bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel CT-guided 188-rhenium brachytherapy device for local primary and secondary lung malignancies.
Authors: Belhadj-Tahar Hafid , Chen Jindde , Song Pieping , Zhao Jun , Quan Ming , Li Caixin , Gu Xingjian , Yang Guanghua , Gao Yong 
Published: October 2019

96 Background: Stereotactic brachytherapy for extensive local tumors offers a very effective treatment option locally without significant complications in medically impaired patients. In this context, we have recently developed a new potential anticancer agent from Poly-L-Lysins dendrimer as a delivery nano system loaded with diffusible Imidazolic probes complexed with 188-Rhenium for targeting in particular hypoxic tumors resistant to conventional cancer treatments. The aim of the study is assessment the safety profile and therapeutic efficacy of anticancer agent derived from [188Re]rhenium-ligand as radioactive ligand loaded 5th generation poly-L-lysine dendrimer in patients with unresectable Lung Malignancies. Methods: The experiment agent “ 188Re-ImDendrim” is consisting of 5th generation poly-L-lysine dendrimer (20 nM) mixed with nitro-imidazole-methyl-1,2,3-triazol-methyl-di-(2-pycolyl) amine at GMP grade and labelled with [188Re]-rhenium. The study was approved by Shanghai East Hospital ethics committee. 5 patients received “188Re-ImDendrim” directly into lung tumors under CT-guidance, at an activity level of 162 MBq/cc of tumor (range 2 to 7 cm; mean diameter, 4 cm) . For voluminous tumors ( > 65 cc) the dose is given in divided injection spaced 2 weeks apart (Tumor of 115cc: 2 administrations, Tumor of 180 cc: 3 administrations). At H0.5, H 4, H24, H36 , H72 post-administration, the patient get a SPECT control. The response to treatment is evaluated thanks to PET/CT Standardized Uptake Values (SUVs). Results: Stereotactic administrations of “188-Rhenium-ImDendrim” were successfully carried out in all patients under local anesthesia. The radioactive product diffuses homogeneously in the tumor volume and remains 72 hours post-administration with no significant diffusion out site of injection. The One of the 5 patients reported discrete transitive hemoptysis as adverse events. All targeted tumors were responding at 12 weeks, with two complete responses. Conclusions: Percutaneous single and iterative administrations of this novel 188-Rhenium-Imdendrim brachytherapy device into lung cancers are safe and well tolerated. The initial data on therapeutic response are promising. Clinical trial information: EC.D (BG) 016.03.1.
Decision Making About Genetic Testing Among Women With a Personal and Family History of Breast Cancer
Authors: Scott Danika , Friedman Sue , Telli Melinda L. , Kurian Allison W. 
Published: October 2019

PURPOSE: To understand genetic testing use and decision making among patients with high genetic risk. MATERIALS AND METHODS: A survey of breast cancer survivors was administered online by a hereditary cancer nonprofit organization, Facing Our Risk of Cancer Empowered, from October 2017 to March 2018. RESULTS: Of 1,322 respondents, 46% had breast cancer at age < 45 years, 61% had a first-degree relative with cancer, and 84% underwent genetic testing, of whom 56% had a risk-associated pathogenic variant. Most (86%; 95% CI, 84% to 88%) tested respondents were very satisfied with their testing decision, versus 34% (95% CI, 27% to 41%) of untested respondents. Factors that encouraged testing included relatives’ cancer risk (75%; 95% CI, 73% to 78%), clinicians’ recommendations (68%; 95% CI, 66% to 71%), and potential treatment implications (67%; 95% CI, 64% to 69%). Factors that discouraged testing included insurance concerns (14%; 95% CI, 12% to 16%), cost (14%; 95% CI, 12% to 16%), and discrimination (9%; 95% CI, 7% to 11%). Thirty-nine percent (95% CI, 36% to 41%) recalled hearing from a clinician that genetic discrimination is illegal. Respondents often recalled clinicians informing them about inheritance patterns (65%; 95% CI, 62% to 67%), surgical implications (65%; 95% CI, 63% to 68%), and other cancer risks (66%; 95% CI, 63% to 68%) but less often that results could have potential implications for clinical trial eligibility (38%; 95% CI, 36% to 42%) or targeted therapies (14%; 95% CI, 12% to 16%). Patients who had genetic counseling were twice as likely to recall clinicians informing them about all queried topics. Results did not vary by diagnosis year. CONCLUSION: Among patients with high genetic risk, clinicians’ recommendations, potential treatment implications, and protections against discrimination were motivating factors to undergo genetic testing, but fewer than half recalled clinicians providing all this information, and this did not improve over time. Clinicians influence testing decisions and should inform patients about legal protections and treatment implications.
The Course of Obstructive Sleep Apnea Syndrome in Patients With Acromegaly During Treatment
Authors: Wolters Thalijn L C , Roerink Sean H P P , Drenthen Linda C A , van Haren-Willems Jolanda H G M , Wagenmakers Margaretha A E M , Smit Johannes W A , Hermus Adrianus R M M , Netea-Maier Romana T 
Published: October 2019

