bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case study: Concurrent palliative care based on SENS‐structure for patients with advanced prostate cancer
Authors: Fliedner Monica , Willener Rita 
Published: April 2020

AbstractOn an acute urological ward, it is challenging to meet all needs of patients with life‐limiting progressive cancer disease in complex situations. The focus shifts from curation to the holistic palliative approach aiming at patients' and their families' needs and planning care in advance with an interprofessional attitude. Based on a patient with castration refractory prostate carcinoma with multiple metastasis, the aim of this case study is to describe the palliative care approach, using the established so‐called SENS‐structure (Symptoms, End‐of‐life decisions, Network and Support of the carer) in which the bio‐, psycho‐, social and spiritual needs are addressed. We report on our practice experience using the SENS‐structure, in which the team discusses palliative care interventions with patients and their family: management of (potential) symptoms and self‐supporting strategies, expectations and end‐of‐life decisions including advance care planning, evaluation of patients' social and professional network and setting up additional support. The palliative care team provides advice to the treating team on future treatment strategies and care activities. The complex situation of a patient with metastatic prostate cancer and his personal sufferings illustrate the interprofessional use and person‐centred focus of the SENS‐structure. Important in this phase is—next to the family carers—the involvement of all professions and disciplines to break down the complexity of the situation into manageable proportions. Early involvement of palliative care for patients with advanced cancer is highly recommended. The SENS‐structure helps to prioritize and include the personalized approach which is strongly supported by nurses.
Toward a research agenda on climate‐related migration
Authors: Andrews Clinton J. 
Published: April 2020

AbstractClimate change is one of the many stressors to which humans must adapt. Environmental concerns usually combine with other factors such as poverty, ethnic strife, or poor governance to become serious enough problems to warrant strong action. Migration away from affected areas is one time‐tested response. This article proposes a migration‐oriented research agenda for industrial ecology based on an examination of migration flows and ways of thinking about them, variations across contexts, implications for infrastructure and housing, the framing of climate‐related migration, and short‐term and longer‐term fluctuations in the demand for shelter and services in high and low income countries. Elements of this agenda include understanding decentralized migration decisions, developing socio‐ecologically based solutions for migration‐related problems, and embracing an urban focus that makes infrastructures more adaptable and makes cities more resilient and equitable.
Ontogenetic changes of tissue compartmentalization and bone type distribution in the humerus of Soay sheep
Authors: Becker Margarethe , Witzel Carsten , Kierdorf Uwe , Frölich Kai , Kierdorf Horst 
Published: April 2020

AbstractWe studied ontogenetic changes of histomorphological features and bone type distribution in the humeral midshaft region of Soay sheep from three postnatal age classes (13, 25, and 33 months). Our study demonstrated a marked change of bone type distribution in the humeri with age. In the cortical midshaft region of 13‐month‐old individuals, periosteal fibrolamellar bone was the dominating bone type. This indicates a rapid bone growth during the first year of life, which was only interrupted by a seasonal growth arrest in the animals’ first winter. In individuals from the two older age classes, periosteal lamellar‐zonal bone and intermediate fibrolamellar bone had been formed at the periosteal surface, and endosteal lamellar‐zonal bone at the endosteal surface. These bone types are indicative of a reduced bone growth rate. A marked reduction in radial growth was already recorded in the 25‐month‐old individuals. Distribution and extent of secondary bone showed a marked bilateral symmetry in the humeri of individual sheep. The presence of secondary bone was largely restricted to the anterior (cranial) and the medial cortical areas. This characteristic distribution of remodeling activity within the humeral cortex of sheep is consistent with the view that remodeling activity is largely caused by compressive stress. Our study further demonstrated the presence of a considerable cortical drift in the sheep humeri over the study period, with endosteal resorption occurring predominantly in the posterior (caudal) quadrant and formation of a prominent endosteal lamellar pocket in the anterior (cranial) and medial cortical quadrants.
Segmental congenital hemangiomas: Three cases of a rare entity
Authors: Smith Robert J. , Metry Denise , Deardorff Matthew A. , Heller Elizabeth , Grand Katheryn L. , Iacobas Ionela , Rubin Adam I. , Phung Thuy L. , Lopez‐Terrada Dolores , Steicher Jenna , Cahill Anne Marie , Low David , Treat James R. 
Published: April 2020

