bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictive clinical factors for penetration and aspiration in Parkinson's disease
Authors: Nienstedt Julie Cläre , Bihler Moritz , Niessen Almut , Plaetke Rosemarie , Pötter‐Nerger Monika , Gerloff Christian , Buhmann Carsten , Pflug Christina 
Published: December 2018

AbstractBackgroundDo the current swallow‐specific subquestions of neurological diagnostic tools reflect the objective swallowing function in Parkinson's disease (PD) patients or are clinical factors superior to predict critical aspiration?MethodsIn a cross‐sectional, observational study a total of 119 Parkinson outpatients were examined clinically and by flexible‐endoscopic evaluation of swallowing (FEES). Self‐reported dysphagia by subquestions of the MDS‐UPDRS and NMS questionnaire and history of subjective aspiration signs were collected.Key ResultsNearly, all PD patients showed deglutition abnormalities in FEES (113/119) while only 12%‐27% of them reported swallowing problems in the swallow‐specific subquestions of neurological standard diagnostic tools (MDS‐UPDRS and NMS‐Quest), and the answers were heterogeneous and poorly reproducible. With a sensitivity of up to a maximum of 50%, self‐reported dysphagia is therefore no reliable tool for identifying dysphagia in PD. While most clinical parameters were linked to dysphagia to some extent, logistic regression analysis revealed high age (Odds Ratio (OR) 1.1 in years, 95% CI 1.03‐1.18, P < 0.01), gender (OR 0.3 for females, 95% CI 0.08‐0.97, P = 0.04), and affirmed subjective aspiration signs (OR 8.6, 95% CI 3.05‐26.52, P < 0.001) as the most significant predictors for critical dysphagia.Conclusions and InferencesSelf‐perception of swallowing is no reliable tool for identifying dysphagia and questionnaires are insufficient for detecting previous aspiration. Consequent and specific asking for previous subjective aspiration signs is the single most important measure for identifying PD patients at risk for critical aspiration.
Increases in sampling support the southern Gondwanan hypothesis for the origin of dinosaurs
Authors: Marsola Júlio C. A. , Ferreira Gabriel S. , Langer Max C. , Button David J. , Butler Richard J. 
Published: December 2018

AbstractDinosaurs were ubiquitous in terrestrial ecosystems through most of the Mesozoic and are still diversely represented in the modern fauna in the form of birds. Recent efforts to better understand the origins of the group have resulted in the discovery of many new species of early dinosaur and their closest relatives (dinosauromorphs). In addition, recent re‐examinations of early dinosaur phylogeny have highlighted uncertainties regarding the interrelationships of the main dinosaur lineages (Sauropodomorpha, Theropoda and Ornithischia), and questioned the traditional hypothesis that the group originated in South Gondwana and gradually dispersed over Pangaea. Here, we use an historical approach to examine the impact of new fossil discoveries and changing phylogenetic hypotheses on biogeographical scenarios for dinosaur origins over 20 years of research time, and analyse the results in the light of different fossil record sampling regimes. Our results consistently optimize South Gondwana as the ancestral area for Dinosauria, as well as for more inclusive clades including Dinosauromorpha, and show that this hypothesis is robust to increased taxonomic and geographic sampling and divergent phylogenetic results. Our results do not find any support for the recently proposed Laurasian origin of dinosaurs and suggest that a southern Gondwanan origin is by far the most plausible given our current knowledge of the diversity of early dinosaurs and non‐dinosaurian dinosauromorphs.
Primary cutaneous CD4+ small‐ to medium‐sized pleomorphic T‐cell lymphoproliferative disorder in a pediatric patient successfully treated with low‐dose radiation
Authors: Kim Esther J. , Aria Alexander B. , Wilmas Kelly , Lewis Daniel J. , Torres‐Cabala Carlos A. , Nunez Cesar , Dabaja Bouthaina S. , Duvic Madeleine 
Published: December 2018

