Medicine and Health Sciences Commons^™

Target Dose Conversion Modeling From Pencil Beam (Pb) To Monte Carlo (Mc) For Lung Sbrt, D. Zheng, X. Zhu, Q. Zhang, X. Liang, W. Zhen, C. Lin, V. Verma, S. Wang, A. Wahl, C. Zhang, +2 Additional Authors

Journal Articles

© 2016 The Author(s). Background: A challenge preventing routine clinical implementation of Monte Carlo (MC)-based lung SBRT is the difficulty of reinterpreting historical outcome data calculated with inaccurate dose algorithms, because the target dose was found to decrease to varying degrees when recalculated with MC. The large variability was previously found to be affected by factors such as tumour size, location, and lung density, usually through sub-group comparisons. We hereby conducted a pilot study to systematically and quantitatively analyze these patient factors and explore accurate target dose conversion models, so that large-scale historical outcome data can be correlated with more …

Quality Measurement In Wonderland: The Curious Case Of A Dialysis Readmissions Measure, S. Fishbane, J. B. Wish

Journal Articles

The standardized readmission ratio is a new quality measure for dialysis facilities that will affect public reporting and payment beginning in 2017. Like all quality measures affecting public reporting and payment, the standardized readmission ratio was vetted by a process that included a technical expert panel convened by the US Centers for Medicare and Medicaid Services, and, then, the National Quality Forum. Unlike previous measures, standardized readmission ratio followed a tortuous path that exposed problems in the development and endorsement process. Although it is acknowledged that processes in the dialysis facility can be improved to decrease readmissions, multiple objections to …

Predicting Treatment Related Imaging Changes (Trics) After Radiosurgery For Brain Metastases Using Treatment Dose And Conformality Metrics., B. F. Taylor, J. P. Knisely, J. M. Qian, J. B. Yu, V. L. Chiang

Journal Articles

Purpose: Treatment-related imaging changes (TRICs) after stereotactic radiosurgery (SRS) involves the benign transient enlargement of radiographic lesions after treatment. Identifying the radiation dose volumes and conformality metrics associated with TRICs for different post-treatment periods would be helpful and improve clinical decision making.

Methods: 367 metastases in 113 patients were treated using Gamma Knife SRS between 1/1/2007-12/31/2009. Each metastasis was measured at each imaging follow-up to detect TRICs (defined as ≥ 20% increase in volume). Fluctuations in small volume lesions (less than 108 mm

Results: From 0-6 months, all measures correlated with the incidence of TRICs (p

Conclusions: All metrics except …

Estradiol-Mediated Spine Changes In The Dorsal Hippocampus And Medial Prefrontal Cortex Of Ovariectomized Female Mice Depend On Erk And Mtor Activation In The Dorsal Hippocampus, J. J. Tuscher, V. Luine, M. Frankfurt, K. M. Frick

Journal Articles

No abstract provided.

Simeprevir Plus Sofosbuvir (12 And 8 Weeks) In Hepatitis C Virus Genotype 1-Infected Patients Without Cirrhosis: Optimist-1, A Phase 3, Randomized Study, P. Kwo, N. Gitlin, R. Nahass, D. Bernstein, K. Etzkorn, S. Rojter, E. Schiff, M. Davis, P. Ruane, J. Witek, +8 Additional Authors

Journal Articles

No abstract provided.

Efficacy Of Direct-Acting Antiviral Combination For Patients With Hepatitis C Virus Genotype 1 Infection And Severe Renal Impairment Or End-Stage Renal Disease, P. J. Pockros, K. R. Reddy, P. S. Mantry, E. Cohen, M. Bennett, M. S. Sulkowski, D. E. Bernstein, D. E. Cohen, N. S. Shulman, E. Lawitz, +4 Additional Authors

Journal Articles

© 2016 AGA Institute. Background & Aims Although hepatitis C virus (HCV) infection is common in patients with end-stage renal disease, highly efficacious, well-tolerated, direct-acting antiviral regimens have not been extensively studied in this population. We investigated the safety and efficacy of ombitasvir co-formulated with paritaprevir and ritonavir, administered with dasabuvir (with or without ribavirin) in a prospective study of patients with stage 4 or 5 chronic kidney disease (CKD). Methods We performed a single-arm, multicenter study of treatment-naïve adults with HCV genotype 1 infection, without cirrhosis and with CKD stage 4 (estimated glomerular filtration rate, 15-30 mL/min/1.73 m2) or …

Cytoplasmic, Full Length And Novel Cleaved Variant, Tblr1 Reduces Apoptosis In Prostate Cancer Under Androgen Deprivation, G. Daniels, X. Zhang, X. Zhong, L. Santiago, L. H. Wang, X. Wu, J. Y. Zhang, F. Liang, X. Li, P. Lee, +6 Additional Authors

Journal Articles

No abstract provided.