AbstractCongenital hemangiomas (CHs) are unusual and diverse tumors distinguished from infantile hemangiomas by being largely developed at birth and glucose transporter (GLUT1)‐negative. We describe three infants who presented in utero or at birth with segmentally distributed vascular tumors that were GLUT1‐negative, had histology compatible with congenital hemangioma, and exhibited spontaneous clinical involution. One of the three patients had high‐output cardiac failure and was found to have a mutation in GNAQ (c.626A>c, p.Gln209Pro); another had high‐output cardiac failure, heterotaxy, and transient hematologic abnormalities and was found to have a mutation in GNA11 (c.626_627delinsCC, p.Gln209Pro). In addition to describing a novel segmental pattern of congenital hemangioma variant with genetic correlations, these cases illustrate the utility of targeted genetic testing to elucidate the exact mutation and thus classification of vascular tumors.
Ex vivo comparison of leakage pressures and leakage location with a novel technique for creation of functional side‐to‐side canine small intestinal anastomoses
Authors: Chu Kyle L. , Duffy Daniel J. , Vieson Miranda D. , Moore George E. 
Published: April 2020

AbstractObjectiveTo determine the ability of functional side‐to‐side small intestinal anastomoses (FSS‐SIA) created with an electrothermal bipolar vessel sealing (EBVS) device to resist leakage.Study designExperimental, ex vivo.Sample populationJejunal segments (n = 130) from 10 healthy canine cadavers.MethodsFour types of anastomoses were created (two segments/construct and 15 constructs/group): EBVS (group A), EBVS + transverse stapling (group B), stapled (group C), and EBVS + suture augmentation (group D). Initial leakage pressure (ILP), initial leakage location (ILL), and maximal intraluminal pressure were compared between groups, and five group A constructs were analyzed histologically.ResultsInitial leakage pressure was greater in group D than in groups A, B, and C (P < .011). There was a difference in ILL among groups (P = .003). Leakage occurred at the side‐to‐side intestinal anastomosis fusion line in 13 of 15 (87%) constructs for groups A and B and in nine of 15 (60%) constructs for group D. Maximal intraluminal pressure was greater in group C than in groups A, B, and D (P < .004). Histological examination was consistent with collagenous fusion without cavitation defects.ConclusionFunctional side‐to‐side small intestinal anastomosis was consistently achieved with an EBVS device. Augmentation of EBVS anastomoses with simple interrupted sutures along the anastomotic fusion line increased ILP compared with stapled anastomoses.Clinical significanceDespite the success and feasibility of creating an FSS‐SIA with an EBVS device, additional in vivo studies are required to determine the effectiveness of intestinal fusion prior to clinical implementation.
Consumption of fat-free dairy products is not associated with a lower risk of maternofetal adverse events
Authors: Assaf-Balut Carla , Garcia de la Torre Nuria , Bordiu Elena , del Valle Laura , Valerio Johanna , Jimenez Inés , Duran Alejandra , Fuentes Manuel , Herraiz Miguel Angel , Izquierdo Nuria , Runkle Isabelle , de Miguel Paz , Familiar Cristina , Montañez Maria Carmen , Barabash Ana , Melero Veronica , Cuesta Martín , Rubio Miguel , Calle-Pascual Alfonso Luis 
Published: April 2020

BackgroundThe consumption of dairy products in pregnancy is widely extended. However, whether the consumption of low or high fat dairy produce is more beneficial for maternofetal health has yet to be established.Research design and methodsThis prospective cohort study evaluated the effect of consumption of dairy products during pregnancy on the frequency of gestational diabetes mellitus (GDM) and a composite of adverse maternofetal outcomes (CMFO). Pregnant women receiving obstetric care between 2014 and 2017 were eligible. Those who consumed ≥3 servings/day of dairy products at 24–28 gestational weeks (GWs) were included and analyzed (n=2004). The population was stratified into three groups according to intake of fat-free dairy products—skimmed milk and fat-free yoghurt and cheese—(days/week): infrequent (1–2), average (3–6) and regular (7). Logistic regression analysis compared ORs (95% CI) for GDM and CMFO between the three groups (where the group of reference was the ‘infrequent’ intake group).ResultsAfter adjusting for confounding factors, no significant associations were found between the degree of consumption of fat-free dairy products and the risk of GDM and a CMFO. Moreover, when categorized by the degree of adherence to the Mediterranean diet (above or below the median score), associations were found between the ‘regular’ intake group and an increased risk of having a CMFO in women with a high adherence to the Mediterranean diet (OR: 1.50; 95% CI: 1.01 to 2.22; p<0.05). Weight gain during pregnancy did not differ among groups.ConclusionsThe consumption of fat-free dairy products during pregnancy does not seem to be beneficial for maternofetal health.
Changes in metabolic complications in patients with alcoholic fatty liver disease monitored over two decades: NAGALA study
Authors: Hamaguchi Masahide , Obora Akihiro , Okamura Takuro , Hashimoto Yoshitaka , Kojima Takao , Fukui Michiaki 
Published: April 2020

