bluuebunny/crossref_metadata_2025_split huggingface dataset:
56-year-old lady with transaortic gradient
Authors: Spina Roberto , Iyer Arjun , Jansz Paul 
Published: April 2018

Clinical introductionA 56-year-old lady with a background of hypertension was admitted to our institution with acute pulmonary oedema. She reported gradual and increasingly severe dyspnoea on exertion over the preceding 12 months and, prior to presentation, her exercise tolerance was restricted to one flight of stairs. On transthoracic echocardiography during the index admission, left ventricular size and systolic function were normal, and peak and mean transaortic gradients were 67 mm Hg and 33 mm Hg, respectively, with a peak velocity of 3.9 m/s. No aortic incompetence or other significant valvular abnormality was noted. A transoesophageal echocardiogram was performed. Figure 1 depicts the mid-oesophageal parasternal long-axis view. What is the explanation behind the significant transaortic gradient?Figure 1Transoesophageal echocardiogram, mid-oesophageal long-axis view at 135 degrees.QuestionWhat is the explanation behind the significant transaortic gradient?Ventricular septal defect Supravalvular aortic stenosisAortic valvular stenosisSubaortic membraneHypertrophic obstructive cardiomyopathy
Long-term effect of low frequency stimulation of STN on dysphagia, freezing of gait and other motor symptoms in PD
Authors: Xie Tao , Bloom Lisa , Padmanaban Mahesh , Bertacchi Breanna , Kang Wenjun , MacCracken Ellen , Dachman Abraham , Vigil Julie , Satzer David , Zadikoff Cindy , Markopoulou Katerina , Warnke Peter , Kang Un Jung 
Published: April 2018

ObjectiveTo evaluate the long-term effect of 60 Hz stimulation of the subthalamic nucleus (STN) on dysphagia, freezing of gait (FOG) and other motor symptoms in patients with Parkinson’s disease (PD) who have FOG at the usual 130 Hz stimulation.MethodsThis is a prospective, sequence randomised, crossover, double-blind study. PD patients with medication refractory FOG at 130 Hz stimulation of the STN were randomised to the sequences of 130 Hz, 60 Hz or deep brain stimulation off to assess swallowing function (videofluoroscopic evaluation and swallowing questionnaire), FOG severity (stand–walk–sit test and FOG questionnaire) and motor function (Unified PD Rating Scale, Part III motor examination (UPDRS-III)) at initial visit (V1) and follow-up visit (V2, after being on 60 Hz stimulation for an average of 14.5 months), in their usual medications on state. The frequency of aspiration events, perceived swallowing difficulty and FOG severity at 60 Hz compared with 130 Hz stimulation at V2, and their corresponding changes at V2 compared with V1 at 60 Hz were set as primary outcomes, with similar comparisons in UPDRS-III and its subscores as secondary outcomes.ResultsAll 11 enrolled participants completed V1 and 10 completed V2. We found the benefits of 60 Hz stimulation compared with 130 Hz in reducing aspiration frequency, perceived swallowing difficulty, FOG severity, bradykinesia and overall axial and motor symptoms at V1 and persistent benefits on all of them except dysphagia at V2, with overall decreasing efficacy when comparing V2 to V1.ConclusionsThe 60 Hz stimulation, when compared with 130 Hz, has long-term benefits on reducing FOG, bradykinesia and overall axial and motor symptoms except dysphagia, although the overall benefits decrease with long-term use.Clinical trial registrationNCT02549859; Pre-results.
Pyridostigmine bromide intoxication in two domestic cats
Authors: Santifort Koen Maurits , van Luin Matthijs , Mandigers Paul 
Published: April 2018

