bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adjunctive ceftaroline in combination with daptomycin or vancomycin for complicated methicillin-resistant Staphylococcus aureus bacteremia after monotherapy failure
Authors: Hornak Joseph Patrik , Anjum Seher , Reynoso David 
Published: November 2019

Background: Methicillin-resistant Staphylococcus aureus bacteremia (MRSA-B) may fail to improve with standard monotherapy, particularly in patients with multifocal infection, incomplete source control, or persistent bacteremia. Synergy observed in vitro between ceftaroline (CPT) and daptomycin (DAP) or vancomycin (VAN) may translate into clinical benefit. Here, we describe our experience with DAP/CPT and VAN/CPT for complicated MRSA-B after monotherapy failure. Methods: Single-center, retrospective review of consecutive patients treated with DAP/CPT or VAN/CPT for MRSA-B after monotherapy failure from 1 January 2016 to 30 November 2018. Results: We identified 11 instances of combination therapy in 10 patients (DAP/CPT = 6, VAN/CPT = 5) with 1 patient receiving VAN/CPT followed by DAP/CPT. Rates of multifocal infection, incomplete source control, persistent bacteremia, and infective endocarditis were high (100%, 80%, 60%, and 60%, respectively). Combination therapy was initiated most commonly for persistent bacteremia (60%). When patients were persistently bacteremic, median preceding duration was 13 days and median time to clearance was 3 days. Total microbiologic cure rate was 100%. There were zero instances of bacteremia relapse at 30 days (30D) or 60 days (60D). All-cause 30D and 60D mortality rates were 11.1% and 33.3%, respectively. Conclusions: Combination therapy demonstrated success in diverse cases of refractory MRSA-B, including instances of persistent bacteremia paired with incomplete source control. Optimal timing and therapeutic cadence for combination therapy remain unclear. Our findings suggest that DAP/CPT and VAN/CPT can be considered for complicated MRSA bacteremia when other treatment options fail or are unavailable. We propose persistent bacteremia with incomplete source control to be a clinical niche particularly worthy of further investigation.
Cervical Computed Tomography Angiography Rarely Leads to Intervention in Patients With Cervical Spine Fractures
Authors: Dunn Conor John , Changoor Stuart , Issa Kimona , Moore Jeffrey , Moontasri Nancy J. , Faloon Michael Joseph , Sinha Kumar , Hwang Ki Soo , Ruoff Mark , Emami Arash 
Published: November 2019

Study Design: Retrospective cohort study. Objectives: To evaluate the impact of computed tomography angiography (CTA) in the management of trauma patients with cervical spine fractures by identifying high-risk patients for vertebral artery injury (VAI), and evaluating how frequently patients undergo subsequent surgical/procedural intervention as a result of these findings. Methods: All trauma patients with cervical spine fractures who underwent CTA of the head and neck at our institution between January 2013 and October 2017 were identified. Patients were indicated for CTA according to our institutional protocol based on the modified Denver criteria, and included patients with cervical fractures on scout CT. Those with positive VAI were noted, along with their fracture location, and presence or absence of neurological deficit on physical examination. Statistical analysis was performed and odds ratios were calculated comparing the relationship of cervical spine fracture with presence of VAI. Results: A total of 144 patients were included in our study. Of those, 25 patients (17.4%) were found to have VAI. Two patients (1.4%) with VAI underwent subsequent surgical/procedural intervention. Of the 25 cervical fractures with a VAI, 20 (80%), were found to involve the upper cervical region (4.2 OR, 95% CI 1.5-12.0; P = .007). Of the 25 who had a VAI, 9 were unable to undergo reliable neurologic examination. Of the remaining 16 patients, 5 (31.3%) had motor or sensory deficits localized to the side of the VAI, with no other attributable etiology. Conclusions: Cervical spine fractures located in the region of the C1-C3 vertebrae were more likely to have an associated VAI on CTA. VAI should also be considered in cervical trauma patients who present with neurological deficits not clearly explained by other pathology. Despite a finding of VAI, patients rarely underwent subsequent surgical or procedural intervention.
Multimorbidity at sea level and high-altitude urban and rural settings: The CRONICAS Cohort Study
Authors: Miranda J Jaime , Bernabe-Ortiz Antonio , Gilman Robert H , Smeeth Liam , Malaga German , Wise Robert A , Checkley William ,   CRONICAS Cohort Study Group
Published: November 2019

