bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for Medical and Surgical Complications Following Single-Level ALIF
Authors: Choy Winward , Barrington Nikki , Garcia Roxanna M. , Kim Robert B. , Rodriguez Heron , Lam Sandi , Dahdaleh Nader , Smith Zachary A. 
Published: April 2017

Study Design: Retrospective cohort study. Objective: The objective of the study was to determine rates of medical and surgical postoperative complications following anterior lumbar interbody fusion (ALIF) along with their associated predictors. Methods: Using the American College of Surgeons National Surgical Quality Improvement database, patients who underwent single-level ALIF surgery from 2006 to 2013 were identified. The 30-day rate of postoperative medical and surgical complications along with associated risk factors were evaluated by multivariable logistic regression. Results: In total, 1474 patients were included in the analysis. The overall rate of complications was 14.5%. The medical complication rate was 12.7%, while the surgical complication rate was 2.8%. Predictors of surgical complications were diabetes (odds ratio [OR] = 2.79, 95% CI = 1.20-6.01, P = .009), corticosteroid dependence (OR = 4.94, 95% CI = 1.73-14.08, P = .003), and preoperative transfusion of >4 units (OR = 7.12, 95% CI = 1.43-35.37, P = .016). Predictors of medical complications were longer operative times (OR = 4.25, 95% CI = 2.90-6.24, P < .001), preoperative anemia (OR = 2.29, 95% CI = 1.50-3.50, P < .001), >10% weight loss prior to surgery (OR = 6.79, 95% CI = 1.01-45.93, P = .049), and more severe American Society of Anesthesiologists classification (OR = 2.18, 95% CI = 1.54-3.11, P < .001). Conclusions: The present study determines postoperative medical and surgical complications among patients undergoing ALIF. The risk factors elucidated in this study indicate that clinical practices to curtail complications should be targeted toward patients with preoperative anemia, weight loss, corticosteroid dependence, and toward those at risk for perioperative transfusions.
Effect of Cervical Sagittal Balance on Laminoplasty in Patients With Cervical Myelopathy
Authors: Kato Minori , Namikawa Takashi , Matsumura Akira , Konishi Sadahiko , Nakamura Hiroaki 
Published: April 2017

Study Design: Retrospective clinical study. Objective: We evaluated the relationship between cervical sagittal alignment parameters and clinical status in patients with cervical myelopathy and analyzed the effect of cervical sagittal balance on cervical laminoplasty. Methods: Patients with cervical myelopathy (n = 110) who underwent laminoplasty were included in this study. The relationship between cervical sagittal alignment parameters and clinical status was evaluated. The changes in radiographic cervical sagittal parameters and clinical status 2 years after surgery were compared between patients with preoperative C2-7 SVA ≥35 mm (group A) and those with preoperative C2-7 SVA <35 mm (group B). Results: Preoperatively, C2-7 SVA had no correlation with defined health-related quality of life evaluation scores. At 2-year follow-up, the improvement in SF-36 physical component summary was significantly lower in group A than in group B. The postoperative change of C2-7 SVA did not significantly differ in 2 groups. Patients in group A maintained cervical regional balance after laminoplasty but experienced extensive postoperative neck pain. Conclusions: Our patients with a C2-7 SVA of ≥35 mm maintained cervical regional balance after laminoplasty and their improvement in myelopathy was equivalent to that in patients with a C2-7 SVA of <35 mm. However, the patents with a C2-7 SVA of ≥35 mm experienced severe postoperative neck pain. C2-7 SVA is a parameter worth considering because it can lead to poor QOL and axial neck pain after laminoplasty.
Anti-apoptotic effect of dexamethasone in an ototoxicity model
Authors: Lee Jin Ho , Oh Se Heang , Kim Tae Ho , Go Yoon Young , Song Jae-Jun 
Published: April 2017

Abstract

Background
Dexamethasone (DEX) is used for the treatment of various inner ear diseases. However, the molecular mechanism of DEX on gentamicin induced hair cell damage is not known. Therefore, this study investigated the protective effect of DEX on gentamicin (GM)-induced ototoxicity and the effect of GM on the expression of apoptosis related genes.