A one‐year‐old female neutered cat died soon after presentation with severe signs of a cholinergic crisis. Its sibling was presented soon thereafter, in which cholinergic signs were also readily apparent. The owner, a myasthenia gravis patient, used pyridostigmine bromide tablets, and it was hypothesised that a pyridostigmine bromide intoxication was the cause of this cholinergic crisis. Treatment with 0.1 mg/kg atropine injected intramuscularly soon alleviated most of the cholinergic signs. Additional treatment, which included decontamination with enteral activated charcoal, intravenous fluid therapy, laxation and supportive care, as well as repeat administration of atropine, resulted in resolution of signs after 48 hours. A serum sample collected 30 hours after admission revealed that the total cholinesterase activity was reduced by 44 per cent, compared with a baseline value measured in a sample taken three weeks after the intoxication. This is the first report of human‐prescribed pyridostigmine bromide intoxication in domestic cats.
The history of the upstream oil and gas industry in Italy
Authors: Cazzini Ferdinando Franco 
Published: April 2018

Abstract
The aim of this work is to provide a synthetic history of the Italian upstream oil and gas industry, from its early start until today. Among European countries, Italy has one of the richest abundance of evidence of hydrocarbon seepages. The populations that have inhabited the country during the various historical periods took advantage of these phenomena, harvesting oil and bitumen from the surface. A testimony of such activity is an ingot of purified bitumen dated as first century AD found in central Italy. In the nineteenth century, seepages attracted the interest of oil companies that began to explore the Apennines. The drilling of the first modern oil well was realized in 1860 near Ozzano (Parma). The first onshore seismic reflection survey was acquired in 1940. The well Caviaga-1 was drilled in 1944 near Milan, discovering a gas field of 12.5 Bcm. It was one of the major European gas fields and it marked the starting point of the modern Italian petroleum industry. The widespread use of seismic reflection triggered an intense period of exploration. The first material oil discoveries were Ragusa (in 1954) and Gela (in 1956), both in Sicily. By the mid-1950s, the first offshore seismic survey started in the Adriatic Sea. In 1959, the drilling of well Gela 21, the first offshore well in Europe, boosted further exploration possibilities. During the following decades, the level of exploration and production (E&P) activities remained high, while from the beginning of the third millennium there has been a general slowdown. Since 2007, the level of exploration drilling has dropped to under 10 wells per year. In 2014, this negative trend was further confirmed with no exploratory wells drilled. The causes of this decline derive from the exploration maturity of the biogenic gas play and from the heavy bureaucratic processes involved in obtaining authorization. However, the main cause is probably the strong opposition from environmentalist associations to any kind of petroleum activities.
OrcFS
Authors: Yoo Jinsoo , Oh Joontaek , Lee Seongjin , Won Youjip , Ha Jin-Yong , Lee Jongsung , Shim Junseok 
Published: April 2018

In this work, we develop the
Orchestrated File System (OrcFS)
for Flash storage. OrcFS vertically integrates the log-structured file system and the Flash-based storage device to eliminate the redundancies across the layers. A few modern file systems adopt sophisticated append-only data structures in an effort to optimize the behavior of the file system with respect to the append-only nature of the Flash memory. While the benefit of adopting an append-only data structure seems fairly promising, it makes the stack of software layers full of unnecessary redundancies, leaving substantial room for improvement. The redundancies include (i) redundant levels of indirection (address translation), (ii) duplicate efforts to reclaim the invalid blocks (i.e., segment cleaning in the file system and garbage collection in the storage device), and (iii) excessive over-provisioning (i.e., separate over-provisioning areas in each layer). OrcFS eliminates these redundancies via distributing the address translation, segment cleaning (or garbage collection), bad block management, and wear-leveling across the layers. Existing solutions suffer from high segment cleaning overhead and cause significant write amplification due to mismatch between the file system block size and the Flash page size. To optimize the I/O stack while avoiding these problems, OrcFS adopts three key technical elements.

