bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lung cancer incidence and mortality in China, 2008
Authors: Zeng Hongmei , Zheng Rongshou , Zhang Siwei , He Jie , Chen Wanqing 
Published: July 2012

AbstractBackground:  To provide cancer statistics to health planners, researchers, and the public, we reported the incidence and mortality data of lung cancer in 2008 in Chinese registration areas by age, sex, and geographic area.Methods:  In 2011, 56 population‐based cancer registries reported the lung cancer incidence and mortality data of 2008 to the Chinese National Central Cancer Registry. Forty‐one registries' data met the national criteria. The crude incidence and mortality rates of lung cancer were calculated by age, gender, and area. Age‐standardized rates were calculated using the Chinese and World populations.Results:  The crude incidence rate for lung cancer was 54.75/100 000 (73.12/100 000 for male and 36.08/100 000 for female; 57.96/100 000 in urban and 42.80/100 000 in rural). Age‐standardized rates by China population (CASR) and World population (WASR) for incidence were 24.98/100 000 and 34.07/100 000, respectively. The crude mortality rate for lung cancer was 46.07/100 000 (62.47/100 000 for male and 29.39/100 000 for female; 48.76/100 000 in urban and 36.03/100 000 in rural). The CASR and WASR for mortality were 20.09/100 000 and 27.68/100 000, respectively. Both for incidence and mortality, the rates for lung cancer were higher in males than in females, and in urban areas than in rural areas. The overall age‐specific incidence and mortality rates showed that both rates were relatively low up to 35 years of age, but dramatically increased from such age, reaching a peak with subjects of 80–84 years old.Conclusion:  The burden of lung cancer remains high in China, especially for males in urban areas. Effective intervention, such as smoking control, should be enhanced in the future.
Discordance of epidermal growth factor receptor mutations between primary tumors and corresponding mediastinal nodal metastases in patients operated on for stage N2 non‐small cell lung cancer
Authors: Fang Qin , Yang Hua , Ou Wei , Ye Xiong , Zhang Bin‐bin , Sun Hai‐bo , Zhang Liang , Cao Xun , Wang Si‐yu 
Published: July 2012

AbstractThe discordance of epidermal growth factor receptor (EGFR) mutations between primary lung tumors and the corresponding mediastinal nodal metastases has not yet been well elucidated. We investigate the discordance of EGFR mutations between primary tumors and the corresponding mediastinal nodal metastases, and the discordance of EGFR mutations between different mediastinal lymph node stations in patients operated on for stage N2 non‐small cell lung cancer (NSCLC). Two hundred and nineteen surgically resected primary tumors and their 553 corresponding mediastinal nodal metastases were evaluated for EGFR mutations in exon 19 or 21 by TaqMan real‐time polymerase chain reaction (PCR) analysis. EGFR mutation was detected in 26.0% (57/219) of the primary tumors and 14.8% (82/553) of the corresponding mediastinal nodal metastases. In 162 cases with EGFR wild‐type in primary tumors, none of their 402 corresponding mediastinal nodal metastases had EGFR mutation. In 57 cases with EGFR mutations in primary tumors, EGFR mutations were detected in 82 of all 151 metastatic lymph node stations (54.3%), 34 cases had EGFR mutations in mediastinal nodal metastases, and 23 cases had lost the mutations in mediastinal nodal metastases. Among the 219 cases, 196 cases had at least two metastatic lymph node stations, 9.0% (18/196) of cases with multiple metastatic nodal stations exhibited discordance in EGFR mutations between different lymph node stations. The possibility of discordance in EGFR mutations between primary tumors and corresponding mediastinal nodal metastases, and between different mediastinal lymph node stations should be considered whenever these mutations are used for the selection of patients for EGFR‐directed tyrosine kinase inhibitor therapy.
Acupuncture Combined with Curcumin Disrupts Platelet-Derived Growth Factor β Receptor/Extracellular Signal-Regulated Kinase Signalling and Stimulates Extracellular Matrix Degradation in Carbon Tetrachloride-Induced Hepatic Fibrosis in Rats
Authors: Zhang Xiao-Ping , Zhang Feng , Zhang Zi-Li , Ma Jin , Kong De-Song , Ni Guang-Xia , Wang Ai-Yun , Chen Wen-Xing , Lu Yin , Zheng Shi-Zhong 
Published: July 2012

