bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical outcomes of treatment with locking compression plates for distal femoral fractures in a retrospective cohort
Authors: Kiyono Masahiro , Noda Tomoyuki , Nagano Hiroshi , Maehara Takashi , Yamakawa Yasuaki , Mochizuki Yusuke , Uchino Takahiko , Yokoo Suguru , Demiya Koji , Saiga Kenta , Shimamura Yasunori , Ozaki Toshifumi 
Published: November 2019

AbstractBackgroundPlate fixation is one of the standard surgical treatments for distal femoral fractures. There are few reports on the relationship between the screw position and bone union when fixing by the bridging plate (relative stability) method.MethodsThis retrospective study included 71 distal femoral fractures of 70 patients who were treated with the locking compression plate for distal femur (DePuy Synthes Co., Ltd, New Brunswick, CA, USA). The following measurements were evaluated and analyzed: (1) bone union rate, (2) bridge span length (distance between screws across the fracture), (3) plate span ratio (plate length/bone fracture length), (4) number of empty holes (number of screw holes not inserted around the fracture), and (5) medial fracture distance (bone fracture distance on the medial side of the distal femur). Patient demographics (age), comorbidities (smoking, diabetes, chronic steroid use, dialysis), and injury characteristics (AO type, open fracture, infection) were obtained for all participants. Univariate analysis was performed on them.ResultsOf 71 fractures, 26 fractures were simple fractures, 45 fractures were comminuted fractures, and 7 fractures resulted in non-union. Non-union rate was significantly higher in comminuted fractures with bone medial fracture distance exceeding 5 mm.Non-union was founded in simple fractures with bone medial fracture distance exceeding 2 mm, but not significant (p= 0.06). In cases with simple fractures, one non-union case had one empty hole and one non-union case had four empty holes, whereas in cases with comminuted fractures, five non-union cases had two more empty holes.ConclusionsWe concluded that bone fragment distance between fracture fragments is more important than bridge span length of the fracture site and the number of empty holes. Smoking and medial fracture distance are prognostic risk factors of nonunion in distal femoral fractures treated with LCP as bridging plate.
Lamotrigine-induced hemophagocytic lymphohistiocytosis with Takotsubo cardiomyopathy: a case report
Authors: Zhou Jenny Y. , Martinez Jordan A. , Shen John Paul 
Published: November 2019

Abstract
Background
Hemophagocytic lymphohistiocytosis is a rare hematological syndrome characterized by excessive and uncontrolled activation of the immune system. The often nonspecific nature of early symptoms and the potential for progression to multiorgan failure and death if appropriate therapy is not started promptly, highlight the importance of heightened recognition for this uncommon disease. Although there are well-described associations of hemophagocytic lymphohistiocytosis with infectious, malignant, and autoimmune diseases and an established treatment protocol for these cases, the link between medications and hemophagocytic lymphohistiocytosis is less clearly established and the optimal treatment of these cases less well defined.

Case presentation
Here we describe the case of a 45-year-old caucasian woman presenting with signs and symptoms consistent with hemophagocytic lymphohistiocytosis, induced by recent exposure to lamotrigine. She had a rapidly progressive clinical course, complicated by multiorgan failure including stress-induced Takotsubo cardiomyopathy and cardiac arrest. With dexamethasone and etoposide therapy, she made a full and sustained recovery.

Conclusions
This case highlights that medication-induced hemophagocytic lymphohistiocytosis appears to respond similarly to the same dexamethasone and etoposide treatment regimen developed for other non-drug-induced forms of hemophagocytic lymphohistiocytosis. With the continued cessation of the offending agent there has not been need for maintenance therapy and no relapse to date. In addition, given the risk for cardiomyopathy, a clinical complication not classically associated with hemophagocytic lymphohistiocytosis, echocardiogram and telemetry monitoring should be considered in the initial workup of suspected hemophagocytic lymphohistiocytosis.
Building an Otoscopic screening prototype tool using deep learning
Authors: Livingstone Devon , Talai Aron S. , Chau Justin , Forkert Nils D. 
Published: November 2019

