bluuebunny/crossref_metadata_2025_split huggingface dataset:
Event and Cost Offsets of Switching 20% of the Type 1 Diabetes Population in Germany From Multiple Daily Injections to Continuous Subcutaneous Insulin Infusion
Authors: Zöllner York Francis , Ziegler Ralph , Stüve Magnus , Krumreich Julia , Schauf Marion 
Published: February 2016

Background: Most patients with type 1 diabetes (T1D) administer insulin by multiple daily injections (MDI). However, continuous subcutaneous insulin infusion (CSII) therapy has been shown to improve glycemic control compared with MDI. Objective: The objective was to determine the key medical event and cost offsets generated over a 4-year period by introducing CSII to T1D patients who have inadequately controlled glucose metabolism on MDI in Germany. Methods: A decision-analytic budget impact model, simulating a treatment switch scenario, was developed. In the base case, all T1D patients received MDI, while in the switch scenario, 20% of the eligible T1D population, randomly selected, moved to CSII. The model focused on 2 medical endpoints and their corresponding cost offsets: severe hypoglycemic events requiring hospitalization (SHEH) and complication-borne diabetic events (CDEs) avoided. Event rates and costs were taken from the literature and official sources, adopting a health insurance perspective. Results: Compared with the base case, treating 20% of patients with CSII in the switch scenario resulted in 47 864 fewer SHEH and 5543 fewer CDEs. This led to total cost offsets of €183 085 281 within the 4-year time horizon. Of these, 92% were driven by avoided SHEH. Compared to an expected budget impact (cost increase) of 83%, only treatment costs considered, the total impact of the switch scenario amounted merely to a 24.5% increase in costs (reduction by 58.5% points; a factor of 3.4). Conclusion: The use of CSII resulted in fewer SHEH and CDEs compared to MDI. The incurred CSII implementation costs are hence offset to a substantial degree by cost savings in complication treatment.
Fundamental Importance of Reference Glucose Analyzer Accuracy for Evaluating the Performance of Blood Glucose Monitoring Systems (BGMSs)
Authors: Bailey Timothy S. , Klaff Leslie J. , Wallace Jane F. , Greene Carmine , Pardo Scott , Harrison Bern , Simmons David A. 
Published: February 2016

Background: As blood glucose monitoring system (BGMS) accuracy is based on comparison of BGMS and laboratory reference glucose analyzer results, reference instrument accuracy is important to discriminate small differences between BGMS and reference glucose analyzer results. Here, we demonstrate the important role of reference glucose analyzer accuracy in BGMS accuracy evaluations. Methods: Two clinical studies assessed the performance of a new BGMS, using different reference instrument procedures. BGMS and YSI analyzer results were compared for fingertip blood that was obtained by untrained subjects’ self-testing and study staff testing, respectively. YSI analyzer accuracy was monitored using traceable serum controls. Results: In study 1 (N = 136), 94.1% of BGMS results were within International Organization for Standardization (ISO) 15197:2013 accuracy criteria; YSI analyzer serum control results showed a negative bias (−0.64% to −2.48%) at the first site and a positive bias (3.36% to 6.91%) at the other site. In study 2 (N = 329), 97.8% of BGMS results were within accuracy criteria; serum controls showed minimal bias (<0.92%) at both sites. Conclusions: These findings suggest that the ability to demonstrate that a BGMS meets accuracy guidelines is influenced by reference instrument accuracy.
Platelet microparticles inhibit IL-17 production by regulatory T cells through P-selectin
Authors: Dinkla Sip , van Cranenbroek Bram , van der Heijden Wouter A. , He Xuehui , Wallbrecher Rike , Dumitriu Ingrid E. , van der Ven André J. , Bosman Giel J. C. G. M. , Koenen Hans J. P. M. , Joosten Irma 
Published: February 2016