Differential Protein Expression In Small Intestinal Neuroendocrine Tumors And Liver Metastases, M. K. Kim, F. Ye, D. Wang, M. Cui, S. C. Ward, R. R. Warner, S. Roayaie, M. Schwartz, D. Zhang, S. Itzkowitz, +1 Additional Author

Journal Articles

OBJECTIVE: Small intestinal neuroendocrine tumors (SI-NETs) are often detected after they have become metastatic. Using a novel protein array, we identified pathways important in SI-NET metastasis development in surgically resected patients. METHODS: Paired primary tumors and liver metastases from 25 patients undergoing surgical resection for metastatic SI-NETs were harvested. Extracted proteins were separated by sodium dodecyl sulfate gel and multiplex immunoblots were performed with 136 antibodies. Significant Analysis of Microarray was used to select for differentially expressed proteins. A tissue microarray was constructed from 27 archived specimens and stained by immunohistochemistry. RESULTS: Comparing primary SI-NETs with matched normal small-bowel mucosa, …

Acalabrutinib (Acp-196) In Relapsed Chronic Lymphocytic Leukemia, J. C. Byrd, B. Harrington, S. O'Brien, J. A. Jones, A. Schuh, S. Devereux, J. Chaves, W. G. Wierda, J. C. Barrientos, R. R. Furman, +20 Additional Authors

Journal Articles

Background Irreversible inhibition of Bruton's tyrosine kinase (BTK) by ibrutinib represents an important therapeutic advance for the treatment of chronic lymphocytic leukemia (CLL). However, ibrutinib also irreversibly inhibits alternative kinase targets, which potentially compromises its therapeutic index. Acalabrutinib (ACP-196) is a more selective, irreversible BTK inhibitor that is specifically designed to improve on the safety and efficacy of first-generation BTK inhibitors. Methods In this uncontrolled, phase 1-2, multicenter study, we administered oral acalabrutinib to 61 patients who had relapsed CLL to assess the safety, efficacy, pharmacokinetics, and pharmacodynamics of acalabrutinib. Patients were treated with acalabrutinib at a dose of 100 …

First Trimester Fetal Heart Rate As A Predictor Of Newborn Sex, L. A. Bracero, D. J. Seybold, S. Witsberger, L. Rincon, A. Modak, L. V. Baxi

Journal Articles

OBJECTIVE: To predict the sex of newborns using first trimester fetal heart rate (FHR). METHODS: This was a retrospective review of medical records and ultrasounds performed between 8 and 13 weeks of gestation. Continuous variables were compared using Student's t-tests while categorical variables were compared using Chi-square test. RESULTS: We found no significant differences between 332 (50.7%) female and 323 (49.3%) male FHRs during the first trimester. The mean FHR for female fetuses was 167.0 +/- 9.1 bpm and for male fetuses 167.3 +/- 10.1 bpm (p = 0.62). There was no significant difference in crown rump length between female …

The Future Of Abortion Law In The United States, Gerard V. Bradley

Journal Articles

In 1971, Judith Jarvis Thomson published what was then and still often is regarded as a trailblazing philosophical defense of a woman’s right to have a lawful abortion. It is time to revisit Thomson’s paper. The aim here is not to engage Thomson’s pro-choice conclusions, which are indeed mistaken, but to show that her question—to what extent can abortion be morally justified, assuming that it is the deliberate killing of one person by his or her mother—is the question today in American law concerning abortion. Pro-life people and groups argue among themselves about the prudence of political efforts to roll …

Comparing The Experiences And Withdrawal Considerations Of Treatment And Regular Foster Care Parents: The Canadian Perspective, Jessica Smith, Susan Rodger, Jason Brown, Laurel E. Pickel, Wendy Den Dunnen, Alan W. Leschied Dr.

