bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lactate is a Prognostic Factor in Patients Admitted With Suspected ST-Elevation Myocardial Infarction
Authors: Frydland Martin , Møller Jacob Eifer , Wiberg Sebastian , Lindholm Matias Greve , Hansen Rikke , Henriques Jose P.S. , Møller-Helgestad Ole Kristian , Bang Lia Evi , Frikke-Schmidt Ruth , Goetze Jens Peter , Udesen Nanna Louise Junker , Thomsen Jakob Hartvig , Ouweneel Dagmar M. , Obling Laust , Ravn Hanne Berg , Holmvang Lene , Jensen Lisette Okkels , Kjaergaard Jesper , Hassager Christian 
Published: October 2018

ABSTRACT

Aims:
The diagnosis of cardiogenic shock depends on clinical signs of poor perfusion and low blood pressure. Lactate concentration will increase with poor tissue perfusion, and it has prognostic value in cardiogenic shock patients. We sought to assess the prognostic value of lactate concentration in subjects admitted with suspected ST-elevation myocardial infarction (STEMI).

Methods and Results:
In 2,094 (93%) out of 2,247 consecutive suspected STEMI-subjects, lactate concentration was measured on admission. The prognostic value of lactate concentration on 30-day mortality was assessed in addition to clinical signs of peripheral hypoperfusion, systolic blood pressure (sBP), and left ventricular ejection fraction (LVEF) in multivariable models.
Lactate concentration added prognostic information beyond signs of peripheral hypoperfusion, sBP, and LVEF, and was independently associated with 30-day mortality (hazard ratio [95% confidence interval] 1.11 [1.07–1.14], P < 0.0001). Lactate also provided predictive information on 30-day mortality to the combination of signs of peripheral hypoperfusion, sBP, and LVEF (area under the receiver-operating characteristics curve = 0.88 vs. 0.83, P < 0.0001).

Conclusions:
In conclusion, admission lactate concentration in suspected STEMI-subjects contains prognostic information on 30-day mortality when added to variables used in cardiogenic shock-definition. We recommend lactate measurement in STEMI-subjects, especially when signs of compromised hemodynamics are present.
How should we assess patient-reported outcomes in the onco-hematology clinic?
Authors: Cannella Laura , Efficace Fabio , Giesinger Johannes 
Published: October 2018

Purpose of review
The improvement of clinical outcomes in hematologic malignancies has paved the way for a more systematic patient-reported outcomes (PROs) assessment in routine clinical practice. PROs help to narrow the gap between patients’ and healthcare professionals’ view of patient health and treatment success. This review outlines key aspects of planning and performing PRO assessments in daily routine such as the selection of PRO instruments, electronic PRO data collection, and the presentation and interpretation of PRO results.

Recent findings
A substantial body of literature has demonstrated that careful planning, adequate logistics, and elaborate methodology allow to successfully integrate the patients’ experience in routine care. Several examples exist of the clinical benefits of systematically collecting PRO information in daily care of patients with solid tumors. These include improved patient–physician communication, better symptom management, and, in patients with advanced disease, also fewer hospitalizations and prolonged survival. However, sparse evidence based data are available for patients with onco-hematologic diseases.

Summary
Data collected through PRO instruments provide unique information that complements traditional clinical examinations and may help improving patients’ management in clinical practice. Major efforts are now needed to implement PRO instruments in daily practice of patients with hematologic malignancies.
What's next in using CT scans to better understand cachexia?
Authors: Antoun Sami , Rossoni Caroline , Lanoy Emilie 
Published: October 2018

Purpose of review
Cachexia (CAX), a protein metabolism disorder commonly associated with cancer, can be evaluated by computed tomography (CT) scan assessment of skeletal muscle mass (SMM), a parameter associated with patient outcome. This review analyzes current barriers for using CT scans of SMM in routine management for defining prognostic risk groups, and proposes new areas of research to reach a better understanding of CAX mechanisms.

Recent findings
Current research is focused on establishing a robust and relevant CAX staging system to reach a consensual definition. Previous biomarkers of CAX are poorly associated with outcome and do not exhibit clinical benefit. Systemic inflammatory marker, decrease in intake assessments, and/or nonnutritional criteria have been integrated to develop a multidimensional, highly complex CAX signature and CAX staging.

