bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors and glucocorticoid usage affecting the prognosis of systemic juvenile idiopathic arthritis
Authors: Paç Kısaarslan Ayşenur , Özdemir Çiçek Sümeyra , Şahin Nihal , Başol Merve , Doğantan Şeyda , Taşkın Sema Nur , Poyrazoğlu Muammer Hakan 
Published: March 2021

AbstractBackgroundThe rate of glucocorticoid (GC) use is significantly higher in systemic juvenile idiopathic arthritis (SJIA) than other juvenile idiopathic arthritis subtypes. There is no consensus on the duration and dosage of GC treatment. We aimed to investigate the risk factors for a polyphasic / persistent disease course and the effect of dose and duration of GC treatment on SJIA prognosis.MethodsForty‐two patients who were diagnosed with SJIA, and for whom the duration of disease was longer than 2 years, were included. Patients were divided into monophasic and others (polyphasic / persistent disease course). Risk factors for polyphasic / persistent disease course, which were clinical and laboratory findings regarding the patients, treatment options, dose, and duration of GCs, were evaluated for the first active disease periods and for all flares in the entire disease course.ResultsOf the 42 SJIA patients, 21 had monophasic, and 21 had polyphasic / persistent disease. Cumulative dosages and durations of glucocorticoid treatment were similar in the two groups at the first flare (odds ratio (OR): 1.032P: 0.671; OR:1,113P: 0.115). Durations of the first active disease period were longer in the polyphasic / persistent group (OR:1.275,P: 0.01). Active disease duration cut‐off values of 1.5 months with sensitivity 85.7%, specificity 52.4% were observed on receiver operating characteristic curve analysis. The presence of hepatosplenomegaly at first flare was detected as an independent risk factor of polyphasic/persistent disease by multivariate analysis included both dosage and duration of a steroid (hazard ratio (HR): 4.129,P: 0.034), (HR: 3.992,P: 0.038). Multivariate recurrent events survival analysis determined ALT levels as a risk factor affecting polyphasic / persistent disease (HR: 0.986,P: 0.037).ConclusionsGlucocorticoid dose and duration did not affect the active disease periods and disease course in SJIA. An active disease period longer than 1.5 months, presentation of hepatosplenomegaly at the initial disease course, and high ALT levels at the recurrences should warn physicians of polyphasic / persistent disease.
Semen analysis of boars under intertropical conditions reveals the relevance of proximal and distal cytoplasm droplets for sperm functional integrity
Authors: Valencia Julian , Alzate Edgar Andrés , Gómez Germán , Yeste Marc , Henao Francisco Javier 
Published: March 2021

AbstractThis work aimed to establish whether the temperature humidity index (THI) under different intertropical zones affects the retention of cytoplasmic droplets (CDs), sperm function and DNA integrity in boars. With this purpose, two separate studies were devised. In the first one, 49 boars from six farms were collected every 45 days (230 ejaculates). THI were measured daily, and sperm parameters were evaluated. Boars were classified into three groups based on the incidence of ejaculates having more than 25% spermatozoa with CDs: persistent (at least three consecutive ejaculates), moderate (less than three ejaculates) and absent (no ejaculate having ≥25% spermatozoa with CDs). Farms were classified based on THI through cluster analysis into two groups. In the second study, 32 liquid‐stored semen samples were classified based on three cluster analysis: low and high incidence of proximal (PCDs), distal (DCDs) CDs and a combination of PCD and DCDs. high THI farms presented significantly (p < .05) higher proportions of boars with moderate and persistent incidence of CD than those with low THI. In study 2, the presence of PCDs was negatively correlated with sperm DNA integrity (r = −0.691; p < .01). However, differences between groups were more apparent when ejaculates were classified based on both PCDs and DCDs than when PCDs or DCDs were considered separately. In conclusion, classification of boars according to the severity and persistence of CDs in boars allows understanding more clearly the dynamics of CD retention and the effects of ambient temperature and relative humidity. Additionally, the joint analysis of both PCDs and DCDs is necessary in routine sperm quality analyses.
Successful denosumab treatment for central giant cell granuloma in a 9‐year‐old child
Authors: Mariz Bruno Augusto Linhares Almeida , Migliorati César Augusto , Alves Fabio de Abreu , Penteado Fabiana de Moraes , Carvalho Neviçolino Pereira , Santos‐Silva Alan Roger , Rocha André Caroli 
Published: March 2021

