bluuebunny/crossref_metadata_2025_split huggingface dataset:
Painless lymphadenopathy, eosinophilia and nephrotic syndrome: a diagnostic challenge in an era of increased migration
Authors: Rebelos Eleni , Bindi Massimo , Masi Lorenzo , Petruccelli Stefania , Taddei Marco , Ciancia Eugenio Mario , Rosada Javier 
Published: May 2020

Abstract
Kimura’s disease is a rare chronic inflammatory condition of unknown cause that most frequently affects Asian adults. It is characterized by painless lymphadenopathy in the head and neck region and eosinophilia, often associated with nephrotic syndrome. Α young Asian male presented to our Department with œdema at the lower limbs and scrotum, retroauricular masses, eosinophilia and proteinuria. Diagnosis was reached by a combination of the clinical picture, the patient’s origin and a histological examination, which revealed well-developed lymph follicles with increased numbers of eosinophils and fibrosis, a finding typical of Kimura’s disease. In case of a young Asian male who is otherwise healthy, but presents head/neck masses and/or unexplained eosinophilia associated with nephrotic syndrome, consider Kimura’s disease in the differential diagnosis.
Instantaneous Wave-Free Ratio Measurement During Intracranial Submaximal Angioplasty: Case Series and 2-Dimensional Operative Video
Authors: Vakharia Kunal , Waqas Muhammad , Fayyaz Najya , Young Amanda , Levy Elad I , Davies Jason M , Siddiqui Adnan H 
Published: May 2020

Abstract

BACKGROUND
Instantaneous wave-free ratios (iFRs) are functional measures of arterial stenosis that have become essential to interventional cardiology procedures. Their use for intracranial submaximal angioplasty (angioplasty with an undersized balloon) has not been studied extensively.

OBJECTIVE
To describe the feasibility and technique of iFR measurement for stenosis assessment during intracranial angioplasty.

METHODS
We present a series of consecutive patients treated between January 1, 2017 and June 30, 2018 with submaximal intracranial angioplasty in whom pre- and postprocedure iFR measurements were obtained with a Verrata-Volcano pressure wire (Philips, Amsterdam, The Netherlands). We collected patient data on age, sex, comorbid conditions, presenting complaints, modified Rankin scale (mRS) score at admission, neurological findings, procedure duration, fluoroscopy time, intraprocedural complications, length of hospital stay, and mRS score at last clinical follow-up (favorable outcome, 0-2). Angiographic stenosis severity and iFR values were recorded before and after angioplasty.

RESULTS
A total of 12 patients underwent iFR-guided angioplasty during the study period. The median patient age was 69.5 yr (range 48-81 yr). All patients had symptomatic intracranial arterial stenosis (3-basilar, 2-vertebral, 6-middle cerebral, 1-internal carotid). Preangioplasty stenosis ranged from 55% to 90%. The median postangioplasty reduction in stenosis was 17% (range 9%-30%). Preangioplasty values ranged from 0.30 to 0.40 (n = 4). Postangioplasty values ranged from 0.6 to 0.9 (n = 5). iFR values improved considerably in all patients. No procedure-related complications occurred. The median follow-up was 8.9 mo (range 3-25 mo). Follow-up outcomes were favorable in 10 patients.

CONCLUSION
iFR measurement before and after intracranial angioplasty is feasible. It may be used to assess the adequacy of intracranial angioplasty.
Public health surveillance of habitual physical activity in adolescents and adults in Namibia: a cross-sectional validation of activity questionnaires against accelerometry
Authors: Nashandi Hilde L , Reilly John J , Janssen Xanne 
Published: May 2020

Abstract

Background
Monitoring population-level physical activity is crucial for examining adherence to global guidelines and addressing obesity. This study validated self-reported moderate-to-vigorous physical activity (MVPA) against an accurate device-based method in Namibia.

Methods
Adolescent girls (n = 52, mean age 16.2 years [SD 1.6]) and adult women (n = 51, mean age 31.3 years [SD 4.7]) completed the PACE+/GPAQ self-report questionnaires and were asked to wear an Actigraph accelerometer for 7 days. Validity of self-reported MVPA was assessed using rank-order correlations between self-report and accelerometry, and classification ability of the questionnaires with Mann–Whitney tests, kappa’s, sensitivity and specificity.

Results
In the adolescents, Spearman’s rank coefficients between self-reported MVPA (days/week) and accelerometry measured MVPA were positive but not significant (r = 0.240; P = 0.104). In the adults, self-reported MVPA (minutes/day) was moderately and significantly correlated with accelerometer-measured MVPA (r = 0.396; P = 0.008). In both groups, there was fair agreement between accelerometry and questionnaire-defined tertiles of MVPA (adolescents κ = 0.267; P = 0.010; adults κ = 0.284; P = 0.008), and measured MVPA was significantly higher in the individuals self-reporting higher MVPA than those reporting lower MVPA.

