bluuebunny/crossref_metadata_2025_split huggingface dataset:
In-vivo imaging of methionine metabolism in patients with suspected malignant pleural mesothelioma
Authors: Lopci Egesta , Novellis Pierluigi , Testori Alberto , Rahal Daoud , Voulaz Emanuele , Bottoni Edoardo , Ferraroli Giorgio Maria , Crepaldi Alessandro , Ceresoli Giovanni Luca , Perrino Matteo , Castello Angelo , Alloisio Marco , Veronesi Giulia , Zucali Paolo Andrea 
Published: September 2019

Objectives
In-vivo characterization of malignant pleural mesothelioma (MPM) with 11C-methionine PET/computed tomography (MET PET).

Methods
Between September 2014 and February 2016, 30 consecutive patients with clinical suspicion of MPM were prospectively recruited. The study was approved and registered at www.clinicaltrials.gov (NCT02519049). Patients were evaluated at baseline with MET PET (experimental) and fluorine-18 fluorodeoxyglucose PET/computed tomography (FDG PET) (standard). Principal parameters analyzed were SUVmax, SUVmean, metabolic tumor volume (MTV), and metabolic tumor burden (MTB  = MTV ×SUVmean). The reference standard for diagnostic performance was based on histology.

Results
The presence of malignancy was confirmed in 29/30 patients: 23 (76.6%) with MPM (20 epithelioid, two biphasic, and one sarcomatoid), five (16.6%) with adenocarcinoma of the lung, and one (3.3%) with an undifferentiated carcinoma. In one case, diagnosis was benign pleural inflammation. All tumors showed increased uptake of 11C-methionine: median SUVmax, SUVmean, MTV, and MTB were, respectively, 5.70 [95% confidence interval (CI): 4.51–6.79], 3.15 (95% CI: 2.71–3.40), 33.85 (95% CI: 14.08–66.64), and 105.25 (95% CI: 41.77–215.25). Pathology data revealed MTV and MTB to be significantly higher in nonepithelioid histology (P < 0.05). The other parameters showed a homogeneous distribution across the tumor types. Overall, MET PET identified 49 lymph nodes, compared with 34 nodes on FDG PET, demonstrating a sensitivity of 91% (95% CI: 80–96%), a positive predictive value of 92% (95% CI: 82– 97%), and an accuracy of 85% (P = 0.0042).

Conclusions
MET PET is able to characterize MPM lesions regardless of histology. This technique shows higher sensitivity than FDG PET for the identification of secondary lymph nodes.
18F-Flourodeoxy glucose PET–computed tomography in testicular carcinoma: diagnostic and prognostic value
Authors: Soydal Cigdem , Araz Mine , Urun Yuksel , Gulpinar Basak , Nak Demet , Ozkan Elgin , Kucuk Nuriye Ozlem 
Published: September 2019

Aim
This study aims to assess the diagnostic role of 18F-FDG PET/computed tomography in primary staging and restaging of testicular cancer in comparison with contrast-enhanced diagnostic thoracic-abdominopelvic computed tomography.

Material and method
Thirty-two consecutive male patients with testicular carcinoma (median age: 29, min–max: 17–65) who were referred to the nuclear medicine department for 18F-FDG PET/computed tomography were retrospectively included in the study. Patients were evaluated based on the 18F-FDG PET/computed tomography indications and germ cell tumor subtypes.

Results
On patient-based analysis, overall sensitivity, specificity, PPV, NPV and accuracy of 18F-FDG PET/computed tomography were 71%, 100%, 100%, 30% and 75%. On lesion-based analysis, for evaluation of lymph node metastasis they were 76%, 100%, 100%, 57% and 81%, and for detection of distant metastasis 85%, 100%, 100%, 90% and 93%, respectively. Median SUVmax for seminomas were calculated as 14.2 and for nonseminomas 7.8 (P = 0.62) Mean time to progression and overall survival were calculated as 76.6 ± 10.7 and 111 ± 7.5 months, respectively. Mean overall survival and time to progression for PET-positive and negative groups was not found significant (P = 0.69 and P = 0.81). The only significant factor in predict overall survival was the presence of distant organ metastases in PET/computed tomography (124.6 ± 5.2 vs. 78.7 ± 14.0 months, P = 0.02).