ObjectiveThe social conditions are changing in the world, which may contribute to the change in lifestyle, including alcohol consumption and dietary intake; however, changes in metabolic complications in patients with alcoholic fatty liver disease (AFLD) have never been reported. Therefore, here we compare the metabolic complications in current AFLD with those of two decades ago.MethodsWe performed this cross-sectional study in a Japanese health check-up centre. Consecutive participants who visited the facilities between June 1994 and December 1997 or between January 2014 and December 2017 were enrolled. A total of 7499 participants (4804 men, 2695 women) in the past cohort and 20 029 participants (11 676 men, 8353 women) in the current cohort were entered to this study.ResultsThe prevalence of drinkers in the current cohort was significantly lower (4.7%) than that in the past cohort in men (5.9%, p<0.001) but significantly higher in women (1.9% in the current vs 1.1% in the past, p<0.001). The prevalence of fatty liver in drinkers has increased in men (22.3% in the past cohort, 36.6% in the current cohort; p<0.001) but not in women (13.3% in the past cohort, 14.7% in the current cohort; p=1.0), while the prevalence of all fatty liver has increased in men and women (men: 24.0% in the past cohort, 36.2% in the current cohort, p<0.001; women: 9.3% in the past cohort, 12.8% in the current cohort, p<0.001). Regarding metabolic abnormalities, the prevalence of hyperglycaemia increased from 25.4% to 43.0% in men with AFLD (p<0.001) and from 25.1% to 39.1% in women with AFLD (p=1.0).ConclusionsAFLD currently tends to be accompanied by hyperglycaemia. The prevalence of fatty liver in drinkers increased in men, although alcoholic consumptions did not increase. We should pay attention to fatty liver combined with hyperglycaemia for individuals who consume alcohol today.
Modifiable risk factors predict incident atrial fibrillation and heart failure
Authors: Wong Jorge A , Conen David , Healey Jeff S , Johnson Linda S B 
Published: April 2020

ObjectiveHeart failure (HF) frequently complicates atrial fibrillation (AF) and significantly increases mortality risk. Limited data exist on the modifiable risk factors associated with development of HF in AF patients.MethodsWe examined two large, prospective, population-based cohorts without prior AF or HF at baseline: Malmö Preventive Project (MPP, n=32 625) and Malmö Diet and Cancer Study (MDCS, n=27 695). Using Lunn-McNeil competing risks, multivariable Cox models were constructed to determine hazard ratios (HR) and 95% confidence intervals (CI) of risk factors for incident HF with AF, and AF alone.ResultsMean follow-up in MPP and MDCS was 27.6±8.4 and 17.7±5.3 years. In MPP, body mass index (HR 1.11, 95% CI 1.09 to 1.13 vs HR 1.05, 95% CI 1.04 to 1.06 per kg/m2), systolic blood pressure (HR 1.20, 95% CI 1.24 to 1.26 vs HR 1.08, 95% CI 1.06 to 1.10 per 10 mm Hg) and current cigarette smoking (HR 1.73, 95% CI 1.54 to 1.95 vs HR 1.23, 95% CI 1.15 to 1.32) had stronger associations with incident AF with HF compared with AF alone (all p for difference <0.0001). Similar results were observed in MDCS (all p for difference <0.009). These three risk factors and diabetes accounted for 51.8% and 54.1% of the population attributable risk (PAR) for AF with HF in MPP and MDCS, respectively, compared with 20.1% and 27.0% for AF alone.ConclusionsObesity, hypertension and active smoking preferentially associated with AF with HF, compared with AF alone, and accounted for >50% of the PAR. Randomised trials are needed to assess whether risk factor modification can reduce the incidence of AF with HF and reduce mortality.
Coronary artery ectasia: prevalence, angiographic characteristics and clinical outcome
Authors: Willner Nadav Asher , Ehrenberg Scott , Musallam Anees , Roguin Ariel 
Published: April 2020

