bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Transplacental Treatment of Fetal Supraventricular Tachyarrhythmias With Digoxin, Flecainide, and Sotalol
Authors: Jaeggi Edgar T. , Carvalho Julene S. , De Groot Ernestine , Api Olus , Clur Sally-Ann B. , Rammeloo Lukas , McCrindle Brian W. , Ryan Greg , Manlhiot Cedric , Blom Nico A. 
Published: September 2011

Background—
Fetal tachyarrhythmia may result in low cardiac output and death. Consequently, antiarrhythmic treatment is offered in most affected pregnancies. We compared 3 drugs commonly used to control supraventricular tachycardia (SVT) and atrial flutter (AF).

Methods and Results—

We reviewed 159 consecutive referrals with fetal SVT (n=114) and AF (n=45). Of these, 75 fetuses with SVT and 36 with AF were treated nonrandomly with transplacental flecainide (n=35), sotalol (n=52), or digoxin (n=24) as a first-line agent. Prenatal treatment failure was associated with an incessant versus intermittent arrhythmia pattern (n=85; hazard ratio [HR]=3.1;
P
<0.001) and, for SVT, with fetal hydrops (n=28; HR=1.8;
P
=0.04). Atrial flutter had a lower rate of conversion to sinus rhythm before delivery than SVT (HR=2.0;
P
=0.005). Cardioversion at 5 and 10 days occurred in 50% and 63% of treated SVT cases, respectively, but in only 25% and 41% of treated AF cases. Sotalol was associated with higher rates of prenatal AF termination than digoxin (HR=5.4;
P
=0.05) or flecainide (HR=7.4;
P
=0.03). If incessant AF/SVT persisted to day 5 (n=45), median ventricular rates declined more with flecainide (−22%) and digoxin (−13%) than with sotalol (−5%;
P
<0.001). Flecainide (HR=2.1;
P
=0.02) and digoxin (HR=2.9;
P
=0.01) were also associated with a higher rate of conversion of fetal SVT to a normal rhythm over time. No serious drug-related adverse events were observed, but arrhythmia-related mortality was 5%.

Conclusion—
Flecainide and digoxin were superior to sotalol in converting SVT to a normal rhythm and in slowing both AF and SVT to better-tolerated ventricular rates and therefore might be considered first to treat significant fetal tachyarrhythmia.
Intrathoracic Impedance Monitoring, Audible Patient Alerts, and Outcome in Patients With Heart Failure
Authors: van Veldhuisen Dirk J. , Braunschweig Frieder , Conraads Viviane , Ford Ian , Cowie Martin R. , Jondeau Guillaume , Kautzner Josef , Muñoz Aguilera Roberto , Lunati Maurizio , Yu Cheuk Man , Gerritse Bart , Borggrefe Martin ,   for the DOT-HF Investigators
Published: September 2011

Background—
Heart failure is associated with frequent hospitalizations, often resulting from volume overload. Measurement of intrathoracic impedance with an implanted device with an audible patient alert may detect increases in pulmonary fluid retention early. We hypothesized that early intervention could prevent hospitalizations and affect outcome.

Methods and Results—

We studied 335 patients with chronic heart failure who had undergone implantation of an implantable cardioverter-defibrillator alone (18%) or with cardiac resynchronization therapy (82%). All devices featured a monitoring tool to track changes in intrathoracic impedance (OptiVol) and other diagnostic parameters. Patients were randomized to have information available to physicians and patients as an audible alert in case of preset threshold crossings (access arm) or not (control arm). The primary end point was a composite of all-cause mortality and heart failure hospitalizations. During 14.9±5.4 months, this occurred in 48 patients (29%) in the access arm and in 33 patients (20%) in the control arm (
P
=0.063; hazard ratio, 1.52; 95% confidence interval, 0.97–2.37). This was due mainly to more heart failure hospitalizations (hazard ratio, 1.79; 95% confidence interval, 1.08–2.95;
P
=0.022), whereas the number of deaths was comparable (19 versus 15;
P
=0.54). The number of outpatient visits was higher in the access arm (250 versus 84;
P
<0.0001), with relatively more signs of heart failure among control patients during outpatient visits. Although the trial was terminated as a result of slow enrollment, a post hoc futility analysis indicated that a positive result would have been unlikely.

