bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genetic diversity and offspring fitness in the red and white fruit color morphs of the wild strawberry Fragaria pentaphylla
Authors: Chen Lu-Xi , Xu Su-Ting , Ding Wei-Hang , Li Jun-Min , Alpert Peter 
Published: December 2019

Abstract

Aims
Fruit color polymorphisms are widespread in plants, but what maintains them is largely unclear. One hypothesis is that some morphs are preferred by dispersers while others have higher pre- or postdispersal fitness. This leads to the prediction that fruit color morphs will differ in pre- or postdispersal fitness.

Methods
We compared genetic and clonal diversity, mating system, morphological traits that might be associated with resistance to freezing, and germination, survival and seed production of progeny of the red and white fruit morphs in a population of a diploid, wild strawberry, Fragaria pentaphylla, from south-central China.

Important Findings
The red morph was much more abundant than the white but did not show higher genetic diversity as measured by observed and effective numbers of alleles, Shannon information index, or expected or observed heterozygosities. AMOVA showed that most of the genetic variation in the population was within rather than between morphs. Morphs did not differ in mating system parameters, and no significant biparental inbreeding was found in either morph. Gene flow between two morphs was high (Nm = 6.89). Seeds of the red morph germinated about 2 days earlier and had a 40% higher rate of germination than those of the white morph, but survival of seedlings and seed production by surviving offspring did not differ between morphs. The whole postdispersal fitness of the red morph was about two times higher than that of the white morph. Red morphs had hairier petioles but not more surface wax on leaves. Overall, results showed partial evidence for difference in pre- and postdispersal fitness between fruit color morphs in F. pentaphylla. Differences in fitness independent of dispersal may thus partially account for fruit color polymorphism in all cases.
Testing the relativistic Doppler boost hypothesis for supermassive binary black holes candidates via broad emission line profiles
Authors: Song Zihao , Ge Junqiang , Lu Youjun , Ji Xiang 
Published: December 2019

ABSTRACTOptical periodicity QSOs found by transient surveys are suggested to be subparsec supermassive binary black holes (BBHs). An intriguing interpretation for the periodicity of some of those QSOs is that the continuum is radiated from the accretion disc associated with the BBH secondary component and modulated by the periodical rotation of the secondary via Doppler-boost effect. Close to edge-on orbital orientation can lead to more significant Doppler-boost effect and thus are preferred for these systems, which is distinct from those normal type-1 QSOs with more or less face-on orientations. Therefore, the profiles of broad lines emitted from these Doppler-modulated systems may be significantly different from other systems that are not Doppler modulated. We investigate the properties of the broad emission lines of optical-periodicity QSOs, including both a sample of QSOs that can be interpreted by the Doppler-modulated effects and a sample that cannot. We find that there is no obvious difference in the profiles and other properties of various (stacked) broad emission lines of these two samples, though a simple broad line region model would suggest significant differences. Our finding raises a challenge to the Doppler boost hypothesis for some of those BBHs candidates with optical periodicity.
Dust masses and grain size distributions of a sample of Galactic pulsar wind nebulae
Authors: Priestley F D , Barlow M J , De Looze I , Chawner H 
Published: December 2019

ABSTRACT
We calculate dust spectral energy distributions (SEDs) for a range of grain sizes and compositions, using physical properties appropriate for five pulsar wind nebulae (PWNe) from which dust emission associated with the ejecta has been detected. By fitting the observed dust SED with our models, with the number of grains of different sizes as the free parameters, we are able to determine the grain size distribution and total dust mass in each PWN. We find that all five PWNe require large ($\ge 0.1 \, {\rm \mu m}$) grains to make up the majority of the dust mass, with strong evidence for the presence of micron-sized or larger grains. Only two PWNe contain non-negligible quantities of small ($\lt 0.01 \, {\rm \mu m}$) grains. The size distributions are generally well-represented by broken power laws, although our uncertainties are too large to rule out alternative shapes. We find a total dust mass of $0.02\rm {-}0.28 \, {\rm M}_\odot$ for the Crab Nebula, depending on the composition and distance from the synchrotron source, in agreement with recent estimates. For three objects in our sample, the PWN synchrotron luminosity is insufficient to power the observed dust emission, and additional collisional heating is required, either from warm, dense gas as found in the Crab Nebula, or higher temperature shocked material. For G54.1+0.3, the dust is heated by nearby OB stars rather than the PWN. Inferred dust masses vary significantly depending on the details of the assumed heating mechanism, but in all cases large mass fractions of micron-sized grains are required.
Temozolomide radiochemotherapy for high-grade glioma patients with hemodialysis: a case series of 7 patients
Authors: Muto Jun , Matsutani Tomoo , Matsuda Ryosuke , Kinoshita Masashi , Oikawa Mitsuteru , Pallud Johan , Sasaki Hikaru 
Published: December 2019