AbstractPrimary cutaneous CD4+ small‐ to medium‐sized pleomorphic T‐cell lymphoproliferative disorder (PCSM‐LPD) is a rare and low‐grade form of cutaneous T‐cell proliferation with the average age of diagnosis of 54 years. Because of its rarity, the etiology or exact clinicopathology of PCSM‐LPD remains unclear, with < 10 pediatric cases reported. A 13‐year‐old boy presented to our clinic with a raised tumor with PCSM‐LPD histology and was successfully treated with ultra‐low‐dose radiation therapy. While no standard of care has been established for pediatric PCSM‐LPD, this report represents an example of achieving remission in a pediatric tumor with minimal potential for therapy‐related long‐term toxicity.
Family violence and mental health in a sample of Finnish health care professionals: the mediating role of perceived sleep quality
Authors: Siltala Heli P. , Holma Juha M. , Hallman Maria 
Published: December 2018

BackgroundFamily violence (FV) is a prevalent health issue around the world and health care services have an important role in both recognizing and treating the consequences of violence. However, FV experiences among health care professionals themselves have not been investigated much. We also lack specific knowledge on the associations between FV and mental health.AimThe purpose of the study was to investigate the prevalence and effects of FV in a sample of Finnish health care professionals. In addition to analysing direct connections between different types of FV and mental health, the mediating effect of sleep quality was also taken into account.MethodsThe study followed a cross‐sectional design. The sample comprised 1952 health care professionals from Central Finland, who participated in a survey measuring their health and well‐being. The dependent variables were perceived sleep quality and mental health as measured by depressive symptoms and the mental health continuum short form (MHC‐SF) questionnaire. Data were analysed using cross‐tabulations, anova and structural equation modelling.ResultsThirty‐eight per cent of the participants reported experiencing FV. The most common forms of abuse were ‘psychological FV only’ and ‘psychological & physical abuse’. Participants with FV experiences scored significantly worse on depressive symptoms (p < 0.001), MHC‐SF classification (p = 0.008), sleep quality (p = 0.001) and emotional (p < 0.001), social (p < 0.001), and psychological (p = 0.008) well‐being. The mediation analyses indicated that the harmfulness of FV was at least partially explained by impaired sleep quality.ConclusionThe results indicate that FV experiences are common among Finnish health care professionals and that they can significantly affect their mental health. FV should thus be taken to account in seeking to promote the occupational well‐being of health care professionals. The results also suggest that the harmfulness of FV might be mediated by sleep quality. This finding prompts the need for further investigation and FV‐related interventions.
A case of pan‐resistant Burkholderia cepacia complex bacteremic pneumonia, after lung transplantation treated with a targeted combination therapy
Authors: Cantón‐Bulnes María Luisa , Hurtado Martínez Ángela , López‐Cerero Lorena , Arenzana Seisdedos Ángel , Merino‐Bohorquez Vicente , Garnacho‐Montero José 
Published: December 2018

AbstractWe describe a case of one patient with cystic fibrosis who developed a pan‐resistant Burkholderia cepacia complex rapidly progressive bacteraemic pneunonia, following bilateral lung transplantation. The patient was treated with a targeted combination antibiotic therapy (meropenem plus ceftazidime/avibactam plus high doses of nebulized colistimethate sodium). Evolution of the disease was complicated by multiple organ system dysfunction. Finally, clinical improvement and microbiological cure was achieved.
Pulsed dye laser repurposed: Treatment of refractory molluscum contagiosum in renal transplant patient
Authors: Fisher Chris , McLawhorn Justin M. , Adotama Prince , Stasko Thomas , Collins Lindsey , Levin Jarad 
Published: December 2018

AbstractWe present a case of a 15‐year‐old girl with an allogenic renal transplant secondary to chronic glomerulonephritis of unknown etiology who presented with treatment refractory molluscum contagiosum of the lower extremities and perineum. Treatment of mollusca with pulsed dye laser resulted in a clinically significant and sustained response. To our knowledge, this is the first report of a successful treatment of molluscum contagiosum with pulsed dye laser in the setting of a renal transplant.
Unusual presentation of Q fever in a kidney‐pancreas transplant recipient
Authors: Poch Joe , Ince Dilek , Thomas Christie , Dhakal Reshika , Gajurel Kiran 
Published: December 2018