Background Otologic diseases are often difficult to diagnose accurately for primary care providers. Deep learning methods have been applied with great success in many areas of medicine, often outperforming well trained human observers. The aim of this work was to develop and evaluate an automatic software prototype to identify otologic abnormalities using a deep convolutional neural network. Material and methods A database of 734 unique otoscopic images of various ear pathologies, including 63 cerumen impactions, 120 tympanostomy tubes, and 346 normal tympanic membranes were acquired. 80% of the images were used for the training of a convolutional neural network and the remaining 20% were used for algorithm validation. Image augmentation was employed on the training dataset to increase the number of training images. The general network architecture consisted of three convolutional layers plus batch normalization and dropout layers to avoid over fitting. Results The validation based on 45 datasets not used for model training revealed that the proposed deep convolutional neural network is capable of identifying and differentiating between normal tympanic membranes, tympanostomy tubes, and cerumen impactions with an overall accuracy of 84.4%. Conclusion Our study shows that deep convolutional neural networks hold immense potential as a diagnostic adjunct for otologic disease management.
Assessment of bee venom therapy in animal model of statin-induced myopathy
Authors: Kader Ann Abdel , Azmy Radwa , Maher Eman A. , El Sayed Basma Bahgat , Khalil Alshaimaa Sobhi , Ghalwash Mohammad , Mahmoud Manal 
Published: November 2019

AbstractBackgroundStatin-induced myopathy is the most common adverse effect of statins. Bee venom provides a potential mean of controlling immune responses and inflammatory reactions; the proposed mechanisms for statin-induced myopathy.ObjectiveThe present study aimed at clarification of the role of the bee venom in prevention of statin-induced myopathy.Materials and methodsIt was carried out on 30 Sprague-Dawley female rats. Rats were randomly classified into 3 groups: control group, statin group which received statins for 2 weeks, and venom group that was exposed to alternate day actual bee sting concurrent to statins administration for 2 weeks. Quantitative electromyography (QEMG) was performed as well as serum creatine kinase (CK) and cholesterol levels, in addition to in vitro muscle contractility tests.ResultsQEMG and contractility tests showed significant changes in the statin group compared to both control and venom groups. Serum cholesterol level decreased with increase in CK levels in the statin and venom groups compared to controls; however, the CK level was significantly lower in the venom group as compared to the statin group.ConclusionBee venom therapy offers a simple and available means of prophylaxis against the myopathic effects induced by statins in animal model. However, it partly restricts the therapeutic effect of statins.
Phylogenetic relationships of some Egyptian soybean cultivars (Glycine max L.) using SCoT marker and protein pattern
Authors: Rayan Walaa A. , Osman Samira A. 
Published: November 2019

AbstractBackgroundElectrophoretic SDS-PAGE and SCoT-PCR techniques were used to study the fingerprints and genetic diversity of six Egyptian soybean (Glycine maxL.) genotypes (Giza111, Giza21, Giza82, Giza35, Giza22, and Giza83).ResultsSDS-PAGE revealed a total of 23 bands with a polymorphism 30.43%. The maximum number of bands (22) was recorded in Giza111 and Giza82, while the minimum number of bands (18) was recorded in Giza35. The highest similarity index for SDS- PAGE (0.909) was observed between Giza111 and Giza82, while the lowest similarity index (0.714) was recorded between Giza35 and Giza83. SCoT technique was performed by using 11 primers to generate reproducible polymorphic products. The total number of bands was 106, from them 52 polymorphic and 54 monomorphic bands with a polymorphism 49.11%. The dendrogram of both SDS-PAGE and SCoT markers revealed two main clusters; the first cluster includes the cultivars Giza111and Giza21, while the second cluster includes the cultivars Giza82, Giza35, Giza22, and Giza83. The second group was further subdivided into two subgroups; the first subgroup includes cultivars (Giza82 and Giza35) while the second subgroup includes cultivars Giza22 and Giza83.ConclusionThe markers used in this study created a number of polymorphic bands among the different cultivars that can be utilized as molecular markers for their differentiation. The obtained data indicated that SCoT and SDS-PAGE techniques could be used efficiently for identification and differentiation of the selected genotypes.
Utility of magnetic resonance proton density fat fraction technique in quantification of liver fat in living donors for liver transplantation
Authors: Sherif Fatma Mohamed , Elmogy Sabry Alameldeen , EL-wahab Rihame Mohamed Abd , Wahab Mohamed Abdel 
Published: November 2019

Abstract
Background
Hepatic steatosis in living donors for liver transplantation causes morbidity of both donor and recipient. This study aims at evaluating magnetic resonance proton density fat fraction technique (MR PDFF) in quantitative evaluation of living donor’s hepatic steatosis compared to histopathology.