Background Acupuncture treatment has been increasingly used to treat chronic liver diseases. We previously reported that acupuncture combined with curcumin, a natural antifibrotic compound, could remarkably attenuate liver fibrosis in chemically intoxicated rats, but the underlying molecular mechanisms are poorly understood. The present study was aimed at investigating the effects of acupuncture combined with curcumin on platelet-derived growth factor (PDGF) signalling and extracellular matrix (ECM) regulation in the fibrotic liver. Methods A total of 60 Sprague-Dawley male rats were randomly divided into control, model, sham, acupuncture, curcumin and combination treatment groups. During the establishment of fibrosis using carbon tetrachloride (CCl4), acupuncture at LR3, LR14, BL18 and ST36 and/or curcumin treatment by mouth were performed simultaneously. After treatment, serum PDGF levels were measured. Protein and mRNA expression of key effectors in PDGF pathway and fibrinolysis in the liver was determined. Results Acupuncture combined with curcumin potently reduced serum PDGF levels and selectively disrupted the PDGF-βR/extracellular signal-regulated kinase (ERK) cascade. Combination treatment also significantly repressed expression of connective tissue growth factor and upregulated expression of matrix metalloproteinase-9, promoting fibrinolysis in the fibrotic liver. Conclusions The beneficial effects of acupuncture and its combination with curcumin could be attributed to the disruption of PDGF-βR/ERK pathway and stimulated ECM degradation in the fibrotic liver. Acupuncture treatment significantly enhanced curcumin effects at the molecular level. These findings may provide molecular insights into the potential of acupuncture combined with curcumin for prevention of hepatic fibrosis.
Effect of exercise-induced dehydration on endurance performance: evaluating the impact of exercise protocols on outcomes using a meta-analytic procedure
Authors: Goulet Eric D B 
Published: July 2012

ObjectiveIt is purported that exercise-induced dehydration (EID), especially if ≥ 2% bodyweight, impairs endurance performance (EP). Field research shows that athletes can achieve outstanding EP while dehydrated > 2% bodyweight. Using the meta-analytic procedure, this study compared the findings of laboratory-based studies that examined the impact of EID upon EP using either ecologically valid (EV) (time-trial exercise) or non-ecologically valid (NEV) (clamped-intensity exercise) exercise protocols.MethodsEP outcomes were put on the same scale and represent % changes in power output between euhydrated and dehydrated exercise tests. Random-effects model meta-regressions and weighted mean effect summaries, mixed-effects model analogue to the ANOVAs and magnitude-based effect statistics were used to delineate treatment effects.Main resultsFifteen research articles were included, producing 28 effect estimates, representing 122 subjects. Compared with euhydration, EID increased (0.09±2.60%, (p=0.9)) EP under time-trial exercise conditions, whereas it reduced it (1.91±1.53%, (p<0.05)) with NEV exercise protocols. Only with NEV exercise protocols did EID ≥ 2% body weight impair EP (p=0.03).ConclusionsEvidence indicates that (1) EID ≤ 4% bodyweight is very unlikely to impair EP under real-world exercise conditions (time-trial type exercise) and; (2) under situations of fixed-exercise intensity, which may have some relevance for military and occupational settings, EID ≥ 2% bodyweight is associated with a reduction in endurance capacity. The 2% bodyweight loss rule has been established from findings of studies using NEV exercise protocols and does not apply to out-of-doors exercise conditions. Athletes are therefore encouraged to drink according to thirst during exercise.
Functional outcomes and quality of life of young adults who survive out-of-hospital cardiac arrest
Authors: Deasy Conor , Bray Janet , Smith Karen , Harriss Linton , Bernard Stephen , Cameron Peter ,   on behalf of the VACAR Steering Committee
Published: July 2012

BackgroundEvaluating the quality of life of young adult survivors of out-of-hospital cardiac arrest (OHCA) is important as they are likely to have a longer life expectancy than older patients. The aim of this study was to assess their functional and quality of life outcomes.MethodologyThe Victorian Ambulance Cardiac Arrest Registry records were used to identify survivors of OHCA that occurred between 2003 and 2008 in the 18-39 year-old age group. Survivors were administered a telephone questionnaire using Short Form (SF-12), EQ-5D and Glasgow Outcome Scale-Extended. Cerebral Performance Category (CPC) ascertained at hospital discharge from the medical record was recorded for the uncontactable survivors.ResultsOf the 106 young adult survivors, five died in the intervening years and 45 were not contactable or refused. CPC scores were obtained for 37 (74%) of those who did not take part in telephone follow-up, and 7 (19%) of these had a CPC ≥3 indicating severe cerebral disability. The median follow-up time was 5 years (range 2.7- 8.6 years) for the 56 (53%) patients included. Of these, 84% were living at home independently, 68% had returned to work, and only 11% reported marked or severe disability. The majority of patients had no problems with mobility (75%), personal care (75%), usual activities (66%) or pain/discomfort (71%). However, 61% of respondents reported either moderate (48%) or severe (13%) anxiety.ConclusionsThe majority of survivors have good functional and quality of life outcomes. Telephone follow-up is feasible in the young adult survivors of cardiac arrest; loss to follow-up is common.
The face arm speech test: does it encourage rapid recognition of important stroke warning symptoms?
Authors: Robinson Thompson G , Reid Ann , Haunton Victoria Joanna , Wilson Andrew , Naylor A Ross 
Published: July 2012