Objective: To characterize the prevalence and clustering of multimorbidity in four diverse geographical settings in Peru. Methods: Multimorbidity, defined as having ≥2 chronic conditions, was studied in adults aged ≥35 years in four diverse settings in Peru: Lima, Tumbes, and urban and rural Puno. Six of these conditions (alcohol disorder, asthma, chronic obstructive pulmonary disease, depression, diabetes, and hypertension) were cataloged as objectively ascertained chronic conditions and paired in dyads to explore clusters of multimorbidity. Results: We analyzed data from 2890 adults, mean age 55.2 years, 49% males. Overall, 19.1% of participants had multimorbidity, ranging from 14.7% in semi-urban Tumbes to 22.8% in Lima. The dyads with the highest coexistence (approximately 20%) were observed in hypertension and diabetes in Tumbes, whereas the dyads with lowest coexistence (approximately 1%) were those involving asthma in all study sites. In terms of clusters, Tumbes showed a predominance of hypertension and diabetes, urban and rural Puno a predominance of depression and alcohol disorders, and Lima a higher degree of coexistence of all of the six conditions than in the other clusters. Conclusion: Multimorbidity is common and the pattern of clusters is highly heterogeneous. The conditions to prioritize will vary in each setting.
Health behaviour, social support, socio-economic status and the 5-year progression of multimorbidity: Results from the MultiCare Cohort Study
Authors: Schäfer Ingmar , Hansen Heike , Kaduszkiewicz Hanna , Bickel Horst , Fuchs Angela , Gensichen Jochen , Maier Wolfgang , Riedel-Heller Steffi G , König Hans-Helmut , Dahlhaus Anne , Schön Gerhard , Weyerer Siegfried , Wiese Birgitt , van den Bussche Hendrik , Scherer Martin 
Published: November 2019

Background: Multimorbidity in elderly patients is a major challenge for physicians, because of a high prevalence of and associations with many adverse outcomes. However, the mechanisms of progressing multimorbidity are not well-understood. The aim of our study was to determine if the progression of multimorbidity is influenced by health behaviour and social support and to analyse if the patients’ socio-economic status had an effect on these prognostic factors. Methods: The study was designed as prospective cohort study based on interviews of 158 GPs and 3189 patients randomly selected from GP records (response rate: 46.2%). Patients were aged 65–85 years at recruitment and observed in four waves of data collection (dropout rate: 41.5%). Statistical analyses of the ‘hot deck’ imputed data included multilevel mixed-effects linear regression allowing for random effects at the study centre and GP practice within study centre level. Results: Regarding cardiovascular and metabolic diseases, multimorbidity progressed more rapidly in patients who reported less physical activity ( ß = −0.28; 95% confidence interval = −0.35 to −0.20), had more tobacco-related pack years (0.15; 0.07–0.22) and consumed less alcohol (−0.21; −0.31 to −0.12) at baseline. Multimorbidity related to psychiatric and pain-related disorders progressed more rapidly if the patients had less perceived social support (−0.31; −0.55 to −0.07) and reported less physical activity (−0.08; −0.15 to −0.02) at baseline. Education and income only slightly modified the effects of these variables. Conclusion: Depending on the multimorbidity cluster, different strategies should be used for slowing down the progression of multimorbidity. Changing lifestyle and increasing social support are beneficial for the entire group of elderly multimorbid patients – regardless of their socio-economic status. Registration: ISRCTN89818205
Clavicle Elevation or Shoulder Girdle Depression in Acromioclavicular Joint Dislocation: A Radiological Investigation
Authors: Azar Fady , Pfeifer Christian , Alt Volker , Pregler Benedikt , Weiss Isabella , Mayr Agnes , Kerschbaum Maximilian 
Published: November 2019