AbstractQ fever is uncommon in solid organ transplant (SOT) recipients. We describe a case of granulomatous lung disease as an unusual presentation of chronic Q fever in a kidney‐pancreas transplant recipient.
Storage‐induced change in platelet transfusion response evaluated by serial transfusions from one donor to one patient
Authors: Tynngård Nahreen , Boknäs Niklas , Trinks Marie , Dreimane Arta , Berlin Gösta 
Published: December 2018

BACKGROUNDStorage of platelet concentrates (PCs) results in storage lesions with possible detrimental effects on platelet recovery after transfusion, which might affect their ability to prevent or arrest bleeding. The aim of this study was to compare the quality of PCs stored for 1 to 3 or 5 to 7 days by assessing the corrected count increment (CCI) after transfusion. To isolate the effects of storage time, we studied serial transfusions of PCs obtained from one donor and one donation, and transfused to one single recipient after storage for 1 to 3 days and 5 to 7 days.STUDY DESIGN AND METHODSPlatelets were obtained from one donor by apheresis, divided into two units (>240 × 109 platelets/unit) and stored for 1 to 3 and 5 to 7 days, respectively, before transfusion. The PCs were transfused on normal indications to patients undergoing treatment at the hematology ward. Platelet count was measured before and after transfusion.RESULTSThirty patients concluded the study according to the protocol. The mean storage time was 2.4 ± 0.7 and 5.7 ± 0.8 days for platelets transfused on Days 1 to 3 and 5 to 7, respectively. Storage for 5 to 7 days decreased the 1‐hour transfusion response as compared to platelets stored 1 to 3 days, from a CCI of 17 ± 7 to 13 ± 5. Despite this decrease, 86% of the 5 to 7 days stored PCs resulted in a CCI above the cutoff value for a successful transfusion of 7.5, which was not significantly different to PCs stored for 1 to 3 days.CONCLUSIONStorage of PCs for 5 to 7 days only slightly altered the transfusion response.
Propensity-matched analysis of minimally invasive approach versus sternotomy for mitral valve surgery
Authors: Grant Stuart W , Hickey Graeme L , Modi Paul , Hunter Steven , Akowuah Enoch , Zacharias Joseph 
Published: December 2018

ObjectiveThe objective of this multicentre study was to compare short-term and midterm outcomes between sternotomy and minimally invasive approaches for mitral valve surgery.MethodsData for all mitral valve procedures with or without concomitant tricuspid atrial fibrillation surgery were analysed from three UK hospitals between January 2008 and December 2016. To account for selection bias between minimally invasive approach and sternotomy, one-to-one propensity score calliper matching without replacement was performed. The main outcome measure was midterm reintervention free survival that was summarised by the Kaplan-Meier estimator and compared between treatment arms using the stratified log-rank test.ResultsA total of 2404 procedures (1757 sternotomy and 647 minimally invasive) were performed during the study period. Propensity score matching resulted in 639 matched pairs with improved balance postmatching in all 31 covariates (absolute standardised mean differences <10%). Despite longer procedural times patients who underwent minimally invasive surgery had a lower need for transfusion (20.5%vs14.4%, p=0.005) and reduced median postoperative length of stay (7 vs 6 days, p<0.001). There were no statistically significant differences in the rates of in-hospital mortality or postoperative stroke. Reintervention-free survival at 8 years was estimated as 86.1% in the minimally invasive group and 84.1% in the sternotomy group (p=0.40).ConclusionsMinimally invasive surgery is associated with excellent short-term outcomes and comparable midterm outcomes for patients undergoing mitral valve surgery. A minimally invasive approach should be considered for all patients who require mitral valve intervention and should be the standard against which transcatheter mitral techniques are compared.
Prospective phase II clinical trial of autologous haematopoietic stem cell transplant for treatment refractory multiple sclerosis
Authors: Moore John J , Massey Jennifer C , Ford Carole D , Khoo Melissa L , Zaunders John J , Hendrawan Kevin , Barnett Yael , Barnett Michael H , Kyle Kain A , Zivadinov Robert , Ma Kris C , Milliken Sam T , Sutton Ian J , Ma David D F 
Published: December 2018