AbstractBackgroundObstructive sleep apnea syndrome (OSAS) is common in active acromegaly and negatively influences quality of life, morbidity, and mortality. This prospective study with 3 predetermined timepoints and a standardized treatment protocol investigates changes in sleep parameters during the first 2.5 years of acromegaly treatment.MethodsBefore initiation of acromegaly treatment (medical pretreatment followed by surgery), polysomnography (PSG) was performed in 27 consecutive patients with treatment-naive acromegaly. PSG was repeated after 1 year (N = 24) and 2.5 years (N = 23), and anthropometric and biochemical parameters were obtained.ResultsAt baseline, 74.1% of the patients was diagnosed with OSAS. The respiratory disturbance index (RDI; P = 0.001), oxygen desaturation index (ODI; P = 0.001), lowest oxygen saturation (LSaO2; P = 0.007) and the Epworth Sleepiness Scale (ESS; P &lt; 0.001) improved significantly during treatment, with the greatest improvement in the first year. After 2.5 years of treatment, all patients had controlled acromegaly. Of the 16 patients with repeated PSG and OSAS at baseline, 11 (68.8%) were cured of OSAS. Changes in RDI, ODI, LSaO2, and ESS correlated with insulin-like growth factor 1 levels.ConclusionOSAS has a high prevalence in active acromegaly. There is a substantial decrease in prevalence and severity of OSAS following acromegaly treatment, with the largest improvement during the first year. Most patients recover from OSAS following surgical or biochemical control of the acromegaly. Therefore, a PSG is advised after diagnosis of acromegaly. When OSAS is present, it should be treated and PSG should be repeated during acromegaly treatment.
Trabecular Bone Score Declines During the Menopause Transition: The Study of Women’s Health Across the Nation (SWAN)
Authors: Greendale Gail A , Huang MeiHua , Cauley Jane A , Liao Diana , Harlow Sioban , Finkelstein Joel S , Hans Didier , Karlamangla Arun S 
Published: October 2019

Abstract

Context
Rapid bone density loss starts during the menopause transition (MT). Whether other components of bone strength deteriorate before the final menstrual period (FMP) remains uncertain.

Objective
To discern whether trabecular bone score (TBS) declines during the MT.

Design
An 18-year longitudinal analysis from the Study of Women’s Health Across Nation.

Setting
Community-based cohort.

Participants
A total of 243 black, 164 Japanese, and 298 white, initially pre- or early perimenopausal women, who experienced their FMP.

Main Outcome Measures
TBS, an indicator of bone strength.

Results
Multivariable mixed effects regressions fitted piecewise linear models to repeated measures of TBS as a function of time before or after the FMP; covariates were age at FMP, race/ethnicity, and body mass index. Prior to 1.5 years before the FMP, in the referent individual (a white woman with age at FMP of 52.2 years and body mass index of 28.0 kg/m2), TBS evidenced no change (slope 0.12% per year, P = 0.2991). TBS loss began 1.5 years before the FMP, declining by 1.16% annually (P &lt; 0.0001). Starting 2 years after the FMP, annual rate of TBS loss lessened to 0.89% (P &lt; 0.0001). In the 5 years before through the 5 years after the FMP, in the referent individual, total TBS decline was 6.3% (P &lt; 0.0001), but black participants’ total TBS loss was 4.90% (P = 0.0008, difference in black and white 10-year change). Results for Japanese did not differ from those of white women.

Conclusions
The occurrence of an MT-related decline in TBS supports the thesis that this period is particularly damaging to skeletal integrity.
Negative Effects of Age at Menarche on Risk of Cardiometabolic Diseases in Adulthood: A Mendelian Randomization Study
Authors: Cao Min , Cui Bin 
Published: October 2019

Abstract

Context
Observational studies have demonstrated that early menarche is associated with cardiometabolic diseases, but confounding factors make it difficult to infer causality.

