bluuebunny/crossref_metadata_2025_split huggingface dataset:
Severe vitamin D deficiency in patients admitted to the emergency department with severe sepsis is associated with an increased 90-day mortality
Authors: Malinverni Stefano , Ochogavia Queitan , Lecrenier Sarah , Scorpinniti Margherita , Preiser Jean-Charles , Cotton Frederic , Mols Pierre , Bartiaux Magali 
Published: June 2022

BackgroundThe role of vitamin D in the response to infection has been increasingly acknowledged. However, the influence of severe vitamin D deficiency on the outcome of patients admitted for severe sepsis is unknown. Hence, this study aimed to investigate the association between severe vitamin D deficiency and sepsis-related outcomes in patients presenting to the ED.MethodsThis single centre prospective study included patients presenting to the ED with severe sepsis from April 2014 until December 2017. 25-Hydroxy vitamin D (25(OH)D) was measured in a blood sample drawn within 24 hours of admission to the ED, and severe vitamin D deficiency was defined as 25(OH)D <12 ng/mL. 90-day mortality was compared between patients with and without severe vitamin D deficiency by a multivariable analysis adjusting for confounders and according to a Kaplan-Meier survival analysis.Results263 patients were initially screened and 164 patients with severe sepsis were included in this study, 18% of whom had septic shock. Severe vitamin D deficiency was present in 46% of patients. The overall 90-day mortality rate was 26.2% and the median length of stay was 14 days. In a logistic regression accounting for sepsis severity and age-adjusted comorbidities, severe vitamin D deficiency was associated with increased mortality (OR=2.69 (95% CI 1.03 to 7.00), p=0.043), and lower chances of hospital discharge (sub-HR=0.66 (95% CI 0.44 to 0.98)). In the subgroup of patients admitted to the intensive care unit, severe vitamin D deficiency was associated with an increased 28-day adjusted mortality (HR=3.06 (95% CI 1.05 to 8.94), p=0.04) and lower chances of discharge (sub-HR=0.51 (95% CI 0.32 to 0.81)).ConclusionsSevere vitamin D deficiency at ED admission is associated with higher mortality and longer hospital stay in patients with severe sepsis.
Effects of hypnosis versus enhanced standard of care on postoperative opioid use after total knee arthroplasty: the HYPNO-TKA randomized clinical trial
Authors: Markovits Jessie , Blaha Ondrej , Zhao Emma , Spiegel David 
Published: June 2022

BackgroundHypnosis decreases perioperative pain and has opioid-sparing potential but has not been rigorously studied in knee arthroplasty. This trial investigates the impact of perioperative hypnosis on inpatient opioid use following total knee arthroplasty.MethodsThis prospective randomized controlled trial was conducted at a single academic medical center. The hypnosis arm underwent a scripted 10 min hypnosis session prior to surgery and had access to the recorded script. The control arm received hypnosis education only. The primary outcome was opioid use in milligram oral morphine equivalents per 24 hours during hospital admission. A secondary analysis was performed for patients taking opioids preoperatively.Results64 primary knee arthroplasty patients were randomized 1:1 to hypnosis (n=31) versus control (n=33) and included in the intent-to-treat analysis. The mean (SD) postoperative opioid use in oral morphine equivalents per 24 hours was 70.5 (48.4) in the hypnosis versus 90.7 (74.4) in the control arm, a difference that was not statistically significant (difference −20.1; 95% CI −51.8 to 11.4; p=0.20). In the subgroup analysis of the opioid-experienced patients, there was a 54% daily reduction in opioid use in the hypnosis group (82.4 (56.2) vs 179.1 (74.5) difference of −96.7; 95% CI -164.4 to –29.0; p=<0.01), equivalent to sparing 65 mg of oxycodone per day.ConclusionPerioperative hypnosis significantly reduced inpatient opioid use among opioid-experienced patients only. A larger study examining these findings is warranted.Trial registration numberNCT03308071.
A Group Decision-Making Approach for Global Consistency of Heterogeneous Models
Authors: Bennani Saloua , Ebersold Sophie , El Hamlaoui Mahmoud , Coulette Bernard , Nassar Mahmoud 
Published: June 2022

