bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of underwater endoscopic mucosal resection and management of residues for superficial non‐ampullary duodenal epithelial neoplasms
Authors: Iwagami Hiroyoshi , Takeuchi Yoji , Yamasaki Yasushi , Nakagawa Kentaro , Ohmori Masayasu , Matsuno Kenshi , Inoue Shuntaro , Iwatsubo Taro , Nakahira Hiroko , Matsuura Noriko , Shichijo Satoki , Maekawa Akira , Kanesaka Takashi , Higashino Koji , Uedo Noriya , Ishihara Ryu 
Published: September 2019

Background and AimUnderwater endoscopic mucosal resection (UEMR) is effective for superficial non‐ampullary duodenal epithelial neoplasms (SNADEN). However, the incidence of residual lesion after UEMR, especially for large lesions (≥20 mm), and their prognosis remain unclear. We aimed to assess the incidence of residual lesions and further outcomes after UEMR for SNADEN.MethodsWe carried out a retrospective study at a tertiary cancer institute. Candidates for the study were systematically retrieved from an endoscopic and pathological database from January 2013 to April 2018.ResultsA total of 162 SNADEN resected with UEMR were analyzed. Median (range) procedure time was 5 (1–70) min. En bloc resection rates for large lesions (≥20 mm) and small lesions (<20 mm) were 14% and 79%, respectively. Intraprocedural bleeding occurred in one (0.6%) case, but no intraprocedural perforation occurred during the study. Delayed bleeding occurred in two (1.2%) cases and delayed perforation occurred in one (0.6%) case. A total of 157 (97%) lesions were followed up by at least one endoscopic examination. Of these lesions, residual lesions were recognized in seven cases (5%). Additional UEMR was carried out in five lesions and underwater cold snare polypectomy in one lesion. One lesion was observed without additional treatment. After salvage intervention, no cases experienced further residual lesions.ConclusionAlthough UEMR for SNADEN can be relevant when other efficacious procedures are unavailable, careful follow up for residual lesions is required especially after piecemeal resection for large lesions.
Diagrammatic scale for severity evaluation of the Eremanthus erythropappus–Puccinia velata pathosystem
Authors: Martins Pereira Renata Cristina , de Alencar Laignier Filho Cézar , Amaral de Melo Lucas , Alozen Paulo Cesar , Gonçalves Mafia Reginaldo , Ferreira Barros Aline , Alves Ferreira Maria 
Published: September 2019

AbstractCandeia (Eremanthus erythropappus (DC.) MacLeish), a native forest species from South America, has garnered commercial interest due to its production of essential oil that contains alpha‐bisabolol. This compound is widely used in the pharmaceutical and cosmetics industry, with approximately 80% of Brazilian production being exported. Since candeia rust (Puccinia velata) has only been reported in Brazil, little is known about its epidemiology and control. There is no methodology to quantify rust severity in candeia, justifying the elaboration and validation of a diagrammatic scale containing eight levels of disease severity based on leaf area coverage (0.25%, 0.5%, 1%, 2%, 4%, 8%, 16% and 32%). In a natural sampling of disease in the field, 95% of the leaves showed severity below 16%, with the remaining 5% showing severities between 16% and 32% of leaf area. Validation of the proposed diagrammatic scale was performed by assessing the results from 10 inexperienced evaluators, performing evaluations of three leaves with different severity levels. The evaluations were performed at 7‐day intervals; in the first instance, severity values were assigned without the diagrammatic scale, and for the second attempt, the scale proposed in this study was used. The accuracy and precision of the severity estimates produced by each evaluator compared to the real severity was analysed by linear regression and by Lin's statistics. The reproducibility of the estimates was evaluated by analysing the coefficient of determination of linear regressions by pairs of evaluators. The scale provided adequate levels of accuracy, precision, repeatability and reproducibility, indicating the proposed scale was a suitable method for quantifying the severity of candeia rust.
Greater effect of warming on community composition with increased precipitation and in moister landscape location
Authors: Ronk Argo , Liancourt Pierre , Boldgiv Bazartseren , Petraitis Peter S. , Casper Brenda B. 
Published: September 2019

