bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep brain stimulation for Parkinson’s disease: defining the optimal location within the subthalamic nucleus
Authors: Bot Maarten , Schuurman P Richard , Odekerken Vincent J J , Verhagen Rens , Contarino Fiorella Maria , De Bie Rob M A , van den Munckhof Pepijn 
Published: January 2018

BackgroundIndividual motor improvement after deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson’s disease (PD) varies considerably. Stereotactic targeting of the dorsolateral sensorimotor part of the STN is considered paramount for maximising effectiveness, but studies employing the midcommissural point (MCP) as anatomical reference failed to show correlation between DBS location and motor improvement. The medial border of the STN as reference may provide better insight in the relationship between DBS location and clinical outcome.MethodsMotor improvement after 12 months of 65 STN DBS electrodes was categorised into non-responding, responding and optimally responding body-sides. Stereotactic coordinates of optimal electrode contacts relative to both medial STN border and MCP served to define theoretic DBS ‘hotspots’.ResultsUsing the medial STN border as reference, significant negative correlation (Pearson’s correlation −0.52, P<0.01) was found between the Euclidean distance from the centre of stimulation to this DBS hotspot and motor improvement. This hotspot was located at 2.8 mm lateral, 1.7 mm anterior and 2.5 mm superior relative to the medial STN border. Using MCP as reference, no correlation was found.ConclusionThe medial STN border proved superior compared with MCP as anatomical reference for correlation of DBS location and motor improvement, and enabled defining an optimal DBS location within the nucleus. We therefore propose the medial STN border as a better individual reference point than the currently used MCP on preoperative stereotactic imaging, in order to obtain optimal and thus less variable motor improvement for individual patients with PD following STN DBS.
Relationship between adverse events and antiplatelet drug resistance in neurovascular intervention: a meta-analysis
Authors: Shim Eun Jung , Ryu Chang-Woo , Park Soonchan , Lee Han Na , Shin Hee Sup , Kim Sang-Beom 
Published: January 2018

BackgroundThis meta-analysis aimed to evaluate the association between antiplatelet resistance and the risk of procedure-related complications in neurovascular interventions.MethodsWe identified relevant articles by searching electronic databases and reviewed the reference lists of selected papers. The risk of adverse events between antiplatelet responders and hyporesponders during neurointervention was compared in eligible clinical studies. Risk ratios (RRs) and 95% CIs were pooled using a random-effects meta-analysis.ResultsOf 2134 potentially relevant studies, our search identified 15 studies enrolling a total of 2365 patients. Pooled RRs showed thromboembolic events (TEE) were more frequent in hyporesponders (RR 2.634, 95% CI 1.465 to 4.734). However, hemorrhagic complications did not differ between the two groups (RR 1.236, 95% CI 0.642 to 2.380). In subgroup analysis, hyporesponders showed a higher prevalence of TEE with standard antiplatelet medication, but there was no obvious difference in TEE between the two arms when using a modified antiplatelet medication (RR 3.645, 95% CI 1.537 to 8.646; and RR 1.877, 95% CI 0.749 to 4.751). Studies using stent placement for aneurysms showed a higher TEE rate in hyporesponders (RR 3.221, 95% CI 1.899 to 5.464).ConclusionAntiplatelet resistance was significantly associated with TEE in neurointervention, and this adverse event was associated with individually-intensified antiplatelet medication as well as the type of neurointerventional procedure. Our findings support the use of antiplatelet resistance assays and tailored antiplatelet medications in neurovascular stent placement as a management strategy to reduce thromboembolic risk.
Increased blood-brain barrier permeability in contralateral hemisphere predicts worse outcome in acute ischemic stroke after reperfusion therapy
Authors: Liu Chang , Yan Shenqiang , Zhang Ruiting , Chen Zhicai , Shi Feina , Zhou Ying , Zhang Meixia , Lou Min 
Published: January 2018