BackgroundAutologous haematopoietic stem cell transplantation (AHSCT) has been explored as a therapeutic intervention in multiple sclerosis (MS) over the last two decades; however, prospective clinical trials of the most common myeloablative conditioning regimen, BEAM, are limited. Furthermore, patient selection, optimal chemotherapeutic regimen and immunological changes associated with disease response require ongoing exploration. We present the outcomes, safety and immune reconstitution (IR) of patients with active, treatment refractory MS.MethodsThis study was a single-centre, phase II clinical trial of AHSCT for patients with active relapsing remitting (RRMS) and secondary progressive MS (SPMS). Patients underwent AHSCT using BEAM (carmustine, etoposide, cytarabine, melphalan)+antithymocyte globulin chemotherapeutic regimen.OutcomesThe primary outcome was event-free survival (EFS); defined as no clinical or radiological relapses and no disability progression. Multiparameter flow cytometry was performed for evaluation of post-transplant IR in both MS and lymphoma patients receiving the same chemotherapy regimen.ResultsThirty-five patients (20 RRMS, 15 SPMS) completed AHSCT, with a median follow-up of 36 months (range 12–66). The median Expanded Disability Status Scores (EDSS) was 6 (2–7) and patients had failed a median of 4 (2–7) disease modifying therapies. 66% failed treatment with natalizumab. EFS at 3 years was 60%, (70% RRMS). Sustained improvement in EDSS was seen in 15 (44%) of patients. There was no treatment-related mortality. A sustained rise in CD39+T regulatory cells, immunosuppressive CD56hinatural killer cells and ablation of proinflammatory mucosal-associated invariant T cells was seen for 12 months following AHSCT in patients with MS. These changes did not occur in patients with lymphoma receiving the same chemotherapy for AHSCT.ConclusionsThe EFS in our MS cohort is significantly greater than other high-efficacy immunosuppressive therapies and similar to other AHSCT studies despite a more heavily pretreated cohort.Trial registration numberACTRN12613000339752.
Women’s occupational exposure to polycyclic aromatic hydrocarbons and risk of breast cancer
Authors: Lee Derrick G , Burstyn Igor , Lai Agnes S , Grundy Anne , Friesen Melissa C , Aronson Kristan J , Spinelli John J 
Published: December 2018

ObjectiveTo estimate the association between occupational polycyclic aromatic hydrocarbon (PAH) exposure and female breast cancer.MethodsLifetime work histories for 1130 cases and 1169 controls from British Columbia and Ontario (Canada) were assessed for PAH exposure using a job-exposure matrix based on compliance measurements obtained during US Occupational Safety and Health Administration workplace safety inspections.ResultsExposure to any level of PAHs was associated with an increased risk of breast cancer (OR=1.32, 95% CI: 1.10 to 1.59), as was duration at high PAH exposure (for >7.4 years: OR=1.45, 95% CI: 1.10 to 1.91; ptrend=0.01), compared with women who were never exposed. Increased risk of breast cancer was most strongly associated with prolonged duration at high occupational PAH exposure among women with a family history of breast cancer (for >7.4 years: OR=2.79, 95% CI: 1.25 to 6.24; ptrend<0.01).ConclusionsOur study suggests that prolonged occupational exposure to PAH may increase breast cancer risk, especially among women with a family history of breast cancer.
Effort matching between arms depends on relative limb geometry and personal control
Authors: Logan Lindsey M. , Semrau Jennifer A. , Cluff Tyler , Scott Stephen H. , Dukelow Sean P. 
Published: December 2018

