bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genetic parameters and trends for growth traits in Blanco Orejinegro cattle
Authors: Ramírez Toro Edison J , Burgos Paz William O , Elzo Mauricio A , Martínez Sarmiento Rodrigo A , Cerón-Muñoz Mario F 
Published: September 2020

AbstractSince 1940, efforts have been made to preserve the Blanco Orejinegro (BON) cattle breed by maintaining gene banks. Nine years ago, a BON genetic improvement program was implemented to increase genetic gain based on control of productivity and the use of performance tests, polygenic and genomic evaluations, and selection indices. The objective of this study was to estimate genetic parameters and trends for growth traits by using polygenic (PM) and genomic–polygenic (GPM) models. Productive information from the years 1980 to 2019 was used. The following data were used: 7,304 birth weight (BW) records, 1,281 records of body weight adjusted to 120 days (W120), 4,791 records of weight adjusted to 240 days (W240), 3,339 records of weight adjusted to 480 days (W480), and 1,364 records of weight adjusted to 720 days (W720). The relationship matrix included 13,612 pure animals belonging to the Colombian Corporation for Agricultural Research - AGROSAVIA and the Producer Network program. A total of 1,224 individuals were genotyped with chips of different densities and all were imputed up to 50,932 SNPs. Polygenic and genomic-polygenic models were used to estimate genetic parameters and correlations between the genetic values estimated by each model. A generalized additive model with smoothing was used to estimate trends of genetic values from 1980 to 2019. Heritabilities between 0.29 and 0.40, genetic correlations between 0.13 and 0.94, and phenotypic correlations between 0.23 and 0.72 were observed. Close-to-zero genetic growth was observed for BW and W120. Genetic trends for the other traits were positive, with higher growth in the last 7 years. The heritabilities observed in this population indicate that the traits measured would respond to selection. Greater genetic progress can be achieved in W240, W480, and W720 by continuing with genetic evaluations and developing performance tests and strategies to make genetic material readily available to producers.
Shade tree species affect gas exchange and hydraulic conductivity of cacao cultivars in an agroforestry system
Authors: Ávila-Lovera Eleinis , Blanco Héctor , Móvil Olga , Santiago Louis S , Tezara Wilmer 
Published: September 2020

Abstract
Shade tolerance is a widespread strategy of rainforest understory plants. Many understory species have green young stems that may assimilate CO2 and contribute to whole-plant carbon balance. Cacao commonly grows in the shaded understory and recent emphasis has been placed on diversifying the types of trees used to shade cacao plants to achieve additional ecosystem services. We studied three agricultural cacao cultivars growing in the shade of four timber species (Cedrela odorata L., Cordia thaisiana Agostini, Swietenia macrophylla King and Tabebuia rosea (Bertol) A.D.C.) in an agroforestry system to (i) evaluate the timber species for their effect on the physiological performance of three cacao cultivars; (ii) assess the role of green stems on the carbon economy of cacao; and (iii) examine coordination between stem hydraulic conductivity and stem photosynthesis in cacao. Green young stem photosynthetic CO2 assimilation rate was positive and double leaf CO2 assimilation rate, indicating a positive contribution of green stems to the carbon economy of cacao; however, green stem area is smaller than leaf area and its relative contribution is low. Timber species showed a significant effect on leaf gas exchange traits and on stomatal conductance of cacao, and stem water-use efficiency varied among cultivars. There were no significant differences in leaf-specific hydraulic conductivity among cacao cultivars, but sapwood-specific hydraulic conductivity varied significantly among cultivars and there was an interactive effect of cacao cultivar × timber species. Hydraulic efficiency was coordinated with stem-stomatal conductance, but not with leaf-stomatal conductance or any measure of photosynthesis. We conclude that different shade regimes determined by timber species and the interaction with cacao cultivar had an important effect on most of the physiological traits and growth variables of three cacao cultivars growing in an agroforestry system. Results suggested that C. odorata is the best timber species to provide partial shade for cacao cultivars in the Barlovento region in Venezuela, regardless of cultivar origin.
Defining ‘Family Members’ of EU Citizens and the Circumstances under Which They Can Rely on EU Law
Authors: Milios Georgios 
Published: September 2020