ObjectivesTo assess public knowledge of stroke and transient ischaemic attack symptoms, and awareness of the content of a recent national health campaign.DesignInterviewer-administered questionnaire.SettingLeicester, UK.Participants1300 members of a mixed urban/rural, multiethnic population that was sampled in public areas, places of work and schools.Main outcome measuresKnowledge of the terms ‘stroke’, ‘stroke risk factors’ and the ‘FAST campaign’. Awareness of stroke symptoms, and ability to distinguish from non-stroke symptoms.Results70% of the public surveyed were aware of the FAST campaign, with highest penetration in the female, older and white population. Overall, high levels of awareness of FAST symptoms (facial weakness 89%, arm weakness 83%, speech problems 91%) as warning signs of stroke were observed, though significantly lower levels were reported in the black and minority ethnic population. However, poor recognition of other important signs, including leg weakness (57%) and visual loss (44%) were seen, and significantly more men were likely to report non-specific symptoms as being associated with stroke.ConclusionsThe survey has confirmed the effectiveness of the recent FAST campaign in raising public awareness of stroke and stroke warning signs, though poorest penetration was seen in the black and minority ethnic population. However, important stroke symptoms, including leg weakness and visual loss, were poorly recognised. This may lead to delays in presentation, specialist assessment and secondary prevention, and such stroke warning signs should be included in future public health campaigns.
O-011 Rate of ischemic events detected by MRI following balloon remodeling for the treatment of aneurysms in the ruptured and unruptured setting
Authors: Spiotta A , Wu O , Bhalla T , Hui F , Moskowitz S 
Published: July 2012

IntroductionThe introduction of balloon remodeling has revolutionized the approach to coiling of wide-necked aneurysms. We compared rates of ischemic events as detected by postprocedure MRI following balloon remodeling for the treatment of aneurysms in the unruptured vs ruptured setting.MethodsA retrospective review was undertaken of 159 patients undergoing balloon remodeling for intracranial aneurysm coil embolization at a single institution (81 unruptured, 78 ruptured). Patients underwent postprocedural MRI. The rates of ischemic events were compared to a control group consisting of an additional 66 unruptured aneurysms treated by unassisted coiling.ResultsPatients in the ruptured and unruptured groups were closely matched for age and risk factors for stroke including incidence of hypertension, diabetes and smoking. Patients with unruptured aneurysms were, however, more likely to have a prior history of an ischemic stroke (18.5%) than those in the ruptured group (1.3%). Patients in both groups underwent full intraprocedural anticoagulation with heparin and none received pharmacologic protection during balloon inflation. The two groups did differ in the distribution of aneurysm locations treated. Among the patients with ruptured aneurysms, clinical Hunt and Hess (HH) grade was as follows: HH1=12.8%, HH2=39.7%, HH3=25.6%, HH4=15.4%, HH5=6.4%. DWI abnormalities were detected on postprocedural MRI in 24.7% (20/81) of patients with unruptured aneurysms treated with balloon assistance. Similarly, unruptured aneurysms treated with unassisted coiling were found to have a 22.7% (15/61) rate of DWI lesions on MRI. By comparison, patients with ruptured aneurysms treated with balloon remodeling had a significantly higher rate of DWI lesions on MRI at 88.9%.ConclusionsBalloon remodeling for aneurysm embolization in the setting of subarachnoid hemorrhage is associated with a significantly higher rate of ischemic events on MRI than those treated in the elective setting.Competing interestsA Spiotta: Integra, Hemedex. O Wu: None. T Bhalla: None. F Hui: None. S Moskowitz: None.
O-022 Pre-radiosurgical embolization of arteriovenous malformations: a single institution review
Authors: Santarelli J , Steinberg G , Do H , Dodd R , McTaggart R , Marcellus M , Adler J , Chang S , Marks M 
Published: July 2012