Proprioception encompasses our sense of position and movement of our limbs, as well as the effort with which we engage in voluntary actions. Historically, sense of effort has been linked to centrally generated signals that elicit voluntary movements. We were interested in determining the effect of differences in limb geometry and personal control on sense of effort. In experiment 1, subjects exerted either extension or flexion torques to resist a torque applied by a robot exoskeleton to their reference elbow. They attempted to match this torque by exerting an equal effort torque (in a congruent direction with the reference arm) with their opposite (matching) arm in different limb positions (±15°). Subjects produced greater matching torque when their matching arm exerted effort toward the mirrored position of the reference (e.g., reference/matching arms at 90°/105° elbow flexion) vs. away (e.g., 90°/75° flexion). In experiment 2, a larger angular difference between arms (30°) resulted in a larger discrepancy in matched torques. Furthermore, in both experiments 1 and 2, subjects tended to overestimate the reference arm torque. This motivated a third experiment to determine whether providing more personal control might influence perceived effort and reduce the overestimation of the reference torques that we observed ( experiments 3a and 3b). Overestimation of the matched torques decreased significantly when subjects self-selected the reference torque that they were matching. Collectively, our data suggest that perceived effort between arms can be influenced by signals relating to the relative geometry of the limbs and the personal control of motor output during action. NEW & NOTEWORTHY This work highlights how limb geometry influences our sense of effort during voluntary motor actions. It also suggests that loss of personal control during motor actions leads to an increase in perceived effort.
Increased Cardiac Uptake of Ketone Bodies and Free Fatty Acids in Human Heart Failure and Hypertrophic Left Ventricular Remodeling
Authors: Voros Gabor , Ector Joris , Garweg Christophe , Droogne Walter , Van Cleemput Johan , Peersman Nele , Vermeersch Pieter , Janssens Stefan 
Published: December 2018

Background:
Deranged energy metabolism contributes to the pathophysiology of heart failure (HF). Recent studies showed diminished free fatty acid (FFA) oxidation in experimental HF models with a shift towards oxidation of ketone bodies. However, conflicting clinical data on FFA metabolism and limited knowledge on ketone body metabolism in human HF mandate additional metabolic profiling studies. We, therefore, investigated cardiac uptake of FFAs and ketone bodies (β-hydroxybutyrate and acetoacetate) in patients with HF with reduced ejection fraction (HFrEF) or with aortic stenosis (AS)–induced left ventricular hypertrophy. We hypothesized that FFA oxidation is impaired in HFrEF and in AS and results in decreased concentrations of free carnitine, the necessary carrier for mitochondrial entry of activated FFAs, and in accumulation of metabolic intermediates.

Methods and Results:
We collected arterial and coronary sinus blood samples in patients with HFrEF (n=15), in AS patients with preserved systolic function (n=15), and in control patients (n=15). Plasma concentration gradients across the heart show significantly greater uptake of ketone bodies in patients with HFrEF than in controls. Patients with AS show significantly increased uptake of β-hydroxybutyrate and FFAs. Free carnitine concentration and concentration gradients of intermediates of FFA oxidation were comparable between groups.

Conclusions:
In conclusion, our results show significantly increased cardiac uptake of ketone bodies in patients with stable HFrEF and AS and increased uptake of FFAs in AS compared with control patients. The lack of myocardial release of acyl-carnitine species or change in free carnitine uptake suggests no impairment of FFA oxidation.
Atmospheric Origins of Variability in the South Atlantic Meridional Overturning Circulation
Authors: Smith Timothy , Heimbach Patrick 
Published: December 2018

Abstract
Insights from the RAPID–MOCHA observation network in the North Atlantic have motivated a recent focus on the South Atlantic, where water masses are exchanged with neighboring ocean basins. In this study, variability in the South Atlantic meridional overturning circulation (SAMOC) at 34°S is attributed to global atmospheric forcing using an inverse modeling approach. The sensitivity of the SAMOC to atmospheric state variables is computed with the adjoint of the Massachusetts Institute of Technology general circulation model, which is fit to 20 years of observational data in a dynamically consistent framework. The dynamical pathways highlighted by these sensitivity patterns show that the domain of influence for the SAMOC is broad, covering neighboring ocean basins even on short time scales. This result differs from what has previously been shown in the North Atlantic, where Atlantic meridional overturning circulation (AMOC) variability is largely governed by dynamics confined to that basin. The computed sensitivities are convolved with surface atmospheric state variability from ERA-Interim to attribute the influence of each external forcing variable (e.g., wind stress, precipitation) on the SAMOC from 1992 to 2011. Here, local wind stress perturbations are shown to dominate variability on seasonal time scales while buoyancy forcing plays a minor role, confirming results from past forward perturbation experiments. Interannual variability, however, is shown to have originated from remote locations across the globe, including a nontrivial component originating from the tropical Pacific. The influence of atmospheric forcing emphasizes the importance of continuous widespread observations of the global atmospheric state for attributing observed AMOC variability.