Conclusions
The PACE+ and GPAQ questionnaires have a degree of validity in adolescent girls and adult females in Namibia, though more suitable for population than individual level measurement.
Effects of soybean meal level on growth performance of 11- to 25-kg nursery pigs12
Authors: Cemin Henrique S , Tokach Mike D , Dritz Steve S , Woodworth Jason C , DeRouchey Joel M , Goodband Robert D 
Published: May 2020

AbstractFour experiments were conducted to determine the effects of increasing soybean meal (SBM) level in diets with or without 25% distillers dried grains with solubles (DDGS) on growth performance of nursery pigs raised in university or commercial facilities. Treatments were arranged in a 2 × 3 factorial with main effects of SBM (27.5%, 32.5%, or 37.5% of the diet) and DDGS (0% or 25% of the diet). A total of 296, 2,502, 4,118, and 711 pigs with initial body weight (BW) of 10.6, 11.7, 12.5, and 12.3 kg were used in Exp. 1, 2, 3, and 4, respectively. There were 10, 16, 13, and 12 replicates per treatment in Exp. 1, 2, 3, and 4, respectively. After weaning, pigs were fed common diets for approximately 21 d. Then, pens of pigs were assigned to treatments in a randomized complete block design with BW as the blocking factor and experimental diets were fed for 21 d. Pigs were weighed and feed disappearance measured to calculate average daily gain (ADG), average daily feed intake (ADFI), gain-to-feed ratio (G:F), and caloric efficiency (CE). Data were analyzed using the GLIMMIX procedure of SAS with block as a random effect and treatment as a fixed effect. Single degree-of-freedom contrasts were constructed to test the linear and quadratic effects of increasing SBM and their interactions with DDGS. Pigs used in all experiments did not undergo major health challenges during the experimental period and due to the low number of mortality and cull events, statistical analysis was not performed on these variables. The average cull rate was 0.7%, 0.5%, 0.2%, and 0%, and the mortality rate was 0.7%, 0.3%, 0.4%, and 0% in Exp. 1–4, respectively. There were interactions (P ≤ 0.039) between SBM and DDGS for G:F and CE in Exp. 2 and for ADG and ADFI in Exp. 3. These were mostly driven by increasing SBM negatively affecting performance in a greater magnitude when diets contained DDGS compared to diets without DDGS. The main effects of DDGS and SBM were more consistently observed across experiments. Pigs fed diets with 25% DDGS had decreased (P ≤ 0.001) ADG and ADFI in all experiments, as well as poorer (P ≤ 0.028) G:F and CE except for Exp. 3. Feeding increasing amounts of SBM generally did not result in any major impact in ADG but consistently improved (linear, P ≤ 0.078) G:F and CE across experiments.
Botulinum Toxin A Treatment for Primary and Secondary Raynaud's Phenomenon in Teenagers
Authors: Quintana Castanedo Lucía , Feito Rodríguez Marta , Nieto Rodríguez Daniel , Maseda Pedrero Rocío , Chiloeches Fernández Clara , de Lucas Laguna Raúl 
Published: May 2020

BACKGROUND
Raynaud's phenomenon (RP) is a clinical syndrome characterized by recurrent episodes of digital vasospasm triggered by exposure to physical and chemical agents or emotional stress. Although many pharmacologic treatments have been tested, there is still no cure or gold standard therapy. Botulinum toxin treatment has been proved to reduce pain and increase arterial blood flow in treated hands of adult patients with RP.

OBJECTIVE
The aim of this study is to evaluate the efficacy of botulinum toxin A on younger than 18-year-old patients with primary and secondary RP.

MATERIALS AND METHODS
A single-center prospective study was performed, including 8 patients aged 14 to 17 years who were clinically diagnosed with primary or secondary RP. BTX was injected into each hand without sedation or anesthetic blockade. The primary outcome was pain reduction after BTX injection. Pain intensity was evaluated at baseline and in the first follow-up. Secondary outcomes included variations in the number and severity of RP episodes after the BTX injection.

RESULTS
All patients stated significant pain reduction and decreased cold sensitivity, except one patient who did not feel any changes. No patients reported any loss of strength on thumb-index finger.