Objective
We used Mendelian randomization (MR) to examine whether age at menarche (AAM) is causally associated with type 2 diabetes (T2D), coronary artery disease (CAD) and cardiometabolic traits.

Design and Methods
A 2-sample MR analysis was conducted using genome-wide association study (GWAS) summary statistics from the Diabetes Genetics Replication and Meta-analysis (DIAGRAM) consortium (n = 159 208) for T2D and the Coronary Artery Disease Genome-wide Replication and Meta-analysis plus the Coronary Artery Disease Genetics (CARDIoGRAMplusC4D) consortium (n = 184 305) for CAD. We used 122 instrumental variables (IVs) extracted from a published GWAS meta-analysis incorporating 182 416 women to determine the causal effect of AAM on cardiometabolic diseases, treating childhood and adult body mass index (BMI) as the confounders. Sensitivity analyses were also performed to detect the pleiotropy of the IVs.

Results
Employing the MR approach, we found that later AAM was associated with decreased risk of CAD (OR, 0.92 [95% CI, 0.88-0.96]; P = 2.06 × 10–4) in adults, as well as lower blood levels of log fasting insulin, log homeostatic model assessment of insulin resistance (HOMA-IR), log HOMA of β-cell function (HOMA-B), triglycerides, and diastolic blood pressure, but higher blood level of high-density lipoprotein. However, the associations were substantially attenuated after excluding BMI-related variants. MR analyses provide little evidence on the causal effect between AAM and T2D.

Conclusions
Our findings showed that AAM did not appear to have a causal effect on the risk of cardiometabolic diseases in adult life, as their associations observed in epidemiological studies might be largely mediated through excessive adiposity. We propose adiposity might be a primary target in future intervention strategy.
CLASP promotes microtubule bundling in metaphase spindle independently of Ase1/PRC1 in fission yeast
Authors: Ebina Hirohisa , Ji Liang , Sato Masamitsu 
Published: October 2019

Microtubules in the mitotic spindle are organised by microtubule-associated proteins. In the late stage of mitosis, spindle microtubules are robustly organised through bundling by the antiparallel microtubule bundler Ase1/PRC1. In early mitosis, however, it is not well characterised whether spindle microtubules are actively bundled, as Ase1 does not particularly localise to the spindle at that stage.
Here we show that the conserved microtubule-associated protein CLASP (fission yeast Peg1/Cls1) facilitates bundling of spindle microtubules in early mitosis. The peg1 mutant displayed a fragile spindle with unbundled microtubules, which eventually resulted in collapse of the metaphase spindle and abnormal segregation of chromosomes. Peg1 is known to be recruited to the spindle by Ase1 to stabilise antiparallel microtubules in late mitosis. However, we demonstrate that the function of Peg1 in early mitosis does not rely on Ase1. The unbundled spindle phenotype of the peg1 mutant was not seen in the ase1 mutant, and Peg1 preferentially localised to the spindle even in early mitosis unlike Ase1. Moreover, artificial overexpression of Ase1 in the peg1 mutant partially suppressed unbundled microtubules. We thus conclude that Peg1 bundles microtubules in early mitosis, in a distinct manner from its conventional Ase1-dependent functions in other cell cycle stages.
Spatial integration of mechanical forces by α-actinin establishes actin network symmetry
Authors: Senger Fabrice , Pitaval Amandine , Ennomani Hajer , Kurzawa Laetitia , Blanchoin Laurent , Théry Manuel 
Published: October 2019

ABSTRACT
Cell and tissue morphogenesis depend on the production and spatial organization of tensional forces in the actin cytoskeleton. Actin network architecture is made of distinct modules characterized by specific filament organizations. The assembly of these modules are well described, but their integration in a cellular network is less understood. Here, we investigated the mechanism regulating the interplay between network architecture and the geometry of the extracellular environment of the cell. We found that α-actinin, a filament crosslinker, is essential for network symmetry to be consistent with extracellular microenvironment symmetry. It is required for the interconnection of transverse arcs with radial fibres to ensure an appropriate balance between forces at cell adhesions and across the actin network. Furthermore, this connectivity appeared necessary for the ability of the cell to integrate and to adapt to complex patterns of extracellular cues as they migrate. Our study has unveiled a role of actin filament crosslinking in the spatial integration of mechanical forces that ensures the adaptation of intracellular symmetry axes in accordance with the geometry of extracellular cues.
This article has an associated First Person interview with the first author of the paper.
MRI native T1 and T2 mapping of myocardial segments in hypertrophic cardiomyopathy: tissue remodeling manifested prior to structure changes
Authors: Huang Lu , Ran Lingping , Zhao Peijun , Tang Dazhong , Han Rui , Ai Tao , Xia Liming , Tao Qian 
Published: October 2019