Key Points
Platelet-derived microparticles inhibit IL-17 and IFN-γ production by Tregs and stimulate Treg stability in an inflammatory environment. Platelet-derived microparticles inhibit Treg plasticity in a P-selectin– and partially CXCR3-dependent manner.
Beyond the plasma cell: emerging therapies for immunoglobulin light chain amyloidosis
Authors: Weiss Brendan M. , Wong Sandy W. , Comenzo Raymond L. 
Published: February 2016

Abstract
Systemic immunoglobulin light chain (LC) amyloidosis (AL) is a potentially fatal disease caused by immunoglobulin LC produced by clonal plasma cells. These LC form both toxic oligomers and amyloid deposits disrupting vital organ function. Despite reduction of LC by chemotherapy, the restoration of organ function is highly variable and often incomplete. Organ damage remains the major source of mortality and morbidity in AL. This review focuses on the challenges posed by emerging therapies that may limit the toxicity of LC and improve organ function by accelerating the resorption of amyloid deposits.
Targeted gene editing restores regulated CD40L function in X-linked hyper-IgM syndrome
Authors: Hubbard Nicholas , Hagin David , Sommer Karen , Song Yumei , Khan Iram , Clough Courtnee , Ochs Hans D. , Rawlings David J. , Scharenberg Andrew M. , Torgerson Troy R. 
Published: February 2016

Key PointsThe CD40LG locus can be specifically targeted and repaired in primary human T cells by insertion of a spliced CD40LG complementary DNA. Gene editing restores regulated CD40L expression in X-HIGM T cells, reconstituting B-cell immunoglobulin class switching.
Loss of Muscle Mass During Chemotherapy Is Predictive for Poor Survival of Patients With Metastatic Colorectal Cancer
Authors: Blauwhoff-Buskermolen Susanne , Versteeg Kathelijn S. , de van der Schueren Marian A.E. , den Braver Nicole R. , Berkhof Johannes , Langius Jacqueline A.E. , Verheul Henk M.W. 
Published: February 2016

Purpose Low muscle mass is present in approximately 40% of patients with metastatic colorectal cancer (mCRC) and may be associated with poor outcome. We studied change in skeletal muscle during palliative chemotherapy in patients with mCRC and its association with treatment modifications and overall survival. Patients and Methods In 67 patients with mCRC (mean age ± standard deviation, 66.4 ± 10.6 years; 63% male), muscle area (square centimeters) was assessed using computed tomography scans of the third lumbar vertebra before and during palliative chemotherapy. Treatment modifications resulting from toxicity were evaluated, including delay, dose reduction, or termination of chemotherapy. Multiple regression analyses were performed for the association between change in muscle area and treatment modification and secondly overall survival. Results Muscle area of patients with mCRC decreased significantly during 3 months of chemotherapy by 6.1% (95% CI, −8.4 to −3.8; P < .001). Change in muscle area was not associated with treatment modifications. However, patients with muscle loss during treatment of 9% or more (lowest tertile) had significantly lower survival rates than patients with muscle loss of less than 9% (at 6 months, 33% v 69% of patients alive; at 1 year, 17% v 49% of patients alive; log-rank P = .001). Muscle loss of 9% or more remained independently associated with survival when adjusted for sex, age, baseline lactate dehydrogenase concentration, comorbidity, mono-organ or multiorgan metastases, treatment line, and tumor progression at first evaluation by computed tomography scan (hazard ratio, 4.47; 95% CI, 2.21 to 9.05; P < .001). Conclusion Muscle area decreased significantly during chemotherapy and was independently associated with survival in patients with mCRC. Further clinical evaluation is required to determine whether nutritional interventions and exercise training may preserve muscle area and thereby improve outcome.
SIRFLOX: Randomized Phase III Trial Comparing First-Line mFOLFOX6 (Plus or Minus Bevacizumab) Versus mFOLFOX6 (Plus or Minus Bevacizumab) Plus Selective Internal Radiation Therapy in Patients With Metastatic Colorectal Cancer
Authors: van Hazel Guy A. , Heinemann Volker , Sharma Navesh K. , Findlay Michael P.N. , Ricke Jens , Peeters Marc , Perez David , Robinson Bridget A. , Strickland Andrew H. , Ferguson Tom , Rodríguez Javier , Kröning Hendrik , Wolf Ido , Ganju Vinod , Walpole Euan , Boucher Eveline , Tichler Thomas , Shacham-Shmueli Einat , Powell Alex , Eliadis Paul , Isaacs Richard , Price David , Moeslein Fred , Taieb Julien , Bower Geoff , Gebski Val , Van Buskirk Mark , Cade David N. , Thurston Kenneth , Gibbs Peter 
Published: February 2016