AbstractBackgroundDenosumab is a nonsurgical treatment option for central giant cell granulomas (CGCG), especially in aggressive lesions.Case reportWe describe a 9‐year‐old girl with an aggressive maxillary CGCG successfully treated with denosumab, avoiding a mutilating surgery after intralesional corticosteroid injections failed, and the lesion continued to rapidly grow. During denosumab treatment, she developed a self‐limiting area of osteonecrosis in the maxillary alveolar bone, which rapidly resolved after antibiotic therapy. Six months after denosumab discontinuation, a maxillary surgical recontour was performed. Two weeks after surgery, the patient presented vomiting, pallor, dehydration, but no fever. Blood tests revealed severe hypercalcemia and acute renal dysfunction. After discarding thyroid, parathyroid, and adrenal alterations, a diagnosis of severe rebound hypercalcemia after denosumab treatment was made. Treatment consisted of hyperhydration, calcium pamidronate, and methylprednisolone, restoring calcium levels to normal.ConclusionAfter 2 years of follow‐up, she remains on orthodontic treatment, with no recurrences or other episodes of hypercalcemia.
Jasmonate induces biosynthesis of anthocyanin and proanthocyanidin in apple by mediating the JAZ1–TRB1–MYB9 complex
Authors: An Jian‐Ping , Xu Rui‐Rui , Liu Xin , Zhang Jiu‐Cheng , Wang Xiao‐Fei , You Chun‐Xiang , Hao Yu‐Jin 
Published: March 2021

SUMMARYJasmonate (JA) induces the biosynthesis of anthocyanin and proanthocyanidin. MdMYB9 is essential for modulating the accumulation of both anthocyanin and proanthocyanidin in apple, but the molecular mechanism for induction of anthocyanin and proanthocyanidin biosynthesis by JA is unclear. In this study, we discovered an apple telomere‐binding protein (MdTRB1) to be the interacting protein of MdMYB9. A series of biological assays showed that MdTRB1 acted as a positive modulator of anthocyanin and proanthocyanidin accumulation, and is dependent on MdMYB9. MdTRB1 interacted with MdMYB9 and enhanced the activation activity of MdMYB9 to its downstream genes. In addition, we found that the JA signaling repressor MdJAZ1 interacted with MdTRB1 and interfered with the interaction between MdTRB1 and MdMYB9, therefore negatively modulating MdTRB1‐promoted biosynthesis of anthocyanin and proanthocyanidin. These results show that the JAZ1–TRB1–MYB9 module dynamically modulates JA‐mediated accumulation of anthocyanin and proanthocyanidin. Taken together, our data further expand the functional study of TRB1 and provide insights for further studies of the modulation of anthocyanin and proanthocyanidin biosynthesis by JA.
Chemoreceptor mechanisms regulating CO2‐induced arousal from sleep
Authors: Abbott Stephen B. G. , Souza George M. P. R. 
Published: March 2021

AbstractArousal from sleep in response to CO2 is a life‐preserving reflex that enhances ventilatory drive and facilitates behavioural adaptations to restore eupnoeic breathing. Recurrent activation of the CO2‐arousal reflex is associated with sleep disruption in obstructive sleep apnoea. In this review we examine the role of chemoreceptors in the carotid bodies, the retrotrapezoid nucleus and serotonergic neurons in the dorsal raphe in the CO2‐arousal reflex. We also provide an overview of the supra‐medullary structures that mediate CO2‐induced arousal. We propose a framework for the CO2‐arousal reflex in which the activity of the chemoreceptors converges in the parabrachial nucleus to trigger cortical arousal.
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Designing a Bioinspired Surface for Improved Wear Resistance and Friction Reduction
Authors: Hoskins Julia K. , Zou Min 
Published: March 2021