First, OrcFS uses
disaggregate mapping
, whereby it partitions the Flash storage into two areas, managed by a file system and Flash storage, respectively, with different granularity. In OrcFS, the metadata area and data area are maintained by 4Kbyte page granularity and 256Mbyte superblock granularity. The
superblock-based storage management
aligns the file system section size, which is a unit of segment cleaning, with the superblock size of the underlying Flash storage. It can fully exploit the internal parallelism of the underlying Flash storage, exploiting the sequential workload characteristics of the log-structured file system. Second, OrcFS adopts
quasi-preemptive segment cleaning
to prohibit the foreground I/O operation from being interfered with by segment cleaning. The latency to reclaim the free space can be prohibitive in OrcFS due to its large file system section size, 256Mbyte. OrcFS effectively addresses this issue via adopting a polling-based segment cleaning scheme. Third, the OrcFS introduces
block patching
to avoid unnecessary write amplification in the partial page program. OrcFS is the enhancement of the F2FS file system. We develop a prototype OrcFS based on F2FS and server class SSD with modified firmware (Samsung 843TN). OrcFS reduces the device mapping table requirement to 1/465 and 1/4 compared with the page mapping and the smallest mapping scheme known to the public, respectively. Via eliminating the redundancy in the segment cleaning and garbage collection, the OrcFS reduces 1/3 of the write volume under heavy random write workload. OrcFS achieves 56% performance gain against EXT4 in
varmail
workload.
IL17A Regulates Tumor Latency and Metastasis in Lung Adeno and Squamous SQ.2b and AD.1 Cancer
Authors: You Ran , DeMayo Francesco J. , Liu Jian , Cho Sung-Nam , Burt Bryan M. , Creighton Chad J. , Casal Roberto F. , Lazarus Donald R. , Lu Wen , Tung Hui-Ying , Yuan Xiaoyi , Hill-McAlester Andrea , Kim Myunghoo , Perusich Sarah , Cornwell Loraine , Rosen Daniel , Song Li-zhen , Paust Silke , Diehl Gretchen , Corry David , Kheradmand Farrah 
Published: April 2018

Abstract
Somatic mutations can promote malignant transformation of airway epithelial cells and induce inflammatory responses directed against resultant tumors. Tumor-infiltrating T lymphocytes (TIL) in early-stage non–small cell lung cancer (NSCLC) secrete distinct proinflammatory cytokines, but the contribution of these TILs to tumor development and metastasis remains unknown. We show here that TILs in early-stage NSCLC are biased toward IL17A expression (Th17) when compared with adjacent tumor-free tissue, whereas Th17 cells are decreased in tumor infiltrating locoregional lymph nodes in advanced NSCLC. Mice in which Pten and Smad4 (Pts4d/d) are deleted from airway epithelial cells develop spontaneous tumors, that share genetic signatures with squamous- (SQ.2b), and adeno- (AD.1) subtypes of human NSCLC. Pts4d/d mice globally lacking in IL17a (Pts4d/dIl17a–/–) showed decreased tumor latency and increased metastasis. Th17 cells were required for recruitment of CD103+ dendritic cells, and adoptive transfer of IL17a-sufficient CD4+ T cells reversed early tumor development and metastasis in Pts4d/dIl17a–/– mice. Together, these findings support a key role for Th17 cells in TILs associated with the Pts4d/d model of NSCLC and suggest therapeutic and biomarker strategies for human SQ2b and AD1 lung cancer. Cancer Immunol Res; 6(6); 645–57. ©2018 AACR.
Left Ventricular Isovolumetric Relaxation Time Is Prolonged in Fetal Long-QT Syndrome
Authors: Clur Sally-Ann B. , Vink Arja S. , Etheridge Susan P. , Robles de Medina Pascale G. , Rydberg Annika , Ackerman Michael J. , Wilde Arthur A. , Blom Nico A. , Benson D. Woodrow , Herberg Ulrike , Donofrio Mary T. , Cuneo Bettina F. 
Published: April 2018

Background:
Long-QT syndrome (LQTS), an inherited cardiac repolarization disorder, is an important cause of fetal and neonatal mortality. Detecting LQTS prenatally is challenging. A fetal heart rate (FHR) less than third percentile for gestational age is specific for LQTS, but the sensitivity is only ≈50%. Left ventricular isovolumetric relaxation time (LVIRT) was evaluated as a potential diagnostic marker for fetal LQTS.