Conclusion
In this single-center experience with a limited number of patients, 18F-FDG PET/computed tomography appears to have a value of staging and restaging for both seminomatous and non-seminomatous GCTs.
Awareness of Hemophagocytic Lymphohistiocytosis as an Unusual Cause of Liver Failure in the Neonatal Period
Authors: Najib Khadijehsadat , Moghtaderi Mozhgan , Bordbar Mohammadreza , Monabati Ahmad 
Published: September 2019

Background:
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening syndrome that predominantly affects infants from birth to 18 months of age, characterized by fever and multiorgan failure. Liver injury has been rarely reported as a presenting sign in the neonatal period. This study reports a case with HLH in the neonatal period who presented with acute liver failure.

Case Presentation:
Herein, a 3-day-old female newborn was admitted with cytopenia, increased liver enzymes, hypofibrinogenemia, and markedly elevated serum ferritin. Hemophagocytosis of bone marrow biopsy confirmed the diagnosis of HLH. The newborn was treated with HLH-2004 protocol, but she finally died from multiorgan failure.

Conclusion:
Growing awareness of HLH as a cause of liver failure in the neonatal period can be associated with early treatment and reduces mortality in this group of patients.
Impact of a Quality Improvement Initiative to Optimize the Discharge Process of Pediatric Gastroenterology Patients at an Academic Children’s Hospital
Authors: Moo-Young Joseph A. , Sylvester Francisco A. , Dancel Ria D. , Galin Sheryl , Troxler Heidi , Bradford Kathleen K. 
Published: September 2019

Introduction:
Discharge is an important and complex process that can be optimized to reduce inpatient healthcare inefficiency and waste. This study aimed to increase the percentage of patients discharged before 1 pm by 20% from an academic inpatient pediatric gastroenterology service (IPGS), over 6 months.

Methods:
We conducted a preintervention and postintervention study of patients discharged from IPGS. Patients discharged from January to June 2016, and those following our intervention from June to December 2016, were studied. Interventions included (1) implementation of the electronic medical record medical and logistical discharge criteria checklists for the 4 most common IPGS discharge diagnoses, (2) standardization of the rounds process to prioritize discharge, (3) education of nursing staff and families about the role they played in discharge. Process, outcome, and balancing measures were analyzed.

Results:
Three hundred fifty-five total discharges were studied. Between the preintervention and postintervention groups, there were no significant improvements in discharge order time, physical discharge time, discharge response time, or discharges before 1 pm. The balancing measure of 30-day readmission was unaffected. However, length of stay (LOS) index, calculated as the ratio of actual to expected LOS, improved; when translated into days, LOS declined by 1 day, with potential associated savings of $373,000.

Conclusions:
Interventions to improve discharge timeliness on IPGS service demonstrated mixed effectiveness. Only LOS index improved. Further iterative quality improvement interventions are needed to continue optimizing discharge timeliness and change the culture of pediatric discharge on inpatient subspecialty services in academic children’s hospitals.
Swinging Eyelid Approach to Zygomaticomaxillary Complex Fracture
Authors: Miyazaki Hidetaka , Okuda Katsuya , Ueno Kazuki , Wada Yoshitaka , Kumegawa Shinji , Uemura Kazuhisa , Sakata Yasuhiro , Asamura Shinichi 
Published: September 2019

Abstract
A surgical approach to zygomaticomaxillary complex (ZMC) fracture has not been standardized. The authors reviewed 15 cases of ZMC fractures treated with the swinging eyelid approach and evaluated the effectiveness of the technique by an observational study of Japanese patients. Results were assessed from authentic and functional perspectives: the presence of entropion/ectropion, external canthal malposition and chemosis of the conjunctiva. After a minimum follow-up of 10 months, no patients had lower eyelid ectropion, entropion or retraction. Wounds appeared inconspicuous, and a lateral canthal shape was preserved. No post-operative chemosis of the conjunctiva was observed. Each case was evaluated based on patient satisfaction about their aesthetic outcomes. Patient self-assessment is classified into 4 groups (excellent, good, fair, and unsatisfactory). Thirteen patients were assessed to have an “excellent” outcome, and 2 patients were assessed to have a “good” outcome. No patients had “fair” or “unsatisfactory” outcomes. Avoidance of scarring is a goal of every craniofacial surgeon. The swinging eyelid approach to ZMC fractures offers a simple alternative to the conventional technique. It is versatile and provides sufficient exposure to surgical fields with less visible scar because skin incision is made along the natural crease line, “the crow's feet.”
The Role of Ultrasound in the Diagnosis of Pediatric Nasal Fractures
Authors: Navaratnam Ragavan , Davis Tessa 
Published: September 2019

Background:
Nasal fractures are the most commonly encountered facial fracture in children presenting to emergency departments. Though plain radiographs have long been used to aid the diagnosis of fractures, its limited diagnostic accuracy has led to the increasing use of ultrasound. Ultrasound offers a cheap, safe, and readily available imaging modality. Evidence in the adult population has shown ultrasound to be far more accurate in identifying nasal fractures. The efficacy of ultrasound in the pediatric setting though remains uncertain.

