bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhancing Efficacy of Anticancer Vaccines by Targeted Delivery to Tumor-Draining Lymph Nodes
Authors: Jeanbart Laura , Ballester Marie , de Titta Alexandre , Corthésy Patricia , Romero Pedro , Hubbell Jeffrey A. , Swartz Melody A. 
Published: February 2014

Abstract
The sentinel or tumor-draining lymph node (tdLN) serves as a metastatic niche for many solid tumors and is altered via tumor-derived factors that support tumor progression and metastasis. tdLNs are often removed surgically, and therapeutic vaccines against tumor antigens are typically administered systemically or in non–tumor-associated sites. Although the tdLN is immune-suppressed, it is also antigen experienced through drainage of tumor-associated antigens (TAA), so we asked whether therapeutic vaccines targeting the tdLN would be more or less effective than those targeting the non-tdLN. Using LN-targeting nanoparticle (NP)-conjugate vaccines consisting of TAA-NP and CpG-NP, we compared delivery to the tdLN versus non-tdLN in two different cancer models, E.G7-OVA lymphoma (expressing the nonendogenous TAA ovalbumin) and B16-F10 melanoma. Surprisingly, despite the immune-suppressed state of the tdLN, tdLN-targeting vaccination induced substantially stronger cytotoxic CD8+ T-cell responses, both locally and systemically, than non–tdLN-targeting vaccination, leading to enhanced tumor regression and host survival. This improved tumor regression correlated with a shift in the tumor-infiltrating leukocyte repertoire toward a less suppressive and more immunogenic balance. Nanoparticle coupling of adjuvant and antigen was required for effective tdLN targeting, as nanoparticle coupling dramatically increased the delivery of antigen and adjuvant to LN-resident antigen-presenting cells, thereby increasing therapeutic efficacy. This work highlights the tdLN as a target for cancer immunotherapy and shows how its antigen-experienced but immune-suppressed state can be reprogrammed with a targeted vaccine yielding antitumor immunity. Cancer Immunol Res; 2(5); 436–47. ©2014 AACR.
Effects of Sex on the Incidence of Cardiac Tamponade After Catheter Ablation of Atrial Fibrillation
Authors: Michowitz Yoav , Rahkovich Michael , Oral Hakan , Zado Erica S. , Tilz Roland , John Silke , Denis Arnaud , Di Biase Luigi , Winkle Roger A. , Mikhaylov Evgeny N. , Ruskin Jeremy N. , Yao Yan , Josephson Mark E. , Tanner Hildegard , Miller John M. , Champagne Jean , Della Bella Paolo , Kumagai Koichiro , Defaye Pascal , Luria David , Lebedev Dmitry S. , Natale Andrea , Jais Pierre , Hindricks Gerhard , Kuck Karl-Heinz , Marchlinski Francis E. , Morady Fred , Belhassen Bernard 
Published: February 2014

Background—
Cardiac tamponade is the most dramatic complication observed during atrial fibrillation (AF) ablation and the leading cause of procedure-related mortality. Female sex is a known risk factor for complications during AF ablation; however, it is unknown whether women have a higher risk of tamponade.

Methods and Results—

A systematic Medline search was used to locate academic electrophysiological centers that reported cases of tamponade occurring during AF ablation. Centers were asked to provide information on cases of acute tamponade according to sex and their mode of management including any case of related mortality. Nineteen electrophysiological centers provided information on 34 943 ablation procedures involving 25 261 (72%) men. Overall, 289 (0.9%) cases of tamponade were reported: 120 (1.24%) in women and 169 (0.67%) in men (odds ratio, 1.83;
P
<0.001). There was a reciprocal association between center volume and the occurrence of tamponade with substantially lower risk in high-volume centers. Most cases of tamponade occurred during catheter manipulation or ablation; women tended to develop more tamponades during transseptal catheterization. No sex difference in the mode of management was observed. However, 16% cases of tamponade required surgery with lower rates in high-volume centers. Three cases of tamponade (1%) culminated in death.