Methods
The protective effects of DEX were measured by phalloidin staining of explant cultures of organ of Corti from postnatal day 2–3 mice with GM-induced hair cell loss. Terminal deoxynucleotidyl transferase dUTP nick end labeling staining was used to detect apoptosis and immunofluorescence was done to analyze the effect of DEX on the expression of apoptosis related genes.

Results
Cochlear explant cultures of postnatal day-4-old mice were exposed to 0, 1, 5, 10, 30, 50, and 100 μg/ml DEX and GM during culture. DEX protected from GM-induced hair cell loss in the inner ear of postnatal day 4 mice. To understand the molecular mechanisms by which DEX pre-treatment decreased hair cell loss, the testes of cochlear explant cultures of postnatal day 4 mice were examined for changes in expression of cochlear apoptosis mediators. The pro-apoptotic protein Bax was significantly down-regulated and numbers of apoptotic hair cells were decreased.

Conclusions
DEX has a protective effect on GM-induced hair cell loss in neonatal cochlea cultures and the protective mechanism may involve inhibition of the mitochondrial apoptosis pathway. The combination with scaffold technique can improve delivery of DEX into the inner ear to protect GM-induced ototoxicity.
Clinical Significance of Androgen Receptor Splice Variant-7 mRNA Detection in Circulating Tumor Cells of Men With Metastatic Castration-Resistant Prostate Cancer Treated With First- and Second-Line Abiraterone and Enzalutamide
Authors: Antonarakis Emmanuel S. , Lu Changxue , Luber Brandon , Wang Hao , Chen Yan , Zhu Yezi , Silberstein John L. , Taylor Maritza N. , Maughan Benjamin L. , Denmeade Samuel R. , Pienta Kenneth J. , Paller Channing J. , Carducci Michael A. , Eisenberger Mario A. , Luo Jun 
Published: April 2017

Purpose We reported previously that the detection of androgen receptor splice variant-7 (AR-V7) mRNA in circulating tumor cells (CTCs) correlated with poor outcomes from the use of abiraterone and enzalutamide in patients with castration-resistant prostate cancer (CRPC). Here, we expanded our cohort size to better characterize the prognostic significance of AR-V7 in this setting. Methods We prospectively enrolled 202 patients with CRPC starting abiraterone or enzalutamide and investigated the prognostic value of CTC detection (+ v –) and AR-V7 detection (+ v –) using a CTC-based AR-V7 mRNA assay. We examined ≥ 50% prostate-specific antigen (PSA) responses, PSA progression-free survival, clinical and radiologic progression-free survival, and overall survival. We constructed multivariable models adjusting for PSA, Gleason sum, number of prior hormone therapies, prior abiraterone or enzalutamide use, prior taxane use, presence of visceral metastases, and Eastern Cooperative Oncology Group score. We also separately examined the first-line and second-line novel hormonal therapy (NHT) settings. Results Median follow-up times were 15.0, 21.7, and 14.6 months for CTC–, CTC+/AR-V7– and CTC+/AR-V7+ patients, respectively. CTC+/AR-V7+ patients were more likely to have Gleason scores ≥ 8 ( P = .05), metastatic disease at diagnosis ( P = .01), higher PSA ( P < .01), prior abiraterone or enzalutamide use ( P = .03), prior taxane use ( P = .02), and Eastern Cooperative Oncology Group ≥ 1 ( P = .01). Outcomes for the overall cohort (and separately for the first-line and second-line NHT cohorts) were best for CTC– patients, intermediate for CTC+/AR-V7– patients, and worse for CTC+/AR-V7+ patients. These correlations remained significant in multivariable models. Conclusion This expanded analysis further characterizes the importance of CTC-based AR-V7 mRNA detection in predicting outcomes in patients with CRPC receiving first- and second-line NHT and, to the best of our knowledge, is the first to suggest that this assay be interpreted using three separate prognostic categories: CTC–, CTC+/AR-V7–, and CTC+/AR-V7+.
Pain With Different Ablation Techniques in Healthy Cervical Tissue
Authors: Alfaro Karla , Ore Ana Sofia , Zevallos Albert , Salinas Manuel , Garai Jillian , Cremer Miriam 
Published: April 2017