AbstractQuestionsWe asked how plant community composition responded to experimentally produced warmer and drier climate conditions at the landscape scale with existing variation in local species composition and environmental conditions. We aimed to identify changes in community composition overall and the species with greatest response in abundance, and hypothesized that locally restricted species may be more sensitive to warming than more widespread species within the landscape based on the assumption that they have a narrower niche breadth with respect to environmental conditions.LocationSemiarid, northern Mongolian steppe.MethodsOpen‐top passive warming chambers (OTCs) elevated temperatures at two slope locations that differed in elevation, degree of slope, environmental conditions, and species composition. The OTC treatment was crossed with watering on the drier upper slope. Community composition differences among treatments were examined using canonical analysis of principal coordinates (CAP), which identified species contributing the most to differences. In response to warming, we also compared species locally restricted to one slope location with locally widespread species.ResultsOpen‐top passive warming chambers affected community composition more where soil moisture was greater, at the lower slope location and where warming was combined with supplemental watering on the drier upper slope. Locally restricted species responded negatively to the OTC while locally widespread species showed no overall response.ConclusionsCommunity composition responses to warming differ even within the landscape over and above the initial differences that exist in community structure and abiotic factors. Our results suggest that a warmer and drier climate will impact community composition sooner under more mesic conditions, affect locally restricted species more strongly, and reduce variation in species composition across the landscape. To better predict community responses to future warming, we must consider combined and interactive effects with changes in precipitation and extant water availability.
Challenging the neurobiological link between number sense and symbolic numerical abilities
Authors: Wilkey Eric D. , Ansari Daniel 
Published: September 2019

AbstractA significant body of research links individual differences in symbolic numerical abilities, such as arithmetic, to number sense, the neurobiological system used to approximate and manipulate quantities without language or symbols. However, recent findings from cognitive neuroscience challenge this influential theory. Our current review presents an overview of evidence for the number sense account of symbolic numerical abilities and then reviews recent studies that challenge this account, organized around the following four assertions. (1) There is no number sense as traditionally conceived. (2) Neural substrates of number sense are more widely distributed than common consensus asserts, complicating the neurobiological evidence linking number sense to numerical abilities. (3) The most common measures of number sense are confounded by other cognitive demands, which drive key correlations. (4) Number sense and symbolic number systems (Arabic digits, number words, and so on) rely on distinct neural mechanisms and follow independent developmental trajectories. The review follows each assertion with comments on future directions that may bring resolution to these issues.
The pomegranate (Punica granatum L.) draft genome dissects genetic divergence between soft‐ and hard‐seeded cultivars
Authors: Luo Xiang , Li Haoxian , Wu Zhikun , Yao Wen , Zhao Peng , Cao Da , Yu Haiyan , Li Kaidi , Poudel Krishna , Zhao Diguang , Zhang Fuhong , Xia Xiaocong , Chen Lina , Wang Qi , Jing Dan , Cao Shangyin 
Published: September 2019

SummaryComplete and highly accurate reference genomes and gene annotations are indispensable for basic biological research and trait improvement of woody tree species. In this study, we integrated single‐molecule sequencing and high‐throughput chromosome conformation capture techniques to produce a high‐quality and long‐range contiguity chromosome‐scale genome assembly of the soft‐seeded pomegranate cultivar ‘Tunisia’. The genome covers 320.31 Mb (scaffold N50 = 39.96 Mb; contig N50 = 4.49 Mb) and includes 33 594 protein‐coding genes. We also resequenced 26 pomegranate varieties that varied regarding seed hardness. Comparative genomic analyses revealed many genetic differences between soft‐ and hard‐seeded pomegranate varieties. A set of selective loci containing SUC8‐like, SUC6, FoxO and MAPK were identified by the selective sweep analysis between hard‐ and soft‐seeded populations. An exceptionally large selective region (26.2 Mb) was identified on chromosome 1. Our assembled pomegranate genome is more complete than other currently available genome assemblies. Our results indicate that genomic variations and selective genes may have contributed to the genetic divergence between soft‐ and hard‐seeded pomegranate varieties.
On Empirical Methodology, Constraints, and Hierarchy in Artificial Grammar Learning
Authors: Levelt Willem J. M. 
Published: September 2019