Purpose SIRFLOX was a randomized, multicenter trial designed to assess the efficacy and safety of adding selective internal radiation therapy (SIRT) using yttrium-90 resin microspheres to standard fluorouracil, leucovorin, and oxaliplatin (FOLFOX)–based chemotherapy in patients with previously untreated metastatic colorectal cancer. Patients and Methods Chemotherapy-naïve patients with liver metastases plus or minus limited extrahepatic metastases were randomly assigned to receive either modified FOLFOX (mFOLFOX6; control) or mFOLFOX6 plus SIRT (SIRT) plus or minus bevacizumab. The primary end point was progression-free survival (PFS) at any site as assessed by independent centralized radiology review blinded to study arm. Results Between October 2006 and April 2013, 530 patients were randomly assigned to treatment (control, 263; SIRT, 267). Median PFS at any site was 10.2 v 10.7 months in control versus SIRT (hazard ratio, 0.93; 95% CI, 0.77 to 1.12; P = .43). Median PFS in the liver by competing risk analysis was 12.6 v 20.5 months in control versus SIRT (hazard ratio, 0.69; 95% CI, 0.55 to 0.90; P = .002). Objective response rates (ORRs) at any site were similar (68.1% v 76.4% in control v SIRT; P = .113). ORR in the liver was improved with the addition of SIRT (68.8% v 78.7% in control v SIRT; P = .042). Grade ≥ 3 adverse events, including recognized SIRT-related effects, were reported in 73.4% and 85.4% of patients in control versus SIRT. Conclusion The addition of SIRT to FOLFOX-based first-line chemotherapy in patients with liver-dominant or liver-only metastatic colorectal cancer did not improve PFS at any site but significantly delayed disease progression in the liver. The safety profile was as expected and was consistent with previous studies.
Effects of climate changes on phenological periods of apple, cherry and wheat in Turkey<p>Türkiye’de iklim değişikliğinin elma, kiraz ve buğdayın fenolojik dönemlerine etkileri
Authors: Türkoğlu Necla , Şensoy Serhat , Aydın Olgu 
Published: February 2016