Background: The side-comparative coracoclavicular (CC) distance is used to describe the vertical instability component of acute acromioclavicular (AC) joint dislocations. Elevation of the clavicle or a depression of the shoulder girdle can lead to an increased CC distance. The dislocation direction has not yet been investigated and is not included in common classification systems. Hypothesis: Clavicle elevation is primarily responsible for vertical dislocation in AC joint separation. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Weighted and nonweighted bilateral plain anteroposterior views of the shoulder girdles of patients with AC joint dislocations (Rockwood [RW] types III and V), diagnosed in our trauma department between 2001 and 2018, were included in this study. After determining the CC distance, a side-comparative determination of the positions of both the clavicle and shoulder girdle, with reference to the spinal column, was conducted. Results: In total, 245 bilateral plain anteroposterior views were evaluated (RW III, n = 116; RW V, n = 129). All patients showed a side-comparative clavicle elevation (mean ± SD: RW III, 5 ± 14 mm; RW V, 11 ± 17 mm) in weighted and nonweighted views. While no depression of the shoulder girdle was measured in RW III injuries (weighted and nonweighted views, 0 ± 11 mm), dropping of the shoulder girdle in RW V lesions on nonweighted views was observed (–5 ± 11 mm). Conclusion: Vertical dislocation is mostly associated with clavicle elevation in RW III injures, while in high-grade AC joint dislocations (RW V), a combination of clavicle elevation and shoulder girdle depression is present. A significantly greater superior displacement of the clavicle in RW V injuries was seen in weighted views, while a depression of the shoulder girdle could be detected in nonweighted views. For the first time, these results include the dislocation direction in the classification of an AC joint injury. Further studies are needed to investigate the extent to which dislocation types differ in optimal therapy and outcome.
Comparison of Generic, Musculoskeletal-Specific, and Foot and Ankle–Specific Outcome Measures Over Time in Tibial Plafond Fractures
Authors: Sepehri Aresh , Lefaivre Kelly A. , O’Brien Peter J. , Broekhuyse Henry M. , Guy Pierre 
Published: November 2019

Background: This study performed a psychometric analysis assessing and comparing the responsiveness of the relevant components of a generic (Short Form–36 [SF36]), a musculoskeletal-specific (Short Musculoskeletal Functional Assessment [SMFA]), and a foot and ankle–specific (Foot and Ankle Outcome Score [FAOS]) outcome score when evaluating surgically treated tibial plafond fractures over time. Methods: Fifty-one patients were followed for 12 months after their tibial plafond fracture. Responsiveness, or the ability to detect clinical change in a disease, was evaluated through the standardized response mean (SRM), the proportion meeting a minimal clinically important difference (MCID), and floor and ceiling effects. Results: The SRM of the SF36–Physical Component Summary (PCS) was significantly greater than the SMFA–dysfunction index (DI) ( P < .01) and FAOS–Activities of Daily Living (ADL) ( P = .01) between baseline and 6 months, whereas the SRMs of only SF36-PCS and FAOS-ADL differed ( P = .01) between 6 and 12 months. The proportion of patients achieving an MCID for SF36-PCS was higher than FAOS-ADL ( P = .03) between baseline and 6 months and higher than SMFA-DI ( P = .04) between 6 and 12 months. The FAOS-ADL showed substantial ceiling effects at baseline (88.2%) but much less at 6 months (5.9%) and 12 months (9.8%). Smaller ceiling effects were observed for the SMFA-DI (11.8%) at baseline, whereas none were observed for the SF36-PCS. Conclusions: This study found that the SF36-PCS had greater responsiveness in assessing tibial plafond fractures compared to the SMFA-DI and FAOS-ADL, particularly in the first 6 months after surgery. In addition, limitations were revealed in the SMFA-DI and FAOS-ADL. This study illustrates the necessary diligence required for selection of outcome measures, as musculoskeletal and anatomy specific scores are not necessarily superior. Level of Evidence: Level II, prospective cohort study.
Genomic characterisation of pulmonary subsolid nodules: mutational landscape and radiological features
Authors: Li Yanmeng , Li Xiao , Li Hao , Zhao Yifan , Liu Ziyang , Sun Kunkun , Zhu Xiang , Qi Qingyi , An Bei , Shen Danhua , Li Ruoyan , Liu Taorui , Mi Jiahui , Wang Lientu , Yang Fan , Bai Fan , Wang Jun 
Published: November 2019

