries) to determine if aspirin monotherapy can be used instead of DAPT.MethodsA structured electronic survey regarding antiplatelet use after TAVI was completed by 45 TAVI centres across Europe, Australasia and the USA. A systematic review of TAVI RCTs and registries was then performed comparing DAPT duration and incidence of stroke, bleeding and death. A variance weighted least squared metaregression was then performed to determine the relationship of antiplatelet therapy and adverse events.Results82.2% of centres routinely used DAPT after TAVI. Median duration was 3 months. 13.3% based their practice on guidelines. 11 781 patients (26 studies) were eligible for the metaregression. There was no benefit of DAPT over aspirin monotherapy for stroke (P=0.49), death (P=0.72) or bleeding (P=0.91).DiscussionAspirin monotherapy appears to be as safe and effective as DAPT after TAVI.
Probing Shells Against Buckling: A Nondestructive Technique for Laboratory Testing
Authors: Thompson J. Michael T. , Hutchinson John W. , Sieber Jan 
Published: January 2018

This paper addresses testing of compressed structures, such as shells, that exhibit catastrophic buckling and notorious imperfection sensitivity. The central concept is the probing of a loaded structural specimen by a controlled lateral displacement to gain quantitative insight into its buckling behavior and to measure the energy barrier against buckling. This can provide design information about a structure’s stiffness and robustness against buckling in terms of energy and force landscapes. Developments in this area are relatively new but have proceeded rapidly with encouraging progress.Recent experimental tests on uniformly compressed spherical shells, and axially loaded cylinders, show excellent agreement with theoretical solutions. The probing technique could be a valuable experimental procedure for testing prototype structures, but before it can be used a range of potential problems must be examined and solved. The probing response is highly nonlinear and a variety of complications can occur. Here, we make a careful assessment of unexpected limit points and bifurcations, that could accompany probing, causing complications and possibly even collapse of a test specimen. First, a limit point in the probe displacement (associated with a cusp instability and fold) can result in dynamic buckling as probing progresses, as demonstrated in the buckling of a spherical shell under volume control. Second, various types of bifurcations which can occur on the probing path which result in the probing response becoming unstable are also discussed. To overcome these problems, we outline the extra controls over the entire structure that may be needed to stabilize the response.
Random GUI Testing of Android Application Using Behavioral Model
Authors: Muangsiri Woramet , Takada Shingo 
Published: January 2018

Automated GUI testing based on behavioral model is one of the most efficient testing approaches. By mining user usage, test scenarios can be generated based on statistical models such as Markov chain. However, these works require static analysis before starting the exploration which requires too much prerequisites and time. To address these challenges, we propose a behavioral-based GUI testing approach for mobile applications that achieves faster and higher coverage. The proposed approach does not conduct static analysis. It creates a behavioral model from usage logs by applying a statistical model. The events within the behavioral model are mapped to GUI components in a GUI tree. Finally, it updates the model dynamically to increase the probability of an event that rarely or never occurs when users use the application. The proposed approach was evaluated on four open-source Android applications, and compared with the state-of-the-art tools and manual testing. The main evaluation criteria are code coverage and ability to find errors. The proposed approach performed better than the current state-of-the-art automated testing tools in most aspects.
Neutrophil Elastase-Derived Fibrin Degradation Products Indicate Presence of Abdominal Aortic Aneurysms and Correlate with Intraluminal Thrombus Volume
Authors: Lindquist Liljeqvist Moritz , Silveira Angela , Hultgren Rebecka , Frebelius Siw , Lengquist Mariette , Engström Jan , Gasser T. , Eriksson Per , Roy Joy 
Published: January 2018

Background The intraluminal thrombi (ILT) of abdominal aortic aneurysms (AAA) contain neutrophils, which can secrete elastase. We evaluated whether plasma neutrophil elastase-derived cross-linked fibrin degradation products (E-XDP) could reveal the presence, size and mechanical stress of AAAs and its ILTs.
Methods E-XDP and D-dimer were measured in plasma from 37 male patients with AAA and 42 male controls. The ILT volumes of the AAAs and any coexisting aneurysms could be measured in 29 patients and finite element analysis was performed to estimate mechanical stress of the ILT. E-XDP, neutrophil elastase and neutrophil marker CD66acd were evaluated in aortic tissue with immunohistochemistry (IHC). The association between ILT volume and E-XDP was validated in a separate cohort (n = 51).
Results E-XDP levels were elevated in patients with AAA compared with controls (p = 5.8e-13), indicated AAA with 98% sensitivity, 86% specificity and increased with presence of coexisting aneurysms. The association between AAA and increased E-XDP was independent of smoking, comorbidities and medication. E-XDP correlated with volume of all ILTs (r = 0.76, p = 4.5e-06), mean ILT stress (r = 0.46, p = 0.013) and the volume of the AAA-associated ILT (r = 0.64, p = 0.00017). E-XDP correlated stronger with ILT volume compared with D-dimer (r = 0.76 vs. r = 0.64, p = 0.018). The correlation between E-XDP and ILT volume was validated in the separate cohort (r = 0.53, p = 7.6e-05). IHC revealed E-XDP expression in the ILT, spatially related to neutrophil elastase and neutrophils.
Conclusion E-XDP is a marker of the presence of AAA and coexisting aneurysms as well as the volume and mechanical stress of the ILT.