bluuebunny/crossref_metadata_2025_split huggingface dataset:
New Cancer Diagnosis After Bleeding in Anticoagulated Patients With Atrial Fibrillation
Authors: Raposeiras Roubín Sergio , Abu Assi Emad , Barreiro Pardal Cristina , Cespón Fernandez María , Muñoz Pousa Isabel , Cobas Paz Rafael , Parada Jose Antonio , Represa Montenegro Marta , Melendo Miu María , Blanco Prieto Sonia , Rosselló Xavier , Ibañez Borja , Íñiguez Romo Andrés 
Published: November 2020

Background
Bleeding is frequent in patients with atrial fibrillation (AF) treated with oral anticoagulant therapy, and may be the first manifestation of underlying cancer. We sought to investigate to what extent bleeding represents the unmasking of an occult cancer in patients with AF treated with oral anticoagulants.

Methods and Results
Using data from CardioCHUVI‐AF (Retrospective Observational Registry of Patients With Atrial Fibrillation From Vigo's Health Area), 8753 patients with AF aged ≥75 years with a diagnosis of AF between 2014 and 2017 were analyzed. Of them, 2171 (24.8%) experienced any clinically relevant bleeding, and 479 (5.5%) were diagnosed with cancer during a follow‐up of 3 years. Among 2171 patients who experienced bleeding, 198 (9.1%) were subsequently diagnosed with cancer. Patients with bleeding have a 3‐fold higher hazard of being subsequently diagnosed with new cancer compared with those without bleeding (4.7 versus 1.4 per 100 patient‐years; adjusted hazard ratio [HR], 3.2 [95% CI, 2.6–3.9]). Gastrointestinal bleeding was associated with a 13‐fold higher hazard of new gastrointestinal cancer diagnosis (HR, 13.4; 95% CI, 9.1–19.8); genitourinary bleeding was associated with an 18‐fold higher hazard of new genitourinary cancer diagnosis (HR, 18.1; 95% CI, 12.5–26.2); and bronchopulmonary bleeding was associated with a 15‐fold higher hazard of new bronchopulmonary cancer diagnosis (HR, 15.8; 95% CI, 6.0–41.3). For other bleeding (nongastrointestinal, nongenitourinary, nonbronchopulmonary), the HR for cancer was 2.3 (95% CI, 1.5–3.6).

Conclusions
In patients with AF treated with oral anticoagulant therapy, any gastrointestinal, genitourinary, or bronchopulmonary bleeding was associated with higher rates of new cancer diagnosis. These bleeding events should prompt investigation for cancers at those sites.
Linking Syriac Liturgies: Digitizing Card Collections and Handwritten Notes from the Archives of the Peshitta Institute
Authors: van Peursen Wido , Veldman Geert Jan 
Published: November 2020

Abstract
The Peshitta is the Syriac translation of the Bible from the second century AD. It had an enormous cultural and literary impact in the Middle East, no less than the role that, for example, the Latin Vulgate played in large parts of (Western) Europe. Up to the present, the Peshitta plays a crucial role in the various Syriac Christian communities in the Middle East and the Syriac Diaspora. A valuable resource for Peshitta studies is the collection of handwritten notes on cards and binders from the first decades of the Peshitta Project (started 1959), which were digitized in the dans “Klein Data Project” (kdp) Linking Syriac Liturgies (2018–2019). The notes relate to a wealth of information about manuscripts, liturgical traditions and calendars and various Syriac Bible translations. The kdp has made this material accessible and allows for computational research into the complex interactions between textual and structured data included in this data set, in which more than 9,000 entries containing pericopes read in liturgy are indexed according to more than 70 categories.
<p><strong><em>Acanthocereus</em></strong><strong> <em>paradoxus</em> (Cactaceae), a new endemic species from Jalisco, Mexico</strong></p>
Authors: GONZÁLEZ-ZAMORA PEDRO , CARRILLO-REYES PABLO , SÁNCHEZ DANIEL 
Published: November 2020

Acanthocereus paradoxus sp. nov., an endemic narrow cylindrical cactus from the state of Jalisco is described and illustrated. The species can be distinguished by its narrow cylindrical mature stems, stem epidermis dull green with some dark green margins, the presence of four central spines, and a greater number of ribs and spines in young stems. A morphological comparison with the other cylindrical members of Acanthocereus and sympatric species of the genus is provided. Data about its habitat and the conservation status are also given.
Targeted Molecular Therapies in Allergy and Rhinology
Authors: Damask Cecelia C. , Ryan Matthew W. , Casale Thomas B. , Castro Mario , Franzese Christine B. , Lee Stella E. , Levy Joshua M. , Lin Sandra Y. , Lio Peter A. , Peters Anju T. , Platt Michael P. , White Andrew A. 
Published: November 2020