Methods:
A systematic review of the Pubmed and EmBase databases was undertaken. The search terms (nose OR nasal) AND (fracture) AND (ultrasound OR ultrasonography OR sonography) and associated MeSH terms were searched. The search was limited to those <18 years of age.

Results:
Following review and exclusion, 3 papers met the inclusion criteria. All 3 studies showed ultrasound was able to detect nasal fractures in children. Two studies showed that ultrasound diagnosed fractures with a greater accuracy than plain radiographs. One study used ultrasound alone and reported a sensitivity of 75% and specificity as 92.3%.

Conclusion:
With the limited evidence to date in the pediatric population, ultrasound appears to offer a more accurate radiological investigation in nasal fractures. It could be considered diagnostically superior to plain radiographs and reduces radiation exposure in children. Further work is required to better determine its true utility and improve its diagnostic accuracy.
Long-term Apomorphine Infusion Users Versus Short-term Users: An International Dual-center Analysis of the Reasons for Discontinuing Therapy
Authors: Bhidayasiri Roongroj , Phokaewvarangkul Onanong , Boonpang Kamolwan , Boonmongkol Thanatat , Thongchuem Yuwadee , Kantachadvanich Nitinan , García Ruiz Pedro J. 
Published: September 2019

Objectives
A retrospective analysis at 2 specialist centers was undertaken to determine the long-term efficacy of subcutaneous apomorphine infusion (APO), rates and reasons for discontinuation, and factors that might contribute to discontinuation.

Methods
Demographics, clinical outcomes data, and reasons for discontinuation were collected for patients treated with APO at Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Bangkok, Thailand (n = 36) and Fundacion Jimemez Diaz Universidad Autonoma de Madrid, Spain (n = 16).

Results
There were 19 (52.7%) patients in the Thai cohort and 10 (62.5%) patients in the Spanish cohort who discontinued treatment within around 6 months of initiation, most commonly due to skin nodules (Thai cohort) and perceived lack of efficacy (Spanish cohort). Those who continued APO tended to stay on treatment. In both cohorts, APO resulted in significant reductions in Unified Parkinson's Disease Rating Scale 3 motor scores, daily OFF time, and levodopa-equivalent dose in patients who subsequently stopped therapy, suggesting APO is clinically effective even when “lack of efficacy” is stated as a reason for discontinuing. Daily OFF hours after APO therapy was found to be a significant predictive factor for APO discontinuation with an odds ratio of 5.952 (P = 0.040). The cutoff point that determined APO discontinuation was calculated to be 1.75 or more OFF hours (sensitivity, 84.6%; specificity, 63.2%).

Conclusions
Apomorphine infusion is a minimally invasive therapy and therefore very easy to discontinue if difficulties arise. This fact might explain the high dropout rate of this technique. Successful long-term adherence to APO therapy requires a multidisciplinary health care team approach including regular patient follow-up and assessment and prompt resolution of queries and concerns.
Intravital dynamic and correlative imaging reveals diffusion-dominated canalicular and flow-augmented ductular bile flux
Authors: Vartak Nachiket , Guenther Georgia , Joly Florian , Damle-Vartak Amruta , Wibbelt Gudrun , Fickel Jörns , Jörs Simone , Begher-Tibbe Brigitte , Friebel Adrian , Wansing Kasimir , Ghallab Ahmed , Rosselin Marie , Boissier Noemie , Vignon-Clementel Irene , Hedberg Christian , Geisler Fabian , Hofer Heribert , Jansen Peter , Hoehme Stefan , Drasdo Dirk , Hengstler Jan G. 
Published: September 2019