Abstract

Background
The pharmacokinetics of temozolomide (TMZ) in patients with severe renal impairments (creatinine clearance, &lt;36 mL/min/m2) or in hemodialysis (HD) patients has not been investigated. TMZ and its metabolic products are mainly excreted in urine, as retention of these in the body may result in increased adverse events in HD patients.

Methods
Seven HD patients with high-grade gliomas from 6 institutions were included in the study. Patient characteristics, treatment schedule, clinical course, pathological/molecular findings, and adverse events were evaluated.

Results
The histopathological diagnoses were isocitrate dehydrogenase (IDH) wild-type glioblastoma in 4 cases, not other specified (NOS) glioblastoma in 2 cases, and IDH-mutant anaplastic astrocytoma in 1 case. Five of the 7 patients completed radiotherapy (48-60 Gy) with concomitant TMZ (75 mg/m2) followed by adjuvant 5-day TMZ (150 mg/m2) every 28 days. During the entire course of treatment with TMZ, severe (Common Terminology Criteria for Adverse Events [CTCAE] ≥ Grade 3) lymphocytopenia occurred in 57%, neutropenia in 0%, and thrombocytopenia in 14% of the patients. Generally, the frequency and degree of myelosuppression do not increase in HD patients with high-grade gliomas. Two of the 7 (28.5%) patients died of infectious disease despite having no direct correlation to myelosuppression; that is similar to the death rate of 21.9% resulting from infection in HD patients in Japan.

Conclusions
Decreasing the dose of TMZ might not be required in HD patients with high-grade gliomas during concomitant radiochemotherapy and maintenance therapy. However, careful clinical and hematological observation is required to avoid critical hematotoxicity and infection.
Portion size estimation in dietary assessment: a systematic review of existing tools, their strengths and limitations
Authors: Amoutzopoulos Birdem , Page Polly , Roberts Caireen , Roe Mark , Cade Janet , Steer Toni , Baker Ruby , Hawes Tabitha , Galloway Catherine , Yu Dove , Almiron-Roig Eva 
Published: December 2019

AbstractContextOverestimation or underestimation of portion size leads to measurement error during dietary assessment.ObjectiveTo identify portion size estimation elements (PSEEs) and evaluate their relative efficacy in relation to dietary assessment, and assess the quality of studies validating PSEEs.Data Selection and ExtractionElectronic databases, internet sites, and cross-references of published records were searched, generating 16 801 initial records, from which 334 records were reviewed and 542 PSEEs were identified, comprising 5% 1-dimensional tools (eg, food guides), 46% 2-dimensional tools (eg, photographic atlases), and 49% 3-dimensional tools (eg, household utensils). Out of 334 studies, 21 validated a PSEE (compared PSEE to actual food amounts) and 13 compared PSEEs with other PSEEs.ConclusionQuality assessment showed that only a few validation studies were of high quality. According to the findings of validation and comparison studies, food image–based PSEEs were more accurate than food models and household utensils. Key factors to consider when selecting a PSEE include efficiency of the PSEE and its applicability to targeted settings and populations.
The effect of Chinese herbal medicine combined with western medicine on vascular endothelial function for patients with hypertension
Authors: Ren Weiquan , Liao Jiangquan , Chen Jialiang , Li Zhonghao , Huang Li 
Published: December 2019

Abstract

Background:
Essential hypertension is one of the most common chronic diseases in the world and a major risk factor for cardiovascular and cerebrovascular diseases. Hypertension often leads to a variety of complications, of which vascular endothelial dysfunction is an important part. Traditional Chinese medicine (TCM) combined with western medicine can significantly improve vascular endothelial function in patients with hypertension, but it has not been systematically evaluated for efficacy and safety of essential hypertension. Therefore, we aim to conduct a systematic review and meta-analysis to evaluate the efficacy and safety of TCM combined with western medicine in improving vascular endothelial function in patients with essential hypertension.