Journal Articles

This study investigated differences in the experiences of Canadian foster parents providing regular and treatment foster care and their consideration to withdraw from their position. Survey responses from 852 foster parents were analyzed subsequent to separating the participants into two groups based on the primary type of care they provided (regular N = 454; treatment N = 398). Results revealed that treatment foster care parents considered withdrawing at a higher rate compared to regular foster care parents. Subsequent analysis revealed numerous differences between the two groups regarding foster parents’ experiences in fostering and reasons to withdraw. The results are discussed …

Effect Of Single Embryo Transfer On The Risk Of Preterm Birth Associated With In Vitro Fertilization, A. J. Fechner, K. R. Brown, N. Onwubalili, S. K. Jindal, G. Weiss, L. T. Goldsmith, P. G. Mcgovern

Journal Articles

To determine whether elective single embryo transfer (eSET) reduces the risk of preterm delivery associated with in vitro fertilization (IVF). This is an observational study of 3125 eSET cycles performed from 2008 to 2009 and reported to the Society for Assisted Reproductive Technology (SART) database. Preterm delivery rates were compared to the overall preterm delivery rate among all patients undergoing IVF over the same time period. The 3125 eSET cycles resulted in 1507 live births (live birth rate 48.2 %) Among these deliveries were 27 twins (1.8 %) and one set of triplets (0.07 %). The overall preterm delivery rate …

A Critical Role For The Host Mediator Macrophage Migration Inhibitory Factor In The Pathogenesis Of Malarial Anemia, M. A. Mcdevitt, J. Xie, S. Ganapathy-Kanniappan, J. Griffith, A. Liu, C. Mcdonald, P. Thuma, V. R. Gordeuk, C. N. Metz, R. Mitchell, J. Keefer, J. David, L. Leng, R. Bucala

Journal Articles

No abstract provided.

Metabolic Resting-State Brain Networks In Health And Disease, P. G. Spetsieris, J. H. Ko, C. C. Tang, A. Nazem, W. Sako, S. Peng, Y. Ma, V. Dhawan, D. Eidelberg

Journal Articles

The delineation of resting state networks (RSNs) in the human brain relies on the analysis of temporal fluctuations in functional MRI signal, representing a small fraction of total neuronal activity. Here, we used metabolic PET, which maps nonfluctuating signals related to total activity, to identify and validate reproducible RSN topographies in healthy and disease populations. In healthy subjects, the dominant (first component) metabolic RSN was topographically similar to the default mode network (DMN). In contrast, in Parkinson's disease (PD), this RSN was subordinated to an independent disease-related pattern. Network functionality was assessed by quantifying metabolic RSN expression in cerebral blood …

Implications Of Epigenetic Variability Within A Cell Population For "Cell Type" Classification, I. Tabansky, J. N.H. Stern, D. W. Pfaff

Journal Articles

Here, we propose a new approach to defining nerve "cell types" in reaction to recent advances in single cell analysis. Among cells previously thought to be equivalent, considerable differences in global gene expression and biased tendencies among differing developmental fates have been demonstrated within multiple lineages. The model of classifying cells into distinct types thus has to be revised to account for this intrinsic variability. A "cell type" could be a group of cells that possess similar, but not necessarily identical properties, variable within a spectrum of epigenetic adjustments that permit its developmental path toward a specific function to be …

Parkinson's Disease-Related Spatial Covariance Pattern Identified With Resting-State Functional Mri, T. Wu, Y. Ma, Z. Zheng, S. Peng, X. Wu, D. Eidelberg, P. Chan

Journal Articles

In this study, we sought to identify a disease-related spatial covariance pattern of spontaneous neural activity in Parkinson's disease using resting-state functional magnetic resonance imaging (MRI). Time-series data were acquired in 58 patients with early to moderate stage Parkinson's disease and 54 healthy controls, and analyzed by Scaled Subprofile Model Principal Component Analysis toolbox. A split-sample analysis was also performed in a derivation sample of 28 patients and 28 control subjects and validated in a prospective testing sample of 30 patients and 26 control subjects. The topographic pattern of neural activity in Parkinson's disease was characterized by decreased activity in …

First-In-Human, Phase 1, Randomized, Dose-Escalation Trial With Recombinant Anti-Il-20 Monoclonal Antibody In Patients With Psoriasis, A. B. Gottlieb, J. G. Krueger, M. Sandberg Lundblad, M. Gothberg, B. E. Skolnick

Journal Articles

BACKGROUND: The current trial was a first-in-human clinical trial evaluating the safety, tolerability, pharmacokinetics, pharmacodynamics, and preliminary efficacy of the recombinant monoclonal anti-interleukin-20 (IL-20) antibody, NNC0109-0012, which targets the inflammatory cytokine IL-20. METHODS: In total, 48 patients aged 18 to 75 years with moderate to severe stable chronic plaque psoriasis with affected body surface area >/=15% and physician global assessment score >/=3 were enrolled in this randomized, double-blind, multicenter, placebo-controlled, phase 1 dose-escalation trial. Patients were randomized within each single dose cohort (0.01, 0.05, 0.2, 0.6, 1.5, or 3.0 mg/kg) or multiple dose cohort (0.05, 0.2, 0.5, 1.0, or 2.0 …