Methods and Results:

LV isovolumetric contraction time, LV ejection time, LVIRT, cycle length, and FHR were measured using pulsed Doppler waveforms in fetuses. Time intervals were expressed as percentages of cycle length, and the LV myocardial performance index was calculated. Single measurements were stratified by gestational age and compared between LQTS fetuses and controls. Receiver-operator curves were performed for FHR and normalized LVIRT (N-LVIRT). A linear mixed-effect model including multiple measurements was used to analyze trends in FHR, N-LVIRT, and LV myocardial performance index. There were 33 LQTS fetuses and 469 controls included. In LQTS fetuses, the LVIRT was prolonged in all gestational age groups (
P
<0.001), as was the N-LVIRT. The best cutoff to diagnose LQTS was N-LVIRT ≥11.3 at ≤20 weeks (92% sensitivity, 70% specificity). Simultaneous analysis of N-LVIRT and FHR improved the sensitivity and specificity for LQTS (area under the curve=0.96; 95% confidence interval, 0.82–1.00 at 21–30 weeks). N-LVIRT, LV myocardial performance index, and FHR trends differed significantly between LQTS fetuses and controls through gestation.

Conclusions:
The LVIRT is prolonged in LQTS fetuses. Findings of a prolonged N-LVIRT and sinus bradycardia can improve the prenatal detection of fetal LQTS.
Lesion Index–Guided Ablation Facilitates Continuous, Transmural, and Durable Lesions in a Porcine Recovery Model
Authors: Whitaker John , Fish Jeffrey , Harrison James , Chubb Henry , Williams Steven E. , Fastl Thomas , Corrado Cesare , Van Zaen Jérôme , Gibbs Jennifer , O’Neill Louisa , Mukherjee Rahul , Rittey Dianna , Thorsten Jason , Donskoy Elina , Sohal Manav , Rajani Ronak , Niederer Steve , Wright Matthew , O’Neill Mark D. 
Published: April 2018

Background:
The Lesion Index (LSI) is a proprietary algorithm from Abbott Medical combining contact force, radiofrequency application duration, and radiofrequency current. It can be displayed during ablation with the TactiCath contact force catheter. The LSI Index was designed to provide real-time lesion formation feedback and is hypothesized to estimate the lesion diameter.

Methods and Results:

Before ablation, animals underwent cardiac computed tomography to assess atrial tissue thickness. Ablation lines (n=2–3 per animal) were created in the right atrium of 7 Göttingen mini pigs with point lesions (25 W). Within each line of ablation, the catheter tip was moved a prescribed distance (D/mm) according to 1 of 3 strategies: D=LSI+0 mm; D=LSI+2 mm; or D=LSI+4 mm. Two weeks after ablation, serial sections of targeted atrial tissue were examined histologically to identify gaps in transmural ablation. LSI-guided lines had a lower incidence of histological gaps (4 gaps in 69 catheter moves, 5.8%) than LSI+2 mm lines (7 gaps in 33 catheter moves, 21.2%) and LSI+4 mm lines (15 gaps in 23 catheter moves, 65.2%,
P
<0.05 versus D=LSI). ΔLSI was calculated retrospectively as the distance between 2 adjacent lesions above the mean LSI of the 2 lesions. ΔLSI values of ≤1.5 were associated with no gaps in transmural ablation.