AbstractSmall-molecule flux in tissue-microdomains is essential for organ function, but knowledge of this process is scant due to the lack of suitable methods. We developed two independent techniques that allow the quantification of advection (flow) and diffusion in individual bile canaliculi and in interlobular bile ducts of intact livers in living mice, namely Fluorescence Loss After Photoactivation (FLAP) and Intravital Arbitrary Region Image Correlation Spectroscopy (IVARICS). The results challenge the prevailing ‘mechano-osmotic’ theory of canalicular bile flow. After active transport across hepatocyte membranes bile acids are transported in the canaliculi primarily by diffusion. Only in the interlobular ducts, diffusion is augmented by regulatable advection. Photoactivation of fluorescein bis-(5-carboxymethoxy-2-nitrobenzyl)-ether (CMNB-caged fluorescein) in entire lobules demonstrated the establishment of diffusive gradients in the bile canalicular network and the sink function of interlobular ducts. In contrast to the bile canalicular network, vectorial transport was detected and quantified in the mesh of interlobular bile ducts. In conclusion, the liver consists of a diffusion dominated canalicular domain, where hepatocytes secrete small molecules and generate a concentration gradient and a flow-augmented ductular domain, where regulated water influx creates unidirectional advection that augments the diffusive flux.One Sentence Summary/KeywordsBile flux proceeds by diffusion in canaliculi, augmented by advection in ducts.
Removing reference bias and improving indel calling in ancient DNA data analysis by mapping to a sequence variation graph
Authors: Martiniano Rui , Garrison Erik , Jones Eppie R. , Manica Andrea , Durbin Richard 
Published: September 2019

AbstractBackgroundDuring the last decade, the analysis of ancient DNA (aDNA) sequence has become a powerful tool for the study of past human populations. However, the degraded nature of aDNA means that aDNA molecules are short and frequently mutated by post-mortem chemical modifications. These features decrease read mapping accuracy and increase reference bias, in which reads containing non-reference alleles are less likely to be mapped than those containing reference alleles. Recently, alternative approaches for read mapping and genetic variation analysis have been developed that replace the linear reference by a variation graph which includes known alternative variants at each genetic locus. Here, we evaluate the use of variation graph software vg to avoid reference bias for ancient DNA and compare our approach to existing methods.ResultsWe used vg to align simulated and real aDNA samples to a variation graph containing 1000 Genome Project variants, and compared these with the same data aligned with bwa to the human linear reference genome. We show that use of vg leads to a balanced allelic representation at polymorphic sites, effectively removing reference bias, and more sensitive variant detection in comparison with bwa, especially for insertions and deletions (indels). Alternative approaches that use relaxed bwa parameter settings or filter bwa alignments can also reduce bias, but can have lower sensitivity than vg, particularly for indels.ConclusionsOur findings demonstrate that aligning aDNA sequences to variation graphs effectively mitigates the impact of reference bias when analysing aDNA, while retaining mapping sensitivity and allowing detection of variation, in particular indel variation, that was previously missed.
The Readiness Potential reflects the internal source of action, rather than decision uncertainty
Authors: Travers Eoin , Haggard Patrick 
Published: September 2019

AbstractVoluntary actions are preceded by a Readiness Potential (RP), a slow EEG component generated in medial frontal cortical areas. The RP is classically thought to be specific to internally-driven decisions to act, and to reflect post-decision motor preparation. Recent work suggests instead that it may reflect noise or conflict during the decision itself, with internally-driven decisions tending to be more random, more conflictual and thus more uncertain than externally-driven actions. To contrast accounts based on endogenicity with accounts based on uncertainty, we recorded EEG in a task where participants decided to act or withhold action to accept or reject visually-presented gambles, and used multivariate methods to extract an RP-like component.. We found no difference in amplitude of this component between actions driven by strong versus weak evidence, suggesting that the RP may not reflect uncertainty. In contrast, the same RP-like component showed higher amplitudes prior to actions performed without any external evidence (guesses) than for actions performed in response to equivocal, conflicting evidence. This supports the view that the RP reflects the internal source of action, rather than decision uncertainty.Significance StatementThe EEG Readiness Potential (RP) seen prior to self-initiated actions is often taken as a neural marker of volition (Shibasaki & Hallett, 2006). It has been argued that the RP may instead reflect conflict and uncertainty in the decisions leading up to these actions, raising questions about decades of previous findings. We directly tested these explanations by asking participants to decide whether to act or not in a gambling task, while manipulating both uncertainty and the source of the information (internal or external) guiding the decision. Only the source of information affected the presence of the RP. Therefore, the RP remains a marker of internally-generated voluntary action, not a marker of uncertainty.
Genetic and epigenetic characteristics associated with the rapid radiation of Aquilegia species
Authors: Wang Zhen-Hui , Lu Tianyuan , Li Ming-Rui , Ding Ning , Lan Li-Zhen , Gao Xiang , Xiong Ai-Sheng , Zhang Jian , Li Lin-Feng 
Published: September 2019