AimsWe sought to investigate the risk factors of blood-brain barrier (BBB) disruption, and its potential impact on 90-day clinical outcome in acute ischemic stroke (AIS) patients after reperfusion therapy.MethodsConsecutive acute anterior circulation AIS patients imaged with computed tomographic perfusion (CTP) before reperfusion therapy were included. Tmax >6 s was used for the volumetric measurement of the hypoperfusion area. BBB permeability (BBBP) was calculated as the average relative permeability-surface area product (rPS) within the hypoperfusion region (rPShypo-i) and its contralateral mirror region (rPShypo-c) on CTP-derived PS color maps. Modified Rankin Scale (mRS) score was obtained at 90-day post-stroke.ResultsA total of 187 patients were included, among whom the median age was 73 (61–80) years and 76 (40.6%) were women. Median baseline NIHSS score was 12 (7– 16). Ninety-eight (52.4%) patients had mRS score >2. Increased rPShypo-iand rPShypo-cwere both independently associated with males and large infarct volume. The increased rPShypo-iwas also independently associated with a history of atrial fibrillation and high NIHSS score. Multivariable analysis showed higher rPShypo-cwas independently associated with higher mRS (OR: 1.064, 95% CI 1.011 to 1.121; P=0.018).ConclusionBBBP in both the hypoperfusion region and its contralateral mirror region are associated with stroke severity, but only increased BBBP in the contralateral mirror hypoperfusion region relates to worse outcome after reperfusion therapy.
Critical role of angiographic acquisition modality and reconstruction on morphometric and haemodynamic analysis of intracranial aneurysms
Authors: Lauric Alexandra , Hippelheuser James E , Malek Adel M 
Published: January 2018

BackgroundSubtracted 3-D rotational angiography (3DRA) and cone-beam computed tomography angiography (CBCT-A) are often used in assessing cerebral aneurysm shape and haemodynamic profile. We sought to evaluate the effect of imaging modality, reconstruction parameters, and kernel selection on patient-derived aneurysm morphology and computational fluid dynamic (CFD) analysis to assess its potential contribution to inter-study variability.MethodsFour patients(five aneurysms) underwent concurrent 3DRA followed by high-resolution CBCT-A. Six models were reconstructed per aneurysm: 3DRA reconstructed with 0.28 and 0.14 mm voxel sizes (large and small volume of interest (VOI) respectively), and two kernel types (normal/smooth). CBCT-A was reconstructed over small VOI using normal/sharp kernel. Maximal dome dimension, neck diameter and dome/neck ratio were evaluated in 3D. Wall shear stress (WSS) magnitude was evaluated on the entire aneurysm dome and in the 5% dome areas covered by lowest (LWSS) and highest (HWSS) WSS. Parameters were evaluated with pairwise t-test analysis.ResultsSmaller VOI reconstructions resulted in smaller Dmax(P value=0.03) and Dmax/neck (P value=0.006) and in larger LWSS (P value=0.03). Use of sharp kernel led to narrower neck (P value=0.04) and higher Dmax/neck values (P value=0.02). CBCT-A resulted in statistically different aneurysm shape (up to 24% difference) and haemodynamics (up to 97% difference) compared with 3DRA.ConclusionThe choice of catheter 3D angiographic modality and reconstruction kernel has a critical impact on derived aneurysm morphological and haemodynamic analysis. The resultant variability can confound and obscure underlying differences within patient populations and between studies performed at different centres using divergent techniques, compromising the accuracy of quantitative aneurysm analysis.
Vaginal microbiota composition and association with prevalent Chlamydia trachomatis infection: a cross-sectional study of young women attending a STI clinic in France
Authors: Tamarelle Jeanne , de Barbeyrac Bertille , Le Hen Isabelle , Thiébaut Anne , Bébéar Cécile , Ravel Jacques , Delarocque-Astagneau Elisabeth 
Published: January 2018

