bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pulmonary hypertension as estimated by Doppler echocardiography in adolescent and adult patients with cystic fibrosis and their relationship with clinical, lung function and sleep findings
Authors: Ziegler Bruna , Perin Christiano , Casarotto Fernanda Cano , Fagondes Simone Chaves , Menna‐Barreto Sérgio Saldanha , Dalcin Paulo de Tarso Roth 
Published: December 2016

AbstractBackgroundIn cystic fibrosis (CF) patients, end stage of pulmonary disease is characterized by pulmonary hypertension (PH), hypoxemia, decrease in exercise tolerance, and sleep quality.ObjectiveTo evaluate the association between clinical, lung function, sleep quality, and polysomnographic variables with PH in CF patients aged 16 years or older.MethodsIn a cross‐sectional study, 51 clinically stable CF patients underwent a clinical evaluation, an overnight polysomnography and answered sleep questionnaires (Pittsburgh Sleep Quality Index and Epworth sleepiness scale). Also, CF patients had their pulmonary function, 6‐minute walk test (6MWT) and echocardiography assessed.ResultsFifty‐one CF patients participated in the study; 47% were female. The mean age was 25.1 ± 8.8 years. Pulmonary artery systolic pressure (PASP) was greater than 35 mm Hg in 11 (27.5%) patients. Variables associated with PASP>35 mm Hg in univariate analysis were Shwachman‐Kulczycki clinical score, forced expiratory volume in 1 second % of predicted, Pseudomonas aeruginosa in sputum culture, at‐rest peripheral capillary oxygen saturation (SpO2), SpO2 at end of 6MWT and time of oxygen desaturation <90% during sleep. These variables were included in the binary logistic regression. The independent variable associated with the PASP > 35 mm Hg was at‐rest SpO2 (OR = 10.8, CI 95% 1.7‐67.3, P = .011). The cuttoff SpO2< 94% had the sensitivity = 7/11 = 64%, specificity = 40/40 = 100%, positive predicted values = 7/7 = 100% and negative predicted values = 40/44 = 91% to the diagnosis of PH.Conclusionthe present study showed a high rate of PH in adolescent and adult CF patients. At‐rest SpO2 was associated with PH.
Both pharyngeal and esophageal phases of swallowing are associated with recurrent pneumonia in pediatric patients
Authors: Serel Arslan Selen , Demir Numan , Karaduman Aynur Ayşe 
Published: December 2016

AbstractIntroductionOne of the underlying causes of recurrent pneumonia in children is swallowing dysfunction, with aspiration syndrome. Swallowing dysfunction should be considered not only a problem of the oropharyngeal phase but also a problem of the esophageal phase.ObjectivesThis study aimed to determine the relationship between findings from a swallowing study and a history of recurrent pneumonia in pediatric patients.MethodsA videofluroscopic swallowing study of 274 pediatric patients who had swallowing dysfunction was conducted. Information on a history of recurrent pneumonia during a 1‐year period was obtained from hospital files.ResultsThe median age of the participants was 33 months (min =10, max = 180), of whom 51.8% were females. In the study, 83.2% of the patients had cerebral palsy, 7.7% had syndromic symptoms, 3.6% had muscular dystrophy, and 5.5% were classified as “other.” During the 1‐year period, 67.9% of the participants had a history of recurrent pneumonia history. Furthermore, 66.4% had oral dysfunction, 32.5% had laryngeal penetration, 46.4% had aspiration, 45.3% had abnormal esophageal body function, and 35.8% had reflux symptoms. There was no correlation between oral dysfunction and recurrent pneumonia (P = .902), but there was a positive correlation between recurrent pneumonia and laryngeal penetration (P < .001, r = .26), aspiration (P < .001, r =.49), abnormal esophageal body function (P = .002, r = .18), and reflux (P < .001, r = .22).ConclusionBoth pharyngeal swallowing disorders, such as penetration and aspiration, and esophageal disorders and reflux may result in recurrent pneumonia in pediatric patients. Thus, all phases of deglutition should be considered and followed up during swallowing evaluation.
Usefulness of admission red blood cell distribution width as a predictor of severity of acute pulmonary embolism
Authors: Akgedik Recep , Karamanli Harun , Kurt Ali Bekir , Günaydın Zeki Yüksel 
Published: December 2016