Summary
A standardized definition of sarcopenia is essential, and its value in clinical practice should be evaluated in prospective interventional studies using skeletal muscle assessment. SMM loss may be a key element in defining early protein disorders occurring before weight loss and could be used as a trigger for initiating early nutritional support. Changes in SMM and body composition during follow-up are useful tools for exploring CAX mechanisms in terms of intrinsic factors or tumor evolution.
Rapidly Progressive Dementia in the Outpatient Clinic: More Than Prions
Authors: Day Gregory S. , Musiek Erik S. , Morris John C. 
Published: October 2018

Background:
Published approaches to the evaluation and management of patients with rapidly progressive dementia (RPD) have been largely informed by experience at academic hospitals and national centers specializing in the diagnosis of Creutzfeldt-Jakob disease. Whether these approaches can be applied to patients assessed within lower-acuity outpatient settings is unknown.

Methods:
A total of 96 patients with suspected RPD were assessed within the Washington University School of Medicine (Saint Louis, MO) outpatient memory clinic from February 2006 to February 2016. Consensus etiologic diagnoses were established following independent review of clinical data by 2 dementia specialists.

Results:
In total, 67/90 (70%) patients manifested with faster-than-expected cognitive decline leading to dementia within 2 years of symptom onset. Female sex (42/67, 63%), median patient age (68.3 y; range, 45.4 to 89.6), and years of education (12 y; range, 6 to 14) were consistent with clinic demographics. Atypical presentations of common neurodegenerative dementing illnesses accounted for 90% (60/67) of RPD cases. Older age predicted a higher odds of amnestic Alzheimer disease dementia (OR, 2.1 per decade; 95% CI, 1.1-3.8; P=0.02). Parkinsonism (OR, 6.9; 95% CI, 1.6-30.5; P=0.01) or cortical visual dysfunction (OR, 10.8; 95% CI, 1.7-69.4; P=0.01) predicted higher odds of another neurodegenerative cause of RPD, including sporadic Creutzfeldt-Jakob disease.

Conclusions and Relevance:
The clinical environment influences the prevalence of RPD causes. The clinical evaluation should be adapted to promote detection of common causes of RPD, specific to the practice setting.
Stroke mimics and chameleons
Authors: Moulin Solène , Leys Didier 
Published: October 2018

Purpose of review
A stroke mimic is a situation in which a diagnosis of stroke at admission is not confirmed, and a stroke chameleon is a situation in which a stroke is revealed by clinical symptoms that are not usual in stroke. The objective of this review is to identify the most frequent clinical situations in which stroke mimics and chameleons are encountered and consequences for the patient.

Recent findings
The safety profile of intravenous thrombolysis (IVT) in patients who have stroke mimics is excellent, and intracranial hemorrhages are rare. Modern neuroimaging techniques help identifying most mimics. For stroke chameleons the role of imaging may be less important, especially when the clinical presentation is not suggestive of a brain disorder that request immediate neuroimaging. Education of health providers to identify such situations is crucial.

Summary
Stroke mimics account for up to 25% of admissions for probable strokes. The proportion of patients with stroke mimics decreases with use of MRI at baseline. Mimics cannot always be ruled out in emergency. The problem with mimics is that stroke facilities are not properly used, and patients may receive IVT. However, thrombolysis is usually well tolerated in mimics and we should not spend much time in all patients to improve diagnostic accuracy, knowing that the time lost is harmful in all patients, and will only prevent treating one mimic out of 100 patients. The problem with chameleons is more serious, because patients are not identified, and are not properly treated.
Differential Susceptibility of Rat Retinal Ganglion Cells Following Optic Nerve Crush
Authors: VanderWall Kirstin B. , Lu Bin , Wang Shaomei , Meyer Jason S. 
Published: October 2018