BackgroundLung adenocarcinomas (LUADs) that display radiologically as subsolid nodules (SSNs) exhibit more indolent biological behaviour than solid LUADs. SSNs, commonly encompassing pre-invasive and invasive yet early-stage adenocarcinomas, can be categorised as pure ground-glass nodules and part-solid nodules. The genomic characteristics of SSNs remain poorly understood.MethodsWe subjected 154 SSN samples from 120 treatment-naïve Chinese patients to whole-exome sequencing. Clinical parameters and radiological features of these SSNs were collected. The genomic landscape of SSNs and differences from that of advanced-stage LUADs were defined. In addition, we investigated the intratumour heterogeneity and clonal relationship of multifocal SSNs and conducted radiogenomic analysis to link imaging and molecular characteristics of SSNs. Fisher's exact and Wilcoxon rank sum tests were used in the statistical analysis.ResultsThe median somatic mutation rate across the SSN cohort was 1.12 mutations per Mb. Mutations inEGFRwere the most prominent and significant variation, followed by those inRBM10,TP53,STK11andKRAS. The differences between SSNs and advanced-stage LUADs at a genomic level were unravelled. Branched evolution and remarkable genomic heterogeneity were demonstrated in SSNs. Although multicentric origin was predominant, we also detected early metastatic events among multifocal SSNs. Using radiogenomic analysis, we found that higher ratios of solid components in SSNs were accompanied by significantly higher mutation frequencies inEGFR,TP53,RBM10andARID1B, suggesting that these genes play roles in the progression of LUADs.ConclusionsOur study provides the first comprehensive description of the mutational landscape and radiogenomic mapping of SSNs.
An Improved Measurement Uncertainty Calculation Method of Profile Error for Sculptured Surfaces
Authors: Liu Chenhui , Song Zhanjie , Sang Yicun , He Gaiyun 
Published: November 2019

Abstract
The current researches mainly adopt “Guide to the expression of uncertainty in measurement (GUM)” to calculate the profile error. However, GUM can only be applied in the linear models. The standard GUM is not appropriate to calculate the uncertainty of profile error because the mathematical model of profile error is strongly non-linear. An improved second-order GUM method (GUMM) is proposed to calculate the uncertainty. At the same time, the uncertainties in different coordinate axes directions are calculated as the measuring points uncertainties. In addition, the correlations between variables could not be ignored while calculating the uncertainty. A k-factor conversion method is proposed to calculate the converge factor due to the unknown and asymmetrical distribution of the output quantity. Subsequently, the adaptive Monte Carlo method (AMCM) is used to evaluate whether the second-order GUMM is better. Two practical examples are listed and the conclusion is drawn by comparing and discussing the second-order GUMM and AMCM. The results show that the difference between the improved second-order GUM and the AMCM is smaller than the difference between the standard GUM and the AMCM. The improved second-order GUMM is more precise in consideration of the nonlinear mathematical model of profile error.
Characterization and Preparation of Nano-porous Carbon Derived from Hemp Stems as Anode for Lithium-Ion Batteries
Authors: Guan Zhongxiang , Guan Zhiping , Li Zhigang , Liu Junhui , Yu Kaifeng 
Published: November 2019

Abstract
As a biomass waste, hemp stems have the advantages of low cost and abundance, and it is regarded as a promising anode material with a high specific capacity. In this paper, activated carbon derived from hemp stems is prepared by low-temperature carbonization and high-temperature activation. The results of characterizations show the activated carbon has more pores due to the advantages of natural porous structure of hemp stem. The aperture size is mainly microporous, and there are mesopores and macropores in the porous carbon. The porous carbon has an excellent reversible capacity of 495 mAh/g after 100 cycles at 0.2 °C as the anode of lithium-ion battery. Compared with the graphite electrode, the electrochemical property of activated carbon is significantly improved due to the reasonable distribution of pore size. The preparation of the activated carbon provides a new idea for low cost and rapid preparation of anode materials for high capacity lithium-ion batteries.
DNA methylation profiles capturing breast cancer heterogeneity
Authors: Chen Xiao , Zhang Jianying , Dai Xiaofeng 
Published: November 2019

Abstract

Background
As one of the most described epigenetic marks in human cancers, DNA methylation plays essential roles in gene expression regulation and has been implicated in the prognosis and therapeutics of many cancers. We are motivated in this study to explore DNA methylation profiles capturing breast cancer heterogeneity to improve breast cancer prognosis at the epigenetic level.

Results
Through comparisons on differentially methylated CpG sites among breast cancer subtypes followed by a sequential validation and functional studies using computational approaches, we propose 313 CpG, corresponding to 191 genes, whose methylation pattern identifies the triple negative breast cancer subtype, and report cell migration as represented by extracellular matrix organization and cell proliferation as mediated via MAPK and Wnt signalings are the primary factors driving breast cancer subtyping.

