bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mutations and Response to Rapalogs in Patients with Metastatic Renal Cell Carcinoma
Authors: Nassar Amin H. , Hamieh Lana , Gray Kathryn P. , Thorner Aaron R. , Fay Andre P. , Lasseter Kathryn D. , Abou Alaiwi Sarah , Nuzzo Pier Vitale , Flippot Ronan , Krajewski Katherine M. , Signoretti Sabina , Choueiri Toni K. , Kwiatkowski David J. 
Published: October 2019

AbstractWe previously showed that alterations in mTOR pathway genes were correlated with response to rapalog therapy in metastatic renal cell carcinoma (mRCC), when the analysis focused on extremes of response. Herein, we expand on the prior cohort and examine genetic correlations with rapalog response in a dataset not selected for extremes of response. Tumors from 58 patients from the phase III trial of temsirolimus and 51 local patients with mRCC treated with rapalogs were studied. Somatic mutations were investigated using a targeted sequencing platform covering 27 genes. Clinical benefit (CB) was defined as patients with complete remission, partial response, or stable disease lasting at least 22 weeks. Mutational analyses focused on 5 mTOR pathway genes (TSC1, TSC2, MTOR, PTEN, PIK3CA) and 6 genes commonly mutated in RCC (BAP1, KDM5C, PBRM1 SETD2, TP53, and VHL). Among the 109 patients, 93 (85%) patients had clear cell histology, and 31 (28%) showed CB. Nine of 30 (30%) patients harboring mTOR pathway mutations in their tumor achieved CB versus 22 of 79 (28%) in the wild-type group. There was no distinct association between any individual or combination of mTOR pathway gene mutations and CB. Three of 7 patients with TSC1 mutations showed CB. In addition, none of the 6 genes commonly mutated in RCC showed a mutation pattern that correlated with CB. Overall, in this large and diverse population of patients with mRCC, there is no suggestion of a correlation between response to rapalog therapy and mutation status for mTOR pathway genes.
TRAF1 Exacerbates Myocardial Ischemia Reperfusion Injury via ASK1–JNK/p38 Signaling
Authors: Xu Weipan , Zhang Li , Zhang Yi , Zhang Kai , Wu Yongbo , Jin Daoqun 
Published: October 2019

Background

After acute myocardial infarction, the recovery of ischemic myocardial blood flow may cause myocardial reperfusion injury, which reduces the efficacy of myocardial reperfusion. Ways to reduce and prevent myocardial ischemia/reperfusion (I/R) injury are of great clinical significance in the treatment of patients with acute myocardial infarction. TRAF1 (tumor necrosis factor receptor–associated factor 1) is an important adapter protein that is implicated in molecular events regulating immunity, inflammation, and cell death. Little is known about the role and impact of
TRAF
1 in myocardial I/R injury.

Methods and Results

TRAF
1 expression is markedly induced in wild‐type mice and cardiomyocytes after I/R or hypoxia/reoxygenation stimulation. I/R models were established in
TRAF
1 knockout mice and wild type mice (n=10 per group). We demonstrated that
TRAF
1 deficiency protects against myocardial I/R–induced loss of heat function, inflammation, and cardiomyocyte death. In addition, overexpression of
TRAF
1 in primary cardiomyocytes promotes hypoxia/reoxygenation‐induced inflammation and apoptosis in vitro. Mechanistically,
TRAF
1 promotes myocardial I/R injury through regulating ASK1 (apoptosis signal‐regulating kinase 1)–mediated JNK/p38 (c‐Jun N‐terminal kinase/p38) MAPK (mitogen‐activated protein kinase) cascades.

Conclusions

Our results indicated that
TRAF
1 aggravates the development of myocardial I/R injury by enhancing the activation of
ASK
1‐mediated
JNK
/p38 cascades. Targeting the
TRAF
1–
ASK
1–
JNK
/p38 pathway provide feasible therapies for cardiac I/R injury.
Disparities in Antihypertensive Prescribing After Stroke
Authors: Dalli Lachlan L. , Kim Joosup , Thrift Amanda G. , Andrew Nadine E. , Lannin Natasha A. , Anderson Craig S. , Grimley Rohan , Katzenellenbogen Judith M. , Boyd James , Lindley Richard I. , Pollack Michael , Jude Martin , Durairaj Ramesh , Shah Darshan , Cadilhac Dominique A. , Kilkenny Monique F. ,   on behalf of the Stroke123 Investigators and the AuSCR Consortium
Published: October 2019

Background and Purpose—
Despite evidence to support the prescription of antihypertensive medications before hospital discharge to promote medication adherence and prevent recurrent events, many patients with stroke miss out on these medications at discharge. We aimed to examine patient, clinical, and system-level differences in the prescription of antihypertensive medications at hospital discharge after stroke.