AbstractThis paper considers the AGL literature from a psycholinguistic perspective. It first presents a taxonomy of the experimental familiarization test procedures used, which is followed by a consideration of shortcomings and potential improvements of the empirical methodology. It then turns to reconsidering the issue of grammar learning from the point of view of acquiring constraints, instead of the traditional AGL approach in terms of acquiring sets of rewrite rules. This is, in particular, a natural way of handling long‐distance dependences. The final section addresses an underdeveloped issue in the AGL literature, namely how to detect latent hierarchical structure in AGL response patterns.
Relationship Between Troponin on Presentation and In‐Hospital Mortality in Patients With ST‐Segment–Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
Authors: Wanamaker Brett L. , Seth Milan M. , Sukul Devraj , Dixon Simon R. , Bhatt Deepak L. , Madder Ryan D. , Rumsfeld John S. , Gurm Hitinder S. 
Published: September 2019

Background

Troponin release in ST‐segment–elevation myocardial infarction (
STEMI
) has predictable kinetics with early levels reflective of ischemia duration. Little research has examined the value of admission troponin levels in
STEMI
patients undergoing primary percutaneous coronary intervention. We investigated the relationship between troponin on presentation and mortality in a large, real‐world cohort of
STEMI
patients undergoing primary percutaneous coronary intervention.

Methods and Results

We used multivariable adaptive regression modeling to examine the association between admission troponin levels and in‐hospital mortality for patients who underwent primary percutaneous coronary intervention for
STEMI
. We adjusted for known clinical risk factors using a validated mortality risk model derived from the NCDR (National Cardiovascular Data Registry) CathPCI database, and this same model was used to calculate patients’ predicted mortality based on clinical and demographic factors. Patients were then stratified by troponin groups to compare predicted versus observed mortality. Of the 14 061 patients included in the cohort, 47.2% had initial troponin levels that were undetectable or within the reference range. Admission troponin was an independent predictor of in‐hospital mortality, and any value above the reference range was associated with increased mortality (1.8% versus 5.1%, [standardized difference, 18.2%]). Patients with the highest predicted risk for mortality (13% predicted) in the highest admission troponin grouping experienced an observed mortality of 19.5%. Patients in low troponin groupings consistently demonstrated lower than predicted mortality based on their clinical and demographic risk profile.

Conclusions

Nearly half of patients undergoing primary percutaneous coronary intervention had normal troponin on presentation and had a relatively good outcome. Mortality increases with elevated admission troponin levels, regardless of baseline clinical risk. The substantial number of patients who present with markedly elevated troponin and their relatively worse outcomes highlights the need for continued improvement in prehospital
STEMI
detection and care.
Machine Learning–Enabled Automated Determination of Acute Ischemic Core From Computed Tomography Angiography
Authors: Sheth Sunil A. , Lopez-Rivera Victor , Barman Arko , Grotta James C. , Yoo Albert J. , Lee Songmi , Inam Mehmet E. , Savitz Sean I. , Giancardo Luca 
Published: September 2019

Background and Purpose—
The availability of and expertise to interpret advanced neuroimaging recommended in the guideline-based endovascular stroke therapy (EST) evaluation are limited. Here, we develop and validate an automated machine learning-based method that evaluates for large vessel occlusion (LVO) and ischemic core volume in patients using a widely available modality, computed tomography angiogram (CTA).

Methods—
From our prospectively maintained stroke registry and electronic medical record, we identified patients with acute ischemic stroke and stroke mimics with contemporaneous CTA and computed tomography perfusion (CTP) with RAPID (IschemaView) post-processing as a part of the emergent stroke workup. A novel convolutional neural network named DeepSymNet was created and trained to identify LVO as well as infarct core from CTA source images, against CTP-RAPID definitions. Model performance was measured using 10-fold cross validation and receiver-operative curve area under the curve (AUC) statistics.

Results—

Among the 297 included patients, 224 (75%) had acute ischemic stroke of which 179 (60%) had LVO. Mean CTP-RAPID ischemic core volume was 23±42 mL. LVO locations included internal carotid artery (13%), M1 (44%), and M2 (21%). The DeepSymNet algorithm autonomously learned to identify the intracerebral vasculature on CTA and detected LVO with AUC 0.88. The method was also able to determine infarct core as defined by CTP-RAPID from the CTA source images with AUC 0.88 and 0.90 (ischemic core ≤30 mL and ≤50 mL). These findings were maintained in patients presenting in early (0–6 hours) and late (6–24 hours) time windows (AUCs 0.90 and 0.91, ischemic core ≤50 mL). DeepSymNet probabilities from CTA images corresponded with CTP-RAPID ischemic core volumes as a continuous variable with
r
=0.7 (Pearson correlation,
P
<0.001).