Abstract
This study used 2-photon three-dimensional lithographic printing and replica molding to fabricate a micro-texture based on the Ocellated Skink. The fabricated surface texture was studied for friction and wear behavior using linear reciprocating tribological tests with a chrome steel ball counterface under various loading conditions and compared with samples fabricated with the same methods without a surface texture. The texture was found to decrease friction at low loads and provide steady friction under all loading conditions. The textured samples also decreased the average wear track width up to 61%. Wear was reduced on surfaces by the texture through the controlled formation of microcracking, which both reduced the amount of debris built up on samples and effectively reduced the worn area.
PREVENTion of CLots in Orthopaedic Trauma (PREVENT CLOT): a randomised pragmatic trial protocol comparing aspirin versus low-molecular-weight heparin for blood clot prevention in orthopaedic trauma patients
Authors: O"Toole Robert V , Stein Deborah M , Frey Katherine P , O"Hara Nathan N , Scharfstein Daniel O , Slobogean Gerard P , Taylor Tara J , Haac Bryce E , Carlini Anthony R , Manson Theodore T , Sudini Kuladeep , Mullins C Daniel , Wegener Stephen T , Firoozabadi Reza , Haut Elliott R , Bosse Michael J , Seymour Rachel B , Holden Martha B , Gitajn Ida Leah , Goldhaber Samuel Z , Eastman Alexander L , Jurkovich Gregory J , Vallier Heather A , Gary Joshua L , Kleweno Conor P , Cuschieri Joseph , Marvel Debra , Castillo Renan C 
Published: March 2021

IntroductionPatients who sustain orthopaedic trauma are at an increased risk of venous thromboembolism (VTE), including fatal pulmonary embolism (PE). Current guidelines recommend low-molecular-weight heparin (LMWH) for VTE prophylaxis in orthopaedic trauma patients. However, emerging literature in total joint arthroplasty patients suggests the potential clinical benefits of VTE prophylaxis with aspirin. The primary aim of this trial is to compare aspirin with LMWH as a thromboprophylaxis in fracture patients.Methods and analysisPREVENT CLOT is a multicentre, randomised, pragmatic trial that aims to enrol 12 200 adult patients admitted to 1 of 21 participating centres with an operative extremity fracture, or any pelvis or acetabular fracture. The primary outcome is all-cause mortality. We will evaluate non-inferiority by testing whether the intention-to-treat difference in the probability of dying within 90 days of randomisation between aspirin and LMWH is less than our non-inferiority margin of 0.75%. Secondary efficacy outcomes include cause-specific mortality, non-fatal PE and deep vein thrombosis. Safety outcomes include bleeding complications, wound complications and deep surgical site infections.Ethics and disseminationThe PREVENT CLOT trial has been approved by the ethics board at the coordinating centre (Johns Hopkins Bloomberg School of Public Health) and all participating sites. Recruitment began in April 2017 and will continue through 2021. As both study medications are currently in clinical use for VTE prophylaxis for orthopaedic trauma patients, the findings of this trial can be easily adopted into clinical practice. The results of this large, patient-centred pragmatic trial will help guide treatment choices to prevent VTE in fracture patients.Trial registration numberNCT02984384.
UK consultants’ experiences of the decision-making process around referral to intensive care: an interview study
Authors: Heidenreich Kaja , Slowther Anne-Marie , Griffiths Frances , Bremer Anders , Svantesson Mia 
Published: March 2021

ObjectiveThe decision whether to initiate intensive care for the critically ill patient involves ethical questions regarding what is good and right for the patient. It is not clear how referring doctors negotiate these issues in practice. The aim of this study was to describe and understand consultants’ experiences of the decision-making process around referral to intensive care.DesignQualitative interviews were analysed according to a phenomenological hermeneutical method.Setting and participantsConsultant doctors (n=27) from departments regularly referring patients to intensive care in six UK hospitals.ResultsIn the precarious and uncertain situation of critical illness, trust in the decision-making process is needed and can be enhanced through the way in which the process unfolds. When there are no obvious right or wrong answers as to what ought to be done, how the decision is made and how the process unfolds is morally important. Through acknowledging the burdensome doubts in the process, contributing to an emerging, joint understanding of the patient’s situation, and responding to mutual moral duties of the doctors involved, trust in the decision-making process can be enhanced and a shared moral responsibility between the stake holding doctors can be assumed.ConclusionThe findings highlight the importance of trust in the decision-making process and how the relationships between the stakeholding doctors are crucial to support their moral responsibility for the patient. Poor interpersonal relationships can damage trust and negatively impact decisions made on behalf of a critically ill patient. For this reason, active attempts must be made to foster good relationships between doctors. This is not only important to create a positive working environment, but a mechanism to improve patient outcomes.
Defining standards in colorectal optimisation: a Delphi study protocol to achieve international consensus on key standards for colorectal surgery prehabilitation
Authors: Pearson Iona , Blackwell Sue , Fish Rebecca , Daniels Sarah , West Malcolm , Mutrie Nanette , Kelly P , Knight Stephen , Fearnhead Nicola S , Moug Susan 
Published: March 2021