Conclusion—
Use of an implantable diagnostic tool to measure intrathoracic impedance with an audible patient alert did not improve outcome and increased heart failure hospitalizations and outpatient visits in heart failure patients.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT 00480077.
Deep hypothermic circulatory arrest: Alternative strategies for cerebral perfusion. A review article
Authors: Elmistekawy E M , Rubens F D 
Published: September 2011

Deep hypothermic circulatory arrest is an essential tool in the surgeon’s armamentarium. There are essentially three strategies to address cerebral ischemia during arrest periods. Early surgical case series pioneered the option of complete anoxia with deep hypothermia. Subsequent innovators introduced the concept of retrograde perfusion of the cerebral vessels through the venous system, and others have advocated the use of selective and non-selective antegrade perfusion of the cerebral arteries. Clinical studies assessing outcomes of the three approaches are compromised by small patient numbers, retrospective design and surgeon bias. In this review, the authors will briefly discuss the conceptual basis of these strategies and the literature comparing these approaches in terms of key neurologic outcomes. The importance of this topic will emphasize the key role the perfusion community plays in establishing guidelines for best practice in circulatory arrest to go forward with education and research in this area.
Can assessing caregiver needs and activating community networks improve caregiver-defined outcomes? A single-blind, quasi-experimental pilot study: Community facilitator pilot
Authors: Greene Aine , Aranda Sanchia , Tieman Jennifer J , Fazekas Belinda , Currow David C 
Published: September 2011

Background: Although the unit of care in palliative care is defined as the patient and their family, there are few rigorous studies on how to improve support for family and friends as they take on the role of caregiver for someone at the end of life. Aim: Separate to patient evaluation and care, this pilot study aimed to define the feasibility and possible outcome measures to evaluate routine assessments and supports specifically for caregivers. Design: In a quasi-experimental design, two communities were included: one received standard specialist palliative care support and one additionally was allocated to a community network facilitator who assessed caregivers’ needs and helped mobilize the caregiver’s own support network or initiated contact with other community supports in three planned visits. Data were collected at baseline, 4 and 8 weeks using three caregiver assessment tools. Within group comparisons were made using Wilcoxon signed rank test and between group using the Mann–Whitney U-test. Participants: Sixty-six caregivers participated. Results: At 8 weeks, participants in the intervention arm showed significant within-group improvement in caregiver fatigue, sufficient support from others, decreased resentment in the role, greater confidence in asking for assistance and were better able to find resources and support. No between-group changes were seen in this pilot study. Conclusions: There were objective measures of improved support within the intervention group over time for caregivers through the active engagement of the community network facilitator. This pilot supports the case for an adequately powered study.
Plasma glucose and insulin responses to mixed meals: Impaired fasting glucose re-visited
Authors: Bhat SL , Abbasi F , Blasey C , Reaven GM , Kim SH 
Published: September 2011

Background: In individuals with varying glucose tolerance, glucose and insulin comparisons are usually made based on response to oral glucose challenge. However, an oral glucose tolerance test may not reflect daylong glucose and insulin excursions in response to meals. To better understand individuals with impaired fasting glucose (IFG), we compared insulin action as well as plasma glucose and insulin responses to mixed meals in individuals with normal fasting glucose (NFG; n = 141) and IFG ( n = 148) concentrations. Methods: Insulin action was quantified by determining steady-state plasma glucose (SSPG) concentrations during the insulin suppression test. Plasma glucose and insulin concentrations were measured before and hourly after two mixed meals. Results: SSPG concentrations were significantly higher in the IFG group (11.8 ± 3.6 vs. 9.1 ± 3.8 mmol/l). Mean hourly daylong glucose (6.4 ± 0.07 vs. 5.5 ± 0.04 mmol/l) and insulin (390 ± 20 vs. 279 ± 15 pmol/l) concentrations were also higher in those with IFG ( p < 0.001). Daylong incremental meal-stimulated glucose response, however, was comparable ( p = 0.77) in the two groups, whereas the incremental insulin response was 44% higher in the IFG group. Conclusion: Although individuals are currently defined as having IFG based on fasting plasma glucose concentration, our data show that these individuals with IFG also are insulin resistant and have higher daylong insulin concentrations.
Mucorales-specific T cells emerge in the course of invasive mucormycosis and may be used as a surrogate diagnostic marker in high-risk patients
Authors: Potenza Leonardo , Vallerini Daniela , Barozzi Patrizia , Riva Giovanni , Forghieri Fabio , Zanetti Eleonora , Quadrelli Chiara , Candoni Anna , Maertens Johan , Rossi Giulio , Morselli Monica , Codeluppi Mauro , Paolini Ambra , Maccaferri Monica , Del Giovane Cinzia , D'Amico Roberto , Rumpianesi Fabio , Pecorari Monica , Cavalleri Francesca , Marasca Roberto , Narni Franco , Luppi Mario 
Published: September 2011

