bluuebunny/crossref_metadata_2025_split huggingface dataset:
New Comprehensive Cytogenetic Scoring System for Primary Myelodysplastic Syndromes (MDS) and Oligoblastic Acute Myeloid Leukemia After MDS Derived From an International Database Merge
Authors: Schanz Julie , Tüchler Heinz , Solé Francesc , Mallo Mar , Luño Elisa , Cervera José , Granada Isabel , Hildebrandt Barbara , Slovak Marilyn L. , Ohyashiki Kazuma , Steidl Christian , Fonatsch Christa , Pfeilstöcker Michael , Nösslinger Thomas , Valent Peter , Giagounidis Aristoteles , Aul Carlo , Lübbert Michael , Stauder Reinhard , Krieger Otto , Garcia-Manero Guillermo , Faderl Stefan , Pierce Sherry , Le Beau Michelle M. , Bennett John M. , Greenberg Peter , Germing Ulrich , Haase Detlef 
Published: February 2012

PurposeThe karyotype is a strong independent prognostic factor in myelodysplastic syndromes (MDS). Since the implementation of the International Prognostic Scoring System (IPSS) in 1997, knowledge concerning the prognostic impact of abnormalities has increased substantially. The present study proposes a new and comprehensive cytogenetic scoring system based on an international data collection of 2,902 patients.Patients and MethodsPatients were included from the German-Austrian MDS Study Group (n = 1,193), the International MDS Risk Analysis Workshop (n = 816), the Spanish Hematological Cytogenetics Working Group (n = 849), and the International Working Group on MDS Cytogenetics (n = 44) databases. Patients with primary MDS and oligoblastic acute myeloid leukemia (AML) after MDS treated with supportive care only were evaluated for overall survival (OS) and AML evolution. Internal validation by bootstrap analysis and external validation in an independent patient cohort were performed to confirm the results.ResultsIn total, 19 cytogenetic categories were defined, providing clear prognostic classification in 91% of all patients. The abnormalities were classified into five prognostic subgroups (P < .001): very good (median OS, 61 months; hazard ratio [HR], 0.5; n = 81); good (49 months; HR, 1.0 [reference category]; n = 1,809); intermediate (26 months; HR, 1.6; n = 529); poor (16 months; HR, 2.6; n = 148); and very poor (6 months; HR, 4.2; n = 187). The internal and external validations confirmed the results of the score.ConclusionIn conclusion, these data should contribute to the ongoing efforts to update the IPSS by refining the cytogenetic risk categories.
Minimal Residual Disease Quantification Is an Independent Predictor of Progression-Free and Overall Survival in Chronic Lymphocytic Leukemia: A Multivariate Analysis From the Randomized GCLLSG CLL8 Trial
Authors: Böttcher Sebastian , Ritgen Matthias , Fischer Kirsten , Stilgenbauer Stephan , Busch Raymonde M. , Fingerle-Rowson Günter , Fink Anna Maria , Bühler Andreas , Zenz Thorsten , Wenger Michael Karl , Mendila Myriam , Wendtner Clemens-Martin , Eichhorst Barbara F. , Döhner Hartmut , Hallek Michael J. , Kneba Michael 
Published: February 2012

Purpose To determine the clinical significance of flow cytometric minimal residual disease (MRD) quantification in chronic lymphocytic leukemia (CLL) in addition to pretherapeutic risk factors and to compare the prognostic impact of MRD between the arms of the German CLL Study Group CLL8 trial. Patients and Methods MRD levels were prospectively quantified in 1,775 blood and bone marrow samples from 493 patients randomly assigned to receive fludarabine and cyclophosphamide (FC) or FC plus rituximab (FCR). Patients were categorized by MRD into low- (< 10−4), intermediate- (≥ 10−4 to <10−2), and high-level (≥ 10−2) groups. Results Low MRD levels during and after therapy were associated with longer progression-free survival (PFS) and overall survival (OS; P < .0001). Median PFS is estimated at 68.7, 40.5, and 15.4 months for low, intermediate, and high MRD levels, respectively, when assessed 2 months after therapy. Compared with patients with low MRD, greater risks of disease progression were associated with intermediate and high MRD levels (hazard ratios, 2.49 and 14.7, respectively; both P < .0001). Median OS was 48.4 months in patients with high MRD and was not reached for lower MRD levels. MRD remained predictive for OS and PFS in multivariate analyses that included the most important pretherapeutic risk markers in CLL. PFS and OS did not differ between treatment arms within each MRD category. However, FCR induced low MRD levels more frequently than FC. Conclusion MRD levels independently predict OS and PFS in CLL. Therefore, MRD quantification might serve as a surrogate marker to assess treatment efficacy in randomized trials before clinical end points can be evaluated.
Predictors of Aromatase Inhibitor Discontinuation as a Result of Treatment-Emergent Symptoms in Early-Stage Breast Cancer
Authors: Henry N. Lynn , Azzouz Faouzi , Desta Zereunesay , Li Lang , Nguyen Anne T. , Lemler Suzanne , Hayden Jill , Tarpinian Karineh , Yakim Elizabeth , Flockhart David A. , Stearns Vered , Hayes Daniel F. , Storniolo Anna Maria 
Published: February 2012