ObjectiveDetermine coronary artery ectasia (CAE) prevalence and clinical outcome in a large cohort of patients underwent coronary angiography.MethodsIn an 11-year period, between 2006 and 2017, 20 455 coronary angiography studies were performed at a large university centre. Patients diagnosed with CAE based on procedure report were included in the final analysis.ResultsCAE was diagnosed in 174 out of 20 455 studies (0.85% per total angiograms, 161 patients). Patients’ average age was 59.6±11.2 years old with male predominance (90.7%). Diffuse ectasia morphology was most common (78.9%), followed by fusiform (16.1%) and saccular (5%). Mixed CAE and atherosclerotic heart disease (ASHD) was present in 75.2% of the patients and isolated CAE in 24.8%. The most common coronary artery involved was the right coronary artery (RCA) (79%). Following index angiography, all the isolated CAE group was managed conservatively, while 67% of the mixed CAE-ASHD group underwent coronary intervention. In an average follow-up of 6±3.6 years, adverse clinical event (a composite endpoint of any death, cerebrovascular accident, myocardial infarction, thromboembolic event, bleeding and stent thrombosis) occurred in 48.8% of the mixed CAE-ASHD group compared with 25% in the isolated CAE group (p<0.05).ConclusionsCAE is a rare phenomenon. The most common artery involved was the RCA, and the diffused type of CAE was the most frequent. Most patients with CAE have also concomitant ASHD, and those patients have higher mortality and complications rate, compared with isolated CAE disease.
CT imaging prior to transcatheter aortic valve implantation in the UK
Authors: Harries Iwan , Weir-McCall Jonathan R , Williams Michelle C , Shambrook James , Roditi Giles , Bull Russel , Morgan-Hughes Gareth J , Nicol Edward D , Moss Alastair J 
Published: April 2020

ObjectiveThis cross-sectional observational study sought to describe variations in CT in the context of transcatheter aortic valve implantation (CT-TAVI) as currently performed in the UK.Methods408 members of the British Society of Cardiovascular Imaging were invited to complete a 27-item online CT-TAVI survey.Results47 responses (12% response rate) were received from 40 cardiac centres, 23 (58%) of which performed TAVI on-site (TAVI centres). Only six respondents (13%) performed high-volume activity (>200 scans per year) compared with 13 (28%) performing moderate (100–200 scans per year) and 27 (59%) performing low (0–99 scans per year) volume activity. Acquisition protocols varied (41% retrospective, 12% prospective with wide padding, 47% prospective with narrow padding), as did the phase of reporting (45% systolic, 37% diastolic, 11% both, 6% unreported). Median dose length product was 675 mGy.cm (IQR 477–954 mGy.cm). Compared with non-TAVI centres, TAVI centres were more likely to report minimum iliofemoral luminal diameter (n=25, 96% vs n=7, 58%, p=0.003) and optimal tube angulation for intervention (n=12, 46% vs n=1, 8%, p=0.02).ConclusionsThis national survey formally describes current CT-TAVI practice in the UK. High-volume activity was only present at one in seven cardiac CT centres. There is wide variation in scan acquisition, scan reporting and radiation dose exposure in cardiac CT centres.
Polypharmacy and health outcomes in atrial fibrillation: a systematic review and meta-analysis
Authors: Gallagher Celine , Nyfort-Hansen Karin , Rowett Debra , Wong Christopher X , Middeldorp Melissa E , Mahajan Rajiv , Lau Dennis H , Sanders Prashanthan , Hendriks Jeroen M 
Published: April 2020

ObjectiveTo undertake a systematic review and meta-analysis examining the impact of polypharmacy on health outcomes in atrial fibrillation (AF).Data sourcesPubMed and Embase databases were searched from inception until 31 July 2019. Studies including post hoc analyses of prospective randomised controlled trials or observational design that examined the impact of polypharmacy on clinically significant outcomes in AF including mortality, hospitalisations, stroke, bleeding, falls and quality of life were eligible for inclusion.ResultsA total of six studies were identified from the systematic review, with three studies reporting on common outcomes and used for a meta-analysis. The total study population from the three studies was 33 602 and 37.2% were female. Moderate and severe polypharmacy, defined as 5–9 medicines and >9 medicines, was observed in 42.7% and 20.7% of patients respectively, and was associated with a significant increase in all-cause mortality (Hazard ratio [HR] 1.36, 95% CI 1.20 to 1.54, p<0.001; HR 1.84, 95% CI 1.40 to 2.41, p<0.001, respectively), major bleeding (HR 1.32, 95% CI 1.14 to 1.52, p<0.001; HR 1.68, 95% CI 1.35 to 2.09, p<0.001, respectively) and clinically relevant non-major bleeding (HR 1.12, 95% CI 1.03 to 1.22, p<0.01; HR 1.48, 95% CI 1.33 to 1.64, p<0.01, respectively). There was no statistically significant association between polypharmacy and stroke or systemic embolism or intracranial bleeding. Among other examined outcomes, polypharmacy was associated with cardiovascular death, hospitalisation, reduced quality of life and poorer physical function.ConclusionsPolypharmacy is highly prevalent in the AF population and is associated with numerous adverse outcomes.PROSPERO registration numberCRD42018105298.
“When All Seems Lost”: The Ultralong Estrogen Priming (ULEP) Cycle Offers Good Pregnancy Outcomes in Poor Responder Patients
Authors: Lahoud Robert 
Published: April 2020