Methods:
We will search PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Excerpta Medica Database (EMBASE), China National Knowledge Infrastructure Database (CNKI), Wanfang Database, China Science Journal Database (VIP Database) and China Biomedical Literature Database (CBM). Clinical trial registrations, potential grey literature, related conference abstracts, and reference lists of identified studies will also be retrieved. The electronic database will be searched for literatures published from the beginning to October 2018. Based on the heterogeneity test, data integration is performed using a fixed effect model or a random effects model. Changes in blood pressure and endothelial function will be assessed as primary outcomes. Drug use, disease progression and adverse events will be assessed as secondary outcomes. RevMan V.5.3.5 will be used for meta-analysis.

Results:
This systematic review and meta-analysis will provide high-quality evidence from a variety of aspects, including efficacy, blood pressure, vascular endothelial function and adverse reactions, to assess the efficacy and safety of TCM combined with western medicine in patients with hypertension.

Conclusion:
This systematic review will determine whether TCM combined with western medicine provides evidence for effective intervention of vascular endothelial function in patients with essential hypertension.

Ethics and dissemination:
This systematic review and meta-analysis of randomized controlled trials does not require ethical recognition, and the results of this paper will be published in an open access, internationally influential academic journal.

PROSPERO registration number:
CRD42019140743
Retrospective analysis of cervical cancer and precancerous lesions in patients with atypical squamous cells of undetermined significance in China
Authors: Wang Yan-Ying , Kong Ling-Hua , Liu Yang , Wang Shu , Fan Qing-Bo , Zhu Lan , Lang Jing-He 
Published: December 2019

Abstract
Atypical squamous cells of undetermined significance (ASCUS) are the most common cytological abnormality of all smear test. No study has demonstrated the prevalence of cervical cancer or its precursor in Chinese patients with ASCUS. This study aims to investigate the prevalence of cervical intraepithelial neoplasia 1 or worse (CIN1+) and CIN3 or worse (CIN3+) in patients with ASCUS in China to provide insight into appropriate management for Chinese health care.
In a retrospective cross-sectional study, patients who underwent liquid-based thin layer cytology and human papillomavirus (HPV) co-testing at the Peking Union Medical College Hospital between January 2014 and January 2017, and had ASCUS results on liquid-based thin layer cytology test and underwent follow-up and colposcopic biopsy were included. Age, HPV DNA test, and pathological outcomes were assessed.
One hundred forty-four patients with ASCUS and positive HPV test results were included. In the 3-year follow-up, 23 (16.0%) patients had CIN1, 28 (19.4%) had CIN2, and 17 (11.8%) had CIN3 or carcinoma in situ. The risk of CIN3+ was significantly higher in those older than 60 years (42.8%, P = .005), whereas the CIN1+ prevalence displayed no significant difference between age groups. Both hybrid Capture II (HC II) value and cytopathological description of HPV infection showed no statistically significant correlation with CIN1+ or CIN3+.
Patients with HPV-positive ASCUS who were older than 60 years had a significantly higher risk of CIN3+, and clinicians should pay more attention to them. Both HC II value and cytopathological description of HPV infection showed no significant correlation with CIN1+ or CIN3+.
Successful treatment of metastatic adrenocortical carcinoma in the spine
Authors: Liu Shuzhong , Zhou Xi , Song An , Huo Zhen , Wang Yipeng , Liu Yong 
Published: December 2019

Abstract

Rationale:
Adrenocortical carcinoma is a rare aggressive type of cancer whose prognosis is poor, particularly for metastatic entities. Metastatic adrenocortical carcinoma in the spine is a rare disease with no standard curative managements yet. The objective of this study is to report a very rare case of spinal metastases of adrenocortical carcinoma successfully managed by combination of cement augmentation, radiotherapy together with adjuvant programmed cell death 1 (PD-1) therapy. The management of these unique cases has yet to be well-documented.