Conclusions—
Tamponade during AF ablation procedures is relatively rare. Women have an ≈2-fold higher risk for developing this complication. The risk of tamponade among women decreases substantially in high-volume centers. Surgical backup and acute management skills for treating tamponade are important in centers performing AF ablation.
Usefulness of N-Terminal Pro–B-Type Natriuretic Peptide Levels for Stroke Risk Prediction in Anticoagulated Patients With Atrial Fibrillation
Authors: Roldán Vanessa , Vílchez Juan Antonio , Manzano-Fernández Sergio , Jover Eva , Gálvez Josefa , Puche Carmen M. , Valdés Mariano , Vicente Vicente , Lip Gregory Y.H. , Marín Francisco 
Published: February 2014

Background and Purpose—
Oral anticoagulation is highly effective in reducing stroke and mortality in atrial fibrillation (AF). Several risk stratification schemes have been developed using clinical characteristics. Elevated levels of N-terminal pro–B-type natriuretic peptide (NT-proBNP) are important markers of increased mortality and morbidity in congestive heart failure and general community population. The aim of our study was to assess the predictive value of NT-proBNP levels in an unselected real-world cohort of anticoagulated patients with AF.

Methods—
We studied 1172 patients (49% male; median age, 76 years) with permanent AF who were well stabilized on oral anticoagulation (international normalized ratio, 2.0–3.0). Plasma NT-proBNP levels were quantified at baseline. We recorded thrombotic and vascular events, mortality, and major bleeding. The best cutoff points were assessed by receiver-operating characteristic curves.

Results—

Median levels (interquartile range) of NT-proBNP were 610 (318–1037) pg/mL. Median follow-up was 1007 (806–1279) days. On multivariate analysis, high NT-proBNP was significantly associated with the risk of stroke (hazards ratio, 2.71;
P
=0.001) and composite vascular events (acute coronary syndrome or acute heart failure; hazards ratio, 1.85;
P
=0.016), as well as a significant association with mortality (adjusted hazards ratio, 1.66;
P
=0.006). No association with bleeding was found (
P
=0.637). The integrated discrimination improvement (IDI) analysis demonstrated that NT-proBNP improved the Congestive heart failure, Hypertension, Age≥75 (doubled), Diabetes mellitus, Stroke (doubled)–Vascular disease and Sex category (female); CHA
2
DS
2
–VASc score for predicting embolic events (relative IDI, 2.8%;
P
=0.001) and all-cause death (relative IDI, 1.8%;
P
=0.001).

Conclusions—

In real-world cohort of anticoagulated patients with AF, NT-proBNP provided complementary prognostic information to an established clinical risk score (CHA
2
DS
2
–VASc) for the prediction of stroke/systemic embolism. NT-proBNP was also predictive of all-cause mortality, suggesting that this biomarker may potentially be used to refine clinical risk stratification in anticoagulated patients with AF.
Is White Matter More Prone to Diffusion Lesion Reversal After Thrombolysis?
Authors: Tisserand Marie , Malherbe Caroline , Turc Guillaume , Legrand Laurence , Edjlali Myriam , Labeyrie Marc-Antoine , Seners Pierre , Mas Jean-Louis , Méder Jean-François , Baron Jean-Claude , Oppenheim Catherine 
Published: February 2014

Background and Purpose—
In acute ischemic stroke, white matter (WM) is considered more resistant to infarction than gray matter (GM). To test this hypothesis, we compared the fate of WM and GM voxels belonging to the acute diffusion-weighted imaging (DWI) lesion, expecting WM voxels to be more prone to reversal after thrombolysis.

Methods—

Reversible acute DWI (RAD) lesion was defined voxel-wise as an acute lesion on initial DWI (DWI
1
) with no visible lesion on 24-hour DWI (DWI
2
). Only patients with RAD lesions >10 mL and >10% of DWI
1
from our previously reported cohort were eligible. The core was defined as voxels hyperintense on DWI
1
and DWI
2
. Semiautomated segmentation of DWI
1
, core, and RAD lesions, normalization into standard space, and WM/GM segmentation allowed calculations of WM/GM proportions in each region of interest using a voxel-counting algorithm.

