bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impaired perfusion in the myocardial microcirculation in asymptomatic patients with Stages 1–4 chronic kidney disease with intrarenal arterial lesions
Authors: Xiao Fei , Zhang Weiwei , He Ya-Ni , Yang Jie , Liu Xinghong , Wang Ling , Zhang Jianguo , Dai Huanzi 
Published: September 2020

Abstract

Background
Even mild renal disease is a powerful cardiovascular risk factor. However, the association between these pathophysiologic processes (especially in the early asymptomatic stage) is not known.

Methods
We recruited 243 asymptomatic patients with Stages 1–4 chronic kidney disease (CKD) without obstructive coronary artery disease (CAD). We distinguished different degrees of severity of intrarenal arterial lesions (IALs) according to the Oxford classification. Myocardial microcirculation perfusion was measured using single-photon emission computed tomography (SPECT). Summed scores of 17 stress and rest image segments produced the summed stress score (SSS) and summed rest score (SRS), respectively. The summed difference score (SDS) was calculated as the difference between the SSS and SRS. Coronary microvascular disease (CMD) was defined as abnormal SPECT (SSS ≥4 or SDS ≥2) in the absence of obstructive CAD.

Results
Participants showed a stepwise increase in CMD severity with IAL aggravation. SSS of no/mild/moderate/severe IALs was 1.64 ± 1.08, 2.56 ± 1.35, 4.42 ± 2.17 and 6.48 ± 3.52, respectively (P &lt; 0.05 for all). SDS of no/mild/moderate/severe IALs was 1.29 ± 0.49, 1.75 ± 0.56, 3.06 ± 1.12 and 4.16 ± 1.85, respectively (P &lt; 0.05 for all). The percentage of subclinical CMD in CKD patients with IALs was significantly higher than in those without IALs (69.57% versus 14.71%; P = 0.01). Multiple regression analysis showed that renal arteriolar hyalinization (odds ratio = 1.578, P = 0.009) was associated independently with subclinical CMD.

Conclusions
We demonstrated, for the first time, that impaired perfusion in the myocardial microcirculation in asymptomatic patients with Stages 1–4 CKD with IALs. Renal arteriolar hyalinization may be a useful marker of CMD in CKD.
A multiaxial lead-free two-dimensional organic-inorganic perovskite ferroelectric
Authors: Huang Chao-Ran , Luo Xuzhong , Chen Xiao-Gang , Song Xian-Jiang , Zhang Zhi-Xu , Xiong Ren-Gen 
Published: September 2020

Abstract
Two-dimensional (2D) hybrid organic-inorganic perovskites (HOIPs) have recently gained tremendous interest because of their unique features in contrast to three-dimensional counterparts and traditional 2D materials. However, although some 2D HOIP ferroelectrics have been achieved, the issue of toxic Pb and uniaxial nature impede their further application. Herein, for the first time, we report a lead-free 2D HOIP multiaxial ferroelectric, [3,3-difluorocyclobutylammonium]2CuCl4 (1), which shows four ferroelectric axes and eight equivalent polarization directions, more than those of the other 2D HOIP ferroelectrics and even the inorganic perovskite ferroelectric BaTiO3 (three ferroelectric axes and six equivalent polarization directions). 1 also features a high Curie temperature of 380 K and exhibits remarkable thermochromism of color change from green-yellow to dark brown. To our knowledge, 1 is the first multiaxial lead-free 2D HOIP ferroelectric. This work sheds light on the exploration of better lead-free 2D HOIP ferroelectrics.
Trusts and jurisdiction clauses—Crociani revisited Ivanishvili, Bidzina and others v Credit Suisse Trust Ltd [2020] SGCA 62
Authors: Kian Peng Soh 
Published: September 2020

Abstract
In the recent Singapore Court of Appeal decision of Ivanishvili, Bidzina and others v Credit Suisse Trust Ltd, the court analysed the effect of a forum administration clause in the trust context, holding that while the clause in question was a jurisdiction clause, it was not an exclusive jurisdiction clause governing the dispute between the trustees and beneficiaries.
Adapting to disruption of research during the COVID-19 pandemic while testing nonpharmacological approaches to pain management
Authors: Coleman Brian C , Kean Jacob , Brandt Cynthia A , Peduzzi Peter , Kerns Robert D 
Published: September 2020