Purpose Aromatase inhibitors (AIs) are effective for treatment of hormone receptor–positive breast cancer, but adherence and persistence with therapy are poor. Predictors of treatment discontinuation are not clearly defined. It is unknown whether patients with intolerable toxicity from one AI are able to tolerate another. Patients and Methods Women with early-stage breast cancer initiating AI therapy were enrolled onto a multicenter, prospective, open-label randomized trial of exemestane versus letrozole. Patients completed symptom questionnaires at baseline and serially during therapy. Patients who developed AI-associated intolerable symptoms and discontinued treatment were given the option to switch to the other study AI after a 2- to 8-week washout period. Results Of the 503 enrolled women, 32.4% discontinued initial AI therapy within 2 years because of adverse effects; 24.3% discontinued specifically because of musculoskeletal symptoms. Median time to treatment discontinuation as a result of any symptom was 6.1 months (range, 0.1 to 21.2 months) and was significantly shorter in patients randomly assigned to exemestane (hazard ratio [HR], 1.5; 95% CI, 1.1 to 2.1; P = .02). Younger age and taxane-based chemotherapy were associated with higher likelihood of treatment discontinuation (HR, 1.4; 95% CI, 1.02 to 1.9; P = .04; and HR, 1.9; 95% CI, 1.00 to 3.6; P = .048, respectively). Of the 83 patients who chose to switch to the second AI, 38.6% continued the alternate AI for a median of 13.7 months. Conclusion Premature discontinuation of initial AI therapy as a result of symptoms is common, although more than one third of patients may be able to tolerate a different AI medication. Additional research is needed to identify predictive tools and interventions for AI-associated treatment-emergent symptoms.
Revised Prognostic Staging System for Light Chain Amyloidosis Incorporating Cardiac Biomarkers and Serum Free Light Chain Measurements
Authors: Kumar Shaji , Dispenzieri Angela , Lacy Martha Q. , Hayman Suzanne R. , Buadi Francis K. , Colby Colin , Laumann Kristina , Zeldenrust Steve R. , Leung Nelson , Dingli David , Greipp Philip R. , Lust John A. , Russell Stephen J. , Kyle Robert A. , Rajkumar S. Vincent , Gertz Morie A. 
Published: February 2012

Purpose Cardiac involvement predicts poor prognosis in light chain (AL) amyloidosis, and the current prognostic classification is based on cardiac biomarkers troponin-T (cTnT) and N-terminal pro–B-type natriuretic peptide (NT-ProBNP). However, long-term outcome is dependent on the underlying plasma cell clone, and incorporation of clonal characteristics may allow for better risk stratification. Patients and Methods We developed a prognostic model based on 810 patients with newly diagnosed AL amyloidosis, which was further examined in two other datasets: 303 patients undergoing stem-cell transplantation, and 103 patients enrolled onto different clinical trials. Results We examined the prognostic value of plasma cell–related characteristics (ie, difference between involved and uninvolved light chain [FLC-diff], marrow plasma cell percentage, circulating plasma cells, plasma cell labeling index, and β2 microglobulin). In a multivariate model that included these characteristics as well as cTnT and NT-ProBNP, only FLC-diff, cTnT, and NT-ProBNP were independently prognostic for overall survival (OS). Patients were assigned a score of 1 for each of FLC-diff ≥ 18 mg/dL, cTnT ≥ 0.025 ng/mL, and NT-ProBNP ≥ 1,800 pg/mL, creating stages I to IV with scores of 0 to 3 points, respectively. The proportions of patients with stages I, II, III and IV disease were 189 (25%), 206 (27%), 186 (25%) and 177 (23%), and their median OS from diagnosis was 94.1, 40.3, 14, and 5.8 months, respectively (P < .001). This classification system was validated in the other datasets. Conclusion Incorporation of serum FLC-diff into the current staging system improves risk stratification for patients with AL amyloidosis and will help develop risk-adapted therapies for AL amyloidosis.
Management strategies for acute proximal deep vein thrombosis: a Delphi consensus
Authors: Patterson B O , Karthikesalingam A , Morgan R , Hunt B J , Thompson M M , Holt P J E 
Published: February 2012