BackgroundMultimodality therapy for brain AVMs utilizing embolization followed by radiosurgery is controversial. We present the results of the largest case series to date of patients who have undergone AVM embolization followed by radiosurgery, in order to evaluate cure rates and complications using this modality of therapy.MethodsA retrospective review of our institutional AVM database was performed, identifying 95 patients over an 11-year period (1997–2008) who underwent dual modality treatment. Patients previously treated with either surgery or radiosurgery prior to embolization were excluded, as were patients who underwent scheduled surgical treatment following embolization. Pre- and post-treatment AVM volumes were assessed using angiography. Post-radiosurgical treatment volumes were assessed using angiography (41%) or MRI (59%). Only those patients with >3-year post-radiosurgical follow-up were included in this analysis.ResultsMean AVM volume pre-embolization was 26 ml and declined to 15 ml post-embolization. Mean modified Pollock-Flickinger score pre-embolization was 3.4 and post-embolization was 2.2. 59 patients had adequate follow-up for inclusion in our study. 34 patients (58%) achieved AVM obliteration within 3 years of treatment, without neurological decline. 23 patients had residual at 3 years. Two patients died in the follow-up period. Excellent outcome was accomplished in 100% of patients with modified Pollock-Flickinger score 2.ConclusionPre-radiosurgical embolization of brain AVMs in our series appears to improve the rate of excellent outcome (obliteration following radiosurgery, without change in modified Rankin score).Competing interestsNone.
O-024 Cost comparison of endovascular treatment of anterior circulation aneurysms with the pipeline embolization device vs stent-assisted coiling
Authors: Colby G , Lin L , Paul A , Huang J , Tamargo R , Coon A 
Published: July 2012

IntroductionThe Pipeline embolization device (PED) is an efficacious endovascular option for anterior circulation aneurysms with broad-based, fusiform involvement of the parent vessel. Endovascular treatment of such aneurysms has classically involved coil embolization with adjunctive use of a stent. However, stent-coiling can incur significant equipment and implant costs, particularly if the aneurysm is large and numerous coils are used. The authors hypothesized that PED embolization is a cost effective alternative to stent-assisted coiling.MethodsA prospective single-center aneurysm database was retrospectively reviewed to identify consecutive patients with anterior circulation aneurysms who underwent aneurysm treatment with the PED or by single-staged stent-assisted coiling. Thirty consecutive patients were selected in each group, for a total of 60 patients. The hospital cost of equipment and implants were analyzed and compared for each group.ResultsHospital equipment and implant costs were analyzed for 30 consecutive aneurysm treatments with the PED (mean aneurysm size 9.8 mm) vs 30 consecutive cases of stent-assisted coiling (mean aneurysm size 7.3 mm). The total combined cost of proximal access/guide catheters, microcatheters, and microwires were equivalent between the two groups (PED $3057±$102 vs stent-coiling $3199±$126, p=0.3927). The cost of implants, however, was significantly lower in the PED group ($13 175±$726 vs $19 069±$2015, p=0.0126), despite this group having a larger mean aneurysm size. Furthermore, the total cost (equipment, implants, and adjunctive devices) was significantly lower for the PED group vs the stent-coiling group ($16 445±$735 vs $22 145±$2022, p=0.0181), representing a 25.7% cost reduction. This represents a 27.1% reduction in the cost per millimeter of aneurysm treated in the PED group ($2261±$299) vs the stent-coiling group ($3102±$193, p=0.0202).ConclusionTreatment of anterior circulation aneurysms by flow diversion with the PED is a cost effective alternative to traditional stent-assisted coiling.Competing interestsG Colby: None. L Lin: None. A Paul: None. J Huang: None. R Tamargo: None. A Coon: Covidien.
O-026 Coil costs and aneurysm size: 2 years of data
Authors: Hui F , Wang C , Spiotta A 
Published: July 2012