Methods—

Adults with acute ischemic stroke or intracerebral hemorrhage alive at discharge were included (years 2009–2013) from 39 hospitals participating in the Australian Stroke Clinical Registry. Patient comorbidities were identified using the
International Statistical Classification of Diseases and Related Health Problems (Tenth Edition, Australian Modification
) codes from the hospital admissions and emergency presentation data. The outcome variable and other system factors were derived from the Australian Stroke Clinical Registry dataset. Multivariable, multilevel logistic regression was used to examine factors associated with the prescription of antihypertensive medications at hospital discharge.

Results—
Of the 10 315 patients included, 79.0% (intracerebral hemorrhage, 74.1%; acute ischemic stroke, 79.8%) were prescribed antihypertensive medications at discharge. Prescription varied between hospital sites, with 6 sites >2 SDs below the national average for provision of antihypertensives at discharge. Prescription was also independently associated with patient and clinical factors including history of hypertension, diabetes mellitus, management in an acute stroke unit, and discharge to rehabilitation. In patients with acute ischemic stroke, females (odds ratio, 0.85; 95% CI, 0.76–0.94), those who had greater stroke severity (odds ratio, 0.81; 95% CI 0.72–0.92), or dementia (odds ratio, 0.65; 95% CI, 0.52–0.81) were less likely to be prescribed.

Conclusions—
Prescription of antihypertensive medications poststroke varies between hospitals and according to patient factors including age, sex, stroke severity, and comorbidity profile. Implementation of targeted quality improvement initiatives at local hospitals may help to reduce the variation in prescription observed.
Woody Plant Cover Estimation in Texas Savanna from MODIS Products
Authors: Yang Xuebin 
Published: October 2019

Abstract
Woody plant cover, the area of the vertical projection of woody plants (trees, shrubs, and bushes), plays an important role in the structure and function of savanna ecosystems and is needed by the savanna modeling community. Recent problems facing savanna ecosystems such as woody plant encroachment and subsequent habitat fragmentation further underscore the relevance of regional-scale and even larger-scale woody plant cover mapping. The mixture of woody plants and herbaceous vegetation in savanna landscapes lends woody plant cover mapping to fractional representation. This study endeavors to develop a simple and reliable approach for fractional woody plant cover mapping in savanna ecosystems. It was tested in the savanna of central Texas, which features a wide woody plant density gradation. A multiple linear regression model was calibrated between orthophoto-based fractional woody plant cover and metrics derived from time series MODIS products of surface reflectance (MOD09A1) and fraction of photosynthetically active radiation (MOD15A2H). By applying this model, woody plant cover was extrapolated to Texas savanna at MODIS scale (500 m). Validation suggests a mean absolute error of 0.098 and an R-squared value of 0.60. This study demonstrates a potential approach for woody plant cover mapping in other savanna ecosystems of the world. It also highlights the utility of time series MODIS products in savanna woody plant cover estimation.
Attitudes of Psychiatry Residents in Canadian Universities toward Neuroscience and Its Implication in Psychiatric Practice
Authors: Hassan Taghreed , Prasad Benjamin , Meek Benjamin P. , Modirrousta Mandana 
Published: October 2019