Conclusions
Our study offers novel CpGs and gene methylation patterns with translational potential on triple negative breast cancer prognosis, as well as fresh insights from the epigenetic level on breast cancer heterogeneity.
Antimicrobial activities and in vitro properties of cold-adapted Lactobacillus strains isolated from the intestinal tract of cold water fishes of high latitude water areas in Xinjiang, China
Authors: Wei Xiaojing , Zhang Yan , Zhou Hong , Tian Fengwei , Ni Yongqing 
Published: November 2019

Abstract

Background
There are still a large variety of microorganisms among aquatic animals, especially probiotic lactic acid bacteria in cold water fishes at high latitudes have not been fully developed. Hence, the present study aims to evaluate the probiotic potential of cold-adapted Lactobacillus strains isolated from the intestinal tract of cold water fishes (Xinjiang) and select candidates to be used as new food preservative agents and/or probiotic additives in feeding of aquaculture.

Results
A total of 43 Lactobacillus spp. were isolated from 16 kinds of intestinal tract of cold-water fishes. They were characterized by phenotypic methods, identified using Rep-PCR and 16S rRNA gene sequencing as four species: Lactobacillus sakei (22 isolates), Lactobacillus plantarum (16 isolates), Lactobacillus casei (4 isolates) and Lactobacillus paracasei (1 isolate). The in vitro tests included survival in low pH and bile, antimicrobial activity (against Escherichia coli, Salmonella enterica subsp. enterica serovar Typhimurium, Salmonella enterica subsp. enterica, Listeria monocytogenes, and Listeria innocua), resistance to 15 antibiotics and hemolytic tests. Among all 43 lactobacilli isolates, the 22 isolates showed a wide range of antimicrobial activity against 6 different pathogenic strains. There were twenty isolates growing at optimal temperature ranging 16~20 °C, which were initially considered to be cold-adapted strains. Two (2) Lb. sakei strains and 2 Lb. plantarum strains demonstrated the highest survivability after 4 h of exposure at pH 2.0. Most of the tested strains cannot be cultured after exposed into 0.5% bile solution for 4 h, while 2 Lb. plantarum strains (E-HLM-3, CQ-CGC-2) and 1 Lb. sakei strain M-DGM-2 survived even at 2% bile concentration. In addition, the safety assessment showed that 22 strains without any detectable hemolytic activity and resistant to glycopeptides (vancomycin, teicoplanin), levofloxacin, aztreonam, amikacin and oxacillin, while all the studied lactobacilli showed sensitivity to or semi-tolerant to other antibiotics.

Conclusions
Based on all the experiments, 3 strains, including E-HLM-3, CQ-CGC-2, and M-DGM-2 might be a candidate of choice for using in the food preservative agents and/or probiotic additives in feeding of aquaculture.
The grapevine R2R3-type MYB transcription factor VdMYB1 positively regulates defense responses by activating the stilbene synthase gene 2 (VdSTS2)
Authors: Yu Yihe , Guo Dalong , Li Guirong , Yang Yingjun , Zhang Guohai , Li Shaohua , Liang Zhenchang 
Published: November 2019

Abstract

Background
Resveratrol is a naturally occurring plant stilbene that exhibits a wide range of valuable biological and pharmacological properties. Although the beneficial effects of trans-resveratrol to human health and plant protection against fungal pathogens and abiotic stresses are well-established, yet little is known about the molecular mechanisms regulating stilbene biosynthesis in plant defense progress.

Results
Here, we cloned and identified the Chinese wild grape (Vitis davidii) R2R3-MYB transcription factor VdMYB1, which activates defense responses against invading pathogen. VdMYB1 transcripts were significantly upregulated after inoculation with the grapevine powdery mildew fungus Erysiphe necator (Schw.) Burr. Transient expression analysis using onion epidermal cells and Arabidopsis thaliana protoplasts showed that VdMYB1 was localized in the nucleus. Yeast one-hybrid assays revealed that VdMYB1 acts as a transcriptional activator. Grapevine leaves transiently overexpressing VdMYB1 showed a lower number of fungal conidiophores compared with wild-type leaves. Overexpression of VdMYB1 in grapevine leaves did not alter the expression of genes in salicylic acid- and jasmonate-dependent pathways, but affected the expression of stilbene synthase (STS) genes, key regulators of flavonoid metabolism. Results of electrophoretic mobility shift assays and in vivo transcriptional activation assays showed that VdMYB1 binds to the MYB binding site (MYBBS) in the STS2 gene promoter, thus activating STS2 transcription. In heterologous expression assays using tobacco leaves, VdMYB1 activated STS2 gene expression and increased the accumulation of resveratrol.

Conclusions
Our study showed that VdMYB1 activates STS2 gene expression to positively regulate defense responses, and increases the content of resveratrol in leaves.