Objectives Deep vein thrombosis (DVT) is a leading cause of cardiovascular disease. We tested the hypothesis that there is a consensus regarding the treatment of acute DVT among clinicians experienced in DVT management. Method A Delphi consensus approach was used to gather expert opinion regarding attitudes towards the treatment of acute proximal DVT and management of specific cases. Strength of preference for various treatment strategies across a number of case scenarios was quantified. Univariate and multivariate analyses were performed to quantify the influence of various factors on treatment modality selected. Results Respondents strongly agreed that DVT was a significant health problem and that further research was a priority. A multidisciplinary team approach with access to various treatment strategies was encouraged. Pregnancy and recent surgery independently predicted preference for medical treatment, whereas proximal DVT and May–Thurner syndrome were associated with interventional strategies. Conclusion Acute proximal DVT is a significant health problem for which a variety of treatments are available. This study demonstrates that no consensus exists as to the optimum strategy for certain patient groups. Trends in opinion based on local experience and case-series exist, but the results of ongoing randomized trials will ultimately inform best practice.
Morbidity and Mortality of Neonatal Respiratory Failure in China: Surfactant Treatment in Very Immature Infants
Authors: Wang Huanhuan , Gao Xirong , Liu Cuiqing , Yan Chaoying , Lin Xinzhu , Yang Changyi , Lin Zhenlang , Zhu Wenjun , Yang Zhenying , Yu Fengqin , Qiu Yinping , Liu Xianzhi , Zhou Xiaoyu , Chen Chao , Sun Bo ,   on behalf of the Chinese Collaborative Study Group for Neonatal Respiratory Diseases
Published: February 2012

OBJECTIVES:
We retrospectively investigated incidence, morbidity, and mortality of neonatal respiratory failure (NRF) in China, with special emphasis on surfactant treated very immature infants.

METHODS:
NRF was defined as respiratory hypoxemia requiring mechanical ventilation and/or nasal continuous positive airway pressure for at least 24 hours.

RESULTS:
There were 6864 cases of NRF, composing 19.7% of total admissions to 55 NICUs in 2008. Of these cases, 62.8% were preterm, and 16.4% of very low birth weight (VLBW, &lt;1500 g). The primary diseases were respiratory distress syndrome (RDS, 43.9%), pneumonia/sepsis (21.7%), transient respiratory insufficiency (14.7%), transient tachypnea (8.1%), and meconium aspiration syndrome (7.0%). Surfactant was given to 26.8% of infants with NRF and 54.8% infants with RDS. The survival rate of surfactant-treated RDS was 79.9% compared to 71.8% in those not receiving surfactant (P &lt; .001). This was also true in those of VLBW, 59.8% vs 52.2% (P = .035), respectively. The overall survival rate in NRF cases was 75.3%, but it was 58.1% among VLBW infants; for those infants of 25, 26, and 27 to 28 weeks’ gestational age, the survival rates were ∼6%, 30%, and 50%, respectively; and the survival rates for infants with meconium aspiration syndrome and pneumonia/sepsis were 70.3% and 71.4%, respectively. The care burden was associated with high treatment withdrawal and death rate.