Objective:
The aim of this study was to examine the local myocardial segments in hypertrophic cardiomyopathy (HCM) by MRI T1 and T2 mapping, and to investigate how tissue remodeling correlates with structural and functional remodeling in HCM.

Methods:
47 patients with HCM and 19 healthy volunteers were enrolled in this study. All subjects underwent cardiac MRI at 3.0 T. Native T1 and T2 values, end-diastolic wall thickness (EDTH), and percentage of systolic wall thickening (PSWT) were assessed in the left ventricular segments according to the American Heart Association model. Myocardial segments were categorized as normal, non-hypertrophic, mild-hypertrophic, moderate-hypertrophic, and severe-hypertrophic based on EDTH. The difference among all five groups, and the correlation between native T1 and T2 values, EDTH, and PSWT were evaluated.

Results:
Native T1 and T2 values were significantly elevated in both non-hypertrophic and hypertrophic segments of HCM patients compared to controls (both p &lt; 0.001). PSWT was preserved in non-hypertrophic segments (p = 0.838), while significantly impaired (p &lt; 0.001) in hypertrophic segments. Native T1 value of severe hypertrophic segments in HCM was significantly higher than segments of mild and moderate hypertrophy (p &lt; 0.05).

Conclusion:
In HCM patients, the non-hypertrophic myocardial segments already demonstrated significantly elevated T1 and T2 values, despite normal wall thickness and preserved contraction function. The finding suggests that tissue remodeling may precede morphological and functional remodeling in HCM. MRI native T1 and T2 mapping can provide additional value for HCM diagnosis at an early stage.

Advances in knowledge:
Myocardial tissue remodeling, as detected by MRI native T1 and T2 mapping, occurs earlier than morphological and functional changes in HCM patients.
Influence of delivery mode on maternal mental status one month after delivery at a perinatal center in Japan: A cross-sectional study
Authors: Suzuki Shunji 
Published: October 2019

Background: Maternal mental status has been thought to be affected by the delivery modes. We examined the influence of delivery modes on the mental status of women who delivered at our institute in Japan. Methods: Data were collected from the medical charts of 645 primiparous women without a history of mental disorders who delivered singleton babies and underwent a 1-month postpartum check-up at our institute from September 2018 to June 2019. The maternal mental status was examined based on the scores of the Edinburgh Postnatal Depression Scale (EPDS) and the Mother-Infant Bonding Scale (MIBS). Results: The rate of high scores of the EPDS and the MIBS in women choosing elective cesarean section were higher than in women with vaginal delivery and emergency cesarean section. Conclusion: A fulfilling birth-plan and birth-review may also be necessary for women choosing elective cesarean section.
Clinical Utility of Procalcitonin in the Diagnosis of Pneumonia
Authors: Wussler Desiree , Kozhuharov Nikola , Tavares Oliveira Mucio , Bossa Aline , Sabti Zaid , Nowak Albina , Murray Karsten , du Fay de Lavallaz Jeanne , Badertscher Patrick , Twerenbold Raphael , Shrestha Samyut , Flores Dayana , Nestelberger Thomas , Walter Joan , Boeddinghaus Jasper , Zimmermann Tobias , Koechlin Luca , von Eckardstein Arnold , Breidthardt Tobias , Mueller Christian , Soeiro Alexandre , Goldstein Priscila , Strabelli Tânia , Strunz Célia , Wildi Karin , Puelacher Christian , Rentsch Katharina , Goudev Assen 
Published: October 2019

Abstract

BACKGROUND
The clinical utility of procalcitonin in the diagnosis and management of pneumonia remains controversial.