CONCLUSION
BTX injection is a simple, noninvasive, and cost-effective treatment alternative, offering an important nonsurgical therapeutic option for the pediatric population. It could also help optimize the dose of other treatments used in these patients. The most commonly observed positive effect is a reduction in the pain associated with RP attacks. Further studies are needed to confirm these results.
Hypertension in children
Authors: Tran Andrew H. , Urbina Elaine M. 
Published: May 2020

Purpose of review
Hypertension is a common finding in children, and increases the risk for future cardiovascular events. This review focuses on recent advances in pediatric hypertension research including changes in hypertension guidelines, epidemiology, predictors of hypertension, blood pressure (BP) measurement, effects on target organs, and treatment of hypertension.

Recent findings
Changes in the 2017 hypertension guidelines by the American Academy of Pediatrics (AAP) have resulted in increased prevalence of elevated BP and hypertension in the United States, and there is no international consensus on these changes. Despite rising pediatric overweight and obesity in China, hypertension prevalence is stable, suggesting multifactorial effects on childhood BP. Maternal diabetes and exposure to particulate matter are associated with higher childhood BP, and body size in infancy and early childhood is a determinant of adult high BP. Children with elevated BP have evidence of target organ damage with altered retinal vasculature and pulse wave velocity parameters compared to normotensive patients. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may be the best antihypertensive medications for the pediatric population even for African-American patients.

Summary
Research continues to illuminate contributors to pediatric hypertension and demonstrates opportunities for further study on the effects of hypertension and its management in children.
Blood pressure variability at midlife is associated with all-cause, coronary heart disease and stroke long term mortality
Authors: Goldbourt Uri , Grossman Ehud 
Published: May 2020

Objective:
Elevated blood pressure (BP) is associated with cardiovascular mortality. BP variability (BPV) is also associated with cardiovascular mortality. However, most studies evaluated hypertensive patients with a relatively short follow-up. We investigated in male workers the association between BPV and long-term all-cause and specific-cause mortality.

Methods:
Among 10 059 men, aged 40–65, tenured civil servants and municipal employees in Israel, 9398 participants who were examined in 1963, 1965 and 1968 had assessment of diabetic and coronary morbidity status and SBP levels. Participants underwent clinical and biochemical evaluations and BP measured in the recumbent position on the right arm. We conducted analysis for SD-SBP across study visits. Hazard ratios were calculated for 18 years all-cause mortality, coronary heart disease (CHD) and stroke mortality associated with quintile of SD-SBP, with the lowest quintile serving as a reference.

Results:
Multivariate analysis yielded a significant association between SD-SBP and all-cause, CHD and stroke mortality. Age and SBP-adjusted hazard ratios of all-cause mortality was 1.02 [95% confidence interval (CI), 0.90–1.17], 1.06 (95% CI, 0.94–1.20), 1.20 (95% CI, 1.06–1.35) and 1.36 (95% CI, 1.21–1.53) (for quintile 2–5, respectively). The results of CHD and stroke mortality similarly and strongly indicated increasing age-adjusted mortality risk with increasing SD-SBP. Further adjustment for smoking, BMI, diabetes mellitus and coronary heart disease yielded similar results.

Conclusion:
In this cohort of tenured male workers, BPV taken over 5 years was clearly associated with 18-year all-cause, CHD and stroke mortality.
2020 International Society of Hypertension global hypertension practice guidelines
Authors: Unger Thomas , Borghi Claudio , Charchar Fadi , Khan Nadia A. , Poulter Neil R. , Prabhakaran Dorairaj , Ramirez Agustin , Schlaich Markus , Stergiou George S. , Tomaszewski Maciej , Wainford Richard D. , Williams Bryan , Schutte Aletta E. 
Published: May 2020

Document reviewers:
Hind Beheiry (Sudan), Irina Chazova (Russia), Albertino Damasceno (Mozambique), Anna Dominiczak (UK), Anastase Dzudie (Cameroon), Stephen Harrap (Australia), Hiroshi Itoh (Japan), Tazeen Jafar (Singapore), Marc Jaffe (USA), Patricio Jaramillo-Lopez (Colombia), Kazuomi Kario (Japan), Giuseppe Mancia (Italy), Ana Mocumbi (Mozambique), Sanjeevi N.Narasingan (India), Elijah Ogola (Kenya), Srinath Reddy (India), Ernesto Schiffrin (Canada), Ann Soenarta (Indonesia), Rhian Touyz (UK), Yudah Turana (Indonesia), Michael Weber (USA), Paul Whelton (USA), Xin Hua Zhang, (Australia), Yuqing Zhang (China).
Assessment of Eye Lens Dose Reduction When Using Lateral Lead Shields on the Patient’s Head during Neurointerventional Fluoroscopic Procedures and Cone-beam Computed Tomography (CBCT) Scans
Authors: Xiong Zhenyu , Rudin Stephen , Bednarek Daniel R. 
Published: May 2020