It is known that the increase in air temperature from 1980 to present has dramatically changed the phenological periods of the plants in a large part of the world. In this study, the relationships between phenological periods of wheat plant, apple and cherry trees planted large areas in Turkey and climate change were investigated. In this study, the climate and phenological data for 1971-2012 period belonging to the General Directorate of Meteorology were used. The correlation coefficients between temperature and phenological data were calculated, and their trends were examined using Mann-Kendall trend analysis. In Turkey, positive temperature anomalies have been observed since 1994 until present days. Negative relationships were found between phenological periods of apple, cherry and wheat and the average temperatures of February-May period when the plants grow faster. This situation shows that the plants shift their phenological periods to the earlier times in response to the increasing temperatures. The trend calculated for harvest times of apple, cherry, and wheat are -25, -22, -40 days/100 years respectively. It was calculated that an increase of 1.0ºC in the temperatures of the February-May period will shift the harvest times of apple, cheery and wheat by 5, 4 and 8 days earlier respectively. Özet1980’lerden günümüze hava sıcaklıklarındaki artış, Dünya’nın büyük bir bölümünde bitkilerin fenolojik dönemlerini önemli ölçüde değiştirmiştir. Bu çalışmada Türkiye’de geniş alanlar kaplayan buğday, elma ve kiraz bitkilerinin fenolojik dönemleri ile iklim değişikliği arasındaki ilişkiler araştırılmıştır. Çalışmada Meteoroloji Genel Müdürlüğü’ne ait 1971-2012 döneminin iklim ve fenolojik verileri kullanılmıştır. Sıcaklık ile fenolojik veriler arasındaki korelasyon katsayıları hesaplanmış ve Mann- Kendall trend analizi ile eğilimlerine bakılmıştır. Türkiye’de 1994 yılından bu yana pozitif sıcaklık anomalileri bulunmuştur. Elma, kiraz ve buğdayın fenolojik dönemleri ile bitki gelişiminin fazla olduğu şubat-mayıs ortalama sıcaklıkları arasında negatif ilişki saptanmıştır. Bu durum bitkilerin artan sıcaklıklara tepki olarak fenolojik dönemlerini erkene kaydırdıklarını göstermektedir. Elma, kiraz ve buğdayın hasat tarihleri için hesaplanan trend sırasıyla-25, -22, -40 gün/100 yıl şeklindedir. Şubat-mayıs arası sıcaklıklarda 1.0°C’lik artışın anılan bitkilerin hasat tarihlerini sırasıyla 5, 4 ve 8 gün erkene kaydıracağı hesaplanmıştır.
Severe verapamil intoxication despite correct use of low-dose verapamil
Authors: Mandigers Loes , Bollen Pauline D.J. , Bijlstra Peter J. , Brands Els 
Published: February 2016

Abstract
We report a case of an adult patient using chronic low-dose verapamil who developed severe verapamil intoxication. A 57-year-old male patient was presented at the emergency room after a collapse of unknown etiology. The airway was compromised, and thus, an endotracheal tube was inserted. The patient deteriorated hemodynamically. Because of verapamil use and bradycardia, verapamil intoxication was suspected. The treatment was supported with intravenous fluids, calcium, inotropes, and a transvenous pacemaker. The patient progressively developed circulatory shock. Verapamil intoxication was confirmed, and therapy was adjusted accordingly. Insulin and calcium infusion were intensified, and glucagon and Intralipid® infusion were initiated. With this therapy, the patient’s condition improved rapidly. We found different factors in this patient that could have precipitated this event such as diminished metabolism by cytochrome P450 iso-enzymes, a slightly diminished renal function with hypoalbuminemia, and interaction with other protein-binding drugs.
Evaluation in the Sit-and-Reach Flexibility Test
Authors: Zanevskyy I. , Zanevska L. 
Published: February 2016

Abstract
The research in this paper aims to correct evaluation tables of the modified flexibility sit-and-reach test, avoiding unreasonable great fluctuations in the scales. A human body model in the test, as a kinematic chain, including trunk and upper-extremity members connected with rotated joints, is proposed. An integral parameter of hip rotation and spine-bend flexibility is derived as an angle between the hip to shoulder straight line and horizon. The corresponding error of the angle in the frames of the simplified model appears to be nearly 1.5 %. The bend of trunk member is investigated, and its modeling with the integral parameter of flexibility causes an error of the fingertips displacement of nearly 0.4 cm, which is smaller than an error of the test score recorder. Two smooth evaluation scales are modeled with a linear function and with a logarithmic function. Corresponding tables for proportional evaluation and for rapidly increased mark values on the higher test scores are derived.
Experience of parents of children with congenital heart disease: feelings and obstacles
Authors: Barreto Thaís Sena Mombach , Sakamoto Victória Tiyoko Moraes , Magagnin Jardel Scremin , Coelho Débora Fernandes , Waterkemper Roberta , Canabarro Simone Travi 
Published: February 2016