The material costs associated with endovascular treatment of cerebral aneurysms include access catheters, equipment utilization, personnel costs, and embolization materials. The costs of coiling aneurysms in general has been discussed, however, detailed analysis of aneurysm embolization costs as a function of aneurysm size is lacking.MethodsWe reviewed the material logs and aneurysm descriptions for a total of 221 aneurysms spanning January 30, 2009 to June 2, 2011, excluding aneurysms that had incomplete chart data, coil costs, ethyl vinyl alcohol embolization and spurious size measurements. We tabulated the total embolisate costs at prices available to the institution as of September 2011, and analyzed the costs of coiling as a function of calculated volume, the variance of costs as a function of volume, and performed a regression analysis in order to model projected costs for a given aneurysm size.FindingsCurves modeled are presented in graph form. As expected, there is a strong correlation of aneurysm size by estimated volume to cost with a p<0.000001. A plot of the residuals is also given, showing from projected cost for a given volume. Given the apparent increase in variance as a function of volume, a log-log transform was applied to the data with regression analysis performed. For every doubling in aneurysm volume, there is a projected 36% increase in cost.ConclusionNeurointerventions are reimbursed at a flat per-aneurysm basis, irrespective of embolysate costs. The variance in coiling costs shown, indicates that aneurysm embolization costs vary according to volume in a relatively predictable fashion. This understanding may be useful in modifying future coding. Additionally, there is a degree of variance in costs for a given estimated volume, which may indicate material choice and strategy may affect embolization as well. Further analysis of this observation may be helpful in optimizing coil selection for therapies.Competing interestsF Hui: None. C Wang: T32 Training Grant NIH A Spiotta: None.Abstract O-026 Figure 1Abstract O-026 Figure 2
O-003 Temporal distribution of stroke volumes and clinical-diffusion mismatch in patients with proximal arterial occlusions: Abstract O-003 Figure 1
Authors: Nogueira R , Liebeskind D , Souza L , Hao Q , Furie K , Yoo A , Saver J , Lev M , Gupta R 
Published: July 2012

Background and PurposePrevious studies have demonstrated that the benefit of reperfusion therapy declines over time. The Clinical-Diffusion Mismatch (CDM) model has been suggested as surrogate for salvable tissue in acute ischemic stroke (AIS) patients. We sought to describe the temporal behavior profile of infarct volumes and CDM in patients suffering AIS due to proximal arterial occlusion (PAO).MethodsWe performed a retrospective analysis of consecutive AIS patients admitted to two large academic institutions fulfilling the following criteria: (1) Baseline NIHSS ≥8; (2) PAO defined as MCA-M1, intracranial ICA, or tandem cervical + ICA/MCA-M1 occlusion on admission CTA/MRA; and (3) MRI-DWI performed ≤8 h from time of stroke onset/last seen well (TSO). CDM was defined as baseline NIHSS ≥8 and DWI volume ≤25cc (as proposed by Davaloset al). Linear regression analysis was performed to define the changes on DWI lesion volume on presentation over time. The observed TSO to MRI were broken down into quartiles to look for any differences in the distribution of the baseline variables over time.ResultsA total of 132 consecutive patients were identified (mean age, 66±16.8 years; 57% females; mean baseline NIHSS 17.5±5.3; occlusion site: MCA-M1, 64%; intracranial-ICA, 29%; tandem, 5%, mean TSO to DWI, 269.5±105.48 min). The mean DWI stroke volume on presentation was 46.7±54.8 cc (range, 0.19–436.1) and 63 (46.7%) patients had CDM. There was no significant changes in age, gender, baseline NIHSS, or occlusion site among the different time quartiles. Median infarct volume (cc) increased (quartile #1=8.5; #2=30.1; #3=38.5; #4=29.4) and the chances of having a CDM decreased (p<0.0001) across the different time quartiles. However, there was an overall poor correlation between DWI lesion volume on presentation and TSO to MRI (R2=0.031, Abstract O-003 figure 1) and a significant proportion of the patients still had a CDM at later time epochs (#1=91.1% (20/22); #2=47.8% (11/23); #3=34.4% (21/61); #4=42.3% (11/26)).Abstract O-003 Figure 1Relationship between Baseline DWI Volume (cc) and Time (minutes). Line is best fitted linear regression model.ConclusionsAlthough infarct volume increases and the amount of penumbral tissue decreases over time, many patients with PAO will still have salvable penumbra at the later time epochs. This reflects individual differences in anatomic and physiological characteristics including the strength of collateral flow and highlights that selected patients may benefit from reperfusion therapy even at the later time windows.Competing interestsR Nogueira: Concentric Medical; ev3 Neurovascular; Coaxia. D Liebeskind: Concentric Medical; Neurovascular; Coaxia. L Souza: None. Q Hao: None. K Furie: NIH. A Yoo: Penumbra. J Saver: ev3 Neurovascular; NIH. M Lev: Coaxia. R Gupta: Concentric Medical; Codman; Coaxia.