AbstractRetinal ganglion cells (RGCs) are a heterogeneous group of cells, comprised of numerous subpopulations, that work together to send visual information to the brain. In numerous blinding disorders termed optic neuropathies, RGCs are the main cell type affected leading to degeneration of these cells and eventual loss of vision. Previous studies have identified and characterized RGC subtypes in numerous animal systems, with only a handful of studies demonstrating their differential loss in response to disease and injury. Thus, efforts of the current study utilized an optic nerve crush (ONC) model to characterize the loss of RGCs and disease phenotypes associated with this injury. Additionally, the loss of RGC subtypes including direction selective-, alpha-, and ip-RGCs following ONC was explored. Results of this study demonstrated the differential loss of RGC subtypes with a high susceptibility for loss of alpha- and direction selective-RGCs and the preferential survival of ip-RGCs following ONC and allows for the establishment of additional studies focused on mechanisms and loss of these cells in optic neuropathies. Additionally, these results put important emphasis on the development of therapeutics targeted at the loss of specific subtypes as well as cellular replacement following injury and disease.
Deep learning facilitates rapid classification of human and veterinary clinical narratives
Authors: Pineda Arturo Lopez , Bear Don’t Walk Oliver J. , Venkataraman Guhan R. , Zehnder Ashley M. , Ayyar Sandeep , Page Rodney L. , Bustamante Carlos D. , Rivas Manuel A. 
Published: October 2018

ABSTRACTObjectiveCurrently, dedicated tagging staff spend considerable effort assigning clinical codes to patient summaries for public health purposes, and machine-learning automated tagging is bottlenecked by availability of electronic medical records. Veterinary medical records, a largely untapped data source that could benefit both human and non-human patients, could fill the gap.Materials and MethodsIn this retrospective study, we trained long short-term memory (LSTM) recurrent neural networks (RNNs) on 52,722 human and 89,591 veterinary records. We established relevant baselines by training Decision Trees (DT) and Random Forests (RF) on the same data. We finally investigated the effect of merging data across clinical settings and probed model portability.ResultsWe show that the LSTM-RNNs accurately classify veterinary/human text narratives into top-level categories with an average weighted macro F1, score of 0.735/0.675 respectively. The evaluation metric for the LSTM was 7 and 8% higher than that of the DT and RF models respectively. We generally did not find evidence of model portability albeit moderate performance increases in select categories.DiscussionWe see a strong positive correlation between number of training samples and classification performance, which is promising for future efforts. The use of LSTM-RNN models represents a scalable structure that could prove useful in cohort selection, which could in turn better address emerging public health concerns.ConclusionDigitization of human and veterinary health information will continue to be a reality. Our approach is a step forward for these two domains to learn from, and inform, one another.
Evidence for the Scarr-Rowe effect on genetic expressivity in a large US sample
Authors: Woodley of Menie Michael A. , Pallesen Jonatan , Sarraf Matthew A. 
Published: October 2018

ABSTRACTUsing the Continuous Parameter Estimation Method (CPEM), a large genotyped sample of the population of Wisconsin, USA (the Wisconsin Longitudinal Study, N=8,509) is examined for evidence of the Scarr-Rowe effect, an adverse gene x environment (GxE) interaction that reduces the heritability of IQ among those with low socioeconomic status. This method allows the differential expressivity of polygenic scores predictive of both educational attainment and IQ (EA3) on the phenotype of IQ to be operationalized throughout the full range of these variables. Utilizing a parental SES factor-weighted composite as a measure of childhood SES, evidence for the Scarr-Rowe effect was found, i.e. the genetic expressivity of EA3 on IQ increased with increasing parental SES (β=.064, p=3.82×10−9, df=8508). The effect was found for both the male and female samples separately (β(males)=.051, p=.002, df=4062; β(females)=.076, p=1.76×10−7, df=4445) — there were no significant sex differences in the effect magnitudes, however. The effects were furthermore robust to removing outlying values of parental SES.
Dual brain cortical calcium imaging reveals social interaction-specific correlated activity in mice
Authors: Michelson Nicholas J. , Bolaños Federico , Bolaños Luis A. , Balbi Matilde , LeDue Jeffrey M. , Murphy Timothy H. 
Published: October 2018

AbstractWe employ cortical mesoscale calcium-imaging to observe brain activity in two head-fixed mice in a staged social touch-like interaction. Using a rail system, mice are brought together to a distance where macrovibrissae of each mouse make contact. Cortical signals were recorded from both mice simultaneously before, during, and after the social contact period. When the mice were together, we observed bouts of mutual whisking and cross-mouse correlated cortical activity in the vibrissae cortex. This correlated activity was specific to individual interactions as the correlations fell in trial-shuffled mouse pairs. Whisk-related global GCAMP6s signals were greater in cagemate pairs during the together period. The effects of social interaction extend outside of regions associated with mutual touch and had global synchronizing effects on cortical activity. We present an open-source platform to investigate the neurobiology of social interaction by including mechanical drawings, protocols, and software necessary for others to extend this work.
Andaman mangrove sediments: source of nutrients and sink of heavy metals
Authors: Mishra A.K. , Manish K. 
Published: October 2018