Conclusions—
These results demonstrate that the information needed to perform the neuroimaging evaluation for endovascular therapy with comparable accuracy to advanced imaging modalities may be present in CTA, and the ability of machine learning to automate the analysis.
Early Efficacy Analysis of Cluster and Conventional Immunotherapy in Patients With Allergic Rhinitis
Authors: Yu Jieqing , Zhong Nongping , Luo Qing , Liu Yuanhua , Yi Huarong , Ye Jing , Zhang Jian 
Published: September 2019

Background: Specific immunotherapy is an important immune-modifying treatment for patients with allergic rhinitis (AR). We compared the early efficacy and safety of cluster and conventional immunotherapies for patients with AR. Methods: One hundred forty-nine patients with persistent AR were enrolled in a randomized and open-label trial and were divided into the following 4 groups: 60 children treated conventionally, 33 children treated using the cluster schedule, 23 adults treated conventionally, and 33 adults treated using the cluster schedule. Patients in the cluster groups reached the maintenance dose within 6 weeks, while those receiving conventional therapy reached the maintenance dose within 14 weeks. Symptom scores and skin prick test scores (SPTs) were used to evaluate clinical efficacy and adverse reactions. Results: After buildup phase of treatment, symptom scores, and SPTs were significantly lower than those prior to treatment in each group ( P < .05). No significant differences were found in the efficacy of nasal symptoms scores among four groups ( P > .05).However, the efficacy of SPTs using conventional schedule was higher than cluster schedule in children groups (group A and B, 57.7 vs 30.2%, P = .001). Besides, the efficacy of SPTs in adults was higher than children when using the cluster treatment (group D and B, 53.0 vs 30.2%, P = .008). No severe adverse reaction occurred. Conclusions: Conventional and cluster immunotherapy schedules have similar efficacies, which do not vary with age; both schedules are safe and reliable. Also, SPT facilitate evaluation of clinical efficacy.
Diagnosing infection after infant open heart surgery: role of procalcitonin
Authors: Fakhri Dicky , Marwali Eva Miranda , Budiwardhana Novik , Roebiono Poppy Surwianti , Rahajoe Anna Ulfah , Caesario Michael 
Published: September 2019

Background Diagnosing infection in infants after cardiac surgery with cardiopulmonary bypass remains challenging. We aimed to determine whether procalcitonin discriminates post-cardiopulmonary bypass systemic inflammatory response syndrome from bacterial infection in infants better than C-reactive protein and leukocyte count. Method One hundred and eight infants underwent cardiac surgery with cardiopulmonary bypass. Leukocyte count, C-reactive protein, and procalcitonin were measured on arrival in the intensive care unit as baseline, and repeated on postoperative day 3. Bacterial infection was defined as proven infection with a positive blood or sputum culture. Results Twenty-four infants had proven bacterial infection. Baseline leukocyte counts and C-reactive protein levels did not differ significantly between the 2 groups. On postoperative day 3, C-reactive protein (62 vs. 38.5 mg·L−1, p = 0.01) and procalcitonin levels (6.58 vs. 0.41 ng·mL−1, p < 0.01) were higher in patients with bacterial infection. Leukocyte counts did not differ significantly between the two groups ( p = 0.94). The area under the receiver operating curve for leukocyte count, C-reactive protein, and procalcitonin was 0.49 ( p = 0.94), 0.67 ( p = 0.01), and 0.87 ( p < 0.0010), respectively. The optimal cutoff value of procalcitonin was 2.5 ng·mL−1 (sensitivity 75%, specificity 88%). Conclusion In infants undergoing cardiac surgery with cardiopulmonary bypass, procalcitonin discriminates bacterial infection from post-cardiopulmonary bypass systemic inflammatory response syndrome better than C-reactive protein and leukocyte count.
Is a combined programme of manual therapy and exercise more effective than usual care in patients with non-specific chronic neck pain? A randomized controlled trial
Authors: Domingues Lucia , Pimentel-Santos Fernando Manuel , Cruz Eduardo Brazete , Sousa Ana Cristina , Santos Ana , Cordovil Ana , Correia Anabela , Torres Laura Sa , Silva Antonio , Branco Pedro Soares , Branco Jaime Cunha 
Published: September 2019