Biologic agents, monoclonal antibodies that target highly‐specific molecular pathways of inflammation, are becoming integrated into care pathways for multiple disorders that are relevant in otolaryngology and allergy. These conditions share common inflammatory mechanisms of so‐called Type 2 inflammation with dysregulation of immunoglobulin E production and eosinophil and mast cell degranulation leading to tissue damage. Biologic agents are now available for the treatment of chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, eosinophilic granulomatosis with polyangiitis (EGPA), atopic dermatitis (AD), and chronic spontaneous urticaria (CSU). This paper summarizes the diagnosis and management of these conditions and critically reviews the clinical trial data that has led to regulatory approval of biologic agents for these conditions.
Buccal Hydromorphone Syrup for Managing Dyspnea in Idiopathic Pulmonary Fibrosis
Authors: Fong Shannon , Richman-Eisenstat Janice , Kalluri Meena 
Published: November 2020

Context: Dyspnea is a highly distressing symptom that characterizes idiopathic pulmonary fibrosis (IPF), a common idiopathic interstitial lung disease (ILD) with a high symptom burden, poor quality of life, and early mortality. Though opioids are mentioned in guidelines for dyspnea management, guidance on how and when to initiate opioids is lacking. Different pharmacologic strategies are needed to address different types of dyspnea (baseline, incident, and crisis). Due to a longer onset of action, the oral route (swallowed) may be less effective for prevention of incident dyspnea or for rapid relief of crisis dyspnea, prompting the use of alternative drug delivery strategies for self-management. We inadvertently discovered the efficacy of buccal administration of low dose, low volume hydromorphone oral syrup for dyspnea management in ILD, which has not been previously reported in the literature. Case Series: We describe our approach to dyspnea assessment and management in IPF, including use of the Multidimensional Dyspnea Scale (MDDS), a novel instrument yet to be validated that we developed to better identify and categorize dyspnea into the types experienced by a patient with IPF over the course of a day. We then describe how buccal hydromorphone oral syrup is initiated and titrated for dyspnea management in 3 patients at different points in their disease trajectory. Conclusion: Buccal hydromorphone oral syrup is effective for dyspnea management across the spectrum of IPF. When integrated into a patient-centered algorithm for symptom assessment and management, it allows for rapid and easy self-management of dyspnea by patients and their caregivers.
Successful treatment and long-term follow up of idiopathic immune-mediated polyarthritis with mycophenolate mofetil in a cat
Authors: Tamura Yu , Nagamoto Tetsuro , Segawa Kazuhito , Neo Sakurako , Igarashi Hirotaka , Hisasue Masaharu 
Published: November 2020

Case summary A 7-year-old neutered male Norwegian Forest Cat was presented with decreased appetite and activity, weight loss, fever, neutrophilia and hyperglobulinaemia. A physical examination showed painful stifle joints and enlarged popliteal lymph nodes. Blood examination showed neutrophilia, hyperglobulinaemia and increased serum amyloid A. Urinalysis, thoracic and abdominal radiographs, and abdominal ultrasonography were unremarkable. Synovial fluid from the knee joints had diminished viscosity and revealed neutrophilic inflammation on the smear. There was no evidence of infection in a microbiological culture of the synovial fluid. A diagnosis of idiopathic immune-mediated polyarthritis (IMPA) was made. Prednisolone was initiated at 2 mg/kg q24h PO and tapered with additional immunosuppressants (leflunomide, ciclosporin A and methotrexate); however, prednisolone could not be discontinued. Informed consent was obtained from the owner and mycophenolate mofetil (MMF) at a dosage of 10 mg/kg q12h PO was initiated on day 798. There were no adverse effects of MMF and prednisolone was discontinued on day 1183. Clinical signs resolved and the cat’s general condition remained stable with MMF alone at a dosage of 10 mg/kg q48h PO on day 1600. Relevance and novel information There is limited information describing feline IMPA and its treatment options other than the use of prednisolone. This is the first report of the successful treatment and long-term follow-up of feline IMPA with MMF. MMF may be a safe and effective option as an additional immunosuppressant in feline IMPA.
Genetic Mutations in Young Nonsmoking Patients With Oral Cavity Cancer: A Systematic Review
Authors: Bahethi Rohini R. , Stepan Katelyn O. , Pinotti Rachel , Li Ryan , Agrawal Nishant , Puram Sidharth V. , Miles Brett A. , Barber Brittany 
Published: November 2020