IntroductionPrehabilitation in colorectal surgery is evolving and may minimise postoperative morbidity and mortality. With many different healthcare professionals contributing to the prehabilitation literature, there is significant variation in reported primary endpoints that restricts comparison. In addition, there has been limited work on patient-related outcome measures suggesting that patients with colorectal cancer needs and issues are being overlooked. The Defining Standards in Colorectal Optimisation Study aims to achieve international consensus from all stakeholders on key standards to provide a framework for reporting future prehabilitation research.Methods and analysisA systematic review will identify key standards reported in trials of prehabilitation in colorectal surgery. Standards that are important to patients will be identified by a patient and public involvement (PPI) event. The longlist of standards generated from the systematic review and PPI event will be used to develop a three-round online Delphi process. This will engage all stakeholders (healthcare professionals and patients) both nationally and internationally. The results of the Delphi will be followed by a face-to-face interactive consensus meeting that will define the final standards for prehabilitation for elective colorectal surgery.Ethics and disseminationThe University of Glasgow College of Medical, Veterinary and Life Sciences Ethics Committee has approved this protocol, which is registered as a study (200190120) with the Core Outcome Measures in Effectiveness Trials Initiative. Publication of the standards developed by all stakeholders will increase the potential for comparative research that advances understanding of the clinical application of prehabilitation.PROSPERO registration numberCRD42019120381.
Tumor-infiltrating plasmacytoid dendritic cells are associated with survival in human colon cancer
Authors: Kießler Maximilian , Plesca Ioana , Sommer Ulrich , Wehner Rebekka , Wilczkowski Friederike , Müller Luise , Tunger Antje , Lai Xixi , Rentsch Anke , Peuker Kenneth , Zeissig Sebastian , Seifert Adrian M , Seifert Lena , Weitz Jürgen , Bachmann Michael , Bornhäuser Martin , Aust Daniela , Baretton Gustavo , Schmitz Marc 
Published: March 2021

BackgroundPlasmacytoid dendritic cells (pDCs) play a key role in the induction and maintenance of antitumor immunity. Conversely, they can act as tolerogenic DCs by inhibiting tumor-directed immune responses. Therefore, pDCs may profoundly influence tumor progression. To gain novel insights into the role of pDCs in colon cancer, we investigated the frequency and clinical relevance of pDCs in primary tumor tissues from patients with colon cancer with different clinicopathological characteristics.MethodsImmunohistochemical stainings were performed to explore the frequency of tumor-infiltrating BDCA-2+pDCs in patients with colon cancer. Statistical analyses were conducted to determine an association between the pDC density and clinicopathological characteristics of the patients. Furthermore, we used multiplex immunofluorescence stainings to evaluate the localization and phenotype of pDCs in stroma and tertiary lymphoid structures (TLS) of colon cancer tissues.ResultsAn increased density of infiltrating pDCs was associated with lower Union for International Cancer Control (UICC) stages. Furthermore, a higher pDC frequency was significantly correlated with increased progression-free and overall survival of patients with colon cancer. Moreover, a lower number of coloncancer-infiltrating pDCs was significantly and independently linked to worse prognosis. In addition, we found that a proportion of pDCs shows a nuclear expression of the transcription factor interferon regulatory factor 7 (IRF7), which is characteristic for an activated phenotype. In various tumor stroma regions, IRF7+pDCs were located in the neighborhood of granzyme B-expressing CD8+T cells. Moreover, pDCs were identified as a novel component of the T cell zone of colon cancer-associated TLS, which are major regulators of adaptive antitumor immunity. A proportion of TLS-associated pDCs displayed a nuclear IRF7 expression and was preferentially located close to CD4+T cells.ConclusionsThese results indicate that higher densities of tumor-infiltrating pDCs are associated with prolonged survival of patients with colon cancer. Moreover, colon cancer-infiltrating pDCs may represent a novel prognostic factor. The colocalization of activated pDCs and T cells in tumor stroma and within TLS may contribute to the correlation between higher pDC densities and better prognosis. In addition, our findings may have implications for the design of novel immunotherapeutic strategies that are based on targeting colon cancer-infiltrating pDCs.
Cardiac-autonomic and hemodynamic responses to a hypertonic, sugar-sweetened sports beverage in physically active men
Authors: Christiani Mark , Grosicki Gregory J. , Flatt Andrew A. 
Published: March 2021