Conclusions:
In this model of chronic atrial ablation, delivery of uninterrupted transmural linear lesions may be facilitated by using LSI to guide catheter movement. When ΔLSI between adjacent lesions is ≤1.5 mm, no gaps in atrial linear lesions should be expected.
Inhibiting Fibronectin Attenuates Fibrosis and Improves Cardiac Function in a Model of Heart Failure
Authors: Valiente-Alandi Iñigo , Potter Sarah J. , Salvador Ane M. , Schafer Allison E. , Schips Tobias , Carrillo-Salinas Francisco , Gibson Aaron M. , Nieman Michelle L. , Perkins Charles , Sargent Michelle A. , Huo Jiuzhou , Lorenz John N. , DeFalco Tony , Molkentin Jeffery D. , Alcaide Pilar , Blaxall Burns C. 
Published: April 2018

Background:
Fibronectin (FN) polymerization is necessary for collagen matrix deposition and is a key contributor to increased abundance of cardiac myofibroblasts (MFs) after cardiac injury. We hypothesized that interfering with FN polymerization or its genetic ablation in fibroblasts would attenuate MF and fibrosis and improve cardiac function after ischemia/reperfusion (I/R) injury.

Methods:

Mouse and human MFs were used to assess the impact of the FN polymerization inhibitor (pUR4) in attenuating pathological cellular features such as proliferation, migration, extracellular matrix deposition, and associated mechanisms. To evaluate the therapeutic potential of inhibiting FN polymerization in vivo, wild-type mice received daily intraperitoneal injections of either pUR4 or control peptide (III-11C) immediately after cardiac surgery for 7 consecutive days. Mice were analyzed 7 days after I/R to assess MF markers and inflammatory cell infiltration or 4 weeks after I/R to evaluate long-term effects of FN inhibition on cardiac function and fibrosis. Furthermore, inducible, fibroblast-restricted, FN gene–ablated (Tcf21
MerCreMer
;
Fn
flox
) mice were used to evaluate cell specificity of FN expression and polymerization in the heart.

Results:
pUR4 administration on activated MFs reduced FN and collagen deposition into the extracellular matrix and attenuated cell proliferation, likely mediated through decreased c-myc signaling. pUR4 also ameliorated fibroblast migration accompanied by increased β1 integrin internalization and reduced levels of phosphorylated focal adhesion kinase protein. In vivo, daily administration of pUR4 for 7 days after I/R significantly reduced MF markers and neutrophil infiltration. This treatment regimen also significantly attenuated myocardial dysfunction, pathological cardiac remodeling, and fibrosis up to 4 weeks after I/R. Last, inducible ablation of FN in fibroblasts after I/R resulted in significant functional cardioprotection with reduced hypertrophy and fibrosis. The addition of pUR4 to the FN-ablated mice did not confer further cardioprotection, suggesting that the salutary effects of inhibiting FN polymerization may be mediated largely through effects on FN secreted from the cardiac fibroblast lineage.

Conclusions:
Inhibiting FN polymerization or cardiac fibroblast gene expression attenuates pathological properties of MFs in vitro and ameliorates adverse cardiac remodeling and fibrosis in an in vivo model of heart failure. Interfering with FN polymerization may be a new therapeutic strategy for treating cardiac fibrosis and heart failure.
Hypertriglyceridemic Waist: A Simple Marker of High‐Risk Atherosclerosis Features Associated With Excess Visceral Adiposity/Ectopic Fat
Authors: LeBlanc Stéphanie , Coulombe François , Bertrand Olivier F. , Bibeau Karine , Pibarot Philippe , Marette André , Alméras Natalie , Lemieux Isabelle , Després Jean‐Pierre , Larose Eric 
Published: April 2018

Background
Subclinical atherosclerosis identification remains challenging; abdominal visceral adiposity may improve risk stratification beyond traditional cardiovascular risk factors. Hypertriglyceridemic waist, a visceral adiposity marker combining elevated triglycerides (≥2 mmol/L) and waist circumference (≥90 cm), has been related to carotid atherosclerosis, although associations with high‐risk features, including lipid‐rich necrotic core (LRNC), remain unknown. We tested the hypothesis that hypertriglyceridemic waist is an independent marker of high‐risk atherosclerosis features.