Results—

Thirty patients were eligible (RAD lesion median volume [interquartile range], 23.3 mL [19.1–35.0 mL]; onset-to-treatment time, 134 minutes [105–185 minutes]). WM voxels fraction was greater in RAD lesions than in the core (59.4% [52.8%–68.9%] versus 49.6% [43.0%–57.5%];
P
=0.011). The proportion of reversibility was greater for WM than for GM voxels (60.8% [25.5%–88.7%] versus 53.5% [21.1%–77.3%];
P
=0.02). The percentage of RAD lesions increased with the proportion of WM present in the acute DWI lesion (
P
<0.0001;
R
=0.67).

Conclusions—
Acute DWI lesions predominantly involving WM may be more prone to reversal and, hence, to respond to therapy than their GM counterparts.
Sensitivity of Intertropical Convergence Zone Movement to the Latitudinal Position of Thermal Forcing
Authors: Seo Jeongbin , Kang Sarah M. , Frierson Dargan M. W. 
Published: February 2014

Abstract
A variety of recent studies have shown that extratropical heating anomalies can be remarkably effective at causing meridional shifts in the intertropical convergence zone (ITCZ). But what latitudinal location of forcing is most effective at shifting the ITCZ? In a series of aquaplanet simulations with the GFDL Atmospheric Model, version 2 (AM2), coupled to a slab mixed layer ocean, it is shown that high-latitude forcing actually causes a larger shift in the ITCZ than when equivalent surface forcing is applied in the tropics. Equivalent simulations are run with an idealized general circulation model (GCM) without cloud and water vapor feedbacks, also coupled to an aquaplanet slab ocean, where the ITCZ response instead becomes weaker the farther the forcing is from the equator, indicating that radiative feedbacks must be important in AM2.
In the absence of radiative feedbacks, the tendency for anomalies to decrease in importance the farther away they are from the equator is due to the quasi-diffusive nature of energy transports. Cloud shortwave responses in AM2 act to strengthen the ITCZ response to extratropical forcing, amplifying the response as it propagates toward the equator. These results emphasize the great importance of the extratropics in determining the position of the ITCZ.
Neutrophil gelatinase-associated lipocalin as a biomarker of acute kidney injury: a critical evaluation of current status
Authors: Haase-Fielitz Anja , Haase Michael , Devarajan Prasad 
Published: February 2014

Background The early prediction of acute kidney injury (AKI) by current clinical and laboratory methods remains inadequate. Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as a promising non-invasive biomarker of kidney injury. We systematically reviewed the utility of plasma and urine NGAL measurements for the prediction of AKI in humans. Methods We searched MEDLINE, PubMed and EMBASE for human biomarker studies that included NGAL (January 2005 to October 2013). Studies reporting on the use of NGAL for the early prediction and prognosis of AKI were analysed in three common clinical settings: cardiac surgery, critical illness and kidney transplantation. Results We identified 58 manuscripts that met our inclusion and exclusion criteria, reporting on more than 16,500 patients. Following cardiac surgery, NGAL measurement in over 7000 patients was predictive of AKI and its severity, with an overall area under the receiver operator characteristic curve (AUC) of 0.82–0.83. Similar results were obtained in over 8500 critically ill patients. In over 1000 patients undergoing kidney transplantation, NGAL measurements predicted delayed graft function with an overall AUC of 0.87. In all three settings, NGAL significantly improved the prediction of AKI risk over the clinical model alone. Conclusions We identified several studies that collectively strongly support the use of NGAL as a biomarker for the prediction of AKI. However, we noted some limitations, including lack of published studies that adhere to diagnostic study guidelines, heterogeneity in AKI definition, the lack of uniformly applicable cut-off values and variability in the performance of commercially available NGAL assays.
Continuity of care by cardiothoracic nurse practitioners: Impact on outcome
Authors: Southey Dawn , Mishra Pankaj Kumar , Nevill Alan , Aktuerk Dincer , Luckraz Heyman 
Published: February 2014