ObjectivesNew molecular techniques have allowed describing groups of bacterial communities in the vagina (community state types (CST)) that could play an important role in Chlamydia trachomatis (CT) infection. Our aim was to describe the distribution of CST in a population of young women in France.MethodsA cross-sectional study was carried out in June 2015 among anonymous young women attending a STI clinic in Bordeaux, France. Participants provided a vaginal sample for CT screening and sociodemographic data. CT was diagnosed using the Aptima-combo 2 transcription-mediated-amplification assay. Vaginal microbiota composition was characterised using 16S rRNA gene amplicon sequencing.ResultsMicrobiota composition and CT status were available for 132 women. CST dominated by Lactobacillus crispatus (CST-I), L. iners (CST-III) and a diversity of anaerobes (CST-IV) represented 37.1%, 38.6% and 22.0% of the sample, respectively. Twenty-one out of 132 women were CT positive. Proportions of CT-positive women were higher for samples belonging to CST-III (21.6%) and CST-IV (17.2%) than to CST-I (8.2%).ConclusionsFive CST were found in 132 young women from a STI clinic in France. These CSTs were not significantly associated with CT but higher proportions of CT-positive women were found in CST-III and CST-IV, consistent with a previous study in the Netherlands. Though our study lacked statistical power and was cross-sectional, it is a necessary first step to understand the structure of the vaginal microbiota in French women with or without infection before performing in-depth longitudinal studies.
Modelling individual vulnerability to sexually transmitted infections to optimise intervention strategies: analysis of surveillance data from Kalamazoo County, Michigan, USA
Authors: Owusu Claudio , Baker Kathleen M , Paul Rajib , Curtis Amy B 
Published: January 2018

ObjectiveWe modelled individual vulnerability to STI using personal history of infection and neighbourhood characteristics.MethodsRetrospective chlamydia and gonorrhoea data of reported confirmed cases from Kalamazoo County, Michigan for 2012 through 2014 were analysed. Unique IDs were generated from the surveillance data in collaboration with local health officials to track the individual STI histories. We then examine the concept that individuals with similar STI histories form a ‘peer’ group. These peer group include: (1) individuals with a single chlamydia; (2) individuals with single gonorrhoea; (3) individuals with repeated cases of one type of STI and (4) individuals that were diagnosed with both infections during the study period. Using Kernel density estimation, we generated densities for each peer group and assigned the intensity of the infection to the location of the individual. Finally, the individual vulnerability was characterised through ordinary least square regression (OLS) using demographics and socioeconomic variables.ResultsIn an OLS regression adjusted for frequency of infection, individual vulnerability to STI was only consistently significant for race and neighbourhood-level socioeconomic status (SES) in all the models under consideration. In addition, we identified six areas in three townships in Kalamazoo County that could be considered for unique interventions based on overlap patterns among peer groups.ConclusionsThe results provide evidence that individual vulnerability to STI has some dependency on individual contextual (race) and exogenous factors at the neighbourhood level such as SES, regardless of that individual’s personal history of infection. We suggest place-based intervention strategies be adopted for planning STI interventions instead of current universal screening of at-risk populations.
Association between Post-Cancer Diagnosis Dietary Inflammatory Potential and Mortality among Invasive Breast Cancer Survivors in the Women's Health Initiative
Authors: Zheng Jiali , Tabung Fred K. , Zhang Jiajia , Liese Angela D. , Shivappa Nitin , Ockene Judith K. , Caan Bette , Kroenke Candyce H. , Hébert James R. , Steck Susan E. 
Published: January 2018

AbstractBackground: Inflammation is important in chronic disease and can be modulated by dietary exposures. Our aim was to examine whether the inflammatory potential of diet after cancer diagnosis, assessed using the dietary inflammatory index (DII), is associated with all-cause and cause-specific mortality among women diagnosed with invasive breast cancer in the Women's Health Initiative (WHI).Methods: Our analytic cohort included 2,150 postmenopausal women, ages 50 to 79 years at baseline, who developed invasive breast cancer during follow-up and completed a food frequency questionnaire (FFQ) on average 1.5 years after diagnosis. Women were followed from breast cancer diagnosis until death or the end of follow-up by October 2014. Energy-adjusted DII (E-DII) scores were calculated from food plus supplements using a nutrient–density approach. Cox proportional hazards models were fit to estimate multivariable-adjusted HRs and 95% confidence intervals (CIs) for all-cause, breast cancer–specific, and cardiovascular disease (CVD) mortality.Results: After a median 13.3 years of follow-up, 580 deaths from any cause occurred, including 212 breast cancer deaths and 103 CVD deaths. Lower (i.e., more anti-inflammatory) E-DII scores were associated with a lower risk of CVD mortality (HRQ1VSQ4 = 0.44; 95% CI, 0.24–0.82; Ptrend = 0.005), but not with breast cancer–specific mortality (HRQ1VSQ4 = 0.96; 95% CI, 0.62–1.49; Ptrend = 0.96) or all-cause mortality (HRQ1VSQ4 = 0.82; 95% CI, 0.63–1.05; Ptrend = 0.17).Conclusions: Consuming a more anti-inflammatory diet after breast cancer diagnosis may be a means for reducing risk of death from CVD.Impact: Survival after invasive breast cancer diagnosis may be improved by consumption of an anti-inflammatory diet. Cancer Epidemiol Biomarkers Prev; 27(4); 454–63. ©2018 AACR.
Cesarean Delivery and Risk of Infant Leukemia: A Report from the Children's Oncology Group
Authors: Marcotte Erin L. , Richardson Michaela R. , Roesler Michelle A. , Spector Logan G. 
Published: January 2018