AbstractBackgroundPrevious researches have represented a considerable relation between acute pulmonary embolism (PE) and red blood cell distribution width (RDW). To the authors' knowledge no research has been informed in subjects with PE severity. Pulmonary arterial obstruction index (PAOI) is associated with the severity of acute PE.ObjectivesIn our investigation, we purposed to assess the relation between PAOI and RDW and the benefit of these factors in the detection of PE severity.MethodsWe retrospectively investigated the demographic information, probability of clinical scores, laboratory parameters, serum D‐dimer levels, and echocardiographic findings of systolic pulmonary artery pressure (PAP) in Acute PE individuals who were diagnosed by computed tomography of pulmonary arterial angiography. Right ventricular dysfunction (RVD) on CT was assessed by calculating the right ventricular/left ventricular (RV/LV) diameter ratios on transverse (RV/LVtrans).ResultsThe information of 131 patients with acute PE and 51 (64.6%) female and 28 (35.4%) male healthy control were evaluated. Acute PE group's RDW values were higher than control subjects (P < .0001). RDW (%) level was remarkable higher in patients with massive PE than in patients with nonmassive PE. There were statistically considerable differences in terms of PAOI and systolic pulmonary arterial pressure (sPAP) between nonmassive and massive PE patients (P < .0001 for all).ConclusionsPAOI was correlated with PE severity, D‐dimer level, sPAP and clinical probability scores. PAOI was correlated with RDW levels. RDW levels, an inexpensive and easily measurable laboratory factor, were considerable associated with the severity and presence of PE.
Nanograin layer formation at crack initiation region for very‐high‐cycle fatigue of a Ti–6Al–4V alloy
Authors: Su H. , Liu X. , Sun C. , Hong Y. 
Published: December 2016

AbstractThe microstructural features and the fatigue propensities of interior crack initiation region for very‐high‐cycle fatigue (VHCF) of a Ti–6Al–4V alloy were investigated in this paper. Fatigue tests under different stress ratios of R = −1, −0.5, −0.1, 0.1 and 0.5 were conducted by ultrasonic axial cycling. The observations by SEM showed that the crack initiation of VHCF presents a fish‐eye (FiE) morphology containing a rough area (RA), and the FiE and RA are regarded as the characteristic regions for crack initiation of VHCF. Further examinations by TEM revealed that a layer of nanograins exists in the RA for the case of R = −1, while nanograins do not appear in the FiE outside RA for the case of R = −1, and in the RA for the case of R = 0.5, which is explained by the Numerous Cyclic Pressing model. In addition, the estimations of the fatigue propensities for interior crack initiation stage of VHCF indicated that the fatigue life consumed by RA takes a dominant part of the total fatigue life and the related crack propagation rate is rather slow.
Metastatic type A thymoma: morphological and genetic correlation
Authors: Bürger Tobias , Schaefer Inga‐Marie , Küffer Stefan , Bohnenberger Hanibal , Reuter‐Jessen Kirsten , Chan John Kwok‐Cheung , Emmert Alexander , Hinterthaner Marc , Marx Alexander , Ströbel Philipp 
Published: December 2016

AimsThe vast majority of type A thymomas are diagnosed in tumour stages 1 or 2, and metastatic cases are exceedingly rare. The histological and genetic features of such metastatic type A thymomas have not been described in detail.Methods and resultsFive metastatic type A thymomas in tumour stage Masaoka IVb that had been reviewed by a panel of expert pathologists were analysed using comparative genomic hybridization (CGH). Cases 1, 2 and 3 showed the prototypical morphology of type A thymomas with mainly solid growth patterns. These cases displayed only very subtle nuclear irregularities and slight nuclear crowding, but no other atypical features. Mitoses were absent. Cases 3 and 4, in contrast, had a distinctly atypical morphology. CGH revealed partially recurrent alterations in four cases (with and without atypical morphology), including gains on chromosome 1q (one case), 17q (two cases), chromosome 19 (three cases) and 22q (one case) and losses on chromosome 17p (two cases) and 22q (one case).ConclusionRare metastatic type A thymomas, both with typical and ‘atypical’ histological features, show partially recurrent genomic alterations that differ from the much more frequent localized and indolent tumours. The fact that these alterations were recurring points to a link between clinical behaviour and molecular features. Our findings may have implications for the management and treatment of such tumours.
NUT midline carcinoma of the larynx: an international series and review of the literature
Authors: Hellquist Henrik , French Christopher A , Bishop Justin A , Coca‐Pelaz Andrés , Propst Evan J , Paiva Correia António , Ngan Bo‐Yee , Grant Ronald , Cipriani Nicole A , Vokes David , Henrique Rui , Pardal Fernando , Vizcaino Jose Ramon , Rinaldo Alessandra , Ferlito Alfio 
Published: December 2016