Patient concerns:
A 42-year-old woman presented with a 3-month history of continuous and progressive back pain. The patient, who had been diagnosed of right pheochromocytoma, received surgical treatment of right adrenalectomy 14 months ago in another hospital, followed by no further treatment.

Diagnosis:
Magnetic resonance imaging of spine showed vertebral pathological fracture of L1, spinal cord compression secondary to the epidural component of the L1 mass, with increased metastatic marrow infiltration of the right L1 vertebral body, which presented as a solid tumor. Postoperative pathology confirmed the diagnosis of spinal metastases of adrenocortical carcinoma.

Interventions:
The patient underwent cement augmentation via a posterior approach, radiotherapy, radiofrequency ablation of psoas major muscle occupying lesions, right chest wall, liver and kidney recess together with adjuvant PD-1 therapy.

Outcomes:
The patient's neurological deficits improved significantly after the surgery, and the postoperative period was uneventful at the 6-month and 1-year follow-up visit. There were no complications associated with the operation during the follow-up period.

Lessons:
Combined efforts of specialists from orthopedics, urology, interventional radiology, radiotherapy, pathology, endocrinology, and medical oncology led to the successful diagnosis and management of this patient. Metastatic adrenocortical carcinoma of the spine, although rare, should be part of the differential diagnosis when the patient has a history of adrenal carcinoma and presents with back pain, myelopathy, or radiculopathy. We recommend the posterior approach for total excision of the spinal metastatic adrenocortical carcinoma when the tumor has caused neurological deficits. Osteoplasty by cement augmentation, radiotherapy, and targeted PD-1 therapy may also be good choices for treatment.
A metastatic skull tumor from intrahepatic cholangiocarcinoma
Authors: Wang Dawei , He Shiwei , Chu Liang , Chao Qing , Zhang Qiujian , Shu Hansheng 
Published: December 2019

Abstract

Rationale:
Intrahepatic cholangiocarcinoma (ICC) originates from the epithelial cells of the secondary branches that are distant from the intrahepatic bile duct. ICC is a rare pathological type of primary liver cancer, with a high malignancy rate and poor prognosis. However, patients with ICC metastasis to the skull are extremely rarely encountered. Herein, we present a case of a metastatic skull tumor from ICC, along with a literature review.

Patient concerns:
A 50-year-old right-handed man who did not smoke was diagnosed with a poorly differentiated ICC (T2aN0M0) in segment VI of the liver in February 2017. Hepatectomy was performed. The patient then presented with a painful mass in the posterior occipital region with dizziness experienced since 1 month, for which he underwent posterior occipital craniotomy. Postoperative specimens were sent for pathological examination.

Diagnoses:
We diagnosed the patient with a metastatic skull tumor from ICC.

Interventions:
The patient underwent posterior occipital craniotomy and total resection of the tumor.

Outcomes:
The patient received chemotherapy 1 month after surgery, and after 6 months of follow-up, the patient was alive.

Lessons:
ICC often shows metastases to the vertebrae. Therefore, physicians should consider the possibility of metastasis in patients with ICC, especially in those who show a painful skull mass of unknown origin; moreover, among patients with vertebral metastasis, physicians should be very vigilant about an occipital mass. We believe that the craniospinal venous system may be the pathway for occipital metastasis in patients with ICC.
Complications of Cesarean Birth
Authors: Burke Carol , Allen Roma 
Published: December 2019

Abstract
The increase in severe maternal morbidity and mortality in the United States correlates with a significant rise in U.S. cesarean birth rates from 5.5% in 1970 to a rate of 31.9% of all births in 2018, far beyond the World Health Organization goal of 10% to 15%. Three key contributors to maternal morbidity and mortality related to cesarean birth include complications of hemorrhage, surgical site infection, and venous thromboembolism. All women should be screened for risk factors associated with these major complications during the antepartum, intrapartum, and postpartum period to assure the availability of immediate resources based on the assessment. Implementing evidence-based maternity care safety bundles, toolkits, and protocols to manage these complications can reduce adverse outcomes.
A Novel Method to Improve Perfusion of Ex Vivo Pumped Human Kidneys
Authors: Zhu Lin , Qureshi Arshna , Awad Mohamed , Hausladen Alfred , Perez-Protto Silvia , Latifi Samir Q. , Lebovitz Daniel J. , Chavin Kenneth , Stamler Jonathan S. , Reynolds James D. 
Published: December 2019

Objective:
To determine if addition of the S-nitrosylating agent ethyl nitrite (ENO) to the preservation solution can improve perfusion parameters in pumped human kidneys.