Mesothelioma Patients With Germline Bap1 Mutations Have 7-Fold Improved Long-Term Survival, F. Baumann, E. Flores, A. Napolitano, S. Kanodia, E. Taioli, H. Pass, H. Yang, M. Carbone

Journal Articles

BRCA1-associated protein-1 (BAP1) mutations cause a new cancer syndrome, with a high rate of malignant mesothelioma (MM). Here, we tested the hypothesis that MM associated with germline BAP1 mutations has a better prognosis compared with sporadic MM. We compared survival among germline BAP1 mutation MM patients with that of all MM (N = 10 556) recorded in the United States Surveillance, Epidemiology, and End Results (SEER) data from 1973 to 2010. We identified 23 MM patients-11 alive-with germline BAP1 mutations and available data on survival. Ten patients had peritoneal MM, ten pleural MM and three MM in both locations. Thirteen …

The Glass Is Half Full: Evidence For Efficacy Of Alcohol-Wise At One University But Not The Other, K. Croom, L. Staiano-Coico, M. Lesser, D. K. Lewis, V. F. Reyna, T. C. Marchell, J. Frank, S. Ives

Journal Articles

This research extends the growing literature about online alcohol prevention programs for first-year college students. Two independent randomized control studies, conducted at separate universities, evaluated the short-term effectiveness of Alcohol-Wise, an online alcohol prevention program not previously studied. It was hypothesized the prevention program would increase alcohol knowledge and reduce alcohol consumption, including high-risk alcohol-related behaviors, among first-year college students. At both universities, the intervention significantly increased alcohol-related knowledge. At one university, the prevention program also significantly reduced alcohol consumption and high-risk drinking behaviors, such as playing drinking games, heavy drinking, and extreme ritualistic alcohol consumption. Implications for the use …

Circulating Adipokines And Inflammatory Markers And Postmenopausal Breast Cancer Risk, M. J. Gunter, T. Wang, M. Cushman, X. Xue, S. Wassertheil-Smoller, H. D. Strickler, T. E. Rohan, J. E. Manson, A. Mctiernan, G. Y. Ho, +5 Additional Authors

Journal Articles

BACKGROUND: Adipokines and inflammation may provide a mechanistic link between obesity and postmenopausal breast cancer, yet epidemiologic data on their associations with breast cancer risk are limited. METHODS: In a case-cohort analysis nested within the Women's Health Initiative Observational Study, a prospective cohort of postmenopausal women, baseline plasma samples from 875 incident breast cancer case patients and 839 subcohort participants were tested for levels of seven adipokines, namely leptin, adiponectin, resistin, interleukin-6, tumor necrosis factor-alpha, hepatocyte growth factor, and plasminogen activator inhibitor-1, and for C-reactive protein (CRP), an inflammatory marker. Data were analyzed by multivariable Cox modeling that included established …

Heart Failure: An Exploration Of Recent Advances In Research And Treatment (A), A. Szema, A. Mclarty, H. Skopicki, M. Bloom, R. Jermyn

Journal Articles

No abstract provided.

Emerging Novel Therapies For Heart Failure, A. M. Szema, S. Dang, J. C. Li

Journal Articles

No abstract provided.

New Best1 Mutations In Autosomal Recessive Bestrophinopathy, A. T. Fung, S. Yzer, N. Goldberg, H. Wang, M. Nissen, A. Giovannini, J. E. Merriam, E. N. Bukanova, L. A. Yannuzzi, R. Allikmets, +2 Additional Authors

Journal Articles

PURPOSE: To report the ocular phenotype in patients with autosomal recessive bestrophinopathy and carriers, and to describe novel BEST1 mutations. METHODS: Patients with clinically suspected and subsequently genetically proven autosomal recessive bestrophinopathy underwent full ophthalmic examination and investigation with fundus autofluorescence imaging, spectral domain optical coherence tomography, electroretinography, and electrooculography. Mutation analysis of the BEST1 gene was performed through direct Sanger sequencing. RESULTS: Five affected patients from four families were identified. Mean age was 16 years (range, 6-42 years). All affected patients presented with reduced visual acuity and bilateral, hyperautofluorescent subretinal yellowish deposits within the posterior pole. Spectral domain optical …

Lifitegrast Ophthalmic Solution 5.0% Versus Placebo For Treatment Of Dry Eye Disease: Results Of The Randomized Phase Iii Opus-2 Study, J. Tauber, P. Karpecki, R. Latkany, J. Luchs, J. Martel, K. Sall, A. Raychaudhuri, V. Smith, C. P. Semba