Abstract
The present article deals with the legal concept of family members of EU citizens in EU and national legislation. In particular, it examines the legal definition of family in Directive 2004/38, as well as the way the Court of Justice of the EU has interpreted the relevant provisions of the Directive. Not least, the present article focuses on the circumstances under which these persons may qualify as family members according to the case law of the CJEU. As for the research at national level, the present study examines the way the same issues are regulated in national implementing legislation of Spain. The article concludes that although the definition of family in Directive 2004/38 is still focused on a formal and traditional family model, the CJEU has quite progressively adopted a more expansive interpretation in relation to this concept. Regardless of this finding, this article argues that a more de facto approach is still necessary in order for the applicable rules to become more compatible with the reality of personal relations nowadays but also with the international human rights standards.
Managing patients with sickle cell disease in primary care
Authors: Hehre Robert J. 
Published: September 2020

ABSTRACT
Sickle cell disease (SCD) is a group of disorders affecting the hemoglobin in erythrocytes. SCD is associated with significant morbidity and mortality and occurs most commonly among people of African ancestry. In 2014, the National Heart, Lung, and Blood Institute updated its guidelines for the management of SCD. These guidelines were implemented to provide evidence-based recommendations to assist primary care clinicians in the proper management of patients with SCD. This article reviews the current practice guidelines for SCD, with attention to health maintenance and hydroxyurea.
Primary immune regulatory disorders: a growing universe of immune dysregulation
Authors: Chan Alice Y. , Torgerson Troy R. 
Published: September 2020

Purpose of review
Primary immune regulatory disorders (PIRD) are a growing subset of diseases referred to as inborn errors of immunity. Unlike classical primary immune deficiency disorders that typically present with severe, recurrent, or unusual infections, the clinical manifestations of PIRD are dominated by immune-mediated diseases (autoimmunity, autoinflammation/hyperinflammation, lymphoproliferation, malignancy, and severe atopy). This review introduces the concept of PIRD including clinical phenotypes, treatments, and new PIRD-associated gene defects.

Recent findings
The number of genetic defects associated with PIRD is rapidly growing. The identified genes often encode proteins that play critical roles in regulating the immune response to various triggers. Understanding the molecular mechanisms underlying PIRD has shed light on the clinical phenotypes and has helped to identify targeted therapies. In some cases, hematopoietic cell transplant (HCT) has been successfully employed as a cure.

Summary
It is important to recognize the broad clinical manifestations of PIRD as patients may have symptoms atypical of classical ‘immunodeficiency’. Because of their diverse immune dysregulation problems, they are often primarily managed by other subspecialists. Immunologists can help connect the diverse immune-mediated pathologies to a gene defect. This, in turn, can play a significant role in directing clinical management, selecting effective therapy, and deciding on appropriateness of HCT.
Building the Next Generation of Researchers: Mentored Training in Dissemination and Implementation Science
Authors: Brownson Ross C. , Jacob Rebekah R. , Carothers Bobbi J. , Chambers David A. , Colditz Graham A. , Emmons Karen M. , Haire-Joshu Debra , Kerner Jon F. , Padek Margaret , Pfund Christine , Sales Anne 
Published: September 2020

Problem
Dissemination and implementation (D&I) science provides the tools needed to close the gap between known intervention strategies and their effective application. The authors report on the Mentored Training for Dissemination and Implementation Research in Cancer (MT-DIRC) program—a D&I training program for postdoctoral or early-career cancer prevention and control scholars.

Approach
MT-DIRC was a 2-year training institute in which fellows attended 2 annual Summer Institutes and other conferences and received didactic, group, and individual instruction; individualized mentoring; and other supports (e.g., pilot funding). A quasi-experimental design compared changes in 3 areas: mentoring, skills, and network composition. To evaluate mentoring and D&I skills, data from fellows on their mentors’ mentoring competencies, their perspectives on the importance of and satisfaction with mentoring priority areas, and their self-rated skills in D&I competency domains were collected. Network composition data were collected from faculty and fellows for 3 core social network domains: contact, mentoring, and collaboration. Paired t tests (mentoring), linear mixed models (skills), and descriptive analyses (network composition) were performed.