AimsNUT midline carcinoma (NMC) is a rare undifferentiated and aggressive carcinoma that locates characteristically to the midline of the head and neck, and mediastinum. NMC is characterized by chromosomal rearrangements of the gene NUT, at 15q14. The BRD4 gene on 19q13 is the most common translocation partner forming a fusion oncogene, BRD4–NUT. By the end of 2014, the International NUT Midline Carcinoma Registry had 48 patients treated for NMC. Laryngeal NMC are exceedingly rare, and we report a case series of seven cases.Methods and resultsWe searched for cases in files of different hospitals as well as a thorough search of the English language literature. The diagnosis of NMC is made by demonstration of NUT rearrangement either by immunohistochemistry, fluorescence in‐situ hybridization (FISH) or reverse transcription–polymerase chain reaction (RT–PCR). We found three previously published cases, and in this series add four cases of our own.ConclusionsNMC consists of monomorphic, often discohesive, cells with an epithelioid appearance and distinct nucleoli. The tumours typically show abrupt squamous differentiation. The mean age of the patients was 34 years, hence significantly lower than that for conventional laryngeal carcinoma. All tumours were located in the supraglottis and five patients died of the disease after 3, 7, 8, 9 and 11 months. Laryngeal NMC may be underdiagnosed, and an increased awareness among pathologists is warranted. NMC has characteristic morphological features, and positive immunostaining with the NUT antibody is diagnostic. Its aggressive behaviour demands a very intense treatment strategy and the need for its recognition is emphasized further by new promising treatment strategies.
Tumour budding evaluated in biopsy specimens is a useful predictor of prognosis in patients with cN0 early stage oral squamous cell carcinoma
Authors: Seki Mai , Sano Takaaki , Yokoo Satoshi , Oyama Tetsunari 
Published: December 2016

AimsOral squamous cell carcinoma (OSCC) prognosis depends upon lymph node metastasis (LNM). We have reported recently that tumour budding is a good predictive factor for LNM in squamous cell carcinoma (SCC) of the tongue and floor of the mouth (FOM). Our aim was to evaluate whether tumour budding is a good prognostic factor in OSCC.Methods and resultsWe examined conventional histopathological assessment and a new factor, tumour budding, in 209 cases of OSCC in incisional biopsy specimens. The relationship of tumour budding with LNM and prognosis was studied. The budding score was evaluated using immunostaining for pan‐cytokeratin in all biopsies specimens; the number of budding foci was counted using a ×20 objective lens. Significant factors using univariate analysis (P < 0.05) in association with LNM were the budding score (intermediate or high score ≥3; high score ≥5), tumour grade (2 and 3), tumour depth (≥5 mm), infiltrative pattern (INF), lymphatic invasion and vessel invasion. In multivariate analysis, the budding score, INF and lymphatic invasion were found to be independent risk factors for LNM; in particular, budding score concerning relapse‐free survival was statistically significant among patients with T1/2 stage and cN0 cancer using the Kaplan–Meier method and the log‐rank test.ConclusionsThe assessment of tumour budding is effective in predicting prognosis in cN0 early stage OSCC. In T1/2 stage and cN0 cancer, prophylactic neck dissection to prevent LNM should be considered when the tumour budding score regarding pre‐operative biopsy specimens is intermediate or high.
Inflammation, oxidative stress and apoptosis cascade implications in bisphenol A‐induced liver fibrosis in male rats
Authors: Elswefy Sahar El‐Sayed , Abdallah Fatma Rizk , Atteia Hebatallah Husseini , Wahba Alaa Samir , Hasan Rehab Abdallah 
Published: December 2016