ObjectiveThis investigation aims to review the known genetic mutations associated with oral cavity squamous cell carcinoma (OCSCC) in young adults with limited environmental risk factors (YLERs).Data SourcesA comprehensive search strategy was designed to identify studies in MEDLINE (Ovid), Embase (Ovid), and Scopus from database inception to May 2017 that included adults ≤50 years of age with OCSCC and minimal tobacco use history (≤10 pack‐years) who had their tumors genetically sequenced or mutational profiles analyzed.Review MethodsIdentified articles were screened by 2 reviewers. Quality of evidence was graded by the MINORS criteria for case‐control studies; other studies were graded by assigning a level of evidence for gene mutation literature.ResultsThirteen studies met our inclusion criteria, and 130 patients met our criteria for age and tobacco history. TP53 was the most commonly evaluated gene (10 of 13 studies) and the most frequently observed mutation. One study reported that nonsmokers had significantly fewer TP53 mutations, while 9 studies found no difference in the prevalence of TP53 mutations. No other mutations were found specific to this cohort.ConclusionsTP53 mutations may occur at a similar rate in YLERs with OCSCC as compared with older patients or those with risk factors. However, few studies have aimed to characterize the genetic landscape of oral cavity tumors in this population, often with small sample sizes. Future studies are needed to explore unidentified genetic alterations leading to tumor susceptibility or alternative mechanisms of carcinogenesis.
Imaging Features of a Retinal Detachment and Secondary Epiretinal Membrane Following Inadvertent Globe Penetration From Peribulbar Anesthesia
Authors: Lim Joshua , Tsai Andrew S.H. , Lee Shu Yen 
Published: November 2020

Purpose: We present imaging features of retinal detachment (RD) and secondary epiretinal membrane in a case of an inadvertent globe penetration following preoperative peribulbar anesthesia. Methods: A 60-year-old woman was referred for a localized RD and epiretinal membrane following uneventful cataract surgery. Widefield fundus photography and optical coherence tomography were used to assess and record the pathology. The current literature was reviewed. Results: Full-thickness breaks were noted in the neurosensory retina extending into the scleral wall. Vertical tracks were noted in the inferotemporal quadrant of the eye. The patient underwent trans pars plana vitrectomy, membrane peel, and gas. Her 1-month postoperative visual acuity was 20/30. Conclusions: Globe penetration with RD is a rare but potentially sight-threatening complication of peribulbar anesthesia. Diagnosis can be challenging because of the infrequency of occurrence and delays in presentation. A high index of suspicion is key alongside consideration of other likely differentials.
Salicylates enhance CRM1 inhibitor antitumor activity by induction of S-phase arrest and impairment of DNA-damage repair
Authors: Abeykoon Jithma P. , Wu Xiaosheng , Nowakowski Kevin E. , Dasari Surendra , Paludo Jonas , Weroha S. John , Hu Chunling , Hou Xiaonan , Sarkaria Jann N. , Mladek Ann C. , Phillips Jessica L. , Feldman Andrew L. , Ravindran Aishwarya , King Rebecca L. , Boysen Justin , Stenson Mary J. , Carr Ryan M. , Manske Michelle K. , Molina Julian R. , Kapoor Prashant , Parikh Sameer A. , Kumar Shaji , Robinson Steven I. , Yu Jia , Boughey Judy C. , Wang Liewei , Goetz Matthew P. , Couch Fergus J. , Patnaik Mrinal M. , Witzig Thomas E. 
Published: November 2020