Abstract
Mucorales-specific T cells were investigated in 28 hematologic patients during the course of their treatment. Three developed proven invasive mucormycosis (IM), 17 had infections of known origin but other than IM, and 8 never had fever during the period of observation. Mucorales-specific T cells could be detected only in patients with IM, both at diagnosis and throughout the entire course of the IM, but neither before nor for long after resolution of the infection. Such T cells predominantly produced IL-4, IFN-γ, IL-10, and to a lesser extent IL-17 and belonged to either CD4+ or CD8+ subsets. The specific T cells that produced IFN-γ were able to directly induce damage to Mucorales hyphae. None of the 25 patients without IM had Mucorales-specific T cells. Specific T cells contribute to human immune responses against fungi of the order Mucorales and could be evaluated as a surrogate diagnostic marker of IM.
Familial hemophagocytic lymphohistiocytosis type 3 (FHL3) caused by deep intronic mutation and inversion in UNC13D
Authors: Meeths Marie , Chiang Samuel C. C. , Wood Stephanie M. , Entesarian Miriam , Schlums Heinrich , Bang Benedicte , Nordenskjöld Edvard , Björklund Caroline , Jakovljevic Gordana , Jazbec Janez , Hasle Henrik , Holmqvist Britt-Marie , Rajić Ljubica , Pfeifer Susan , Rosthøj Steen , Sabel Magnus , Salmi Toivo T. , Stokland Tore , Winiarski Jacek , Ljunggren Hans-Gustaf , Fadeel Bengt , Nordenskjöld Magnus , Henter Jan-Inge , Bryceson Yenan T. 
Published: September 2011

AbstractFamilial hemophagocytic lymphohistiocytosis (FHL) is an autosomal recessive, often-fatal hyperinflammatory disorder. Mutations in PRF1, UNC13D, STX11, and STXBP2 are causative of FHL2, 3, 4, and 5, respectively. In a majority of suspected FHL patients from Northern Europe, sequencing of exons and splice sites of such genes required for lymphocyte cytotoxicity revealed no or only monoallelic UNC13D mutations. Here, in 21 patients, we describe 2 pathogenic, noncoding aberrations of UNC13D. The first is a point mutation localized in an evolutionarily conserved region of intron 1. This mutation selectively impairs UNC13D transcription in lymphocytes, abolishing Munc13-4 expression. The second is a 253-kb inversion straddling UNC13D, affecting the 3′-end of the transcript and likewise abolishing Munc13-4 expression. Carriership of the intron 1 mutation was found in patients across Europe, whereas carriership of the inversion was limited to Northern Europe. Notably, the latter aberration represents the first description of an autosomal recessive human disease caused by an inversion. These findings implicate an intronic sequence in cell-type specific expression of Munc13-4 and signify variations outside exons and splice sites as a common cause of FHL3. Based on these data, we propose a strategy for targeted sequencing of evolutionary conserved noncoding regions for the diagnosis of primary immunodeficiencies.
mRNA expression profiles of primary high-grade central osteosarcoma are preserved in cell lines and xenografts
Authors: Kuijjer Marieke L , Namløs Heidi M , Hauben Esther I , Machado Isidro , Kresse Stine H , Serra Massimo , Llombart-Bosch Antonio , Hogendoorn Pancras CW , Meza-Zepeda Leonardo A , Myklebost Ola , Cleton-Jansen Anne-Marie 
Published: September 2011