SummaryBisphenol A (BPA) is a key monomer in the production of plastics. It has been shown to be hepatotoxic. Inflammation and oxidative stress are closely linked with liver fibrosis, the major contributing factor to hepatic failure. Therefore, the aim of this study was to evaluate the impact of chronic exposure to BPA on the development of hepatic fibrosis in male rats and to determine the cross‐talk between the hepatic cytokine network, oxidative stress and apoptosis. For this purpose, 30 male Wistar albino rats were divided into three equal groups as follows: the first group was given no treatment (normal control group); the second group was given corn oil once daily by oral gavage for 8 weeks (vehicle control group); and the third group received BPA (50 mg/kg body weight/day, p.o.) for 8 weeks. BPA administration induced liver fibrosis as reflected in an increase in serum hepatic enzymes activities, hepatic hydroxyproline content and histopathological changes particularly increased collagen fibre deposition around the portal tract. In addition, there was inflammation (as reflected in increase in interleukin‐1beta ‘IL‐1β’, decrease in interleukin‐10 ‘IL‐10′ serum levels and increase in IL‐1β/IL‐10 ratio), oxidative stress (as reflected in increase in malondialdehyde (MDA) level, reduction in reduced glutathione (GSH) content and inhibition of catalase (CAT) activity) and apoptosis [as reflected in an increase in caspase‐3 level and a decrease in numbers of B‐cell lymphoma 2 (BCL2)‐immunopositive hepatocytes]. Interestingly, BPA had an upregulating effect on an extracellular matrix turnover gene [as reflected in matrix metalloproteinase‐9 (MMP‐9)] and a downregulating effect on its inhibitor gene [as reflected in tissue inhibitor of matrix metalloproteinase‐2 (TIMP‐2)] expression. Thus, the mechanism by which BPA induced liver fibrosis seems to be related to stimulation of the inflammatory response, along with oxidative stress, the apoptotic pathway and activation of extracellular matrix turnover.
Doctors’ use of mobile devices in the clinical setting: a mixed methods study
Authors: Nerminathan Arany , Harrison Amanda , Phelps Megan , Scott Karen M. , Alexander Shirley 
Published: December 2016

BackgroundMobile device use has become almost ubiquitous in daily life and therefore includes use by doctors in clinical settings. There has been little study as to the patterns of use and impact this has on doctors in the workplace and how negatively or positively it impacts at the point of care.AimTo explore how doctors use mobile devices in the clinical setting and understand drivers for use.MethodsA mixed methods study was used with doctors in a paediatric and adult teaching hospital in 2013. A paper‐based survey examined mobile device usage data by doctors in the clinical setting. Focus groups explored doctors’ reasons for using or refraining from using mobile devices in the clinical setting, and their attitudes about others’ use.ResultsThe survey, completed by 109 doctors, showed that 91% owned a smartphone and 88% used their mobile devices frequently in the clinical setting. Trainees were more likely than consultants to use their mobile devices for learning and accessing information related to patient care, as well as for personal communication unrelated to work. Focus group data highlighted a range of factors that influenced doctors to use personal mobile devices in the clinical setting, including convenience for medical photography, and factors that limited use. Distraction in the clinical setting due to use of mobile devices was a key issue. Personal experience and confidence in using mobile devices affected their use, and was guided by role modelling and expectations within a medical team.ConclusionDoctors use mobile devices to enhance efficiency in the workplace. In the current environment, doctors are making their own decisions based on balancing the risks and benefits of using mobile devices in the clinical setting. There is a need for guidelines around acceptable and ethical use that is patient‐centred and that respects patient privacy.
Is it all about price? Why requests for government subsidy of anticancer drugs were rejected in Australia
Authors: Karikios Deme J. , Chim Lesley , Martin Andrew , Nagrial Adnan , Howard Kirsten , Salkeld Glenn , Stockler Martin R. 
Published: December 2016

BackgroundAustralians access anticancer drugs predominantly through the Pharmaceutical Benefits Scheme (PBS).AimTo determine why the Pharmaceutical Benefits Advisory Committee (PBAC) rejects submissions to list anticancer drugs on the PBS.MethodsWe reviewed publicly available information about submissions made to the PBAC for PBS listing of anticancer drugs from 2005 to 2014. Submission characteristics, including clinical and economic evidence, PBAC recommendations, and the reasons offered for rejection were recorded. Two reviewers independently categorised the reason for rejection offered by the PBAC. Logistic regression was used to determine submission characteristics associated with rejection.ResultsWe identified 213 submissions for 110 unique indications of 60 anticancer drugs. The overall rejection rate was 56% (119/213). Of the 110 indications assessed, 69% (76/110) were rejected at least once. The annual rejection rate ranged from 50 to 73% with little evidence of a trend over time (P = 0.2). Submission characteristics strongly associated with rejection in multivariable analysis included: PBAC judged the clinical evidence to be problematic or uncertain (P < 0.001); PBAC judged the economic evidence to be problematic or uncertain (P < 0.001); and, inactive comparator used (P < 0.001). The most frequent reasons for rejection offered by the PBAC was ‘inadequate cost‐effectiveness or drug price too high’ (75/109, 69%).ConclusionsInadequate cost‐effectiveness and PBAC uncertainty about the clinical and economic evidence were the most frequent reasons for rejection. Clarity of information about PBAC deliberations and their reasons for rejection are important for patients and doctors grappling with decisions about the use of expensive unfunded anticancer drugs.
Analyst Tipping: Additional Evidence
Authors: Markov Stanimir , Muslu Volkan , Subasi Musa 
Published: December 2016