AbstractElucidating the genetic and epigenetic bases underlying species diversification is crucial to understanding the evolution and persistence of biodiversity. As a well-known horticultural plant grown worldwide, the genus Aquilegia (columbine) is also a model system in adaptive radiation research. In this study, we surveyed the genomes and DNA methylomes of ten representative Aquilegia species from the Asian, European and North American lineages. Our inferences of the phylogenies and population structure revealed clearly high genetic and DNA methylomic divergence across the three lineages. By multi-levelled genome-wide scanning, we identified candidate genes exhibiting lineage-specific genetic or epigenetic variation patterns that are signatures of inter-specific divergence. We demonstrated that these species diversification-associated genetic variations and epigenetic variabilities were partially independent but were both functionally related to various biological processes vital to adaptation, including stress tolerance, cell reproduction and DNA repair. Our study provides an exploratory overview of how the established genetic and epigenetic signatures are associated with the rapid radiation of Aquilegia species.
Pan-genome analysis identifies intersecting roles for Pseudomonas specialized metabolites in potato pathogen inhibition
Authors: Pacheco-Moreno Alba , Stefanato Francesca L. , Ford Jonathan J. , Trippel Christine , Uszkoreit Simon , Ferrafiat Laura , Grenga Lucia , Dickens Ruth , Kelly Nathan , Kingdon Alexander D. H. , Ambrosetti Liana , Nepogodiev Sergey A. , Findlay Kim C. , Cheema Jitender , Trick Martin , Chandra Govind , Tomalin Graham , Malone Jacob G. , Truman Andrew W. 
Published: September 2019

AbstractAgricultural soil harbors a diverse microbiome that can form beneficial relationships with plants, including the inhibition of plant pathogens. Pseudomonas spp. are one of the most abundant bacterial genera in the soil and rhizosphere and play important roles in promoting plant health. However, the genetic determinants of this beneficial activity are only partially understood. Here, we genetically and phenotypically characterize the Pseudomonas fluorescens population in a commercial potato field, where we identify strong correlations between specialized metabolite biosynthesis and antagonism of the potato pathogens Streptomyces scabies and Phytophthora infestans. Genetic and chemical analyses identified hydrogen cyanide and cyclic lipopeptides as key specialized metabolites associated with S. scabies inhibition, which was supported by in planta biocontrol experiments. We show that a single potato field contains a hugely diverse and dynamic population of Pseudomonas bacteria, whose capacity to produce specialized metabolites is shaped both by plant colonization and defined environmental inputs.
Cachexia and fibrosis are costs of chronic IL-1R-mediated disease tolerance inT. gondiiinfection
Authors: Melchor Stephanie J. , Hatter Jessica A. , LaTorre Castillo Erika A. , Saunders Claire M. , Byrnes Kari A. , Sanders Imani , Abebayehu Daniel , Barker Thomas , Coutermarsh-Ott Sheryl , Ewald Sarah E. 
Published: September 2019

AbstractCachexia is an immune-metabolic disease of progressive muscle wasting that impairs patient survival and quality of life across a range of chronic diseases.T. gondiiis a protozoan parasite that causes lifelong infection in many warm-blooded organisms, including humans and mice. Here we show that mice infected withT. gondiidevelop robust, sustained cachexia and perivascular fibrosis in metabolic tissues. Consistent with an emerging role for the IL-1 axis in disease tolerance, we show that mice deficient in the Type 1 IL-1 receptor (IL-1R) have more severe acute muscle wasting, adipocyte and hepatocyte necrosis, independent of parasite burden. Unexpectedly, IL-1R-/-mice rapidly recover from acute disease, despite sustained parasite infection, and are protected from chronic cachexia as well as perivascular liver and muscle fibrosis. These data are consistent with a model where IL-1R signaling benefits cell survival and tissue integrity over short periods of inflammation, but sustained reliance on IL-1 mediated tolerance programs come at the cost of fibrosis and cachexia.SummaryIL-1R signaling drives a disease tolerance program that protects mice from tissue pathology during acuteToxoplasma gondiiinfection. However, extended IL-1R signaling drives chronic cachexia and perivascular fibrosis in the liver and skeletal muscle.