Abstract
Chromosome region maintenance protein 1 (CRM1) mediates protein export from the nucleus and is a new target for anticancer therapeutics. Broader application of KPT-330 (selinexor), a first-in-class CRM1 inhibitor recently approved for relapsed multiple myeloma and diffuse large B-cell lymphoma, have been limited by substantial toxicity. We discovered that salicylates markedly enhance the antitumor activity of CRM1 inhibitors by extending the mechanisms of action beyond CRM1 inhibition. Using salicylates in combination enables targeting of a range of blood cancers with a much lower dose of selinexor, thereby potentially mitigating prohibitive clinical adverse effects. Choline salicylate (CS) with low-dose KPT-330 (K+CS) had potent, broad activity across high-risk hematological malignancies and solid-organ cancers ex vivo and in vivo. The K+CS combination was not toxic to nonmalignant cells as compared with malignant cells and was safe without inducing toxicity to normal organs in mice. Mechanistically, compared with KPT-330 alone, K+CS suppresses the expression of CRM1, Rad51, and thymidylate synthase proteins, leading to more efficient inhibition of CRM1-mediated nuclear export, impairment of DNA-damage repair, reduced pyrimidine synthesis, cell-cycle arrest in S-phase, and cell apoptosis. Moreover, the addition of poly (ADP-ribose) polymerase inhibitors further potentiates the K+CS antitumor effect. K+CS represents a new class of therapy for multiple types of blood cancers and will stimulate future investigations to exploit DNA-damage repair and nucleocytoplasmic transport for cancer therapy in general.
Global mRNA and microRNA expression dynamics in response to anthracnose infection in sorghum
Authors: Fu Fuyou , Girma Gezahegn , Mengiste Tesfaye 
Published: November 2020

AbstractBackgroundAnthracnose is a damaging disease of sorghum caused by the fungal pathogenColletotrichum sublineolum.Genome-wide mRNA and microRNA (miRNA) profiles of resistant and susceptible sorghum genotypes were studied to understand components of immune responses, and fungal induced miRNA and target gene networks.ResultsA total of 18 mRNA and 12 miRNA libraries from resistant and susceptible sorghum lines were sequenced prior to and after inoculation withC. sublineolum. Significant differences in transcriptomes of the susceptible and resistant genotypes were observed with dispersion distance and hierarchical cluster tree analyses. Of the total 33,032 genes predicted in the sorghum genome, 19,593 were induced byC. sublineolum,and 15,512 were differentially expressed (DEGs) between the two genotypes. The resistant line was marked by significant reprogramming of the transcriptome at 24 h post inoculation (hpi), and a decrease at 48 hpi, whereas the susceptible line displayed continued changes in gene expression concordant with elevated fungal growth in the susceptible genotype. DEGs encode proteins implicated in diverse functions including photosynthesis, synthesis of tetrapyrrole, carbohydrate and secondary metabolism, immune signaling, and chitin binding. Genes encoding immune receptors, MAPKs, pentatricopeptide repeat proteins, and WRKY transcription factors were induced in the resistant genotype. In a parallel miRNA profiling, the susceptible line displayed greater number of differentially expressed miRNAs than the resistant line indicative of a widespread suppression of gene expression. Interestingly, we found 75 miRNAs, including 36 novel miRNAs, which were differentially expressed in response to fungal inoculation. The expression of 50 miRNAs was significantly different between resistant and susceptible lines. Subsequently, for 35 differentially expressed miRNAs, the corresponding 149 target genes were identified. Expression of 56 target genes were significantly altered after inoculation, showing inverse expression with the corresponding miRNAs.ConclusionsWe provide insights into genome wide dynamics of mRNA and miRNA profiles, biological and cellular processes underlying host responses to fungal infection in sorghum. Resistance is correlated with early transcriptional reprogramming of genes in various pathways. Fungal induced genes, miRNAs and their targets with a potential function in host responses to anthracnose were identified, opening avenues for genetic dissection of resistance mechanisms.
Can voucher scheme enhance primary care provision for older adults: cross-sectional study in Hong Kong
Authors: Cheung Johnny T. K. , Wong Samuel Y.S. , Chan Dicken C. C. , Zhang Dexing , Luk Lawrence H. F. , Chau Patsy Y. K. , Yip Benjamin H. K. , Lee Eric K. P. , Wong Eliza L. Y. , Yeoh E. K. 
Published: November 2020

Abstract

Background
The Hong Kong government has launched the Elderly Health Care Voucher (EHCV) scheme to facilitate primary care in the private sector for older adults. This study aimed to examine whether voucher use was associated with a shift of healthcare burden from the public to the private sector, vaccine uptake and continuity of care.

Methods
This cross-sectional survey recruited older adults with ≥3 chronic diseases through convenience sampling from seven general outpatient clinics, seven geriatric day hospitals, and five specialist outpatient clinics of the public healthcare sector in Hong Kong. We used multiple logistic regression to address the study objective.