Abstract
The purpose of this study was to evaluate the effect of placing small lead shields on the temple region of the skull to reduce radiation dose to the lens of the eye during interventional fluoroscopically-guided procedures and cone-beam computed tomography (CBCT) scans of the head. EGSnrc Monte-Carlo code was used to determine the eye lens dose reduction when using lateral lead shields for single x-ray projections, CBCT scans with different protocols, and interventional neuroradiology procedures with the Zubal computational head phantom. A clinical C-Arm system was used to take radiographic projections and CBCT scans of anthropomorphic head phantoms without and with lead patches, and the images were compared to assess the effect of the shields. For single lateral projections, a 0.1 (0.3)-mm-thick lead patch reduced the dose to the left-eye lens by 40% to 60% (55% to 80%) from 45° to 90° RAO and to the right-eye lens by around 30% (55%) from 70° to 90° RAO. For different CBCT protocols, the reduction of lens dose with a 0.3-mm-thick lead patch ranged from 20% to 53% at 110 kVp. For CBCT scans of the anthropomorphic phantom, the lead patch introduced streak artifacts that were mainly in the orbital regions but were insignificant in the brain region where most neurointerventional activity occurs. The dose to the patient’s eye lens can be reduced considerably by placing small lead shields over the temple region of the head without substantially compromising image quality in neuro-imaging procedures.
Bowman Layer Onlay Graft for Reducing Fluctuation in Visual Acuity After Previous Radial Keratotomy
Authors: Parker Jack S. , Dockery Philip W. , Parker John S. , Dapena Isabel , van Dijk Korine , Melles Gerrit R. J. 
Published: May 2020

Purpose:
To describe the clinical outcome of a first patient undergoing Bowman layer (BL) transplantation with an onlay graft to reduce fluctuation in visual acuity and refractive error after previous radial keratotomy (RK) surgery.

Methods:
In 2018, a 66-year-old woman presented with complaints of long-standing diurnal fluctuation in best-spectacle corrected visual acuity (BSCVA) after RK in 1983. After the removal of host epithelium, a BL graft was positioned onto the host cornea. BSCVA, Scheimpflug-based corneal tomography, and anterior segment optical coherence tomography were evaluated up to 12 months postoperatively.

Results:
The surgery and postoperative course were uneventful. After surgery, the subjective complaints of visual fluctuation were reduced from 10 to 3 on a scale from 1 to 10. BSCVA (20/40; 0.5) did not change from preoperative to postoperative. Corneal tomography showed an overall central corneal steepening of 5.9 diopters. Biomicroscopy, Scheimpflug imaging, and anterior segment optical coherence tomography showed a completely epithelialized and well-integrated graft, with some minor epithelial remnants located in the preexisting keratotomy incisions.

Conclusions:
BL onlay grafting may have the potential to manage patients with subjective complaints of diurnal fluctuation in visual acuity after previous RK.
Difference in thrombotic microangiopathy between concurrently and previously diagnosed systemic lupus erythematosus
Authors: Chen Wen-Chun , Ko Po-Shen , Wang Hao-Yuan , Liu Yao-Chung , Hsiao Liang-Tsai , Gau Jyh-Pyng , Liu Jin-Hwang 
Published: May 2020

Background:
Thrombotic microangiopathy (TMA) syndromes are potentially life-threatening complications and are defined as integrated syndromes of microangiopathic hemolytic anemia, thrombocytopenia, and organ injury. Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect various organs, including the hematopoietic system. SLE can complicate with TMA and can be categorized into two distinct groups by chronological association: TMA occurring as the initial presentation and leading to a diagnosis of SLE concurrently (TMA-cSLE) or TMA developing in patients previously diagnosed as having SLE (TMA-pSLE). We examined the differences in clinical characteristics, treatment responses, and clinical outcomes between these groups.

Methods:
We reviewed data of patients diagnosed as having TMA and SLE at Taipei Veterans General Hospital between 2002 and 2013. We included 29 patients: 8 and 21 in TMA-cSLE and TMA-pSLE groups, respectively. All underwent plasma exchange. Patients’ demographic and clinical characteristics, disease activity, and treatment modality were summarized.

Results:
Overall survival (OS) from SLE or TMA diagnosis was poor for the TMA-cSLE group. Median OS from SLE diagnosis was 2.9 months in the TMA-cSLE group and 103.5 months in the TMA-pSLE group (p < 0.001). Median OS from TMA diagnosis was 2.9 months in the TMA-cSLE group and 10.7 months in the TMA-pSLE group (p = 0.58). Time to TMA remission after treatment appeared longer in the TMA-cSLE group (38.00 vs 10.76 days). Multivariate Cox analysis revealed TMA-cSLE and anti-RNP positivity were independent risk factors for mortality in SLE patients with TMA.