Abstract
The COVID-19 pandemic has slowed research progress, with particularly disruptive effects on investigations of addressing urgent public health challenges, such as chronic pain. The National Institutes of Health (NIH) Department of Defense (DoD) Department of Veterans Affairs (VA) Pain Management Collaboratory (PMC) supports 11 large-scale, multisite, embedded pragmatic clinical trials (PCTs) in military and veteran health systems. The PMC rapidly developed and enacted a plan to address key issues in response to the COVID-19 pandemic. The PMC tracked and collaborated in developing plans for addressing COVID-19 impacts across multiple domains and characterized the impact of COVID-19 on PCT operations, including delays in recruitment and revisions of study protocols. A harmonized participant questionnaire will facilitate later meta-analyses and cross-study comparisons of the impact of COVID-19 across all 11 PCTs. The pandemic has affected intervention delivery, outcomes, regulatory and ethics issues, participant recruitment, and study design. The PMC took concrete steps to ensure scientific rigor while encouraging flexibility in the PCTs, while paying close attention to minimizing the burden on research participants, investigators, and clinical care teams. Sudden changes in the delivery of pain management interventions will probably alter treatment effects measured via PMC PCTs. Through the use of harmonized instruments and surveys, we are capturing these changes and plan to monitor the impact on research practices, as well as on health outcomes. Analyses of patient-reported measures over time will inform potential relationships between chronic pain, mental health, and various socioeconomic stressors common among Americans during the COVID-19 pandemic.
Heated Humidified High-Flow Nasal Cannula vs. Nasal Continuous Positive Airway Pressure for Post-extubation Respiratory Support in Preterm Infants: A Randomized Controlled Trial
Authors: Yengkhom Rameshwor , Suryawanshi Pradeep , Gupta Bhvya , Deshpande Sujata 
Published: September 2020

Abstract

Objective
The objective of this study was to compare the efficacy and safety of heated humidified high-flow nasal cannula (HHHFNC) and nasal continuous positive airway pressure (nCPAP) for prevention of extubation failure in preterm infants.

Methods
Preterm infants (gestation ≥28 weeks) were randomized to HHHFNC or nCPAP after extubation. Primary outcome was extubation failure within 72 h of extubation.

Results
A total of 128 preterm infants were randomized to receive either HHHFNC (n = 63) or nCPAP (n = 65) after extubation. The primary outcome of extubation failure within 72 h after extubation was not different between the two groups (HHHFNC, 22.2% vs. nCPAP, 18.5%, risk difference of 3.7% and 95% CI −10.3 to 17.6, p = 0.604). The incidence of nasal trauma was significantly lower in the HHHFNC group than in the nCPAP group 6.3% vs. 21.5%, p = 0.020.

Conclusions
In our study, HHHFNC was as effective as nCPAP for prevention of extubation failure in preterm infants. Also, HHHFNC was associated with significantly less nasal trauma compared with nCPAP.
Evaluating the Microbiome of Hemp
Authors: Barnett Samuel E. , Cala Ali R. , Hansen Julie L. , Crawford Jamie , Viands Donald R. , Smart Lawrence B. , Smart Christine D. , Buckley Daniel H. 
Published: September 2020

Plant microbiomes contribute to plant fitness and crop yields through a variety of mechanisms. Determining variability in microbiome composition among individuals of a species, and identifying core microbiome membership, are essential first steps for exploring host–microbe interactions. Members of a core microbiome are microorganisms that are tightly associated with and are found widespread across individuals of a plant genotype or species. Hemp (Cannabis sativa L.) is an economically important crop that has gained a resurgence following its removal from the list of controlled substances by the U.S. government. Despite renewed interest in this crop, the microbiome of hemp has not been well studied. We analyzed the bacterial and fungal communities associated with four plant compartments (rhizosphere, root tissue, leaf surface, and flowers) of C. sativa ‘Anka’ across six fields in the Finger Lakes region of New York, United States. We found that both bacterial and fungal community composition varied significantly among plant compartments. Rhizosphere communities were largely similar to the bulk soil communities but root tissue, leaf, and flower communities had distinct compositions. We identified candidate core microbiome members of each plant compartment (bacterial core taxa: root tissue [n = 6], leaves [n = 11], and flowers [n = 7]; fungal core taxa: rhizosphere [n = 1], leaves [n = 14], and flowers [n = 2]). Many of these candidate core microbiome members were related to organisms previously associated with plant growth promotion or pathogen resistance in various plants. The core microbiome identified in this study can be further investigated to improve cultivation of this important crop.[Formula: see text] Copyright © 2020 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Improvement of Sleep Quality in Patients With Ankylosing Spondylitis Kyphosis After Corrective Surgery
Authors: Hu Fanqi , Song Kai , Hu Wenhao , Zhang Zhifa , Liu Chao , Wang Qi , Ji Quanbo , Zhang Xuesong 
Published: September 2020

Study Design.
A retrospective study.