Understand the meaning of the experiences of parents of children with congenital heart disease regarding feelings, obstacles and expectations. Methods: exploratory qualitative study conducted at a pediatric intensive care unit of a reference hospital. Participants corresponded to seven mothers and four fathers of children with congenital heart defect, surgically corrected and with more than 8 hours of admission, totalling 11 participants. Data collection was performed through semi-structured individual recorded interviews. Data were described according to thematic content analysis. Results: five thematic categories emerged: (1) unpreparedness to face the problem; (2) feelings involved (3) factors that make difficult to face the problem; (4) factors that facilitate facing the problem; (5) spirituality. Conclusion: each family is unique and needs support to better face the disease and its process. It is essential to develop interdisciplinary network support, providing comprehensive care.
Leptin secretory dynamics and associated disordered eating psychopathology across the weight spectrum
Authors: Baskaran Charumathi , Eddy Kamryn T , Miller Karen K , Meenaghan Erinne , Misra Madhusmita , Lawson Elizabeth A 
Published: February 2016

ObjectiveLeptin secretory dynamics across the weight spectrum and their relationship with disordered eating psychopathology have not been studied. Our objective was to compare leptin secretory dynamics in 13 anorexia nervosa (AN), 12 overweight/obese (OB) and 12 normal-weight women using deconvolution analysis.MethodsIn this cross-sectional study conducted at a tertiary referral center, serum leptin levels were obtained every 20 min from 2000 to 0800 h. Dual energy X-ray absorptiometry was used to measure percent body fat. Disordered eating psychopathology was assessed by the Eating Disorders Examination-Questionnaire (EDE-Q) and the Eating Disorders Inventory-2 (EDI-2).ResultsThe groups differed for basal leptin secretion (BASAL) (P=0.02). Mean leptin pulse amplitude, pulse mass, total pulsatile secretion (TPS) and area under the curve (AUC) were significantly different between groups before and after adjustment for BASAL (P<0.0001 for all). Leptin AUC correlated strongly with TPS (r=0.97,P<0.0001) and less with BASAL (r=0.35,P=0.03). On multivariate analysis, only TPS was a significant predictor of leptin AUC (P<0.0001). TPS was inversely associated with most EDE-Q and EDI-2 parameters and the associations remained significant for EDE-Q eating concern (P=0.01), and EDI-2 asceticism, ineffectiveness and social insecurity (P<0.05) after adjusting for BASAL. These relationships were not significant when controlled for percent body fat.ConclusionSecretory dynamics of leptin differ across weight spectrum, with mean pulse amplitude, mean pulse mass and TPS being low in AN and high in OB. Pulsatile, rather than basal secretion, is the major contributor to leptin AUC. Decreased pulsatile leptin is associated with disordered eating psychopathology, possibly reflecting low percent body fat in AN.
Institutional prevalence of malignancy of indeterminate thyroid cytology is necessary but insufficient to accurately interpret molecular marker tests
Authors: Valderrabano Pablo , Leon Marino E , Centeno Barbara A , Otto Kristen J , Khazai Laila , McCaffrey Judith C , Russell Jeffery S , McIver Bryan 
Published: February 2016

Abstract
Objective
Several molecular marker tests are available to refine the diagnosis of thyroid nodules. Knowing the true prevalence of malignancy (PoM) within each cytological category is considered necessary to select the most appropriate test and to interpret results accurately. We describe our institutional PoM among cytological categories and report our experience with molecular markers.

Design
Single-center retrospective study.

Methods
We calculated the institutional PoM for each category of the Bethesda system (Bethesda) on all thyroid nodules with cytological evaluation from October 2008 to May 2014. We estimated the predictive values for Afirma, miRInform, and ThyroSeq v2, based on published sensitivity and specificity. Finally, we assessed our own experience with miRInform.

Results
The PoMs for Bethesda III and IV categories were 21 and 28%, respectively. ThyroSeq v2 achieves the highest theoretical negative and positive predictive values (NPV and PPV) in Bethesda III (98 and 75%) and Bethesda IV categories (96 and 83%). At our institution, miRInform detected a mutation in 16% of 109 indeterminate nodules tested, all in Bethesda IV specimens. Histology was available in 56 (51%) nodules. The observed sensitivity and specificity in Bethesda IV specimens were 63 and 86%, yielding an NPV and a PPV of 75 and 77%, respectively.