CONCLUSIONS:
The outcomes of NRF, especially in extremely premature infants, reflect both progress and persistent limitations in providing respiratory support in the emerging NICUs of China, but overall survival for sick newborns had improved steadily.
Discharged on Supplemental Oxygen From an Emergency Department in Patients With Bronchiolitis
Authors: Halstead Sarah , Roosevelt Genie , Deakyne Sara , Bajaj Lalit 
Published: February 2012

BACKGROUND AND OBJECTIVE:
Bronchiolitis is the most common reason for hospital admission in patients aged &lt;1 year. Admissions have been increasing with hypoxia frequently cited as the determinant. Home oxygen (O2) has been shown to be feasible, although safety data are lacking. The objective of this study was to evaluate the impact of a home O2 clinical care protocol on admission rates in patients with bronchiolitis from the pediatric emergency department.

METHODS:
We performed a retrospective chart review of patients with bronchiolitis who presented to a children’s hospital pediatric emergency department (altitude 1600 m) between 2005 and 2009. Patients between the ages of 1 and 18 months were included in the analysis. Patients requiring baseline O2 were excluded. We calculated the percentage of patients discharged on O2 and their readmission rates. We reviewed charts of patients who were admitted after home O2 for adverse outcomes. We also compared rates of admission before and after initiation of the protocol.

RESULTS:
In this study, 4194 illnesses were analyzed; 2383 (57%) were discharged on room air, 649 (15%) were discharged on O2, and 1162 (28%) were admitted. Of those discharged on room air, 4% were subsequently admitted, and 6% of those discharged on O2 were admitted. There were no ICU admissions or need for advanced airway management in those patients discharged on O2. Our overall admission rates for bronchiolitis dropped from a rate of 40% to 31%.

CONCLUSIONS:
Home O2 is an effective way to decrease hospital admissions in a select group of patients with bronchiolitis.
Impact of State Laws That Extend Eligibility for Parents’ Health Insurance Coverage to Young Adults
Authors: Blum Alexander B. , Kleinman Lawrence C. , Starfield Barbara , Ross Joseph S. 
Published: February 2012

BACKGROUND AND OBJECTIVES:
The 2010 Affordable Care Act mandates that health insurance companies make those up to age 26 eligible for their parents’ policies. Thirty-four states previously enacted similar laws. The authors sought to examine the impact on access to care of state laws extending eligibility of parents’ insurance to young adults.

METHODS:
By using a difference-in-differences analysis, we examined the 2002–2004 and 2008–2009 Behavior Risk Factor Surveillance System to compare 3 states enacting laws in 2005 or 2006 with 17 states that have not enacted laws on 4 outcomes: self-reported health insurance coverage, identification of a personal physician/clinician, physical exam from a physician within the past 2 years, and forgoing care in the past year due to cost.

RESULTS:
For each outcome there was differential improvement among states enacting laws compared with states without laws. Health insurance differentially increased 0.2% (95% confidence interval [CI], −3.8% to 4.2%), from 67.6% to 68.1% pre-post in states enacting laws and from 68.5% to 68.7% in states without. Personal physician/clinician identification differentially increased 0.9% (95% CI −3.1% to 5.0%), from 62.4% to 65.5% in states enacting laws and from 58.0% to 60.2% in states without. Recent physical exams differentially increased significantly 4.6% (95% CI, 0%–9.2%), from 77.3% to 81.2% in states enacting laws and from 76.2% to 75.5% in states without. Forgone care due to cost differentially decreased significantly 3.9% (95% CI, −0.3% to −7.5%), from 20.4% to 18.2% in states enacting laws and from 17.8% to 19.4% in states without.

CONCLUSIONS:
States that expanded eligibility to parents’ insurance in 2005 or 2006 experienced improvements in access to care among young adults.
Never Enough Sleep: A Brief History of Sleep Recommendations for Children
Authors: Matricciani Lisa Anne , Olds Tim S. , Blunden Sarah , Rigney Gabrielle , Williams Marie T. 
Published: February 2012