AbstractBackground: Studies have reported increased risks of pediatric acute lymphoblastic leukemia (ALL) among children born by cesarean delivery (CD). However, no previous study has examined the impact of CD on risk of infant leukemia specifically.Methods: In this study, 443 infants diagnosed with acute leukemia, including both ALL and acute myelogenous leukemia (AML), were identified at Children's Oncology Group institutions between January 1996 and December 2006; 324 controls frequency matched by year of birth were identified though random digit dialing and random selection from U.S. birth registries. Using interview data and, for a subset of participants, medical record data, we analyzed CD overall and by indications that likely resulted in pre-labor CD (PLCD) or emergency CD (ECD). Odds ratios (ORs) and 95% confidence intervals (CIs) for risk of ALL and AML were estimated using multivariable unconditional logistic regression models, adjusted for year of birth, birth weight, and maternal race.Results: We observed an increased point estimate for the association between CD and ALL (OR, 1.52 and 95% CI, 1.02–2.25). We did not observe an association between CD and AML (OR, 1.02 and 95% CI, 0.64–1.62). In analyses of indication for CD, we observed elevated effect estimates for the associations of both PLCD and ECD and infant ALL.Conclusions: Our analysis suggests an increased risk of infant ALL following CD, including both PLCD and ECD. Altered microbiota colonization may be involved in development of leukemia in infants, but clear biological mechanisms have yet to be determined.Impact: This study provides the first in-depth examination of CD and infant leukemia. Cancer Epidemiol Biomarkers Prev; 27(4); 473–8. ©2018 AACR.
Use of a Non-Crosslinked Porcine Dermal Matrix in Repair of the Achilles and Other Tendons of the Foot
Authors: Anaim Ali A. 
Published: January 2018

Background. Ankle tendon augmentation with biological matrixes has been shown to be beneficial, especially for Achilles tendon rupture as it adds to the integrity of the repair. Biologic matrix augmentation has been used increasingly in chronic and complex injuries where reinforcement is required. The objective of this study was to present outcomes of a series of patients who underwent tendon repair augmented with a new biologic matrix. Methods: Sixteen patients underwent ankle tendon repair, augmented with Proformix biologic tissue matrix. Patients were evaluated pre- and postoperatively for function and pain, and were followed for up to 3 years for complications. Results: This study included 10 females and 6 males, with a mean age of 44.6 years (range, 23-71 years). Patients were evaluated at 2 months postoperatively, and then further followed for a mean 19.0 months (range 7-38 months) to assess complications and reinjuries. Foot and Ankle Disability Index scores significantly increased from preoperatively (38.3) to 2 months postoperatively (85.2) ( P < .001). Furthermore, there were no reports of reruptures or significant complications. Conclusions: Weakness or rupture in tendons of the foot, especially the Achilles tendon, can be treated surgically and the repair augmented with Proformix, a new, biological matrix. Our study presented a series of 16 patients whose surgical repairs had been augmented with the new biological matrix, all of whom have achieved excellent results. Levels of Evidence: Level IV: Case series
Tyrosine kinase inhibitors and immune checkpoint blockade in allogeneic hematopoietic cell transplantation
Authors: Soiffer Robert J. , Davids Matthew S. , Chen Yi-Bin 
Published: January 2018