Results
The examined potential living liver donors’ liver biopsies revealed hepatic steatosis < 5% (grade 0) in 40 donors and 5–10% (grade 1) in 7 donors. MR PDFF technique with IDEAL sequence showed excellent results for prediction and quantitative evaluation of liver fat with sensitivity, specificity, and accuracy of 85.7%, 97.5%, and 95.7%, respectively, compared to histopathology (95% confidence interval 0.98–1.01). There was an excellent inter-reader agreement between both readers in estimation of MR liver fat fraction (r = 0.969 at 95% confidence interval 0.946–0.983).

Conclusion
Noninvasive hepatic MR PDFF technique with IDEAL sequence is a precise reliable technique for pre-operative quantitative assessment of hepatic steatosis in potential living liver donors.
The role of multidetector CT angiography in characterizing vascular compression syndromes of the abdomen
Authors: Sankaran Lakshmi , Ramachandran Rajoo , Bala Raghu Raji Venkatesh , Periasamy Varadaraju Prithiviraj , Panneerselvam Pranesh , Radhakrishnan Prabhu Radhan 
Published: November 2019

Abstract
Background
Various abdominal vessels can compress the adjacent structures or in turn can get compressed by them. Most of these compression syndromes present with non-specific symptoms. Unlike the common causes of acute abdomen, the various vascular compression syndromes have bizarre clinical presentations and subtle imaging findings, which can easily be missed by the physicians as well as the radiologists.

Main body of the abstract
This is a retrospective study which was done for a period of 3 years from April 2015 to April 2018 using a 64-slice CT scanner. Among 2412 cases that came for evaluation, 114 patients were diagnosed to have one of the various vascular compression syndromes. These 114 cases were further managed either conservatively or surgically depending on the pathology and the severity of the compression. The syndromes discussed in this article include median arcuate ligament syndrome (29 cases), superior mesenteric artery syndrome (23 cases), portal biliopathy (3 cases), nutcracker syndrome (6 cases), pelvi-ureteric junction obstruction due to crossing of vessels (8 cases), and retrocaval ureter and May-Thurner syndrome (45 cases).

Conclusions
The primary goal of this article is to reinforce the knowledge of the radiologists of the various vascular compression syndromes and to make them possess a high degree of vigilance to detect them. This article elaborates the imaging findings of these syndromes and the role of multidetector CT angiography in diagnosing them.
Clinical benefit and toxicity of nivolumab plus ipilimumab in patients with advanced melanoma previously treated with checkpoint blockade inhibitors.
Authors: Friedman Claire Frances , Wolchok Jedd D. , Postow Michael Andrew , Shoushtari Alexander Noor , Callahan Margaret K. , Momtaz Parisa , Chapman Paul B. 
Published: November 2019

100 Background: The combination of nivolumab and ipilimumab (nivo+ipi) prolongs progression-free survival in treatment-naïve patients (pts) with advanced melanoma. However, the efficacy and tolerability of nivo+ipi in pts previously treated with checkpoint blockade inhibitors (CPI) are unknown. Methods: 19 pts previously treated with CPI (ipi or anti-PD-1 as single agents) were treated with nivo+ipi at MSKCC. Ipi (3mg/kg) and nivo (1mg/kg) were administered q3 weeks for 4 doses with the option to continue anti-PD1 maintenance. Pts were followed for time to treatment failure (TTF), defined as the time from the date of first nivo+ipi infusion to the date of one of the following: clinical progression, new locally-directed treatment (ie surgery or radiotherapy), new systemic treatment other than anti-PD-1 monotherapy, or death. Results: 15 pts (79%) had stage M1c disease and 12 (63%) had a cutaneous primary. Pts had received a median of 2 prior systemic treatments (range 1-7). 10 pts (53%) had received prior ipi and 17 pts (89%) had received prior anti-PD-1 treatment; 8 pts (42%) had received both. The median time between anti-PD-1 monotherapy and nivo+ipi was 51 days (range 20-385). Pts received a median of 3 doses of combination therapy; 9 of 19 pts (47%) received all 4 doses. With a median follow-up time of 210 days, 8 pts (42.1%) remained on combination immune therapy, 9 pts (47%) switched systemic treatments or had a local procedure and 6 pts (31.6%) died. Median time on immunotherapy for those still alive and without treatment failure was 105 days (range 26-343). The median TTF was 78 days (range 42-220). The most common systemic treatment after nivo+ipi failure was BRAF-targeted therapy (5/9 or 56.3%). The median number of immune related adverse events (irAEs) was 1 (range 0-3). Rash (26%), Hepatitis (16%) and Colitis (16%) were the most common irAEs. Conclusions: With a short median follow-up, administration of nivo+ipi in CPI-experienced patients with advanced melanoma was associated with a short TTF. 58% of patients died or had treatment failure within the follow-up period. More research is needed to guide the utilization of combination immunotherapy in this setting.
Overcoming resistance to immune checkpoint blockade with RNA-loaded nanoparticles.
Authors: Sayour Elias Joseph , Grippin Adam , Mitchell Duane Anthony 
Published: November 2019