Conclusion:
The occurrence of TMA with SLE is rare, and its vigorous course results in high mortality and morbidity rates. In patients without a history of autoimmune disease, early suspicion of TMA and working-up for SLE under this condition are vital. Early recognition of TMA-cSLE and prompt plasma exchange with upfront immunosuppressive therapies for TMA-cSLE patients or anti-RNP-positive patients may improve their prognosis.
Predictive molecular markers in the era of immunotherapy
Authors: Nagaria Teddy S. , Wang Hua , Wang Huamin 
Published: May 2020

Abstract
Recent development in anticancer therapeutics has been centered on immune checkpoint inhibitors (ICIs). Despite early success of ICIs in several cancer types, majority of cancer patients do not respond to ICI therapy. Therefore, predictive biomarkers are urgently needed to select patients who would likely benefit from ICI therapy. Currently immunohistochemical (IHC) assay for programmed cell death ligand 1 (PD-L1) and microsatellite instability (MSI) testing are the only Food and Drug Administration-approved predictive biomarkers for ICI therapies. Tumor mutation burden (TMB) and tumor infiltrating lymphocytes (TILs) are emerging markers, which may prove to be useful predictive markers for ICIs. The guidelines for MSI testing have been well established. However, rigorous quality controls and systemic standardization for PD-L1 IHC testing and analysis of TMB and TILs, such as sample selection, tissue fixation, assay/platform selection, scoring methods, and clinically meaningful cutoff values etc. are needed to improve their clinical utility as predictive biomarkers for ICI therapy. Studies have suggested that the results of PD-L1 expression in tumor cells from various PD-L1 IHC assays are concordant and may be interchangeable. However, the variations and poor interobserver concordance of PD-L1 expression in immune cells is a major issue to be addressed for the interchangeability of different PD-L1 IHC assays, especially for carcinomas of the gastrointestinal tract. Development of new predictive biomarkers and better understanding the difference in tumor immune microenvironments between ICI-sensitive and ICI-resistant tumors will help to develop more effective strategies for immunotherapy.
64Cu-labeled minibody D2101 visualizes CDH17-positive gastric cancer xenografts with short waiting time
Authors: Fujiwara Kentaro , Akiba Hiroki , Tsuji Atsushi B. , Sudo Hitomi , Sugyo Aya , Nagatsu Kotaro , Zhang Ming-Rong , Iwanari Hiroko , Kusano-Arai Osamu , Kudo Shota , Kikuchi Chika , Tsumoto Kouhei , Momose Toshimitsu , Hamakubo Takao , Higashi Tatsuya 
Published: May 2020

Objective
We previously reported 111In-labeled anti-cadherin17 (CDH17) IgG visualized CDH17-positive gastric cancer xenografts. Unfortunately, a long waiting time was required to obtain high-contrast images due to long blood retention (blood half-life: 26 h). To accelerate blood clearance, we have developed anti-CDH17 minibody (D2101 minibody) and evaluated the pharmacokinetics in gastric cancer mouse models.

Methods
Two different single chain Fvs (scFvs), D2101 mutant and D2111, were developed from each parental IgG. The binding ability to CDH17 and stability in plasma were evaluated. D2101 minibody, constructed based on D2101 mutant scFv, was labeled with 64Cu (64Cu-D2101 minibody), and the in-vitro and in-vivo properties were evaluated by cell ELISA, biodistribution experiments, and PET imaging in mice bearing CDH17-positive AGS and CDH17-negative MKN74 tumors.

Results
D2101 mutant and D2111 scFvs showed similar affinities to CDH17. D2101 mutant scFv was more stable than D2111 scFv in plasma. No loss of binding affinity of the D2101 minibody by chelate conjugation and radiolabeling procedures was observed. The biodistribution of 64Cu-D2101 minibody showed high uptake in AGS tumors and low uptake in MKN74. The blood half-life of 64Cu-D2101 minibody was 6.5 h. Improved blood clearance of 64Cu-D2101 minibody provided high tumor-to-blood ratios compared with the previous results of parental IgG in AGS xenograft mice. PET studies showed consistent results with biodistribution studies.

Conclusions

64Cu-D2101 minibody exhibited higher tumor-to-blood ratios at earlier time points than those of the radiolabeled parental IgG. 64Cu-D2101 minibody has potential as an immunoimaging agent for CDH17-positive tumors.