Objective.
The aim of this study is to investigate the changes in sleep quality in patients surgically treated for kyphosis due to ankylosing spondylitis (AS) and the correlation between these changes and spinal sagittal realignment.

Summary of Background Data.
Sleep problems are prevalent in AS patients. However, little attention has been paid to the sleep quality in patients with AS kyphosis and the effect of surgical intervention on sleep quality.

Methods.
We have retrospectively reviewed 62 patients with AS-induced thoracolumbar kyphosis who underwent surgically treatment from October 2012 to November 2016. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Preoperative and postoperative radiological characteristics and supine function were documented. We compared the above-mentioned parameters pre- and 24 months postoperatively and analyzed the correlation of the changes in the PSQI with the changes in radiological characteristics.

Results.
Fifity-one patients (82%) classified as poor sleepers preoperatively. In addition to use of sleeping medication, each domain of the PSQI and the total PSQI were increased postoperatively. Improved sleep quality was correlated with changes in spinal sagittal characteristics, among which the lumbar lordosis (LL) and the chin-brow vertical angle (CBVA) were the independent correlation factors. The number of patients with supine dysfunction decreased from 89% to 15% after surgery. Significant differences were identified in the PSQI scores between the patients with and without supine dysfunction either pre- or postoperatively.

Conclusion.
Surgical correction of spinal deformity may improve sleep quality and supine function in patients with AS. Spinal sagittal realignment may be correlated with the improvement of sleep quality.

Level of Evidence: 4
Practical approach to the management of smoldering myeloma
Authors: Joseph Nisha S. , Lonial Sagar 
Published: September 2020

Purpose of review
The aim of this article is to review the diagnosis and risk stratification of smoldering myeloma (SMM), describe recently published data regarding the early treatment of SMM, and to provide practical strategies on how to manage patients with SMM in the clinic.

Recent findings
Recently published data from the ECOG E3A06 and GEM-CESAR studies supporting early intervention for certain subsets of high-risk SMM patients will be presented, and the relevance of these findings in relation to real-life application will be explored.

Summary
Accurate risk-stratification and standard of care for SMM is evolving, and here we summarize the pertinent clinical data and provide recommendations for clinical management of SMM patients.
Prevention of brain metastases in human epidermal growth factor receptor 2-positive breast cancer
Authors: Eberst Lauriane , Bailleux Caroline , Bachelot Thomas 
Published: September 2020

Purpose of review
For patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer, treatments that could prevent or delay occurrence of brain metastases would improve outcome.

Recent findings
Few studies were specifically designed to assess brain metastasis prevention. Most evidence derives from subgroup analyses of randomized trials. In the first-line metastatic setting, lapatinib, was not superior to trastuzumab to prevent CNS metastases as first site of relapse. Pertuzumab when added to trastuzumab and taxane significantly delay occurrence of brain metastases. In the second line setting, trastuzumab–emtansine has shown to improve overall survival of patients with brain metastases when compared with capecitabine–lapatinib, but there was no significant delay in brain metastases progression. Neratinib, has shown that it was able to delay brain metastases progression. Finally, tucatinib, has demonstrated benefit in progression-free survival and overall survival in combination with trastuzumab and capecitabine over trastuzumab and capecitabine for patients with or without brain metastases.

Summary
There has been an impressive improvement of the outcome of patients with HER2-positive metastatic breast cancer, with improved control of systemic disease and delayed occurrence of CNS progression. Specific studies are needed to assess TKI for brain metastases prevention, particularly in the adjuvant setting.
Evaluation of Blood-filling Patterns in Schlemm Canal for Trabectome Surgery
Authors: Sugihara Kae , Narita Akiko , Mitsui Naruka , Okuda Seido , Seguchi Jiro , Morizane Yuki 
Published: September 2020

Précis:
Regardless of the blood-filling patterns in Schlemm canal (SC) before the trabecular meshwork (TM) ablation, the trabectome surgery, combined with phacoemulsification, is effective for mild to moderate primary open-angle glaucoma patients.

Purpose:
The purpose of this study was to evaluate the association between trabectome surgery outcomes and the blood filling patterns in SC before TM ablation.