117 Background: While checkpoint blockade has shown promising survival benefits in patients with solid tumors, immune escape through loss of MHCI expression juxtaposed to an immunoregulatory milieu remain significant hurdles. To overcome these limitations, we developed a novel treatment platform, which leverages the use of commercially available and clinically translatable nanoparticles (NPs) that can be combined with tumor-derived RNA to activate systemic immunity and re-program the intratumoral microenvironment from a regulatory into an immune activated locale. Methods: Since local vaccination strategies are mired with poor immunogenicity, we assessed if i.v. delivery of tumor-derived RNA encapsulated in lipophilic NPs could activate peripheral and intratumoral antigen presenting cells (APCs) for induction of therapeutic anti-tumor immunity in pre-clinical murine melanoma models. Results: We identified a clinically translatable NP formulation that when administered intravenously, mediates release of inflammatory cytokines (i.e. CCL2, IFN-alpha) into serum, systemically activates host APCs in reticuloendothelial organs, and induces precipitous upregulation of MHCI and immune activation markers (i.e. CD86) within the tumor microenvironment. Both model-antigen encoding RNA and physiologically-relevant tumor-derived RNA, when encapsulated in NPs, could expand potent anti-tumor T-cell immunity. We demonstrated that RNA-NPs harness the anti-viral defense mechanism against tumor antigens in a type I interferon dependent manner, and can be further engineered to deliver combinatorial therapies by co-encapsulating mRNAs encoding for immunomodulatory molecules (i.e. HCV PAMPs, GM-CSF). In a pre-clinical melanoma model, RNA-NPs mediate anti-tumor efficacy and significantly enhance activity of immune checkpoint mAbs when used in combination. Conclusions: By employing a systemic RNA-NP formulation encoding for both tumor RNAs and immunomodulatory molecules, as an innovative and versatile platform for delivering combinatorial therapeutics via a single treatment modality, this platform can be harnessed to simultaneously target tumor antigens and re-program the intratumoral microenvironment
Prognostic significance of professional antigen presenting cells according to morphological subtype of periampullary adenocarcinoma.
Authors: Lundgren Sebastian , Warfvinge Carl Fredrik , Elebro Jacob , Nodin Bjorn , Krzyzanowska Agnieszka , Bjartell Anders , Karnevi Emelie , Eberhard Jakob , Leandersson Karin , Jirstrom Karin 
Published: November 2019