Abstract 21 Background: Traditional cryotherapy and thermoablation are safe and effective treatments for precancerous cervical lesions. Women can present with short-term pain during and after the procedures. Comparing conventional treatments with CryoPen (CryoPen, Corpus Christi, TX) will stablish efficacy and adverse effects with the goal of developing low-cost, effective treatments for developing countries. We undertook this work to determine pain after treatment with conventional cryotherapy with CO2, the CryoPen adapted for low-resource settings, and the thermocoagulator. Methods: One hundred twenty-five women age 25 to 65 years who were scheduled for hysterectomy for indications other than cervical pathology were randomly assigned to one of five treatment arms: single- and double-freeze arms for conventional cryotherapy and the adapted CryoPen, and a single application of thermoablation at 100° C for 40 seconds. Treatment was administered 12 to 24 hours before hysterectomy. By using the verbal numerical pain scale, treating physicians asked participants to rate their pain intensity from 0 to 10. Results: To date, 118 pain scores have been collected—23 single-freeze and 25 double-freeze conventional cryotherapy; 23 single-freeze and 25 double-freeze CryoPen; and 22 thermoablation. Pain ranged from 0 to 3 for single-freeze cryotherapy, 0 to 4 for double-freeze cryotherapy, 0 to 6 for single-freeze CryoPen, 1 to 8 for double-freeze CryoPen, and 2 to 8 for thermoablation. In descending order of median pain scores, thermoablation (3) was followed by double-freeze CryoPen (2.5), single-freeze CryoPen and double-freeze conventional cryotherapy (both 2), and single-freeze conventional cryotherapy ( Fig 1 ). Conclusion: Both conventional cryotherapy and CryoPen are less painful ablation techniques compared with thermoablation. Lower pain ratings for single-freeze compared with double-freeze strategies with both conventional cryotherapy and CryoPen support further research into the rationale for the traditional double-freeze regimen. [Figure: see text] AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST Karla Alfaro No relationship to disclose Ana Sofia Ore No relationship to disclose Albert Zevallos No relationship to disclose Manuel Salinas No relationship to disclose Jillian Garai No relationship to disclose Miriam Cremer Honoraria: Merck Speakers' Bureau: Merck
Depth of Necrosis Using Different Ablation Techniques in Healthy Cervical Tissue
Authors: Cremer Miriam , Alfaro Karla , Maza Mauricio , Castle Philip E. , Zevallos Albert , Diaz de Uriarte Ana Cecilia , Alvarez Manuel , Salinas Manuel , Ore Ana Sofia , Taxa Luis , Felix Juan 
Published: April 2017

Abstract 22 Background: Screening followed by treatment has been a key contributor to the reduction of cervical cancer in industrialized countries and is critical to reduce its burden in low-resource countries. Screening technologies that are appropriate for low-resource settings have advanced considerably; however, treatment technologies have lagged. Treatment methods that are used in developing countries must be low cost, effective, and adaptable for areas with limited infrastructure and health care providers. This study was performed to determine the depth of necrosis in cervical tissue achieved with three treatment devices: conventional cryotherapy with CO2, the CryoPen (CryoPen, Corpus Christi, TX) adapted for low-resource settings, and the thermocoagulator. Methods: One hundred twenty-five women who were scheduled for hysterectomy for indications other than cervical pathology were randomly assigned to one of five treatment arms: single-freeze arms and double-freeze arms for both conventional cryotherapy and the adapted CryoPen, and a single application of thermoablation at 100° C for 40 seconds. Treatment was administered 12 to 24 hours before hysterectomy. Depth of necrosis in cervical specimens was measured by pathologists who were blinded to the treatment modality. Results: A total of 119 women have been enrolled to date, and 114 specimens have been reviewed. Mean depth of necrosis is 5.1 mm (0.9 to 8.5 mm) for single-freeze cryotherapy, 5.6 mm (3.8 to 10.5 mm) for double-freeze cryotherapy, 4.9 mm (3.5 to 8.5 mm) for single-freeze adapted CryoPen; 4.5 mm (3.0 to 7.3 mm) for double-freeze adapted CryoPen, and 3.7 mm (1.9 to 5.5 mm) for the thermoablation ( Table 1 ). Conclusion: The depths of necrosis achieved with the three different ablation modalities are competitive and surpass the targeted depth of 3.5 mm established a priori. Results thus far have demonstrated that devices that are optimized for use in low-resource settings can be as effective as conventional cryotherapy in treating cervical intraepithelial neoplasia. [Table: see text] AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST Miriam Cremer Honoraria: Merck Speakers' Bureau: Merck Travel, Accommodations, Expenses: Merck Other Relationship: Basic Health International Karla Alfaro No relationship to disclose Mauricio Maza No relationship to disclose Philip E. Castle No relationship to disclose Albert Zevallos No relationship to disclose Ana Cecilia Diaz de Uriarte No relationship to disclose Manuel Alvarez No relationship to disclose Manuel Salinas No relationship to disclose Ana Sofia Ore No relationship to disclose Luis Taxa No relationship to disclose Juan Felix Expert Testimony: Johnson & Johnson, Philip Morris
High Urinary Polycyclic Aromatic Hydrocarbon Concentrations in Bomet County, Kenya, a Region With a High Incidence of Esophageal Squamous Cell Carcinoma
Authors: Pritchett Natalie R. , Murphy Gwen , Etemadi Arash , Burgert Stephen L. , Abnet Christian C. , Dawsey Sanford M. , Mwachiro Michael M. 
Published: April 2017