AbstractBackgroundConventional high-grade osteosarcoma is a primary malignant bone tumor, which is most prevalent in adolescence. Survival rates of osteosarcoma patients have not improved significantly in the last 25 years. Aiming to increase this survival rate, a variety of model systems are used to study osteosarcomagenesis and to test new therapeutic agents. Such model systems are typically generated from an osteosarcoma primary tumor, but undergo many changes due to culturing or interactions with a different host species, which may result in differences in gene expression between primary tumor cells, and tumor cells from the model system. We aimed to investigate whether gene expression profiles of osteosarcoma cell lines and xenografts are still comparable to those of the primary tumor.MethodsWe performed genome-wide mRNA expression profiling on osteosarcoma biopsies (n = 76), cell lines (n = 13), and xenografts (n = 18). Osteosarcoma can be subdivided into several histological subtypes, of which osteoblastic, chondroblastic, and fibroblastic osteosarcoma are the most frequent ones. Using nearest shrunken centroids classification, we generated an expression signature that can predict the histological subtype of osteosarcoma biopsies.ResultsThe expression signature, which consisted of 24 probes encoding for 22 genes, predicted the histological subtype of osteosarcoma biopsies with a misclassification error of 15%. Histological subtypes of the two osteosarcoma model systems,i.e. osteosarcoma cell lines and xenografts, were predicted with similar misclassification error rates (15% and 11%, respectively).ConclusionsBased on the preservation of mRNA expression profiles that are characteristic for the histological subtype we propose that these model systems are representative for the primary tumor from which they are derived.
Costs of Home Versus Inpatient Treatment for Fever and Neutropenia: Analysis of a Multicenter Randomized Trial
Authors: Hendricks Ann M. , Loggers Elizabeth Trice , Talcott James A. 
Published: September 2011

PurposeFor patients with cancer who have febrile neutropenia, relative costs of home versus hospital treatment, including unreimbursed costs borne by patients and families, are poorly characterized. We estimated costs from a randomized trial of patients with low-risk febrile neutropenia for whom outpatient care was feasible, comparing inpatient treatment with discharge to home care after inpatient observation.MethodsWe collected direct medical and self-reported indirect costs for 57 inpatient and 35 outpatient treatment episodes of patients enrolled in a randomized trial from 1996 through 2000. Charges from hospital bills were converted to costs using Medicare cost-to-charge ratios. Patients kept daily logs of out-of-pocket payments and time spent by informal caregivers providing care. Dollar amounts were standardized to June 2008.ResultsMean total charges for the hospital arm were 49% higher than for the home treatment arm ($16,341 v $10,977; P < .01). Mean estimated total costs for the hospital arm were 30% higher ($10,143 v $7,830; P < .01). Inspection of sparse available data suggests that payments made were similar by treatment arm. Inpatients and their caregivers spent more out of pocket than their outpatient counterparts (mean, $201 v $74; P < .01). Informal caregivers for both treatment arms reported similar time caring and lost from work.ConclusionHome intravenous antibiotic treatment was less costly than continued inpatient care for carefully selected patients with cancer having febrile neutropenia without significantly increased indirect costs or caregiver burden.
Phase II Randomized, Double-Blind, Placebo-Controlled Study of Tasquinimod in Men With Minimally Symptomatic Metastatic Castrate-Resistant Prostate Cancer
Authors: Pili Roberto , Häggman Michael , Stadler Walter M. , Gingrich Jeffrey R. , Assikis Vasileios J. , Björk Anders , Nordle Örjan , Forsberg Goran , Carducci Michael A. , Armstrong Andrew J. 
Published: September 2011

Purpose The activity of the novel antitumor agent tasquinimod (TASQ) with S100A9 as a molecular target was investigated in men with metastatic castration-resistant prostate cancer (CRPC) and minimal symptoms. Patients and Methods We conducted a randomized, double-blind, placebo-controlled phase II trial in men assigned (at a ratio of two to one) to either oral once-daily TASQ 0.25 mg/d escalating to 1.0 mg/d over 4 weeks or placebo. The primary end point was the proportion of patients without disease progression at 6 months, defined by Response Evaluation Criteria in Solid Tumors Group, Prostate Cancer Working Group (PCWG2), or pain criteria, excluding prostate-specific antigen. Results Two hundred one men (134 assigned to TASQ; 67 to placebo) were evaluable, and baseline characteristics were well balanced. Six-month progression-free proportions for TASQ and placebo groups were 69% and 37%, respectively (P < .001), and median progression-free survival (PFS) was 7.6 versus 3.3 months (P = .0042). In PCWG2 CRPC clinical subgroups, PFS in months was as follows: nodal metastases, 6.1 versus 3.1; bone metastases, 8.8 versus 3.4; and visceral metastases, 6.0 versus 3.0 for patients receiving TASQ versus placebo, respectively. Bone alkaline phosphatase levels were stabilized in the TASQ group, whereas the impact on PSA kinetics was less pronounced. Adverse events (AEs) occurring more frequently in the TASQ arm included GI disorders, fatigue, musculoskeletal pains, and elevations of pancreatic and inflammatory biomarkers. Grade 3 to 4 AEs, including asymptomatic elevations of laboratory parameters, were reported in 40% of patients receiving TASQ versus 10% receiving placebo; deep vein thrombosis (4% v 0%) was more common in the TASQ arm. Conclusion TASQ significantly slowed progression and improved PFS in patients with metastatic CRPC with an acceptable AE profile.
Clinical Trial Participation and Time to Treatment Among Adolescents and Young Adults With Cancer: Does Age at Diagnosis or Insurance Make a Difference?
Authors: Parsons Helen M. , Harlan Linda C. , Seibel Nita L. , Stevens Jennifer L. , Keegan Theresa H.M. 
Published: September 2011