Objectives There have been recent reports on increased mortality in British National Health Service hospitals during weekends. This study aimed to assess the impact on patient care following the introduction of nurse practitioner cover for the cardiothoracic ward, including weekends. Methods Prospectively collected and validated data of patients operated on from January 2005 to October 2011 were analyzed. The patients were grouped according to era: before ( n = 2385) and after ( n = 3910) the introduction of nurse practitioners in October 2007. Results There were no significant differences in preoperative patient characteristics such as age, logistic EuroSCORE, sex, smoking, and extracardiac vascular problems. There were more patients from an Asian background ( p < 0.01), more with noninsulin-dependent diabetes ( p < 0.01), and more requiring urgent cardiac surgery ( p < 0.01) in the later era. Following the introduction of nurse practitioner grade, there was a decrease in the rate of cardiac intensive care unit readmission from 2.6% to 1.9% ( p = 0.05) and length of hospital stay from 10 to 8 days ( p < 0.01). There was a significant improvement in overall survival after cardiac surgery from 96.5% to 98.0% ( p < 0.01). Logistic regression analysis confirmed that the presence of nurse practitioners on the ward was the strongest predictor of survival with an odds ratio of 1.9 (95% confidence interval: 1.23–3.01). Conclusion The introduction of the nurse practitioner grade to provide continuity in patient care including at weekends has been confirmed to improve patient outcomes including survival after cardiac surgery.
Low-level laser and local corticosteroid injection in the treatment of subacromial impingement syndrome: a controlled clinical trial
Authors: Kelle Bayram , Kozanoglu Erkan 
Published: February 2014

Objective: To investigate the effectiveness of low-level laser treatment and local corticosteroid injection in patients with subacromial impingement syndrome. Design: Controlled clinical trial. Setting: Physical Medicine and Rehabilitation outpatient clinic. Subjects: One hundred thirty-five patients with subacromial impingement syndrome. Intervention: The patients were allocated to three groups: local corticosteroid injection (group I); sham laser treatment (group II); and low-level laser treatment (group III). Low-level laser treatment was performed three times per week for a total of nine sessions. Local corticosteroid injections were administered twice, with an interval of 10 days between each. The patients were assessed at pre-treatment, post-treatment and three and six months after the first visit. Main measures: The primary outcome of the study was pain intensity (visual analog scale) during activity and at rest. The secondary outcomes were, shoulder functional status and quality of life measured by the University of California at Los Angeles rating score (UCLA) and Nottingham Health Profile (NHP) scale respectively. Results: Significant differences were observed between groups I and II and between groups II and III regarding pain during activity and at rest scores at all of the visits ( p<0.05). Nevertheless, significant improvement was observed between groups I and III regarding pain during activity only at post-treatment ( p=0.013). The UCLA scores were significantly changed in all three study groups at all of the visits ( p<0.05). Conclusion: The effectiveness of low-level laser treatment was similar to that of local corticosteroid injection in patients with subacromial impingement syndrome. We concluded that both low-level laser treatment and corticosteroid injection were more effective than sham laser treatment.
How to measure fatigue in neurological conditions? A systematic review of psychometric properties and clinical utility of measures used so far
Authors: Tyson Sarah F , Brown Philip 
Published: February 2014

Objective: To systemically review the psychometric properties and clinical utility (feasibility) of tools to measure fatigue in neurological conditions. Data sources: AMED, CINAHL, MEDLINE, Science Direct and Web of Knowledge were searched for studies of the psychometric properties of fatigue measures in adults with central nervous system disorders. Search terms were: Fatigue AND assess* OR measure* OR tool OR outcome OR index OR test OR scale AND stroke OR cerebrovascular* OR hemi* OR parkinson* OR sclerosis OR head injury OR brain injury OR motor neurone disease OR neuro* Review methods: Articles that addressed validity; reliability and ability to detect change were selected. Two authors independently selected articles and extracted data. Strength of the psychometric properties and clinical utility were assessed against predetermined thresholds. Results: A total of 25 articles were selected and 17 measurement tools identified including six versions of the Fatigue Severity Scale and five versions of the Fatigue Impact Scale. All were clinically feasible but none met all the criteria. Most were valid. Reliability and ability to detect change were infrequently evaluated, but were adequate when reported. The most thoroughly developed and psychometrically robust measures were the Neurological Fatigue Indices. Conclusion: Although many measures of fatigue in neurological conditions have published, none met all of the criteria for psychometric robustness and clinical utility but the Neurological Fatigue Indices are the best and can be used with caution
Transarterial chemoembolization as first-line therapy for hepatocellular carcinomas infeasible for ultrasound-guided radiofrequency ablation: a retrospective cohort study of 116 patients
Authors: Song Yun Gyu , Shin Sung Wook , Cho Sung Ki , Choi Dongil , Rhim Hyunchul , Lee Min Woo , Kim Young-sun , Park Kwang Bo , Park Hong Suk , Choo Sung Wook , Do Young Soo , Choo In-wook , Hyun Dongho 
Published: February 2014