Abstract 43 Background: Polycyclic aromatic hydrocarbons (PAHs) are a group of more than 100 compounds that are formed during incomplete combustion of organic materials, many of which have been classified as known carcinogens. Exposure to PAHs has been suggested as an important risk factor for developing esophageal squamous cell carcinoma (ESCC) in several high-incidence areas, such as China and Iran, but corresponding PAH assessments have not been conducted in East Africa, another ESCC hot spot. To assess the internal uptake of PAH as a result of external exposures, body fluids and tissues can be monitored for PAHs or their metabolites. The primary aim of this study was to quantify the concentration of seven PAH urine metabolites in a cross-section of participants from Bomet, Kenya, an endemic area for ESCC. An additional aim was to assess demographic and lifestyle factors that may be associated with PAH metabolites. Methods: A community-based sample of 294 asymptomatic adults were recruited. Participants collected spot urine specimens and completed a questionnaire. Urine specimens were analyzed at the National Center for Environmental Health at the Centers for Disease Control—the same lab has performed similar analyses on urine samples from the US National Health and Nutrition Examination Survey (NHANES). The seven PAH analytes were hydroxylated metabolites of naphthalene, fluorene, phenanthrene, and pyrene. Median creatinine-adjusted PAH metabolite concentrations (nanogram per gram of creatinine) were compared by all relevant questionnaire items. Results: All seven measured PAH metabolites in the study population were markedly elevated compared with the US population. For example, the median value for 1-hydroxypyrene in Bomet was 1,190 ng/g in males versus 106 ng/g in NHANES, and 2,840 ng/g in females versus 133 ng/g in NHANES. Age (< 50 years), sex (female), and performing indoor cooking were significantly ( P < .01) associated with higher PAH concentrations for all measured metabolites. Regular tobacco use was not reported by many participants (19%) and was not associated with PAH concentrations. Conclusion: PAH metabolite concentrations in Bomet were high compared with the US population. Elevated PAH concentrations were associated with age, sex, and indoor cooking. Additional studies are needed to define the association between high PAH exposure and the risk of developing ESCC as well as to determine the sources of PAH exposure in this high-risk population. Funding: The African Organization for Research and Training in Cancer’s Beginning Investigator Grant for Catalytic Research (BIG Cat) Program, in collaboration with the US National Institutes of Health’s National Cancer Institute, Office of International Affairs. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.
Cervical Pap Smear Cytology at Kamuzu Central Hospital in Malawi: A Quality Assurance Study
Authors: Liauw Daniel , Dhungel Bal Mukunda , Tomoka Tamiwe , Krysiak Robert , Kampani Coxcilly , Chimzimu Fred , Fedoriw Yuri 
Published: April 2017