Purpose Because adolescent and young adult (AYA) patients with cancer have experienced variable improvement in survival over the past two decades, enhancing the quality and timeliness of cancer care in this population has emerged as a priority area. To identify current trends in AYA care, we examined patterns of clinical trial participation, time to treatment, and provider characteristics in a population-based sample of AYA patients with cancer. Methods Using the National Cancer Institute Patterns of Care Study, we used multivariate logistic regression to evaluate demographic and provider characteristics associated with clinical trial enrollment and time to treatment among 1,358 AYA patients with cancer (age 15 to 39 years) identified through the Surveillance, Epidemiology, and End Results Program. Results In our study, 14% of patients age 15 to 39 years had enrolled onto a clinical trial; participation varied by type of cancer, with the highest participation in those diagnosed with acute lymphoblastic leukemia (37%) and sarcoma (32%). Multivariate analyses demonstrated that uninsured, older patients and those treated by nonpediatric oncologists were less likely to enroll onto clinical trials. Median time from pathologic confirmation to first treatment was 3 days, but this varied by race/ethnicity and cancer site. In multivariate analyses, advanced cancer stage and outpatient treatment alone were associated with longer time from pathologic confirmation to treatment. Conclusion Our study identified factors associated with low clinical trial participation in AYA patients with cancer. These findings support the continued need to improve access to clinical trials and innovative treatments for this population, which may ultimately translate into improved survival.
Nanomorphing with Ultrafast Lasers and Biomedical Applications
Authors: Hunt Alan J. 
Published: September 2011

ABSTRACTClassically, the limit for optical machining is on the order of the wavelength of the incident light. However, by taking advantage of precise, nonlinear damage mechanisms that occur for femtosecond laser pulses, damage can be achieved on a scale an order of magnitude lower, allowing precise removal of very small amounts of material to produce holes mere tens of nanometers wide. Femtosecond laser nanomachining can be carried out in a variety of dielectrics, and in transparent substrates machining can be sub-surface, in contrast to other nanomachining techniques such as using an electron beam or focused ion beam. We focus on the use of glass, as it is in many ways an ideal material for use in biological applications due to its chemical, optical, electrical and mechanical properties. By precisely placing laser pulses in glass, three dimensional nano and microfluidic channels and devices can be formed including nozzles, mixers, and separation columns. Recent advances in this technique allow the formation of high aspect ratio nanochannels from single pulses, thus helping address the fabrication speed limitations presented by serial processing. These nanochannels have a range of applications including the fabrication of nanoscale pores and nanowells that may serve as vias between fluidic channels, or from channels to a surface. These nanochannels have applications as a standalone technique for fabrication of nanopores and nanowells, but can also complement other fabrication techniques by allowing precisely placed jumpers that can connect channels that are out of plane. We discuss applications for diagnostic microfluidic devices, and basic cell biology research.
Bridgman Growth of SrI2
Authors: Alaribe Leonard , Disch Christian , Fauler Alex , Engels Ralf , Keller Egbert , Cecilia Angelica , Santos Rolo Tomy dos , Fiederle Michael 
Published: September 2011

ABSTRACTEu2+– activated strontium iodide is a promising material for x-ray and gamma ray detector. A lot of difficulties are though encountered growing strontium iodide crystals due to the high oxygen-sensitivity, hygroscopic property and high impurity concentration. Single crystals of SrI2:Eu were grown from zone refined starting materials in silica ampoules. The crystals showed good optical qualities. The light yield of two samples cut from the same ingot was determined to be 53 000 photons/MeV and 119±22 photons/keV for a 0.4 cm3 sample and a 360 μm sample respectively, indicating some level of light trapping in the bulk sample.