Background Ultrasound (US)-guided radiofrequency ablation (RFA) is frequently infeasible even for very early or early stage hepatocellular carcinoma (HCC) due to various reasons such as inconspicuous tumors or absence of a safe electrode path and the infeasibility rate is reportedly as high as 45%. In such cases, transarterial chemoembolization (TACE) is a commonly practiced alternative. Purpose To analyze long-term outcomes including tumor progression patterns and factors contributing to survival of patients who received TACE as the first line of therapy for very early or early stage HCC infeasible for US-guided RFA. Material and Methods From October 2006 through October 2009, 116 patients with very early or early stage HCCs underwent the first-line therapy TACE after their tumors were deemed infeasible for RFA. Long-term survival rates were calculated and prognostic factors were assessed by univariate and multivariate analyses. The patterns and rates of tumor progression or recurrence were also evaluated. Results The 1, 3, and 5-year survival rates of the whole cohort were 94.7%, 68.4%, and 47.2% with a mean overall survival of 53.1 months (95% CI: 48.2–58.0). Preserved liver function with Child-Pugh class A was the only independent factor associated with longer survival. The most common first tumor progression pattern was intrahepatic distant recurrence. The cumulative rates of local tumor progression and intrahepatic distant recurrence at 1, 3, and 5 years were 33% and 22%, 52% and 49%, and 73% and 75%, respectively. Conclusion TACE is a viable first-line treatment of HCC infeasible for RFA, especially when liver function was preserved.
Percutaneous biliary covered stent insertion in patients with malignant duodenobiliary obstruction
Authors: Lee Eunsol , Gwon Dong Il , Ko Gi-Young , Sung Kyu-Bo , Yoon Hyun-Ki , Shin Ji Hoon , Kim Jin Hyoung , Ko Heung Kyu , Song Ho-Young 
Published: February 2014

Background Although the use of polytetrafluoroethylene (PTFE)-covered biliary stents has proven to be feasible for the treatment of benign and malignant biliary disease, less is known regarding the outcomes of percutaneous placement of a covered stent in patients with malignant duodenobiliary obstruction. Purpose To investigate the technical and clinical efficacy of the percutaneous placement of a PTFE-covered biliary stent in patients with malignant duodenobiliary obstruction. Material and Methods From April 2007 to September 2012, the medical records of 45 consecutive patients with malignant duodenobiliary obstruction were retrospectively reviewed. All percutaneous biliary stent deployment was performed using PTFE-covered stents, whereas duodenal stent insertion was performed either fluoroscopically or endoscopically using covered or uncovered stents. Results Biliary stent deployment was technically successful in all patients. None of the stents migrated after deployment. Procedure-related minor complications, including self-limiting hemobilia, occurred in three (7%) patients. Successful internal drainage was achieved in 39 (87%) of the 45 patients. The median survival time after biliary stent placement was 62 days (95% confidence interval, 8–116 days), and the cumulative stent patency rates at 1, 3, 6, and 12 months were 96%, 92%, 75%, and 38%, respectively. The causes of biliary stent dysfunction included stent occlusion caused by a subsequently inserted duodenal stent ( n = 7), food impaction ( n = 3), and sludge incrustation ( n = 1). One patient developed acute cholecystitis 131 days after biliary stent placement and underwent percutaneous transhepatic gallbladder drainage. Conclusion Percutaneous insertion of a PTFE-covered stent is a safe and effective method for palliative treatment of patients with malignant duodenobiliary obstruction. If possible, subsequent biliary stent insertion is preferable in order to prevent possible biliary stent dysfunction caused by subsequent insertion of a duodenal stent.