The design of complex systems goes through a multi-view paradigm in which separate teams, from different viewpoints, build partial source models describing the system. These source models are called heterogeneous models since they are expressed in different languages. The main objective of this paper is to provide an approach — called CAHM for Collaborative Alignment of Heterogeneous Models — that leverages collaborative engineering and especially group decision-making principles to ensure the overall consistency of heterogeneous source models. This approach defines two sub-processes: a first one to collaboratively match heterogeneous models to develop the inter-model correspondences and a second one ensuring the consistency of the produced model of correspondences in case of model evolution. In this paper, we restate the basis of the CAHM approach, then, we detail the second sub-process that aims at maintaining the coherence of the overall system. This sub-process handles the evolution of source models by managing the impact of these evolutions on the established model of correspondences. It incorporates mechanisms to calculate the impact of changes, as well as mechanisms to formalize the group decision-making, while addressing the inconsistencies that may occur due to changes. CAHM is illustrated and validated on a real example of a hospital emergency department case study.
Investigation of Atom-Bond Connectivity Indices of Line Graphs Using Subdivision Approach
Authors: Husin Mohamad Nazri , Zafar Sohail , Gobithaasan R. U. 
Published: June 2022

A topological index is a numerical measure that characterises the whole structure of a graph. Based on vertex degrees, the idea of an atom-bond connectivity

A
B
C

index was introduced in chemical graph theory. Later, different versions of the ABC index were created, and some of these indices were recently designed. In this paper, we present the edge version of the atom-bond connectivity

A
B

C

e

index, edge version of the multiplicative atom-bond connectivity

A
B
C
I

I

e

index, and atom-bond connectivity temperature (

A
B
C
T

) index for the line graph of subdivision graph of tadpole graph

T

n
,
k

, ladder graph

L

n

, and wheel graph

W

n
+
1

. Numerical simulation has also been shown for some novel families of atom-bond connectivity index comparing the three types of indices which can be useful for QSAR and QSPR studies.
Rules of Engagement: The Lymphocyte Receptor Ecosystem in Renal Cell Carcinoma
Authors: Krishna Chirag , Hakimi A. Ari 
Published: June 2022

Immune receptor repertoires provide insight into the clonal distribution of tumor-infiltrating lymphocytes, yet the clinical implications of T-cell receptor (TCR) and B-cell receptor (BCR) repertoire diversity in cancer are unclear. In this issue of Cancer Research, Ferral-Fairbanks and colleagues reveal the interplay between repertoire diversity, tumor molecular features, and clinical outcome in renal cell carcinoma (RCC). The authors show that aggressive tumors harbor increasingly diverse TCR and BCR repertoires and that both repertoires are altered by common RCC driver mutations. Moreover, the authors demonstrate that high TCR diversity is associated with improved overall survival. This study highlights the contribution of lymphocyte receptor dynamics to the emerging complexity of RCC antitumor immune responses.
See related article by Ferral-Fairbanks et al., p. 929
Hispanic Ethnicity Differences in Birth Characteristics, Maternal Birthplace, and Risk of Early-Onset Hodgkin Lymphoma: A Population-Based Case–Control Study
Authors: Graham Connor , Metayer Catherine , Morimoto Libby M. , Wiemels Joseph L. , Siddique Arfan , Di Mengyang , Rodwin Rozalyn L. , Kadan-Lottick Nina S. , Ma Xiaomei , Wang Rong 
Published: June 2022

Abstract

Background:
Hispanic ethnicity differences in the risk of early-onset Hodgkin lymphoma diagnosed at &lt;40 years are understudied. We conducted a population-based case–control study to evaluate associations between birth characteristics and early-onset Hodgkin lymphoma with a focus on potential ethnic differences.

Methods:
This study included 1,651 non-Hispanic White and 1,168 Hispanic cases with Hodgkin lymphoma endorsing a range of races diagnosed at the age of 0 to 37 years during 1988–2015 and 140,950 controls without cancer matched on race/ethnicity and year of birth from the California Linkage Study of Early-Onset Cancers. OR and 95% confidence intervals (CI) were estimated from multivariable logistic regression models.