Background: Treating patients with a history of poor ovarian response (POR) presents many challenges for the clinician. Poor in vitro fertilization (IVF) outcomes are a common end result. The aim of this article is to provide a detailed description of an ultralong estrogen priming (ULEP) cycle in the treatment of patients with a history of POR and to compare the outcomes to matched controls which were treated with other IVF protocols. Methods: In a retrospective study, 50 patients who meet the Bologna criteria for POR were treated with 50 ULEP cycles. The results of these cycles were compared to 50 matched controls, who were treated with other IVF protocols. Results: Patients who underwent the ULEP cycles required 3.2 more days of controlled ovarian hyperstimulation (COH) and required an extra 579 IU of follicle-stimulating hormone (FSH). The ongoing pregnancy rates per transfer were significantly greater in the ULEP group (35.1% vs. 9.1%, OR 5.4, 95% CI 1.4-21.2, p = 0.005) and per cycle started (26% vs. 6%, OR 5.5, 95% CI 1.5-20.8, p = 0.003). Conclusions: Even though the ULEP cycle is long and demanding for the patients, the outcomes suggest that this treatment regime offers a viable alternative in patients with a history of POR.
A domain-specific language for exploratory data visualization
Authors: Smeltzer Karl , Erwig Martin 
Published: April 2020

With an ever-growing amount of collected data, the importance of visualization as an analysis component is growing in concert. The creation of good visualizations often doesn't happen in one step but is rather an iterative and exploratory process. However, this process is currently not well supported in most of the available visualization tools and systems. Visualization authors are forced to commit prematurely to particular design aspects of their creations, and when exploring potential variant visualizations, they are forced to adopt ad hoc techniques such as copying code snippets or keeping a collection of separate files.
We propose variational visualizations as a model supporting open-ended exploration of the design space of information visualization. Together with that model, we present a prototype implementation in the form of a domain-specific language embedded in Purescript.
Verteporfin Inhibits PD-L1 through Autophagy and the STAT1–IRF1–TRIM28 Signaling Axis, Exerting Antitumor Efficacy
Authors: Liang Jiyong , Wang Lulu , Wang Chao , Shen Jianfeng , Su Bojin , Marisetty Anantha L. , Fang Dexing , Kassab Cynthia , Jeong Kang Jin , Zhao Wei , Lu Yiling , Jain Abhinav K. , Zhou Zhicheng , Liang Han , Sun Shao-Cong , Lu Changming , Xu Zhi-Xiang , Yu Qinghua , Shao Shan , Chen XiaoHua , Gao Meng , Claret Francois X. , Ding Zhiyong , Chen Jian , Chen Pingsheng , Barton Michelle C. , Peng Guang , Mills Gordon B. , Heimberger Amy B. 
Published: April 2020

Abstract
Programmed cell death 1 ligand 1 (PD-L1) is a key driver of tumor-mediated immune suppression, and targeting it with antibodies can induce therapeutic responses. Given the costs and associated toxicity of PD-L1 blockade, alternative therapeutic strategies are needed. Using reverse-phase protein arrays to assess drugs in use or likely to enter trials, we performed a candidate drug screen for inhibitors of PD-L1 expression and identified verteporfin as a possible small-molecule inhibitor. Verteporfin suppressed basal and IFN-induced PD-L1 expression in vitro and in vivo through Golgi-related autophagy and disruption of the STAT1–IRF1–TRIM28 signaling cascade, but did not affect the proinflammatory CIITA-MHC II cascade. Within the tumor microenvironment, verteporfin inhibited PD-L1 expression, which associated with enhanced T-lymphocyte infiltration. Inhibition of chromatin-associated enzyme PARP1 induced PD-L1 expression in high endothelial venules (HEV) in tumors and, when combined with verteporfin, enhanced therapeutic efficacy. Thus, verteporfin effectively targets PD-L1 through transcriptional and posttranslational mechanisms, representing an alternative therapeutic strategy for targeting PD-L1.