AbstractAdvances in the prevention of graft-versus-host disease (GVHD) and opportunistic infection have improved survival after allogeneic hematopoietic cell transplantation (allo-HCT) in the past decade. However, few inroads have been made into the treatment or prevention of relapse of the underlying malignancy for which allo-HCT is being performed. The introduction of US Food and Drug Administration–approved agents with significant activity in a variety of hematologic malignancies provides an opportunity to evaluate these interventions in the allo-HCT setting. Some of the most promising new agents include tyrosine kinase inhibitors (TKIs) directed at bcr-abl, kinase inhibitors targeting fms-like tyrosine kinase 3, and immune checkpoint inhibitors blocking both CTLA4 and PD-1. Data have emerged indicating potential efficacy of these agents in preventing or treating relapse, though definitive evidence remains elusive. However, potential toxicity can be considerable, highlighting the need for further clinical trials to define the therapeutic window. This review explores the immunologic and clinical consequence of treatment with both TKIs and checkpoint inhibitors in the peri- and post–allo-HCT setting.
Drug resistant tuberculosis in Saudi Arabia: an analysis of surveillance data 2014–2015
Authors: Al Ammari Maha , Al Turaiki Abdulrahman , Al Essa Mohammed , Kashkary Abdulhameed M. , Eltigani Sara A. , Ahmed Anwar E. 
Published: January 2018

Abstract
Background
There is limited data that investigates the national rates of drug-resistant tuberculosis (TB) in Saudi Arabia.
This study aimed to estimate the rates of multi-drug-resistant tuberculosis (MDR-TB), rifampicin-resistant tuberculosis (RR-TB), and monoresistance (MR) in Saudi Arabia.

Methods
A retrospective cohort study was conducted on all TB cases reported to the National TB Control and Prevention Program (NTCPP) registry at the Saudi Ministry of Health between January 1, 2014 and December 31, 2015. A total of 2098 TB patients with positive TB cultures were included in the study. Subgroup analyses and multivariate binary logistic regression models were performed with IBM SPSS 23.0.

Results
Of the total TB cases, 4.4% (95% CI: 3.59%–5.40%) were found to have MDR-TB. The rates of MR were 3.8% (95% CI: 2.99%–4.67%) for ethambutol, 5.4% (95% CI: 4.50%–6.49%) for pyrazinamide, 10.2% (95% CI: 5.89%–11.52%) for isoniazid, 11% (95% CI: 9.70%–12.43%) for streptomycin, and 5.9% (95% CI: 4.90%–6.96%) for rifampicin. The high rates of MDR and RR-TB were found among the younger age group, female gender, and those who had a previous history of TB. We also discovered that renal failure tends to increase the risk of rifampicin resistance.

Conclusions
National TB data in Saudi Arabia shows that the rate of MDR-TB was similar to the global rate reported by the World Health Organization (WHO). It is a relatively high rate as compared to Western countries. The proportion of MDR/RR-TB patients tends to be higher in the younger age group, female gender, and in patients with a previous history of TB treatment. Effective strategies for prevention of all multi-drug-resistant TB cases are warranted.
Does Context Matter? Convergent and Divergent Findings in the Cross-Institutional Evaluation of Graduate Teaching Assistant Professional Development Programs
Authors: Reeves Todd D. , Hake Laura E. , Chen Xinnian , Frederick Jennifer , Rudenga Kristin , Ludlow Larry H. , O’Connor Clare M. 
Published: January 2018

Graduate teaching assistants (GTAs) play important instructional roles in introductory science courses, yet they often have little training in pedagogy. The most common form of teaching professional development (PD) for GTAs is a presemester workshop held at the course, department, or college level. In this study, we compare the effectiveness of presemester workshops at three northeastern research universities, each of which incorporated scientific teaching as the pedagogical content framework. The comparison of GTA PD program outcomes at three different institutions is intended to test theoretical assertions about the key role of contextual factors in GTA PD efficacy. Pretest and posttest surveys were used to assess changes in GTA teaching self-efficacy and anxiety following the workshops, and an objective test was used to assess pedagogical knowledge. Analysis of pretest/posttest data revealed statistically significant gains in GTA teaching self-efficacy and pedagogical knowledge and reductions in teaching anxiety across sites. Changes in teaching anxiety and self-efficacy, but not pedagogical knowledge, differed by training program. Student ratings of GTAs at two sites showed that students had positive perceptions of GTAs in all teaching dimensions, and relatively small differences in student ratings of GTAs were observed between institutions. Divergent findings for some outcome variables suggest that program efficacy was influenced as hypothesized by contextual factors such as GTA teaching experience.