Results:
Having a foreign-born mother versus a United States–born mother (i.e., the reference group) was associated with an increased risk of early-onset Hodgkin lymphoma among non-Hispanic Whites (OR = 1.52; 95% CI, 1.31–1.76; P &lt; 0.01) and a decreased risk among Hispanics (OR = 0.78; 95% CI, 0.69–0.88; P &lt; 0.01). Among both race groups, risk of early-onset Hodgkin lymphoma increased with birthweight and maternal age (all Ptrends &lt; 0.01). Among non-Hispanic Whites, each 5-year increase in maternal age (OR = 1.11; 95% CI, 1.04–1.18; Ptrend &lt; 0.01) and paternal age (OR = 1.07; 95% CI, 1.02–1.13; Ptrend &lt; 0.01) was associated with increased risk of early-onset Hodgkin lymphoma. Compared with female Hispanics, male Hispanics had an increased risk of early-onset Hodgkin lymphoma (OR = 1.26; 95% CI, 1.12–1.42; P &lt; 0.01).

Conclusions:
Maternal birthplace may play a role in risk of early-onset Hodgkin lymphoma that differs by ethnicity.

Impact:
The ethnic differences observed between certain birth characteristics, maternal birthplace, and early-onset Hodgkin lymphoma raise questions about the underlying biological, generational, lifestyle, residential, and genetic contributions to the disease.
Convergent Clonal Evolution of Signaling Gene Mutations Is a Hallmark of Myelodysplastic Syndrome Progression
Authors: Menssen Andrew J. , Khanna Ajay , Miller Christopher A. , Nonavinkere Srivatsan Sridhar , Chang Gue Su , Shao Jin , Robinson Joshua , O'Laughlin Michele , Fronick Catrina C. , Fulton Robert S. , Brendel Kimberly , Heath Sharon E. , Saba Raya , Welch John S. , Spencer David H. , Payton Jacqueline E. , Westervelt Peter , DiPersio John F. , Link Daniel C. , Schuelke Matthew J. , Jacoby Meagan A. , Duncavage Eric J. , Ley Timothy J. , Walter Matthew J. 
Published: June 2022

AbstractProgression from myelodysplastic syndromes (MDS) to secondary acute myeloid leukemia (AML) is associated with the acquisition and expansion of subclones. Our understanding of subclone evolution during progression, including the frequency and preferred order of gene mutation acquisition, remains incomplete. Sequencing of 43 paired MDS and secondary AML samples identified at least one signaling gene mutation in 44% of MDS and 60% of secondary AML samples, often below the level of standard sequencing detection. In addition, 19% of MDS and 47% of secondary AML patients harbored more than one signaling gene mutation, almost always in separate, coexisting subclones. Signaling gene mutations demonstrated diverse patterns of clonal evolution during disease progression, including acquisition, expansion, persistence, and loss of mutations, with multiple patterns often coexisting in the same patient. Multivariate analysis revealed that MDS patients who had a signaling gene mutation had a higher risk of AML progression, potentially providing a biomarker for progression.Significance:Subclone expansion is a hallmark of progression from MDS to secondary AML. Subclonal signaling gene mutations are common at MDS (often at low levels), show complex and convergent patterns of clonal evolution, and are associated with future progression to secondary AML.See related article by Guess et al., p. 316 (33).See related commentary by Romine and van Galen, p. 270.This article is highlighted in the In This Issue feature, p. 265
A Phase IB Trial of the PI3K Inhibitor Alpelisib and Weekly Cisplatin in Patients with Solid Tumor Malignancies
Authors: Tsang Erica S. , Aggarwal Rahul R. , Dhawan Mallika S. , Bergsland Emily K. , Alvarez Edwin A. , Calabrese Susan , Pacaud Romain , Garcia Jose , Fattah Delaire , Thomas Scott , Grabowsky Jennifer , Moasser Mark M. , Munster Pamela N. 
Published: June 2022