BACKGROUND AND OBJECTIVE:There is a common belief that children are not getting enough sleep and that children’s total sleep time has been declining. Over the century, many authors have proposed sleep recommendations. The aim of this study was to describe historical trends in recommended and actual sleep durations for children and adolescents, and to explore the rationale of sleep recommendations.METHODS:A systematic literature review was conducted to identify recommendations for children’s sleep requirements and data reporting children’s actual total sleep time. For each recommendation identified, children’s actual sleep time was determined by identifying studies reporting the sleep duration of children of the same age, gender, and country in the same years. Historical trends in age-adjusted recommended sleep times and trends in children’s actual sleep time were calculated. A thematic analysis was conducted to determine the rationale and evidence-base for recommendations.RESULTS:Thirty-two sets of recommendations were located dating from 1897 to 2009. On average, age-specific recommended sleep decreased at the rate of –0.71 minute per year. This rate of decline was almost identical to the decline in the actual sleep duration of children (–0.73 minute per year). Recommended sleep was consistently ∼37 minutes greater than actual sleep, although both declined over time.CONCLUSIONS:A lack of empirical evidence for sleep recommendations was universally acknowledged. Inadequate sleep was seen as a consequence of “modern life,” associated with technologies of the time. No matter how much sleep children are getting, it has always been assumed that they need more.
Maternal Serum Vitamin D Levels During Pregnancy and Offspring Neurocognitive Development
Authors: Whitehouse Andrew J. O. , Holt Barbara J. , Serralha Michael , Holt Patrick G. , Kusel Merci M. H. , Hart Prue H. 
Published: February 2012

OBJECTIVES:To determine the association between maternal serum 25(OH)-vitamin D concentrations during a critical window of fetal neurodevelopment and behavioral, emotional, and language outcomes of offspring.METHODS:Serum 25(OH)-vitamin D concentrations of 743 Caucasian women in Perth, Western Australia (32°S) were measured at 18 weeks pregnancy and grouped into quartiles. Offspring behavior was measured with the Child Behavior Checklist at 2, 5, 8, 10, 14, and 17 years of age (n range = 412–652). Receptive language was assessed with the Peabody Picture Vocabulary Test—Revised at ages 5 (n = 534) and 10 (n = 474) years. Raw scores were converted to standardized scores, incorporating cutoffs for clinically significant levels of difficulty.RESULTS:χ2 analyses revealed no significant associations between maternal 25(OH)-vitamin D serum quartiles and offspring behavioral/emotional problems at any age. In contrast, there were significant linear trends between quartiles of maternal vitamin D levels and language impairment at 5 and 10 years of age. Multivariate regression analyses, incorporating a range of confounding variables, found that the risk of women with vitamin D insufficiency (≤46 nmol/L) during pregnancy having a child with clinically significant language difficulties was increased close to twofold compared with women with vitamin D levels &gt;70 nmol/L.CONCLUSIONS:Maternal vitamin D insufficiency during pregnancy is significantly associated with offspring language impairment. Maternal vitamin D supplementation during pregnancy may reduce the risk of developmental language difficulties among their children.
Growth Techniques for Bulk ZnO and Related Compounds
Authors: Klimm Detlef , Schulz Detlev , Ganschow Steffen , Galazka Zbigniew , Uecker Reinhard 
Published: February 2012

ABSTRACTZnO bulk crystals can be grown by several methods. 1) From the gas phase, usually by chemical vapor transport. Such CVT crystals may have high chemical purity, as the growth is performed without contact to foreign material. The crystallographic quality is often very high (free growth). 2) From melt fluxes such as alkaline hydroxides or other oxides (MoO3, V2O5, P2O5, PbO) and salts (PbCl2, PbF2). Melt fluxes offer the possibility to grow bulk ZnO under mild conditions (<1000°C, atmospheric pressure), but the crystals always contain traces of solvent. The limited purity is a severe drawback, especially for electronic applications. 3) From hydrothermal fluxes, usually alkaline (KOH, LiOH) aqueous solutions beyond the critical point. Due to the amphoteric character of ZnO, the supercritical bases can dissolve it up to several per cent of mass. The technical requirements for this growth technology are generally hard, but this did not hinder its development as the basic technique for the growth of α-quartz, and meanwhile also of zinc oxide, during the last decades. 4) From pure melts, which is the preferred technology for numerous substances applied whenever possible, e.g. for the growth of silicon, gallium arsenide, sapphire, YAG. The benefits of melt growth are (i) the high growth rate and (ii) the absence of solvent related impurities. In the case of ZnO, however, it is difficult to find container materials that are compatible from the thermal (fusion pointTf= 1975°C) and chemical (required oxygen partial pressure) point of view. Either cold crucible (skull melting) or Bridgman (with reactive atmosphere) techniques were shown to overcome the problems that are inherent to melt growth. Reactive atmospheres allow to grow not only bulk ZnO single crystals, but also other TCOs such as β-Ga2O3and In2O3.