Objective: Despite recent advances in neuroscience highlighting its potential applications in the assessment and treatment of psychiatric disorders, the training of psychiatrists in neuroscience is lacking. However, it is not clear to what extent Canadian trainees are interested in further learning and using neuroscience in their daily clinical practice. This study explored the attitudes of Canadian psychiatry trainees with regard to neuroscience education and training by asking them to assess their own understanding of neuroscience and the perceived relevance of neuroscience knowledge to effective psychiatric practice. Methods: An online questionnaire was sent to psychiatry residents at Canadian universities. This questionnaire consisted of self-assessments of neuroscience knowledge, attitudes toward neuroscience education, preferences in learning modalities, and interest in specific neuroscience topics. Results: One hundred and eleven psychiatry residents from psychiatry residency programs at Canadian universities responded to this survey. Participants represented trainees from all 5 years of residency. Almost half of all trainees (49.0%) reported their knowledge of neuroscience to be either “inadequate” or “less than adequate,” and only 14.7% of trainees reported that they feel “comfortable” or “very comfortable” discussing neuroscience findings with their patients. 63.7% of Canadian trainees rated the quantity of neuroscience education in their residency program as either less than adequate or inadequate, and 46.1% rated the quality of their neuroscience education as “poor” or “very poor.” The vast majority of participants (>70%) felt that additional neuroscience education would be moderately-to-hugely helpful in finding personalized treatments, discovering future treatments, destigmatizing patients with psychiatric illness, and understanding mental illness. Conclusions: Canadian trainees generally feel that their neuroscience knowledge and the neuroscience education they receive during their psychiatry residencies is inadequate. However, as the first step for any change, the majority of future Canadian psychiatrists are very motivated and have a positive attitude toward neuroscience learning.
Use of Pamidronate for Hypercalcemia of Malignancy in Renal Dysfunction
Authors: Norman Sarah J. , Reeves David J. , Saum Lindsay M. 
Published: October 2019

Background: Few studies have been conducted investigating the use of bisphosphonates in hypercalcemia of malignancy (HCM) in the setting of renal dysfunction. Objective: The primary objective was to compare the incidence of acute kidney injury (AKI) within 7 days of receiving pamidronate for the treatment of HCM with pre-existing renal dysfunction versus normal renal function at the time of pamidronate administration. The secondary objectives explored the effects of pamidronate doses and infusion rates on the safety and efficacy in those with pre-existing renal dysfunction for the treatment of HCM. Methods: A retrospective chart review was conducted on patients who received pamidronate for the treatment of HCM at a community teaching hospital in Indianapolis, Indiana, from January 1, 2013, to May 31, 2017. Results: A total of 141 pamidronate administrations were included (116 patients had normal baseline renal function, and 25 patients had pre-existing renal dysfunction before pamidronate administration for the treatment of HCM). Two (8%) patients developed AKI in the pre-existing renal dysfunction group, compared with 4 (3.4%) patients in those without pre-existing renal dysfunction ( P = .288). For those with pre-existing renal dysfunction, the incidence of AKI did not differ based on the dosage of pamidronate given ( P = .762) or infusion rates ( P = .373). Conclusion: Pamidronate appears to have limited impact on renal function at doses up to 90 mg in the setting of pre-existing renal dysfunction for the treatment of HCM.
Effectiveness of endoscopic ultrasound-guided drainage for noncapsulated postoperative pancreatic collection
Authors: Tamura Takashi , Kitano Masayuki , Kawai Manabu , Tanioka Kensuke , Itonaga Masahiro , Kawaji Yuki , Nuta Junya , Hatamaru Keiichi , Yamashita Yasunobu , Kitahata Yuji , Miyazawa Motoki , Hirono Seiko , Okada Ken-ichi , Yamaue Hiroki 
Published: October 2019

Background: Postoperative pancreatic collection (POPC) is a frequent complication after pancreatectomy. Although percutaneous drainage (PD) has been the treatment of choice for POPC with encapsulation, endoscopic ultrasound-guided transmural drainage (EUS-TD) was recently reported effective for this condition. The main aim of this retrospective study was to compare EUS-TD and PD in terms of effectiveness and safety as the first procedure in patients with noncapsulated POPC. Methods: Consecutive patients who underwent pancreatectomy and developed noncapsulated POPC requiring EUS-TD or PD between April 2003 and May 2018 were enrolled. Noncapsulated POPC was defined as pancreatic collection appearing within 28 days postoperatively and lacking a thick encapsulating inflammatory wall on contrast-enhanced computed tomography. The effectiveness of drainage was compared between the two groups before and after propensity-score matching of patient characteristics. Outcomes of interest included re-intervention rate, number of re-interventions, immediate complication, remote complication, and time to clinical resolution after the procedure. Results: A sum of 81 patients were included: 14 underwent EUS-TD, and 67 underwent PD. There were significant differences between groups in POPC size and type of surgery. Propensity-score matching selected 13 patients who underwent EUS-TD and 28 who underwent PD. Re-intervention rate ( p = 0.045), and number of re-interventions ( p = 0.026) were significantly lower in the matched EUS-TD group than in the matched PD group. There were no significant between-group differences in immediate complication and remote complication. The time to clinical resolution after the procedure was significantly shorter in the matched EUS-TD than in the matched PD group (14 versus 26 days; p < 0.0001). Conclusion: EUS-TD is more effective than PD for drainage of noncapsulated POPC. EUS-TD should be considered as the first treatment of choice for noncapsulated POPC visible on EUS.
Acute Focal Bacterial Nephritis: Two Cases and Review of the Literature
Authors: Guella Adnane , Khan Arshee , Jarrah Dima 
Published: October 2019