The PI3K pathway may be a potential mechanism to overcome cisplatin resistance. We conducted a phase Ib trial of alpelisib and cisplatin for patients with solid tumor malignancies with planned dose expansion in HPV-associated tumors. The primary objective was to determine the MTD and recommended phase II dose. Two different weekly doses of cisplatin (30 and 35 mg/m2) were evaluated with escalating doses of alpelisib, administered daily during a 21-day treatment cycle. Twenty-three patients were enrolled: 91% received &gt;3 prior regimens with median of 4 (range 1–10), and 78% progressed on prior platinum. The MTD was alpelisib 250 mg daily with weekly cisplatin 30 mg/m2. There were 3 DLTs: all grade 4 hyperglycemia. Frequent treatment-related adverse events of any grade included fatigue (52%), diarrhea (39%), nausea (38%), hyperglycemia (30%), anemia (22%), and nephropathy (17%). Hyperglycemia was linked to baseline hemoglobin A1C, but not body mass index. Twelve patients discontinued treatment for toxicity (n = 9 during cycle 1) and 11 discontinued for progression. Of 14 evaluable patients who received at least one treatment cycle, 4 (29%) patients demonstrated partial response, and 7 had stable disease for a disease control rate of 79%. The median PFS measured 4.3 months (95% CI, 1.6–4.5). No difference in PFS was observed between PIK3CA-mutated and wild-type tumors. While the combination of alpelisib and cisplatin demonstrated preliminary evidence of activity despite platinum resistance, toxicities hindered prolonged treatment. Prospective studies are planned using carboplatin and alpelisib to improve toxicity and tolerability.Significance:The PI3K inhibitor alpelisib has limited activity alone, but there is interest in combinations in platinum-resistant tumors. In this phase Ib study of alpelisib with cisplatin, the objective response rate measured 29% but adverse events limited dose intensity. These promising results provide rationale for studying combinations with better tolerated platinum agents.
Assessment of Colorectal Cancer Screening Disparities in U.S. Men and Women Using a Demographically Representative Sample
Authors: Shah Sumit K. , Narcisse Marie-Rachelle , Hallgren Emily , Felix Holly C. , McElfish Pearl A. 
Published: June 2022

Timely receipt of colorectal cancer screening can reduce morbidity and mortality. This is the first known study to adopt Andersen's model of health services use to identify factors associated with colorectal cancer screening among U.S. adults. The data from National Health Interview Survey from 2019 was utilized to conduct the analyses. Multivariable logistic regression was used to separately analyze data from 7,503 age-eligible women and 6,486 age-eligible men. We found similar colorectal cancer screening levels among men (57.7%) and women (57.6%). Factors associated with higher screening odds in women were older age, married/cohabitating with a partner, Black race, &gt;bachelor's degree, having a usual source of care, and personal cancer history. Factors associated with lower odds for women were American Indian/Alaska Native race, living in the United States for ≤10 years, ≤138% federal poverty level (FPL), uninsured or having Medicare, and in fair/poor health. For men, factors associated with higher screening odds were older age, homosexuality, married/cohabitating with a partner, Black race, &gt;high school/general educational development education, having military insurance, having a usual source of care, and personal cancer history. Factors associated with lower odds for men were being a foreign-born U.S. resident, living in the South or Midwest, ≤138% FPL, and being uninsured or having other insurance. Despite lower screening rates in the past, Black adults show a significantly higher likelihood of colorectal cancer screening than White adults; yet, screening disparities remain in certain other groups. Colorectal cancer screening efforts should continue to target groups with lower screening rates to eliminate screening disparities.Significance:Timely receipt of colorectal cancer screening can reduce morbidity and mortality. Identification of populations and domains of factors associated with colorectal cancer screening receipt among men and women can help future interventions to alleviate impeding factors and target screening promotion efforts in populations not adherent with screening guidelines.
A escrita de si em Só de António Nobre
Authors: Picosque Tatiana Aparecida 
Published: June 2022

Este artigo pretende estudar a escrita de si na poética de António Nobre (1867-1900), analisando versos de seu livro mais conhecido, intitulado Só. Para a sua abordagem, escolhemos alguns dos profícuos momentos em que o autor entrelaça obra e biografia, o que, por sua vez, contribuiu para a construção de um efeito poético singular no cenário literário do fim do século XIX.
Interleukin-6 Predicts Carotid Plaque Severity, Vulnerability, and Progression
Authors: Kamtchum-Tatuene Joseph , Saba Luca , Heldner Mirjam R. , Poorthuis Michiel H.F. , de Borst Gert J. , Rundek Tatjana , Kakkos Stavros K. , Chaturvedi Seemant , Topakian Raffi , Polak Joseph F. , Jickling Glen C. ,   for the Carotid Atherosclerosis and Stroke Collaboration (CASCO)
Published: June 2022

Background:
IL-6 (interleukin-6) has important roles in atherosclerosis pathophysiology. To determine if anti-IL-6 therapy warrants evaluation as an adjuvant stroke prevention strategy in patients with carotid atherosclerosis, we tested whether circulating IL-6 levels predict carotid plaque severity, vulnerability, and progression in the prospective population-based CHS (Cardiovascular Health Study).