Conclusions
For our current Bethesda III and IV PoM, the actual performance of miRInform was worse than expected. Theoretically ThyroSeq v2 should have the best performance, but it could be affected in the same way as miRInform, given the similarities between the tests. Assessing the institutional performance of each test is necessary along with PoM individualization.
Prevalence of HPV After Introduction of the Vaccination Program in the United States
Authors: Markowitz Lauri E. , Liu Gui , Hariri Susan , Steinau Martin , Dunne Eileen F. , Unger Elizabeth R. 
Published: February 2016

BACKGROUND:
Since mid-2006, human papillomavirus (HPV) vaccination has been recommended for females aged 11 to 12 years and through 26 years if not previously vaccinated.

METHODS:
HPV DNA prevalence was analyzed in cervicovaginal specimens from females aged 14 to 34 years in NHANES in the prevaccine era (2003–2006) and 4 years of the vaccine era (2009–2012) according to age group. Prevalence of quadrivalent HPV vaccine (4vHPV) types (HPV-6, -11, -16, and -18) and other HPV type categories were compared between eras. Prevalence among sexually active females aged 14 to 24 years was also analyzed according to vaccination history.

RESULTS:
Between the prevacccine and vaccine eras, 4vHPV type prevalence declined from 11.5% to 4.3% (adjusted prevalence ratio [aPR]: 0.36 [95% confidence interval (CI): 0.21–0.61]) among females aged 14 to 19 years and from 18.5% to 12.1% (aPR: 0.66 [95% CI: 0.47–0.93]) among females aged 20 to 24 years. There was no decrease in 4vHPV type prevalence in older age groups. Within the vaccine era, among sexually active females aged 14 to 24 years, 4vHPV type prevalence was lower in vaccinated (≥1 dose) compared with unvaccinated females: 2.1% vs 16.9% (aPR: 0.11 [95% CI: 0.05–0.24]). There were no statistically significant changes in other HPV type categories that indicate cross-protection.

CONCLUSIONS:
Within 6 years of vaccine introduction, there was a 64% decrease in 4vHPV type prevalence among females aged 14 to 19 years and a 34% decrease among those aged 20 to 24 years. This finding extends previous observations of population impact in the United States and demonstrates the first national evidence of impact among females in their 20s.
Educació, valors i guerres
Authors: Revista Comunicació Educativa Direcció 
Published: February 2016

Els creixents corrents migratoris han posat damunt la taula la necessitat d’educar per a la convivència. Els valors han de ser un tema d’importància cabdal i entre ells, democràcia, convivència, respecte a l’altre, diàleg i consens han de tenir un lloc destacat. La resposta del món de l’ensenyament davant la guerra ha estat massiva, creativa, àgil i amb la urgència que calia. Les escoles han fet bandera de la seva funció d’educar en valors, i s’han multiplicat els actes en favor de la pau.
Tema d'escola: La intervenció del Programa d'Educació Compensatòria als centres educatius de les comarques tarragonines
Authors: Pardo Júlia 
Published: February 2016

En els darrers dos cursos s’ha produït un increment considerable d’alumnat estranger de procedencia diversa, amb un degoteig constant al llarg de tot el curs, principalment en les poblacions més grans. Aquesta constant arribada de nouvinguts a Catalunya ha fet que les escoles es plantegin com vetllar per la integració d’aquests alumnes. Amb aquesta finalitat, el Programa d’Educació Compensatòria tracta de donar suport a la tasca docent dels mestres i dels professors oferint una adequada atenció educativa als centres amb alumnat amb necessitats educatives associades a situacions socials o culturals desafavorides, i a l’alumnat pertanyent a minories ètniques o culturals en situació de desavantatge.