Materials and Methods:
This retrospective cohort study included 105 eyes of 84 Japanese primary open-angle glaucoma patients who had undergone trabectome surgery in combination with cataract surgery. Provocative gonioscopy was performed before TM ablation to classify the blood filling patterns in SC into 3 groups: no filling (group 1); patchy/irregular filling (group 2); and complete filling (group 3). The subjects were divided into 3 groups according to the blood filling patterns and the trabectome surgery outcomes were compared, including intraocular pressure (IOP), the percentage reduction in IOP, surgical success rate, and the number of glaucoma medications. Success was defined by IOP ≤15 mm Hg and a >20% reduction in IOP with/without glaucoma medication, and without additional glaucoma surgery after trabectome surgery combined with cataract surgery.

Results:
Twenty-four eyes were assigned to group 1, 48 to group 2, and 33 to group 3. Between-group analyses showed no significant intergroup differences in age (P=0.213), preoperative mean deviation (P=0.505), preoperative and postoperative IOP (P=0.941 and 0.458, respectively), preoperative and postoperative number of glaucoma medications (P=0.805 and 0.077, respectively), percentage IOP reduction (P=0.256), and success rates (P=0.540).

Conclusion:
Trabectome surgery is effective for mild to moderate primary open-angle glaucoma patients, independent of the blood-filling patterns in SC before the TM ablation.
Punctal Congestion Syndrome: A Reversible, Functional Punctal Stenosis Causing Epiphora in the Setting of Chronic Pretarsal Conjunctivitis
Authors: Bian Yandong , Scofield-Kaplan Stacy M. , Zemsky Christine , Campagnoli Thalmon , Ghadiali Larissa , Dagi Glass Lora R. , Sallee Brigitte , Belsito Donald V. , Winn Bryan J 
Published: September 2020

Purpose:
To describe a reversible syndrome of epiphora, functional punctal stenosis, and chronic pretarsal conjunctivitis associated with corticosteroid or corticosteroid-antibiotic eyedrop use.

Methods:
This is an Institutional Review Board-approved retrospective review of patients diagnosed with epiphora, punctal stenosis, and chronic conjunctivitis by a single surgeon (B.J.W.). These patients were subsequently invited to participate in a prospective study involving allergy skin patch testing for ophthalmic drops, common excipients, and active ingredients.

Results:
Thirteen patients received a diagnosis of punctal congestion syndrome. The average age was 63 years (range, 41–93) and 69.2% were female. Findings were bilateral in 61.5%. All had used preserved drops in the affected eye(s). Various antecedent diagnoses resulted in treatment with preserved drops. Patients experienced epiphora for an average of 3.8 months (median, 3 months; mode, 3 months; range, 1–8 months) prior to presentation. Two patients had undergone punctoplasty which failed to resolve symptoms. 92.3% of patients had been taking tobramycin-dexamethasone drops, loteprednol drops, or a combination of both prior to presentation. All were taken off preserved drops. 69.2% were also treated with a preservative-free loteprednol etabonate 0.5% ophthalmic ointment taper. All improved. Partial relief of symptoms was achieved by an average of 1.6 months (median, 2 months; mode, 2 months; standard deviation, ±0.7 months) and resolution of symptoms by 2.5 months (median, 2 months; mode, 2 months; standard deviation, ±1.7 months). One patient underwent patch testing with strong positive reactions to formaldehyde and neomycin and a weak positive reaction to gentamicin.

Conclusions:
Functional punctal stenosis is associated with topical ophthalmic preparations, especially preserved corticosteroids and antibiotic-corticosteroid combinations. Treatment consists of removal of all preserved eyedrops. Symptoms often improve over several months.
Itch-related quality of life impact across 3 autoimmune blistering diseases: a retrospective cohort study
Authors: Cole Emily F. , DeGrazia Taryn , AlShamekh Shomoukh , Feldman Ron 
Published: September 2020

Introduction:
Autoimmune blistering diseases (AIBD) produce a range of debilitating symptoms potentially greatly impacting quality of life (QoL). We sought to compare the disease-related and itch-related QoL impact between AIBD including pemphigus, bullous pemphigoid (BP), and mucous membrane pemphigoid (MMP).

Methods:
We performed a retrospective cohort study of patients attending a specialty Autoimmune Blistering Disease Clinic at a single academic center between July 2017 and April 2019. Patients with an established histopathologic or serological diagnosis of pemphigus, BP or MMP with mucosal and/or cutaneous lesions on clinical examination, or patient-reported QoL impact in the past week were recruited to participate. Patients completed Autoimmune Blistering Disease Quality of Life (ABQoL), Treatment of Autoimmune Blistering Disease Quality of Life (TABQoL), and ItchyQoL survey instruments, and disease severity was assessed using the Pemphigus Disease Area Index (PDAI) (pemphigus), Bullous Pemphigoid Disease Area Index (BPDAI) (BP), and Mucous Membrane Pemphigoid Disease Area Index (MMPDAI) (MMP). Statistical analyses were performed using IBM SPSS 26.