Outcomes
Mentors were rated as highly competent across all mentoring competencies, and each mentoring priority area showed reductions in gaps between satisfaction and importance between the 6 and 18 months post-first Summer Institute. Fellows’ self-rated skills in D&I competencies improved significantly in all domains over time (range: 42.5%–52.9% increase from baseline to 18 months post-first Summer Institute). Mentorship and collaboration networks grew over time, with the highest number of collaboration network ties for scholarly manuscripts (n = 199) in 2018 and for research projects (n = 160) in 2019.

Next Steps
Building on study findings and existing literature, mentored training of scholars is an important approach for building D&I skills and networks, and thus to better applying the vast amount of available intervention evidence to benefit cancer control.
Appropriate therapy for patients with stable ischemic heart disease: a review of literature and the implication of the International Study of Comparative Effectiveness with Medical and Invasive Approaches trial
Authors: Guo Ming Hao , Nantsios Alex , Ruel Marc 
Published: September 2020

Purpose of review
The aim of this review is to review the current literature on the management of stable ischemic heart disease in light of findings from the International Study of Comparative Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial.

Recent findings
Compared with optimal medical therapy, coronary artery bypass grafting (CABG) has been shown to improve survival and incidence of myocardial infarction in patients with stable ischemic heart disease whereas percutaneous coronary intervention (PCI) has not. The ISCHEMIA trial compared an initial conservative management strategy with optimal medical therapy with an initial invasive strategy with coronary angiogram followed by revascularization and found no difference in survival and myocardial infarction between the two groups. However, the trial was conducted under the assumption that patients would be referred to the most efficacious revascularization therapy; it was apparent that CABG was underutilized in many appropriate patients in the ISCHEMIA trial. The study highlighted the importance of optimizing medical therapy in stable ischemic heart disease (SIHD) patients but does not answer whether revascularization or conservative management is better for patients with SIHD.

Summary
Optimal medical therapy is an important element and should be included in the Heart Team discussion, and also applied after revascularization from PCI or CABG. Cardiac surgeons need to continue to advocate for the appropriate use of CABG based on the current available evidence.
Using a Likelihood Heuristic to Summarize Conflicting Literature on Predictors of Clinical Outcome Following Sport-Related Concussion
Authors: Büttner Fionn , Terry Douglas P. , Iverson Grant L. 
Published: September 2020

Objective:
To introduce a new methodology for summarizing the results from systematic reviews–a likelihood heuristic–to the field of sport-related concussion.

Data Sources:
We applied the likelihood heuristic to the results of a systematic review published by Iverson et al (2017), containing 101 studies, on the predictors of worse clinical outcome following sport-related concussion.

Study Selection:
We re-examined 5 individual prognostic factors that are of clinical interest and for which there is conflicting literature (female sex = 44 studies, prior concussion history = 41 studies, loss of consciousness = 31 studies, post-traumatic amnesia = 25 studies, and retrograde amnesia = 10 studies).

Data Extraction:
For each prognostic factor, likelihood ratios were generated using the (1) number of significant and nonsignificant studies, (2) study power, (3) alpha level, and (4) prior probability that the alternative hypothesis was true.

Data Synthesis:
Assuming each study had 80% power and an alpha level of 5%, observing the reported number of conflicting studies for female sex, prior concussion history, and retrograde amnesia is substantially more likely if each prognostic factor is associated with worse clinical outcome following sport-related concussion. For loss of consciousness, the observed number of conflicting studies is more likely if loss of consciousness is not associated with worse clinical outcome following sport-related concussion. A secondary analysis incorporating potentially more realistic study parameters of statistical power (45%) and alpha level (25%) generates weaker likelihood evidence that the observed numbers of studies for each prognostic factor are associated with worse clinical outcome following sport-related concussion than they are not.

Conclusions:
Using a likelihood heuristic with 80% power and 5% alpha level, there is very strong likelihood evidence that female sex, prior concussion history, and retrograde amnesia are associated with worse clinical outcome following sport-related concussion. The strength of likelihood evidence that prognostic factors are associated with worse clinical outcome reduces when statistical power is lower and alpha level is inflated.
Keratoconus Patient Satisfaction and Care Burden with Corneal Gas-permeable and Scleral Lenses
Authors: Shorter Ellen , Schornack Muriel , Harthan Jennifer , Nau Amy , Fogt Jennifer , Cao Dingcai , Nau Cherie 
Published: September 2020

SIGNIFICANCE
Scleral lenses (SLs) are increasingly being considered as the initial correction for patients with keratoconus. In this study, keratoconus patients report higher levels of comfort and visual satisfaction with SL compared with corneal gas-permeable lenses (GPs).