Methods and Results

In this cross‐sectional study including 467 white men (mean age, 45.9±14.8 years; range 19.4–77.6 years), carotid atherosclerosis characteristics were examined by magnetic resonance imaging and associations with hypertriglyceridemic waist and benefits beyond Framingham Risk Score (FRS) and Pathobiological Determinants of Atherosclerosis in Youth (PDAY) were determined. Subclinical carotid atherosclerosis was present in 61.9% of participants, whereas 50.1% had LRNC. Hypertriglyceridemic waist was associated with carotid maximum wall thickness (
P
=0.014), wall volume (
P
=0.025), normalized wall index (
P
=0.004), and Carotid Atherosclerosis Score (derived from wall thickness and LRNC;
P
=0.049). Hypertriglyceridemic waist was associated with carotid LRNC volume beyond FRS (
P
=0.037) or PDAY (
P
=0.015), contrary to waist circumference alone (both
P
>0.05). Although 69.7% and 62.0% of participants with carotid atherosclerosis and/or LRNC were not high‐risk by FRS or PDAY, respectively, hypertriglyceridemic waist correctly reclassified 9.7% and 4.5% of them, respectively. Combining hypertriglyceridemic waist with FRS (net reclassification improvement=0.17;
P
<0.001) or PDAY (net reclassification improvement=0.05;
P
=0.003) was superior to each score alone in identifying individuals with carotid atherosclerosis and/or LRNC.

Conclusions
Hypertriglyceridemic waist is an independent marker of carotid high‐risk atherosclerosis features in men, improving on FRS and PDAY risk score.
Serum Magnesium Levels and Outcomes in Patients With Acute Spontaneous Intracerebral Hemorrhage
Authors: Goyal Nitin , Tsivgoulis Georgios , Malhotra Konark , Houck Alexander L. , Khorchid Yasser M. , Pandhi Abhi , Inoa Violiza , Alsherbini Khalid , Alexandrov Andrei V. , Arthur Adam S. , Elijovich Lucas , Chang Jason J. 
Published: April 2018

Background

Magnesium (Mg) has potential hemostatic properties. We sought to investigate the potential association of serum Mg levels (at baseline and at 48 hours) with outcomes in patients with acute spontaneous intracerebral hemorrhage (
ICH
).

Methods and Results

We reviewed data on all patients with spontaneous
ICH
with available Mg levels at baseline, over a 5‐year period. Clinical and radiological outcome measures included initial hematoma volume, admission National Institutes of Health Stroke Scale and
ICH
scores, in‐hospital mortality, favorable functional outcome (modified Rankin Scale scores, 0–1), and functional independence (modified Rankin Scale scores, 0–2) at discharge. Our study population consisted of 299 patients with ICH (mean age, 61±13 years; mean admission serum Mg, 1.8±0.3 mg/dL). Increasing admission Mg levels strongly correlated with lower admission National Institutes of Health Stroke Scale score (Spearman's
r
, −0.141;
P
=0.015), lower
ICH
score (Spearman's
r
, −0.153;
P
=0.009), and lower initial hematoma volume (Spearman's
r
, −0.153;
P
=0.012). Higher admission Mg levels were documented in patients with favorable functional outcome (1.9±0.3 versus 1.8±0.3 mg/dL;
P
=0.025) and functional independence (1.9±0.3 versus 1.8±0.3 mg/dL;
P
=0.022) at discharge. No association between serum Mg levels at 48 hours and any of the outcome variables was detected. In multiple linear regression analyses, a 0.1‐mg/dL increase in admission serum Mg was independently and negatively associated with the cubed root of hematoma volume at admission (regression coefficient, −0.020; 95% confidence interval, −0.040 to −0.000;
P
=0.049) and admission
ICH
score (regression coefficient, −0.053; 95% confidence interval, −0.102 to −0.005;
P
=0.032).

Conclusions

Higher admission Mg levels were independently related to lower admission hematoma volume and lower admission
ICH
score in patients with acute spontaneous
ICH
.