Objective: The aim of this study was to compare the effectiveness of a combined intervention of manual therapy and exercise (MET) versus usual care (UC), on disability, pain intensity and global perceived recovery, in patients with non-specific chronic neck pain (CNP). Design: Randomized controlled trial. Setting: Outpatient care units. Subjects: Sixty-four non-specific CNP patients were randomly allocated to MET ( n = 32) or UC ( n = 32) groups. Interventions: Participants in the MET group received 12 sessions of mobilization and exercise, whereas the UC group received 15 sessions of usual care in physiotherapy. Main measures: The primary outcome was disability (Neck Disability Index). The secondary outcomes were pain intensity (Numeric Pain Rating Scale) and global perceived recovery (Patient Global Impression Change). Patients were assessed at baseline, three weeks, six weeks (end of treatment) and at a three-month follow-up. Results: Fifty-eight participants completed the study. No significant between-group difference was observed on disability and pain intensity at baseline. A significant between-group difference was observed on disability at three-week, six-week and three-month follow-up (median (P25–P75): 6 (3.25–9.81) vs. 15.5 (11.28–20.75); P < 0.001), favouring the MET group. Regarding pain intensity, a significant between-group difference was observed at six-week and three-month follow-up (median (P25–P75): 2 (1–2.51) vs. 5 (3.33–6); P < 0.001), with superiority of effect in MET group. Concerning the global perceived recovery, a significant between-group difference was observed only at the three-month follow-up ( P = 0.001), favouring the MET group. Conclusion: This study’s findings suggest that a combination of manual therapy and exercise is more effective than usual care on disability, pain intensity and global perceived recovery.
Blood concentrations of vitamins B1, B6, B12, C and D and folate in palliative care patients: Results of a cross-sectional study
Authors: Vollbracht Claudia , Gündling Peter W , Kraft Karin , Friesecke Iris 
Published: September 2019

Objective The main purpose of palliative care is symptom relief. Frequently, the symptoms of patients requiring palliative care are the same as common symptoms of vitamin deficiency (e.g. pain, weakness, fatigue, depression). The study aim was to investigate whether patients in palliative care are vitamin deficient. Method This was a monocentre cross-sectional study. Patients attending the palliative care unit of a general hospital in Germany from October 2015 to April 2016 were examined for vitamin blood concentrations and symptoms. Data were analysed using univariate analysis and bivariate correlations. Results Data were available from 31 patients. Vitamin D3 deficiency (<62.5 nmol/L) affected 93.5% of patients, vitamin B6 deficiency (<4.1 ng/mL) 48.4%, vitamin C deficiency (<4.5 mg/L) 45.2%, vitamin B1 deficiency (<35 µg/L) 25.8% and vitamin B12 deficiency (<193 pg/mL) 12.9%. There was a significant negative correlation between vitamin B1 ranges and pain (r = −0.384) and depression (r = −0.439) symptoms. Conclusion All patients showed a deficiency in at least one of the measured vitamins; 68% had concurrent deficiencies in >1 vitamin. A follow-up study using validated questionnaires and a larger sample is needed to investigate the effects of targeted vitamin supplementation on quality of life and symptom burden.
Clinical comparisons of patients with giant cell arteritis with versus without fever at onset
Authors: Zhang Yun , Wang Dongmei , Yin Yue , Fan Hongwei , Zhang Wen , Zeng Xuejun 
Published: September 2019

Objective Giant cell arteritis (GCA) is the most common systemic vasculitis in individuals aged ≥50 years. Some patients with GCA who develop fever at onset without typical ischemic manifestations may be misdiagnosed with fever of unknown origin. Methods In the present study, we retrospectively evaluated the clinical records of patients with GCA. Patients with and without fever at onset were compared. Results This study included 91 patients with GCA, 55 of whom had fever at onset. The patients with fever at onset showed a lower frequency of jaw claudication and arthralgia and a higher percentage of constitutional symptoms than patients without fever. Additionally, their laboratory results revealed a lower percentage of positive anti-neutrophil cytoplasmic antibody. Furthermore, a lower proportion of affected intracranial vessels was found in patients with fever at onset. Finally, the proportion of biopsy-positive cases was higher in patients with than without fever at onset. Conclusions In this study, 60.4% of patients with GCA had fever at onset. Patients in this group usually had more severe inflammation with a potentially lower risk of ischemic accidents of the central nervous system than patients without fever at onset.