Hydration practices may confound heart rate variability (HRV) measurements when collected in the pre-training period. We aimed to determine the effects of ingesting a hypertonic, sugar-sweetened sports beverage on HRV and hemodynamic parameters in physically active young men. Fifteen subjects consumed 591 mL of Gatorade (6% carbohydrate, ∼330 mOsmol/kg), 591 mL water, or 10 mL water (control) in random order on separate days following overnight fasting. HRV and hemodynamics were evaluated in 5-min windows immediately before (T1) and 5–10 min (T2), 25–30 min (T3), 40–45 min (T4), and 55–60 min (T5) post-drinking. Root-mean square of successive differences and the standard deviation of normal RR intervals increased post-water intake at all time-points relative to T1 (P < 0.05). No increases were observed post-Gatorade intake, though small effect sizes were noted at T2 and T3 (P > 0.05, ES = 0.27–0.32). Systemic vascular resistance increased at T2 post-Gatorade intake and at T2 and T3 post-water intake (P < 0.05). No interactions were observed for blood pressure measures, stroke volume, or cardiac output. Gatorade does not evoke cardiovascular adjustments to the same magnitude as water. Practitioners should wait at least 45 min to record HRV post-Gatorade intake and >60 min post-water intake. Novelty: Equal volumes of cold water and Gatorade produce inequivalent cardiac-autonomic and hemodynamic responses. HRV responses of greater amplitude and duration were observed following intake of water versus Gatorade. Failure to account for recent fluid intake may result in misinterpretation of autonomic status.
Fracture Risks in Patients Treated With Different Oral Anticoagulants: A Systematic Review and Meta‐Analysis
Authors: Huang Huei‐Kai , Peng Carol Chiung‐Hui , Lin Shu‐Man , Munir Kashif M. , Chang Rachel Huai‐En , Wu Brian Bo‐Chang , Liu Peter Pin‐Sung , Hsu Jin‐Yi , Loh Ching‐Hui , Tu Yu‐Kang 
Published: March 2021

Background
Evidence on the differences in fracture risk associated with non‐vitamin K antagonist oral anticoagulants (NOAC) and warfarin is inconsistent and inconclusive. We conducted a systematic review and meta‐analysis to assess the fracture risk associated with NOACs and warfarin.

Methods and Results

We searched PubMed, Embase, Cochrane Library, Scopus, Web of Science, and ClinicalTrials.gov from inception until May 19, 2020. We included studies presenting measurements (regardless of primary/secondary/tertiary/safety outcomes) for any fracture in both NOAC and warfarin users. Two or more reviewers independently screened relevant articles, extracted data, and performed quality assessments. Data were retrieved to synthesize the pooled relative risk (RR) of fractures associated with NOACs versus warfarin. Random‐effects models were used for data synthesis. We included 29 studies (5 cohort studies and 24 randomized controlled trials) with 388 209 patients. Patients treated with NOACs had lower risks of fracture than those treated with warfarin (pooled RR, 0.84; 95% CI, 0.77–0.91;
P
<0.001) with low heterogeneity (
I
2
=38.9%). NOACs were also associated with significantly lower risks of hip fracture than warfarin (pooled RR, 0.89; 95% CI, 0.81–0.98;
P
=0.023). A nonsignificant trend of lower vertebral fracture risk in NOAC users was also observed (pooled RR, 0.74; 95% CI, 0.54–1.01;
P
=0.061). Subgroup analyses for individual NOACs demonstrated that dabigatran, rivaroxaban, and apixaban were significantly associated with lower fracture risks. Furthermore, the data synthesis results from randomized controlled trials and real‐world cohort studies were quite consistent, indicating the robustness of our findings.

Conclusions
Compared with warfarin, NOACs are associated with lower risks of bone fracture.