AbstractWe examine whether analysts tip investors during investor conferences. We find that conference‐day abnormal returns of a presenting company are about 0.6% higher when the conference is hosted by an analyst who will initiate coverage with a Buy recommendation than when the conference is hosted by non‐initiating analysts. Furthermore, conference‐day abnormal returns of the presenting company amount to half of the price run‐up during the 20 trading days prior to the Buy initiation. Finally, there is a statistically and economically significant price run‐up prior to a Sell initiation (by about –0.7%) when the analyst who will initiate coverage with a Sell recommendation hosts a conference but does not invite the company to present. Our findings collectively suggest that analysts, rather than companies, tip select investors about upcoming initiations during conferences.
Incidence of Cardiac Perforation With Conventional and With Leadless Pacemaker Systems: A Systematic Review and Meta‐Analysis
Authors: VAMOS MATE , ERATH JULIA W. , BENZ ALEXANDER P. , BARI ZSOLT , DURAY GABOR Z. , HOHNLOSER STEFAN H. 
Published: December 2016

Meta‐Analysis of Pacemaker Lead PerforationIntroductionTwo leadless pacemaker (PM) systems were recently developed to avoid pocket‐ and lead‐related complications. As leadless PMs are implanted with a large delivery catheter, cardiac perforation remains a major safety concern. We aimed to provide a literature review on incidence of cardiac perforation with conventional and with leadless PM systems.Methods and ResultsA systematic review over the last 25 years for studies reporting data on PM lead perforation was performed. Findings were synthesized descriptively. Where control groups were available, data were meta‐analyzed to identify important clinical risk factors.A total of 28 studies comprising 60,744 patients undergoing conventional PM implantation were analyzed. The incidence of lead perforation ranged from 0% to 6.37% (mean 0.82%, weighted mean 0.31%, median of 0.40%). There was no significant difference in perforation risk between atrial and ventricular electrodes (POR 0.72, 95% confidence interval [CI], 0.28–1.87, P = 0.50) and between MRI conditional and conventional leads (POR 5.93, 95% CI, 0.72–48.76, P = 0.10). The use of active fixation leads (POR 4.25, 95% CI, 1.00–17.95, P = 0.05) and utilization of DDD versus VVI PM systems (POR 3.50, 95% CI, 1.48–8.28, P < 0.01) were associated with higher rates of perforation. In the 2 leadless PM studies, the incidence of cardiac perforation was 1.52% for each.ConclusionPM lead perforation rates vary in individual studies with an overall low incidence. Leadless PMs seem to be associated with a slightly higher perforation risk, most likely reflecting a learning curve effect of this novel technology.
Financial Compliance in the European Union: A Cross‐National Assessment of Financial Correction Patterns and Causes in Cohesion Policy
Authors: Mendez Carlos , Bachtler John 
Published: December 2016

AbstractEU compliance scholarship has expanded rapidly over the last decade but has neglected the financial dimension of compliance in terms of Member States' conformity with EU financial rules on the regularity and legality of EU spending. This article makes the case for a multi‐dimensional approach to compliance research and provides the first cross‐national assessment of financial compliance in EU Cohesion policy, employing quantitative and qualitative methods. To account for cross‐national variations in the application of financial corrections for non‐compliant spending, several factors are explored, focusing on regional autonomy, administrative capacity and goodness‐of‐fit. The quantitative analysis finds strong support for the impact of administrative capacity on cross‐national compliance patterns and some evidence for the role of goodness‐of‐fit. Contrary to expectations, regional autonomy is not associated with compliance in this critical case of EU multi‐level governance. Qualitative analysis reinforces these findings while revealing additional factors of relevance.