Results
A total of 1032 patients participated in the survey. We included 714 participants aged 70 or above in the analysis. EHCV use was associated with higher utilization of private primary care services, including general practitioner and family doctor (Adjusted Odds Ratio (AOR) 2.67, 95% Confidence Interval (95%CI) 1.51–4.72) and Chinese medicine clinic (AOR 3.53, 95%CI 1.47–8.49). There were no significant associations of EHCV use with public general outpatient clinic attendance, Accident & Emergency attendance, and hospitalization. Furthermore, EHCV users were more likely to receive pneumococcal vaccination (AOR 2.17, 95%CI 1.22–3.85) and were less likely to visit the same doctors for chronic disease management (AOR 0.10, 95%CI 0.01–0.73).

Conclusions
While the EHCV may promote private primary care utilization and preventive care, older patients continue to rely on public services and the EHCV may worsen continuity of care. Policy-makers should designate voucher usage for chronic disease management and continuity of care.
Ongoing donor-transmitted diabetic kidney disease in kidney transplant recipients with fair sugar control: a single center retrospective study
Authors: Hsu Chia-Tien , Wen Mei-Chin , Chiu Hsien-Fu , Tsai Shang-Feng , Yu Tung-Min , Yang Cheng-Kuang , Wu Ming-Ju , Chen Cheng-Hsu 
Published: November 2020

Abstract

Background
Transplantation with a diabetic donor kidney may have some benefits compared to remaining on the waitlist for selected patients. However, we found that some kidney transplant recipients have ongoing donor-transmitted diabetic kidney disease (DT-DKD) despite fair blood sugar control. This study aimed to survey the incidence and clinical pattern of DT-DKD in kidney transplant recipients.

Methods
We retrospectively reviewed the medical records of kidney transplantations in our hospital. We found 357 kidney transplantations from February 2006 to April 2018. Among these, 23 (6.4%) diabetic donor kidney transplantations were done in the study period.

Results
Among the 23 recipients, 6 (26.1%) displayed biopsy-proven DKD. Recipients with biopsy-proven DKD had longer dialysis vintage, higher proteinuria amount, lower last estimated glomerular filtration rate (eGFR), and a more rapid decline in the eGFR. The median fasting blood sugar level in the biopsy-proven DKD group was unexpectedly lower than the non-DKD group. Most of the pre-implantation frozen sections in biopsy-proven DKD group showed diabetic lesions worse than diabetic nephropathy (DN) class IIa. In the biopsy-proven DKD group, 5 recipients had no history of diabetes before or after transplantation. Among the 23 recipients, 5 (21.7%) were diagnosed with DT-DKD. Serial post-transplant biopsies showed the histological progression of allograft DN.

Conclusions
To the best of our knowledge, this is the first study to report the phenomenon of ongoing DT-DKD in kidney transplant recipients with fair blood sugar control. The zero-time pre-transplant kidney biopsy may be an important examination before the allocation of diabetic donor kidneys. Further study is needed to elucidate the possible mechanism of ongoing DT-DKD in non-diabetic recipients with fair blood sugar control as well as the impaction of pre-implantation diabetic lesion on the graft outcome.
Evaluating documentation of social history in paediatric medical notes at a regional paediatric centre – a quality improvement initiative
Authors: Foley DJ , Hannon JK , O’Gorman CS , Murphy AM 
Published: November 2020

AbstractBackgroundA child’s home and family environment plays a vital role in neuro-cognitive and emotional development. Assessment of a child’s home environment and social circumstances is an crucial part of holistic Paediatric assessment.AimsOur aim is to achieve full compliance with comprehensive documentation of biopsychosocial history, for all children medically admitted to the children’s inpatient unit in University Hospital Limerick.MethodsWe performed a retrospective chart review to audit documentation within our department. This was followed by teaching interventions and a survey on knowledge, attitudes and behaviour of paediatric non-consultant hospital doctors (NCHDs) towards the social history. We performed two subsequent re-audits to assess response to our interventions, and provided educational sessions to seek improvement in quality of care.ResultsResults showed a significant improvement in quality of documentation following interventions, demonstrated by a net increase of 53% in levels of documentation of some social history on first re-audit. Though this was not maintained at an optimum level throughout the course of the year with compliance reduced from 95% to 82.5% on second re-audit, there was nonetheless a sustained improvement from our baseline. Our qualitative survey suggested further initiatives and educational tools that may be helpful in supporting the ongoing optimisation of the quality of documentation of social history in our paediatric department.ConclusionWe hope this quality improvement initiative will ultimately lead to sustained improvements in the quality of patient-centred care, and early identification and intervention for children at risk in our community.