Rationale: Acute focal bacterial nephritis (AFBN) has mainly been reported in pediatrics. It may be an underdiagnosed condition in adults because it resembles acute pyelonephritis (APN) in its clinical presentation. Presenting concerns of the patients: Two young women (25 and 27 years old, respectively) presented with complaints compatible with a diagnosis of APN. However in both, fever was of high grade, persistent for several days in spite of antibiotic administration, and there was demonstrated worsening of the inflammatory biomarkers. A contrast-enhanced computed tomography (CECT) led to the diagnosis in both cases. Diagnoses: Contrast-enhanced computed tomography reveals the most sensitive and specific images of AFBN. This includes wedge-shaped lesions with decreased enhancement, which may be focal or multifocal. Interventions (including prevention and lifestyle): Antibiotic therapy for at least 3 weeks. Outcomes: Resolution of AFBN was obtained after 3 weeks of antibiotics. Lessons learned: Our 2 cases illustrate the importance of CECT imaging to confirm the diagnosis of AFBN. Interstitial bacterial inflammation may have a worse prognosis if not diagnosed early and efficiently treated. Unlike APN, the management of AFBN requires at least 3 weeks of antibiotics to prevent the development of renal scarring and renal abscess.
Modelling of population structure through contemporary groups in genetic evaluation
Authors: Klápště Jaroslav , Suontama Mari , Dungey Heidi S , Telfer Emily J , Stovold Grahame T 
Published: October 2019

AbstractBackgroundForest trees can occupy extensive geography and environmentally highly variable areas which result in high genetic variability in the direction of pressure from natural selection. At the same time, the majority of conifer species are wind-pollinated from both short and long distances, resulting in wide-spread gene flow, which can lead to maladaptation to local conditions. Quantitative analyses of provenance/progeny tests correct for genetic differences between populations to ensure unbiased genetic parameters are obtained. Commonly, the provenance effect is fitted as a fixed term or can be implemented as a contemporary group in the pedigree.ResultsThe use of a provenance effect, either as a fixed term or as the same contemporary groups in both maternal and paternal sides of the pedigree, resulted in fairly similar precision of genetic parameters in our case. However, when we developed a phantom contemporary group for the paternal side of the pedigree that considered a different genetic quality of pollen compared with the maternal contribution from trees in the local environment, the model fit and accuracy of breeding values increased.ConclusionConsideration of the mating dynamics and the vector of gene flow are important factors in modelling contemporary genetic groups, particularly when implementing pedigrees within a mixed model framework to obtain unbiased estimates of genetic parameters. This approach is especially important in traits involved in local adaptation.
Comprehensive transcriptome analysis of grafting onto Artemisia scoparia W. to affect the aphid resistance of chrysanthemum (Chrysanthemum morifolium T.)
Authors: Zhang Xue-ying , Sun Xian-zhi , Zhang Sheng , Yang Jing-hui , Liu Fang-fang , Fan Jie 
Published: October 2019

AbstractBackgroundAphid (Macrosiphoniella sanbourni) stress drastically influences the yield and quality of chrysanthemum, and grafting has been widely used to improve tolerance to biotic and abiotic stresses. However, the effect of grafting on the resistance of chrysanthemum to aphids remains unclear. Therefore, we used the RNA-Seq platform to perform a de novo transcriptome assembly to analyze the self-rooted grafted chrysanthemum (Chrysanthemum morifoliumT. ‘Hangbaiju’) and the grafted Artermisia-chrysanthemum (grafted ontoArtemisia scopariaW.) transcription response to aphid stress.ResultsThe results showed that there were 1337 differentially expressed genes (DEGs), among which 680 were upregulated and 667 were downregulated, in the grafted Artemisia-chrysanthemum compared to the self-rooted grafted chrysanthemum. These genes were mainly involved in sucrose metabolism, the biosynthesis of secondary metabolites, the plant hormone signaling pathway and the plant-to-pathogen pathway. KEGG and GO enrichment analyses revealed the coordinated upregulation of these genes from numerous functional categories related to aphid stress responses. In addition, we determined the physiological indicators of chrysanthemum under aphid stress, and the results were consistent with the molecular sequencing results. All evidence indicated that grafting chrysanthemum ontoA. scopariaW. upregulated aphid stress responses in chrysanthemum.ConclusionIn summary, our study presents a genome-wide transcript profile of the self-rooted grafted chrysanthemum and the grafted Artemisia-chrysanthemum and provides insights into the molecular mechanisms ofC. morifoliumT. in response to aphid infestation. These data will contribute to further studies of aphid tolerance and the exploration of new candidate genes for chrysanthemum molecular breeding.
Acute pelvic pain following miscarriage heterotopic pregnancy must be excluded: case report
Authors: Thakur Udit , Atmuri Kiran , Borozdina Angelika 
Published: October 2019