Methods:

Duplex carotid ultrasound was performed at baseline and 5 years. Baseline plaque severity was scored 0 to 5 based on North American Symptomatic Carotid Endarterectomy Trial grade of stenosis. Plaque vulnerability at baseline was the presence of markedly irregular, ulcerated, or echolucent plaques. Plaque progression at 5 years was a ≥1 point increase in stenosis severity. The relationship of baseline plasma IL-6 levels with plaque characteristics was modeled using multivariable linear (severity) or logistic (vulnerability and progression) regression. Risk factors of atherosclerosis were included as independent variables. Stepwise backward elimination was used with
P
>0.05 for variable removal. To assess model stability, we computed the
E
-value or minimum strength of association (odds ratio scale) that unmeasured confounders must have with log IL-6 and the outcome to suppress the association. We performed internal validation with 100 bootstrap samples.

Results:

There were 4334 participants with complete data (58.9% women, mean age: 72.7±5.1 years), including 1267 (29.2%) with vulnerable plaque and 1474 (34.0%) with plaque progression. Log IL-6 predicted plaque severity (β=0.09,
P
=1.3×10
−3
), vulnerability (OR, 1.21 [95% CI, 1.05–1.40];
P
=7.4×10
−3
,
E
-value=1.71), and progression (OR, 1.44 [95% CI, 1.23-1.69],
P
=9.1×10
−6
,
E
-value 2.24). In participants with >50% predicted probability of progression, mean log IL-6 was 0.54 corresponding to 2.0 pg/mL. Dichotomizing IL-6 levels did not affect the performance of prediction models.

Conclusions:
Circulating IL-6 predicts carotid plaque severity, vulnerability, and progression. The 2.0 pg/mL cutoff could facilitate the selection of individuals that would benefit from anti-IL-6 drugs for stroke prevention.
Understanding of the Lower Extremity Motor Recovery After First-Ever Ischemic Stroke
Authors: Lee Hyun Haeng , Sohn Min Kyun , Kim Deog Young , Shin Yong-Il , Oh Gyung-Jae , Lee Yang-Soo , Joo Min Cheol , Lee So Young , Song Min-Keun , Han Junhee , Ahn Jeonghoon , Lee Young-Hoon , Chang Won Hyuk , Choi Soo Mi , Lee Seon Kui , Lee Jongmin , Kim Yun-Hee 
Published: June 2022

Background:
We aimed to verify the validity of the proportional recovery model for the lower extremity.

Methods:
We reviewed clinical data of patients enrolled in the Korean Stroke Cohort for Functioning and Rehabilitation between August 2012 and May 2015. Recovery proportion was calculated as the amount of motor recovery over initial motor impairment, measured as the Fugl-Meyer Assessment of Lower Extremity score. We used the logistic regression method to model the probability of achieving the full Fugl-Meyer Assessment of Lower Extremity score, whereby we considered the ceiling effect of the score. To show the difference in the prevalence of achieving the full Fugl-Meyer Assessment of Lower Extremity score between 3 and 6 months poststroke, we constructed a marginal model through the generalized estimating equation method. We also performed the propensity score matching analysis to show the dependency of recovery proportion on the initial motor deficit at 3 and 6 months poststroke.

Results:
We evaluated 1085 patients. The recovery proportions at 3 and 6 months poststroke were 0.67±0.42 and 0.75±0.39, respectively. A 1-unit decrease in the initial neurological impairment and the age at stroke onset increased the probability of achieving the full Fugl-Meyer Assessment of Lower Extremity score, which occurred at both 3 and 6 months poststroke. The prevalence of those who reach full lower limb motor recovery differs significantly between 3 and 6 months poststroke. We also found out that the recovery proportion at both 3 and 6 months poststroke is determined by the initial motor deficits of the lower limb. These results are not consistent with the proportional recovery model.

Conclusions:
Our results demonstrated that the proportional recovery model for the lower limb is invalid.