AbstractAndaman Islands (AI) of India is a biodiversity hotspot of mangroves but biogeochemical dynamics of AI is less understood. We collected sediment samples of four AI mangrove sites and one site without mangroves for nutrients and trace metal analysis. Samples were collected from each site at the inlet of seawater (Zone A) and the other 500m into the mangrove creek (Zone B). Nutrients (sulphate, ammonium, nitrite and nitrate) levels, organic matter (OM) and carbon content were higher at Zone B of mangrove ecosystem due to the higher OM content from mangrove leaf litter decomposition and microbial degradation. Metal (Pb &Cd) content of zones with and without mangroves were similar and Igeo values indicated moderate contamination of mangrove zones of AI due to lack of anthropogenic pollution. Our results suggest mangrove ecosystems of AI are uncontaminated from heavy metals and are source of nutrients to the oligotrophic coastal ecosystems of Andaman Sea.
Dissociable Cerebellar-Prefrontal Networks Underlying Executive Function: Evidence from the Human Connectome Project
Authors: Orr Joseph M. , Jackson Trevor B. , Imburgio Michael J. , Bernard Jessica A. 
Published: October 2018

AbstractTo date, investigations of executive function (EF) have focused on the prefrontal cortex (PFC), and prominent theories of EF are framed with respect to this brain region. Multiple theories describe a hierarchical functional organization for the lateral PFC. However, recent evidence has indicated that the cerebellum (CB) also plays a role in EF. Posterior CB regions (Crus I & II) show structural and functional connections with the PFC, and CB networks are associated with individual differences in EF in healthy adults. However, it is unclear whether the cerebellum shows a similar functional gradient as does the PFC. Here, we investigated high-resolution resting-state data from 225 participants in the Human Connectome Project. We compared resting-state connectivity from posterior cerebellar ROIs, and examined functional data from several tasks that activate the lateral PFC. Demonstrating preliminary evidence for parallel PFC and CB gradients, Crus I was functionally connected with rostrolateral PFC, Crus II with middle and ventral PFC, and Lobule VI with posterior PFC. Contrary to previous work, the activation of the task thought to activate rostrolateral PFC resembled the connectivity maps of Crus II, not Crus I; similarly, the activation of the task thought to activate middle PFC resembled the connectivity maps of Crus I, not Crus II. Nevertheless, there was evidence for dissociable CB-PFC networks. Further work is necessary to understand the functional role of these networks.
pH Gradient Mitigation in the Leaf Cell Secretory Pathway Alters the Defense Response ofNicotiana benthamianato Agroinfiltration
Authors: Jutras Philippe V. , Sainsbury Frank , Goulet Marie-Claire , Lavoie Pierre-Olivier , Tardif Rachel , Hamel Louis-Philippe , D’Aoust Marc-André , Michaud Dominique 
Published: October 2018

ABSTRACTPartial neutralization of the Golgi lumen pH by ectopic expression of influenza virus M2 proton channel stabilizes acid-labile and protease-susceptible recombinant proteins in the plant cell secretory pathway. Here, we assessed the impact of M2 channel expression on the proteome ofNicotiana benthamianaleaf tissue infiltrated with the bacterial gene vectorAgrobacterium tumefaciens, keeping in mind the key role of pH homeostasis on secreted protein processing and the involvement of protein secretion processes in plant cells upon microbial challenge. The proteomes of leaves agroinfiltrated with an empty vector or with an M2 channel-encoding vector were compared with the proteome of non-infiltrated leaves using a iTRAQ quantitative proteomics procedure. Leaves infiltrated with the empty vector had a low soluble protein content compared to non-infiltrated leaves, associated with a strong decrease of photosynthesis-associated proteins (including Rubisco) and a parallel increase of stress-related secreted proteins (including pathogenesis-related proteins, protease inhibitors and molecular chaperones). M2 expression partly compromised these alterations of the proteome to restore original soluble protein and Rubisco contents, associated with higher levels of translation-associated (ribosomal) proteins and reduced levels of stress-related proteins in the apoplast. Proteome changes in M2-expressing leaves were determined both transcriptionally and post-transcriptionally, to alter the steady-state levels of proteins not only along the secretory pathway but also in other cellular compartments including the chloroplast, the cytoplasm, the nucleus and the mitochondrion. These data illustrate the cell-wide influence of Golgi lumen pH homeostasis on the leaf proteome ofN. benthamianaplants responding to microbial challenge. They underline in practice the relevance of carefully considering the eventual off-target effects of accessory proteins used to modulate specific cellular or metabolic functions in plant protein biofactories.
Common and dissociable contributions of alexithymia and autism to domain-specific interoceptive dysregulations – a dimensional neuroimaging approach
Authors: Li Jialin , Xu Lei , Zheng Xiaoxiao , Fu Meina , Zhou Feng , Xu Xiaolei , Ma Xiaole , Li Keshuang , Kendrick Keith M. , Becker Benjamin 
Published: October 2018