Abstract 53 Background: Cervical cancer remains the most common cancer in women of the developing world, largely as a result of a lack of screening. The gold standard screening test for cervical cancer, the Pap smear, has been effective in reducing cervical cancer incidence and mortality by identifying precancerous and cancerous lesions; however, little is known about quality assurance practices for gynecologic cytopathology in resource-limited settings. The goal of this study was to document baseline clinical and laboratory characteristics in the hope of improving the efficacy of cervical cancer screening and informing future quality improvement initiatives. Methods: A retrospective study of cervical cytology at Kamuzu Central Hospital, Malawi, from January 1, 2013, to April 30, 2016, was conducted. Results: Of 2,809 Pap smears processed, 2,396 (85.3%) samples were diagnostic, with 92.3% of nondiagnostic smears (381 of 413) deemed unsatisfactory because of improper collection techniques. The 18-month patient follow-up rate for unsatisfactory Pap smear was found to be 23.0% (n = 95), with repeat smears reflecting a similar satisfactory rate (n = 82; 86%). Of diagnostic Pap smears, 6.1% (n = 147) were premalignant, whereas 2.0% (n = 48) were malignant. Cytology-histology correlation was also investigated one the basis of the corresponding samples collected concurrently. Of 70 pairs, 55 pairs (78.6%) were concordant, whereas six (8.6%) and nine (12.9%) were majorly and minorly discordant, respectively. The sensitivity and specificity of the Pap smear as a screening test were 83.8% and 81.8%, respectively. Conclusion: The Pap smear is a sensitive and specific screening method for cervical cancer in our setting. We hope that documentation of baseline quality and services of cervical cytology will inform future quality assurance programs and assist other laboratories in the development of similar programs in resource-limited settings. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST Daniel Liauw No relationship to disclose Bal Mukunda Dhungel No relationship to disclose Tamiwe Tomoka No relationship to disclose Robert Krysiak No relationship to disclose Coxcilly Kampani No relationship to disclose Fred Chimzimu No relationship to disclose Yuri Fedoriw Honoraria: Alexion Pharmaceuticals Consulting or Advisory Role: Alexion Pharmaceuticals
Feasibility Study of Molecular Profiling of Gastric Cancer Specimens From Rwanda
Authors: Chamberlin Mary D. , Rugwizangoga Belson , DeAbreu Francine B. , Rutaganda Eric , Dusabejambo Vincent , Habyarimana Oswald , Bensen Steve , Tsongalis Gregory J. 
Published: April 2017

Abstract 51 Background: Gastric cancer is associated with high mortality in Rwanda. Geographic or genetic differences may lead to variations in somatic mutations and novel therapies. Overseas collaboration to determine gastric cancer molecular profiles is paramount. We undertook this work to determine the feasibility of collaboration between researchers in Rwanda and the United States by creating a research platform for gastric and other cancers in Rwanda. Methods: Patients consented for biopsy. Cases that were confirmed as gastric adenocarcinoma were included. Formalin-fixed paraffin-embedded tissue blocks or eight unstained sections (4 μm) were transported to the United States. DNA extraction and library preparation was performed by using 50 ng gDNA. Samples were normalized, pooled, and sequenced by using the Pillar NGS SLIMamp Lung Hot Spot Panel (Pillar Biosciences, Natick, MA). FASTq files were uploaded to Pillar Biosciences to perform sequence alignment, annotation, and variant classification. Results: Fifty-seven samples were received and 35 were excluded because of low DNA yield or quality (18 and 17, respectively). Mutations were detected in nine (41%) of 22 samples. One sample contained three mutations, other cases had one to two mutations identified. In total, 12 mutations were identified: TP53 (four), SMAD4 (two), ERBB4 (two; S341L and D228N), PTEN (two; K267RfsTer9 and C136Y), FBXW7 (one), and KRAS (one). Conclusion: Overseas collaboration for the molecular profiling of gastric cancer samples is feasible. Quality improved with larger biopsies or tissue blocks. Frequency of mutations is lower than expected. ERBB4 mutations identified are not known to be pathogenic. PTEN mutations are considered pathogenic—a potential target for therapy in larger trials. A larger fusion panel may be more effective in identifying potential targets. Funding: Pillar Biosciences provided reagents for sequencing. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST Mary D. Chamberlin Research Funding: Pillar Biosciences Belson Rugwizangoga No relationship to disclose Francine B. DeAbreu No relationship to disclose Eric Rutaganda No relationship to disclose Vincent Dusabejambo No relationship to disclose Oswald Habyarimana No relationship to disclose Steve Bensen No relationship to disclose Gregory J. Tsongalis Honoraria: Roche, ChromaCode, Foundation Medicine, Physician Choice Labs Consulting or Advisory Role: Baystate Health System, Jackson Laboratory for Genomic Medicine (Inst) Research Funding: Qiagen, Illumina, QuanDx, Leica Biosystems, Abbott Molecular, Affymetrix