Journal Articles

PURPOSE: Lifitegrast is an integrin antagonist that decreases T-cell-mediated inflammation associated with dry eye disease (DED). We report the results of OPUS-2, a phase III study evaluating the efficacy and safety of lifitegrast compared with placebo for the treatment of DED. DESIGN: A 12-week, multicenter, randomized, prospective, double-masked, placebo-controlled clinical trial. PARTICIPANTS: Adults aged >/=18 years with use of artificial tears within 30 days, inferior corneal staining score >/=0.5 (0-4 scale), Schirmer tear test (without anesthesia) >/=1 and/=40 (0-100 visual analogue scale [VAS]). METHODS: Subjects were randomized 1:1 after 14-day placebo run-in to lifitegrast ophthalmic solution 5.0% or placebo twice …

Microvolt T-Wave Alternans In Patients Undergoing Elective Coronary Artery Bypass Grafting: A Pilot Study, G. Khoueiry, M. Abdallah, M. Shariff, M. Kowalski, J. Lafferty

Journal Articles

INTRODUCTION: We designed a prospective observational study targeting a selective population of patients undergoing elective coronary artery bypass grafting with normal systolic function. In this study we looked at the prevalence of pre-operative microvolt T-wave alternans and if it predicts atrial fibrillation after surgery. METHODS: The inclusion criteria included all patients referred to the cardiothoracic outpatient clinic for elective bypass, who can perform aerobic exercise, with a recent exercise stress test exercising at least to 85% of the maximal predicted heart rate (220 - age) and with non-limiting chest pain at maximal exercise. Twenty patients met the inclusion/exclusion criteria between …

Left Ventricular Metastasis From A Primary Pancreatobiliary Tumor, A. N. Makaryus, L. Boxt

Journal Articles

Metastatic disease to the heart is not uncommon. We describe a case of a man in his 60s with an unusual metastasis to the heart and detail its intracardiac location by means of cardiac computerized tomography (CCT) and transthoracic echocardiography. To our knowledge, this is the first report of a pancreatobiliary tumor metastasizing exclusively to the left ventricle (LV) of the heart.

A Case Of Ventricular Fibrillation Triggered By Ventricular Premature Depolarizations Exiting From Different Sites Of The Purkinje Network, S. E. Mountantonakis, H. Ismail, D. Lin

Journal Articles

No abstract provided.

Interest In Bariatric Surgery Among Obese Patients With Obstructive Sleep Apnea, K. A. Dudley, A. Tavakkoli, R. A. Andrews, A. N. Seiger, J. P. Bakker, S. R. Patel

Journal Articles

BACKGROUND: Standard obstructive sleep apnea (OSA) therapies are poorly tolerated. Bariatric surgery is a potential alternative but the level of interest in this intervention among OSA patients is unknown. OBJECTIVES: Determine the proportion of OSA patients who would be interested in bariatric surgery. SETTING: Sleep clinics, United States. METHODS: Consecutive adult patients with untreated severe OSA and a body mass index of 35-45 kg/m2 were approached. Patients at low perioperative risk and no urgent indication for OSA treatment were invited to a separate informational visit about bariatric surgery as primary treatment for OSA. RESULTS: Of 767 eligible patients, 230 (30.0%) …

Prothrombin Time And Activated Partial Thromboplastin Time Testing: A Comparative Effectiveness Study In A Million-Patient Sample, M. N. Capoor, J. L. Stonemetz, J. C. Baird, F. S. Ahmed, A. Awan, C. Birkenmaier, M. A. Inchiosa, S. K. Magid, K. Mcgoldrick, E. Molmenti, S. Naqvi, S. D. Parker, S. M. Pothula, A. Shander, R. G. Steen, M. K. Urban, J. Wall, V. A. Fischetti

Journal Articles

Background A substantial fraction of all American healthcare expenditures are potentially wasted, and practices that are not evidence-based could contribute to such waste. We sought to characterize whether Prothrombin Time (PT) and activated Partial Thromboplastin Time (aPTT) tests of preoperative patients are used in a way unsupported by evidence and potentially wasteful. Methods and Findings We evaluated prospectively-collected patient data from 19 major teaching hospitals and 8 hospital-affiliated surgical centers in 7 states (Delaware, Florida, Maryland, Massachusetts, New Jersey, New York, Pennsylvania) and the District of Columbia. A total of 1,053,472 consecutive patients represented every patient admitted for elective surgery …