METHODS
We assessed the clinical utility of procalcitonin in 2 prospective studies: first, a multicenter diagnostic study in patients presenting to the emergency department with acute dyspnea to directly compare the diagnostic accuracy of procalcitonin with that of interleukin 6 and C-reactive protein (CRP) in the diagnosis of pneumonia; second, a randomized management study of procalcitonin guidance in patients with acute heart failure and suspected pneumonia. Diagnostic accuracy for pneumonia as centrally adjudicated by 2 independent experts was quantified with the area under the ROC curve (AUC).

RESULTS
Among 690 patients in the diagnostic study, 178 (25.8%) had an adjudicated final diagnosis of pneumonia. Procalcitonin, interleukin 6, and CRP were significantly higher in patients with pneumonia than in those without. When compared to procalcitonin (AUC = 0.75; 95% CI, 0.71–0.78), interleukin 6 (AUC = 0.80; 95% CI, 0.77–0.83) and CRP (AUC = 0.82; 95% CI, 0.79–0.85) had significantly higher diagnostic accuracy (P = 0.010 and P &lt; 0.001, respectively). The management study was stopped early owing to the unexpectedly low AUC of procalcitonin in the diagnostic study. Among 45 randomized patients, the number of days on antibiotic therapy and the length of hospital stay were similar (both P = 0.39) in patients randomized to the procalcitonin-guided group (n = 25) and usual-care group (n = 20).

CONCLUSIONS
In patients presenting with dyspnea, diagnostic accuracy of procalcitonin for pneumonia is only moderate and lower than that of interleukin 6 and CRP. The clinical utility of procalcitonin was lower than expected.

SUMMARY
Pneumonia has diverse and often unspecific symptoms. As the role of biomarkers in the diagnosis of pneumonia remains controversial, it is often difficult to distinguish pneumonia from other illnesses causing shortness of breath. The current study prospectively enrolled unselected patients presenting with acute dyspnea and directly compared the diagnostic accuracy of procalcitonin, interleukin 6, and CRP for the diagnosis of pneumonia. In this setting, diagnostic accuracy of procalcitonin for pneumonia was lower as compared to interleukin 6 and CRP. The clinical utility of procalcitonin was lower than expected.

ClinicalTrials.gov Identifier
NCT01831115.
ESQUETE
Authors: Travaglia Luiz Carlos 
Published: October 2019

O objetivo deste estudo é caracterizar o gênero oral e humorístico esquete, e, secundariamente, trabalhar, em alguns aspectos, sua correlação com outros gêneros orais como a piada e o stand up, mais no sentido de distinguir o esquete do que de buscar uma caracterização desses outros gêneros. Apresentam-se as razões que levam a considerar o esquete um gênero oral e, a partir de um corpus com sessenta esquetes, apresentam-se suas características específicas enquanto gênero humorístico, narrativo, representativo, considerando seu conteúdo temático típico, sua estrutura composicional de narrativa da espécie história (superestrutura, extensão), as linguagens nele utilizadas, bem como algumas características de sua superfície linguística, seus objetivos e funções, suas condições de produção. Dessa forma é feita a caracterização do esquete, distinguindo-o da piada e do stand up. Verifica-se ainda a existência de um gênero homônimo a que chamamos de “esquete pedagógico”, mas com objetivos e funções totalmente distintas do esquete humorístico.
Global existence theory for fractional differential equations: New advances via continuation methods for contractive maps
Authors: Almuthaybiri Saleh S. , Tisdell Christopher C. 
Published: October 2019

Abstract
The aim of this article is to form new existence theory for global solutions to nonlinear fractional differential equations. Traditional approaches to existence, uniqueness and approximation of global solutions for initial value problems involving fractional differential equations have been unwieldy or intractable due to the limitations of previously used methods. This includes, for example, certain invariance conditions of the underlying local fixed point strategies. Herein we draw on an alternative tactics, applying the more modern ideas of continuation methods for contractive maps to fractional differential equations. In doing so, we shed new light on the situation, producing these new perspectives through a range of novel theorems that involve sufficient conditions under which global existence, uniqueness, approximation and location of solutions are ensured.
On certain integral means of functions of generalized bounded variation
Authors: Bakhvalov Alexandr N. 
Published: October 2019

Abstract
For certain classes of functions of Λ-bounded variation on

[

-
π

,
π
]

{[-\pi,\pi]}

, Waterman and D’Antonio constructed a sequence of summability kernels such that the corresponding integral means converge for any function from the class,
but not for any function from a broader

Λ
′

⁢
BV

{\Lambda^{\prime}\mathrm{BV}}

class.
In our paper, we extend this result to the case of functions of two variables.