PURPOSE
This study aimed to compare patient satisfaction and care burden associated with GP and SL for the management of keratoconus.

METHODS
An electronic survey was distributed by the National Keratoconus Foundation from October 2016 to March 2017. Age at diagnosis, initial and current treatment, lens complications, access to care, lens handling time, and annual out-of-pocket treatment costs were collected. Vision, lens comfort, and ease of use satisfaction were rated from 1 to 5.

RESULTS
A total of 422 responses were received, including 75 bilateral GP and 76 bilateral SL wearers. Scleral lens wearers had greater satisfaction with vision (3.2 ± 1.1 [SL] vs. 2.6 ± 1.1 [GP]; P < .001) and comfort (3.3 ± 1.0 [SL] vs. 2.2 ± 1.2 [GP]; P < .001) but similar ease of use satisfaction in both groups (2.8 ± 1.1 [SL] vs. 2.7 ± 1.1 [GP]; P < .90). Both groups reported issues with cloudy or foggy vision (GP, 63%; SL, 58%) and contact lens discomfort (GP, 77%; SL, 67%). Although GP wearers reported more issues with lens movement or loss (40 [GP] vs. 18% [SL]), they had fewer difficulties with halos (53 vs. 72% [SL]) and lens handling (40%) compared with SL wearers (63%). Gas-permeable lens (48%) and SL (45%) wearers spend 6 to 10 minutes daily handling their lenses. Sixty percent of GP wearers reported annual out-of-pocket cost expenses less than U.S.$1000, whereas only 41% of SL wearers reported the same.

CONCLUSIONS
Scleral lens wearers with keratoconus report greater satisfaction with vision and comfort than do GP wearers, although both groups reported cloudy vision and lens discomfort.
Differences between Inferior and Superior Bulbar Conjunctiva Goblet Cells in Scleral Lens Wearers: A Pilot Study
Authors: Macedo-de-Araújo Rute J. , Serramito-Blanco Maria , van der Worp Eef , Carracedo Gonzalo , González-Méijome José M. 
Published: September 2020

SIGNIFICANCE
Scleral lenses (SLs) rest on the scleroconjunctival region, which could result in a mechanical impact in the bulbar conjunctiva that can hypothetically modify some properties of conjunctival cells.

PURPOSE
The purpose of this study was to evaluate the differences in goblet cell density (GCD) and mucin cloud amplitude (MCA) between superior and inferior bulbar conjunctiva in SL wearers.

METHODS
A total of 26 eyes wearing SL were randomly selected from 26 subjects (11 females) with different grades of keratoconus enrolled in a prospective clinical series. Superior and inferior conjunctival impression cytologies were performed and therefore analyzed with scanning laser confocal microscopy to evaluate GCD and MCA. All subjects filled out the Ocular Surface Disease Index (OSDI) questionnaire.

RESULTS
The mean ± standard deviation OSDI score was 23.62 ± 15.12. Although a higher density of goblet cells was observed in the samples taken in the superior conjunctiva (74.70 ± 57.55 cells/mm2) than on the inferior conjunctiva (55.91 ± 34.80 cells/mm2), there were no statistically significant differences between them (P = .14, Wilcoxon). Regarding MCA, no differences were found between superior (21.81 ± 3.30 μm) and inferior (20.72 ± 2.95 μm) samples (P = .201, Wilcoxon). No statistically significant differences were found in GCD and MCA regarding the time of SL wear.

CONCLUSIONS
There were no differences in GCD and MCA in the samples taken in the superior and inferior conjunctival areas. Also, it seems that the SL wearing time does not affect the density and secretion of goblet cells. Prospective studies need to be conducted in larger samples to confirm those outcomes.
Pediatric Sepsis in Community Emergency Care Settings: Guideline Concordance and Outcomes
Authors: Greenwald Emily , Olds Elizabeth , Leonard Jan , Deakyne Davies Sara J. , Brant Julia , Scott Halden F. 
Published: September 2020

Objectives
Bundled pediatric sepsis care has been associated with improved outcomes in tertiary pediatric emergency departments. Sepsis care at nontertiary sites where most children seek emergency care is not well described. We sought to describe the rate of guideline-concordant care, and we hypothesized that guideline-concordant care in community pediatric emergency care settings would be associated with decreased hospital length of stay (LOS).