Abstract

Background
Heterotopic pregnancies are increasing in prevalence and this case highlights the importance of excluding the diagnosis in patients with pelvic pain following miscarriage. A known pre-existing intrauterine pregnancy can be falsely reassuring and delay the diagnosis of a potentially life-threatening concurrent ectopic pregnancy.

Case presentation
In this report, we describe a case of spontaneous heterotopic pregnancy in a woman who had initially presented with pelvic pain and vaginal bleeding, and was diagnosed on pelvic ultrasound with a missed miscarriage; a non-viable intrauterine pregnancy. She re-presented 7 days later with worsening pelvic pain and bleeding, and a repeat pelvic ultrasound identified a ruptured tubal ectopic pregnancy in addition to an incomplete miscarriage of the previously identified intrauterine pregnancy. She underwent an emergency laparoscopy where a ruptured tubal ectopic pregnancy was confirmed.

Conclusion
Being a time critical diagnosis with the potential for an adverse outcome, it is important that the emergency physician considers heterotopic pregnancy as a differential diagnosis in patients presenting with pelvic pain following a recent miscarriage. The same principle should apply to pelvic pain in the context of a known viable intrauterine pregnancy or recent termination of pregnancy. A combination of clinical assessment, beta human chorionic gonadotropin levels, point of care ultrasound and formal transvaginal ultrasound must be utilized together in these situations to explicitly exclude heterotopic pregnancy.
Atrial fibrillation care in rural communities: a mixed methods study of physician and patient perspectives
Authors: Rush Kathy L. , Burton Lindsay , Van Der Merwe Fransien , Hatt Linda , Galloway Camille 
Published: October 2019

AbstractBackgroundAtrial fibrillation (AF) is a serious heart arrhythmia associated with devastating outcomes such as stroke. Inequitable rural AF care may put patients at risk. Virtually delivered specialty AF care offers a viable option, but stakeholder perceptions of this option within the context of rural AF care is unknown. The study purpose was to obtain patient and primary care physician perspectives of rural AF care and virtually delivered AF care as a potential option.MethodsUsing a mixed methods design, AF patients (n = 101) and physicians (n = 15) from three rural communities participated in focus groups and/or surveys. Focus group data were thematically analyzed, survey data were descriptively analyzed, and data were triangulated.ResultsFindings captured patients’ and physicians’ perceptions of prioritized, needs, concerns and problems in AF management, available/unavailable services, and their ideas about virtual AF care. Patients and physicians identified eclectic problems in managing AF. Overall, patients felt ill informed about managing their AF and their most salient problems related to fatigue, exercise intolerance, weight maintenance, sleep apnea, and worry about stroke and bleeding. Physicians found treating patients with co-morbidities and cognitive decline problematic and balancing risks related to anticoagulation challenging. Patients and physicians identified education as a pressing need, which physicians lacked time and resources to meet. Despite available rural services, access to primary and cardiology care was a recurring challenge, and emergency department (ED) use highly contentious but often the only option for accessing care. Physicians’ managed AF care and varied in the referrals they made, often reserving them for complex situations to avoid patient travel. Patients and providers supported a broad approach to virtual AF care, tailored to an inclusive rural patient demographic.ConclusionsThe study offered valuable physician and patient perspectives on AF care in rural communities including diverse management challenges, gaps in access to primary and specialty services that made ED an often used but contentious option. Findings point to the potential value of virtual care designed to reach patients with AF across the spectrum and geared to local contexts that preserve the vital role of primary care physicians in AF care in their communities.