Results:
BP and pemphigus demonstrated similar itch-related QoL impact, greater than that of MMP. Disease severity was significantly associated with itch-related QoL in BP and pemphigus, as was use of biological/targeted therapies in BP alone.

Discussion:
Itch is a significant symptom in both BP and pemphigus and can negatively affect QoL. Disease severity and treatment type play a role in itch-related QoL in pemphigus and BP. Additional studies are needed to elucidate the mechanisms for itch in AIBD, particularly in pemphigus where this symptom has only recently been described.
Evaluating the Timeliness and Specificity of CD69, CD64, and CD25 as Biomarkers of Sepsis in Mice
Authors: Goswami Dinesh G. , Garcia Luiz F. , Dodoo Christopher , Dwivedi Alok K. , Zhou Yun , Pappas Dimitri , Walker Wendy E. 
Published: September 2020

ABSTRACT
Sepsis occurs when an infection induces a dysregulated immune response, and is most commonly bacterial in origin. This condition requires rapid treatment for successful patient outcomes. However, the current method to confirm infection (blood culture) requires up to 48 h for a positive result and many true cases remain culture-negative. Therefore, new diagnostic tests are urgently needed. Recent clinical studies suggest that CD69, CD64, and CD25 may serve as useful biomarkers of sepsis. In this study, we evaluated the cecal ligation and puncture and cecal slurry mouse models as tools to study these biomarkers in young and aged mice, and elucidate the timeliness and specificity of sepsis diagnosis. Fluorescence-activated cell sorting analysis revealed that all three biomarkers were elevated on blood leukocytes during sepsis. CD69 was specifically upregulated during sepsis, while CD64 and CD25 were also transiently upregulated in response to sham surgery. The optimal biomarker, or combination of biomarkers, depended on the timing of detection, mouse age, and presence of surgery. CD69 demonstrated an excellent capacity to distinguish sepsis, and in some scenarios the diagnostic performance was enhanced by combining CD69 with CD64. We also analyzed biomarker expression levels on specific cell populations (lymphocytes, monocytes, and neutrophils) and determined the cell types that upregulate each biomarker. Elevations in blood biomarkers were also detected via microfluidic analyses; in this case CD64 distinguished septic mice from naive controls. Our results suggest that CD69 and CD64 are valuable biomarkers to rapidly detect sepsis, and that mouse models are useful to study and validate sepsis biomarkers.
Admission Lactate and Base Deficit in Predicting Outcomes of Pediatric Trauma
Authors: Huh Yo , Ko Yura , Hwang Kyungjin , Jung Kyoungwon , Cha Yoon-ho , Choi Yoo Jin , Lee Jisook , Kim Jung Heon 
Published: September 2020

ABSTRACT

Background:
To compare admission lactate and base deficit (BD), which physiologically reflect early hemorrhagic shock, as outcome predictors of pediatric trauma.

Methods:
We reviewed the data of children with trauma who visited a Korean academic hospital from 2010 through 2018. Admission lactate and BD were compared between children with and without primary outcomes. The outcomes included in-hospital mortality, early (≤24 h) transfusion, and early surgical interventions for the torso or major vessels. Subsequently, performances of lactate and BD in predicting the outcomes were compared using receiver operating characteristic curves. Logistic regressions were conducted to identify the independent associations of the two markers with each outcome.

Results:
Of the 545 enrolled children, the mortality, transfusion, and surgical interventions occurred in 7.0%, 43.5%, and 14.9%, respectively. Cutoffs of lactate and BD for each outcome were as follows: mortality, 5.1 and 6.7 mmol/L; transfusion, 3.2 and 4.9 mmol/L; and surgical interventions, 2.9 and 5.2 mmol/L, respectively. No significant differences were found in the areas under the curve for each outcome. Of the two markers, a lactate of >5.1 mmol/L was associated with mortality (adjusted odds ratio, 6.43; 95% confidence interval, 2.61–15.84). A lactate of >3.2 mmol/L (2.82; 1.65–4.83) and a BD of >4.9 mmol/L (2.32; 1.32–4.10) were associated with transfusion, while only a BD of >5.2 mmol/L (2.17; 1.26–3.75) was done with surgical interventions.

Conclusions:
In pediatric trauma, lactate is more strongly associated with mortality. In contrast, BD may have a marginally stronger association with the need for hemorrhage-related procedures.