Method
This retrospective cohort study of children with severe sepsis presenting to pediatric community emergency and urgent care sites included children 60 days to 17 years with severe sepsis. The primary predictor was concordance with the American College of Critical Care Medicine 2017 pediatric sepsis resuscitation bundle, including timely recognition, vascular access, intravenous fluids, antibiotics, vasoactive agents as needed.

Results
From January 1, 2015, to December 31, 2017, 90 patients with severe sepsis met inclusion criteria; 22 (24%) received guideline-concordant care. Children receiving concordant care had a median hospital LOS of 95.3 hours (50.9–163.8 hours), with nonconcordant care, LOS was 88.3 hours (57.3–193.2 hours). In adjusted analysis, guideline-concordant care was not associated with hospital LOS (incident rate ratio, 0.99 [0.64–1.52]). The elements that drove overall concordance were timely recognition, achieved in only half of cases, vascular access, and timely antibiotics.

Conclusions
Emergency care for pediatric sepsis in the community settings studied was concordant with guidelines in only 24% of the cases. Future study is needed to evaluate additional drivers of outcomes and ways to improve sepsis care in community emergency care settings.
The Role of Targeted Therapy in the Management of High-Risk Resected Kidney Cancer
Authors: Brown Landon C. , Zhang Tian , George Daniel J. 
Published: September 2020

Abstract
The primary treatment for localized renal cell carcinoma (RCC) is surgical resection with curative intent. Despite this, many patients, especially those with high-risk features, will develop recurrent or metastatic disease. Antiangiogenic therapies targeting vascular endothelial growth factor have been a mainstay of treatment of advanced RCC for more than 10 years. Evidence supporting the use of these therapies in the adjuvant setting is mixed, although one clinical trial, S-TRAC, has shown improvements in disease-free survival with 1 year of adjuvant sunitinib among patients with clear cell histology and high-risk features, leading to the first US Food and Drug Administration approval of an adjuvant therapy for high-risk RCC patients. Further investigation into combination therapies with immunotherapy, neoadjuvant approaches, and patient selection will be key to determining optimal adjuvant therapy regimens to improve outcomes and increase cure rates for patients with localized RCC.
The Reintroduction of Radiotherapy Into the Integrated Management of Kidney Cancer
Authors: Dohopolski Michael , Hannan Raquibul , Wardak Zabi , Hammers Hans , Garant Aurelie 
Published: September 2020

Abstract
The incidence of renal cell carcinoma (RCC) has been increasing, with a moderate subgroup of individuals who later develop metastatic disease. Historically, metastatic RCC has been managed with systemic therapy because RCC was believed to be radioresistant. Local therapies, such as stereotactic body radiation therapy, also known as stereotactic ablative radiotherapy, which utilize focused high-dose-rate radiation delivered over a limited number of treatments, have been successful in controlling local disease and, in some cases, extending survival in patients with intracranial and extracranial metastatic RCC. Stereotactic ablative radiotherapy is highly effective in treating intact disease when patients are not surgical candidates. Stereotactic ablative radiotherapy is well tolerated when used in conjunction with systemic therapy such as tyrosine kinase inhibitors and immune checkpoint inhibitors. These successes have prompted investigators to evaluate the efficacy of stereotactic body radiation therapy in novel settings such as neoadjuvant treatment of advanced RCC with tumor thrombus and oligometastatic/oligoprogressive disease states.
The von Hippel-Lindau Tumor Suppressor Gene
Authors: Elias Roy , Zhang Qing , Brugarolas James 
Published: September 2020

Abstract
The discovery of the von Hippel-Lindau (VHL) gene marked a milestone in our understanding of clear cell renal cell carcinoma (ccRCC) pathogenesis. VHL inactivation is not only a defining feature of ccRCC, but also the initiating event. Herein, we discuss canonical and noncanonical pVHL functions, as well as breakthroughs shaping our understanding of ccRCC evolution and evolutionary subtypes. We conclude by presenting evolving strategies to therapeutically exploit effector mechanisms downstream of pVHL.