Background:
A significant percentage of actively stored kidneys experience elevations in resistance and decreases in flow rate during the ex vivo storage period. Preclinical work indicates that renal status after brain death is negatively impacted by inflammation and reduced perfusion—processes regulated by protein S-nitrosylation. To translate these findings, we added ENO to the preservation solution in an attempt to reverse the perfusion deficits observed in nontransplanted pumped human kidneys.

Methods:
After obtaining positive proof-of-concept results with swine kidneys, we studied donated human kidneys undergoing hypothermic pulsatile perfusion deemed unsuitable for transplantation. Control kidneys continued to be pumped a 4°C (ie, standard of care). In the experimental group, the preservation solution was aerated with 50 ppm ENO in nitrogen. Flow rate and perfusion were recorded for 10 hours followed by biochemical analysis of the kidney tissue.

Results:
In controls, perfusion was constant during the monitoring period (ie, flow rate remained low and resistance stayed high). In contrast, the addition of ENO produced significant and sustained reductions in resistance and increases in flow rate. ENO-treated kidneys had higher levels of cyclic guanosine monophosphate, potentially explaining the perfusion benefits, and increased levels of interleukin-10, suggestive of an anti-inflammatory effect.

Conclusions:
S-Nitrosylation therapy restored the microcirculation and thus improved overall organ perfusion. Inclusion of ENO in the renal preservation solution holds promise to increase the number and quality of kidneys available for transplant.
Severe Hypocalcemia After Thyroidectomy
Authors: Kazaure Hadiza S. , Zambeli-Ljepovic Alan , Oyekunle Taofik , Roman Sanziana A. , Sosa Julie A. , Stang Michael T. , Scheri Randall P. 
Published: December 2019

Objective:
The aim of the study was to determine severe hypocalcemia rate following thyroidectomy and factors associated with its occurrence.

Background:
Hypocalcemia is the most common complication after thyroidectomy. Severe post-thyroidectomy hypocalcemia can be life-threatening; data on this specific complication are scarce.

Methods:
Patients who underwent thyroidectomy in the American College of Surgeons-National Surgical Quality Improvement Program thyroidectomy-targeted database (2016–2017) were abstracted. A severe hypocalcemic event was defined as hypocalcemia requiring intravenous calcium, emergent clinic/hospital visit, or a readmission for hypocalcemia. Multivariable regression was used to identify factors independently associated with occurrence of severe hypocalcemia.

Results:
Severe hypocalcemia occurred in 5.8% (n = 428) of 7366 thyroidectomy patients, with 83.2% necessitating intravenous calcium treatment. Rate of severe hypocalcemia varied by diagnosis and procedure (0.5% for subtotal thyroidectomy to 12.5% for thyroidectomy involving neck dissections). Overall, 38.3% of severe hypocalcemic events occurred after discharge; in this subset, 59.1% experienced severe hypocalcemia despite being discharged with calcium and vitamin D. Severe hypocalcemia patients had higher rates of recurrent laryngeal nerve injury (13.4% vs 6.6%), unplanned reoperations (4.4% vs 1.3%), and longer hospital stay (30.4% vs 6.2% ≥3 days (all P < 0.01). After multivariate adjustment, severe hypocalcemia was associated with multiple factors including Graves disease [odds ratio (OR) = 2.06], lateral neck dissections (OR: 3.10), and unexpected reoperations (OR = 3.55); all P values less than 0.01.

Conclusions:
Severe hypocalcemia and suboptimal hypocalcemia management after thyroidectomy are common. Patients who experienced severe hypocalcemia had higher rates of nerve injury and unexpected reoperations, indicating surgical complexity and provider inexperience. More biochemical surveillance particularly a parathyroid hormone–based protocol, fine-tuned supplementation, and selective referral could reduce occurrence of this morbid complication.