121 Background: Dendritic cells (DCs) and macrophages play vital roles in tumorigenesis and may, depending on the context, promote or inhibit tumor progression. In this study, we examined the prognostic significance of DCs and macrophages in periampullary adenocarcinoma, with particular reference to morphological type. Methods: Immune cell-specific expression of CD68, CD163 and CD1a was analysed by immunohistochemistry on tissue microarrays with tumours from 175 consecutive cases of periampullary adenocarcinoma, 110 of pancreatobiliary type (PB-type) and 65 of intestinal type (I-type) morphology. Kaplan-Meier and Cox regression analysis were applied to determine the impact of the investigated cells on 5-year overall survival (OS). Results: Low density of CD68+ cells or CD163 + cells was significantly associated with an improved 5-year OS in unadjusted Cox regression analysis in the entire cohort (HR = 1.66; 95% CI 1.05-2.63 and HR = 1.84; 95 % CI 1.09-3.09, respectively), but not in adjusted analysis or in strata according to subtype. CD1a+ cell density was not prognostic in entire cohort or in I-type tumours. However, in PB-type tumors, high CD1a+ cell density was significantly associated with a reduced OS in unadjusted as well as in adjusted analysis (HR = 2.09; 95% CI 1.07-4.09 and HR = 2.35; 95% CI 1.13-4.87). The prognostic value of the investigated markers did not differ in strata according to adjuvant chemotherapy, neither in the entire cohort nor according to morphological type. Conclusions: The results from study demonstrate that the prognostic significance of dendritic cells, but not macrophages, differs by morphological subtype in periampullary adenocarcinoma. Hence, morphological subtype is an important factor to consider in studies on the prognostic and predictive role of the immune microenvironment in these types of cancer.
Changes in peripheral lymphocyte subpopulations following radiation therapy.
Authors: Campostrini Franco , Zorzi M , Capodaglio G , Guizzardi E , Nicolis E , Battaglia P 
Published: November 2019

128 Background: Since ionizing radiation can affect the immune system, in this research we sought to analyze the changes of peripheral blood lymphocyte subpopulations (LS) in patients undergoing Radiation Therapy (RT). Methods: In 2015 we enrolled 58 patients, 97% with no systemic cancer (breast 47%, prostate 23%,head and neck 16%, abdomen-pelvis 11%, metastases 3%). The percentages of patients with lowered LS were determined prior to RT, and at different intervals in the patients’ history.The average dose of RT was 50Gy (+/-10 ) with 2 Gy/day fractions. Results: As baseline, total T lymphocytes, T helper, T suppressor, B lymphocytes and Natural Killer cells, were reduced vs. normal range in 24%, 33%, 24%, 59% and null of patients, respectively.A second blood sample was withdrawn after 14-58 days (mean 36) from starting RT, in which we found significantly increased the patients damaged up to 66%, 65%, 62%, 88% and 7% (p=< 0,0001 for each LS ). Compared with the nadir of LS depletion, at 44 (5-180) and 153 (43-130) days from the completion of RT, all the LS raised significantly, except for a weak value of T Helper category (p=0,0145 and 0,0226 respectively). Conclusions: After common RT regimens for solid tumors, all LS can be substantially impaired, and for the T Helper the recovery is particularly slow in the following months.
Immunomodulatory pathways in both breast cancer and placental tissues: Insights from a unique clinical and genomic case report.
Authors: Hernandez Bronchud Miguel 
Published: November 2019

13 Background: some cancers might partially ectopically express intrinsic immune escape gene programs naturally developed during mammalian evolution to allow for materno-fetal immune tolerance. Methods: Genomic analysis (Nanostring Inc, Seattle, WA, USA) was carried out in primary breast cancer with metastatic homolateral axillary lymph nodes as well as placenta tissue (both uterine decidual tissue and term placenta tissue) from a pregnant woman (same patient). Gene expression profiling of paired non-self and self tissues (i.e. placenta/uterus; breast cancer/normal breast tissue; metastatic lymphnode/normal lymphnode tissue) was performed using the PanCancer Immune gene panel, a 770 Nanostring gene expression panel. Results: Our findings reveal overlapping in specific immune gene expression in placenta and cancer tissue, suggesting that these genes might play an important role in maintaining immune tolerance both physiologically (placenta) and pathologically ( cancer). Placenta and uterus, breast tissues (tumor and normal) and lymph node tissues (tumor and normal) formed their own RNA transcription cluster, suggesting that tissue specific gene expression patterns were well preserved during experimental procedures . We analyzed differential expression within each tissue type (i.e. matching for the analysis placenta with uterus, breast cancer with normal breast tissue and node positive with node negative tissue). Among the 583 genes analyzed, 103 genes were upregulated > 1.5 fold in placenta versus uterus, while 258 genes were downregulated at least 1.5 fold. Using the same cut-off, 258 genes were upregulated and 44 genes downregulated in breast tumor versus normal breast tissue, and 178 genes were upregulated while 146 genes downregulated in tumor bearing lymph node versus non-involved lymph node. Conclusions: A variety of complex immune regulation mechanisms seem to be shared by both placental tissues and cancer.