AbstractAlexithymia represents a transdiagnostic marker across psychiatric entities associated with emotional impairments, including autism spectrum disorders (ASD). Accumulating evidence suggests that interoceptive dysfunctions that underpin the core symptomatic emotion recognition and empathy deficits in ASD may be contributed to by high levels of alexithymia rather than autistic symptoms per se. However, previous findings are hampered by generally elevated alexithymia in ASD patients, and thus were not able to differentiate common and distinct contributions across the entire spectrum of variations of autism and alexithymia. Moreover, the multi-factorial nature of the domains affected, such as distinct neural reactivity towards perceiving physical and affective pain, has not been accounted for. Against this background the present fMRI study employed a dimensional trait approach in n = 242 healthy subjects to determine common and distinct associations between both traits and pain empathic responses towards physical and affective pain. Higher levels of alexithymia associated with increased left anterior insula pain empathic reactivity. Disentangling these effects revealed a positive association during perceived physical pain, but a negative one during affective pain. No significant associations with trait autism were found, but an interaction effect between the trait dimensions was observed in the mid-cingulate cortex. Moderation analysis demonstrated that trait autism only impacted mid-cingulate reactivity towards physical pain in high alexithymia subjects, whereas reactivity towards affective pain was specifically associated with trait autism in low alexithymia subjects. Findings confirm previous patient studies suggesting that alexithymia rather than autism per se may drive altered insula pain empathic reactivity. Importantly, the present approach allowed for the first time to demonstrate that the impact of alexithymia on insula reactivity varies as a function of the pain empathic domain and that effects on other core empathy nodes evolve in interaction with trait autism.
Endogenous retroviruses transcriptional modulation after severe infection, trauma and burn
Authors: Tabone Olivier , Mommert Marine , Jourdan Camille , Cerrato Elisabeth , Legrand Matthieu , Lepape Alain , Allaouchiche Bernard , Rimmelé Thomas , Pachot Alexandre , Monneret Guillaume , Venet Fabienne , Mallet François , Textoris Julien 
Published: October 2018

AbstractAlthough human endogenous retroviruses (HERVs) expression is a growing subject of interest, no study focused before on specific endogenous retroviruses loci activation in severely injured patients. Yet, HERV reactivation is observed in immunity compromised settings like some cancers and auto-immune diseases. Our objective was to assess the transcriptional modulation of HERVs in burn, trauma and septic shock patients. We analyzed HERV transcriptome with microarray data from whole blood samples of a burn cohort (n=30), a trauma cohort (n=105) and 2 septic shock cohorts (n=28, n=51), and healthy volunteers (HV, n=60). We described expression of the 337 probesets targeting HERV from U133 plus 2.0 microarray in each dataset and then we compared HERVs transcriptional modulation of patients compared to healthy volunteers. Although all 4 cohorts contained very severe patients, the majority of the 337 HERVs was not expressed (around 74% in mean). Each cohort had differentially expressed probesets in patients compared to HV (from 19 to 46). Strikingly, 5 HERVs were in common in all types of severely injured patients, with 4 being up-modulated in patients. We highlighted co-expressed profiles between HERV and nearby gene as well as autonomous HERV expression. We suggest an inflammatory-specific HERV transcriptional response, and importantly, we introduce that the HERVs close to immunity-related genes might have a role on its expression.