bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Either Left Ventricular Hypertrophy or Diastolic Dysfunction With 24-Hour Central and Peripheral Blood Pressure
Authors: Blanch Pedro , Armario Pedro , Oliveras Anna , Fernández-Llama Patricia , Vázquez Susana , Pareja Julia , Álvarez Empar , Calero Francesca , Sierra Cristina , de la Sierra Alejandro 
Published: July 2018

Abstract

BACKGROUND
Central blood pressure (BP) is considered as a better estimator of hypertension-associated risks than peripheral BP. We aimed to evaluate the association of 24-hour central BP, in comparison with 24-hour peripheral BP, with the presence of left ventricular hypertrophy (LVH), or diastolic dysfunction (DD).

METHODS
The cross-sectional study consisted of 208 hypertensive patients, aged 57 ± 12 years, of which 34% were women. Office and 24-hour central and peripheral BP were measured by the oscillometric Mobil-O-Graph device. We performed echocardiography–Doppler measurements to calculate LVH and DD, defined as left atrium volume ≥34 ml/m2 or septal e′ velocity &lt;8 cm/s or lateral e′ velocity &lt;10 cm/s.

RESULTS
Seventy-seven patients (37%) had LVH, and 110 patients (58%) had DD. Systolic and pulse BP estimates (office, 24-hour, daytime, and nighttime) were associated with the presence of LVH or DD, after adjustment for age, gender, and antihypertensive treatment, with higher odds ratios for ambulatory-derived values. The comparison between central and peripheral BP estimates did not reveal a statistically significant superiority of the former neither in multiple regression models with simultaneous adjustments nor in the comparison of areas under receiver-operating curves. Correlation coefficients of BP estimates with left ventricular mass, although numerically higher for central BP, did not significantly differ between central and peripheral BP.

CONCLUSIONS
We have not found a significant better association of 24-hour central over peripheral BP, with hypertensive cardiac alterations, although due to the sample size, these results require further confirmation in order to assess the possible role of routine 24-hour central BP measurement.
Proprioceptive Weighting Ratio for Balance Control in Static Standing Is Reduced in Elderly Patients With Non–Specific Low Back Pain
Authors: Ito Tadashi , Sakai Yoshihito , Morita Yoshifumi , Yamazaki Kazunori , Igarashi Kazuma , Nishio Reiya , Sato Noritaka 
Published: July 2018

MINI
Elderly patients older than 65 years were divided into non-specific low back pain (NSLBP) and non-LBP (NLBP) groups. The postural control study of the relative contributions of different proprioceptive signals (relative proprioceptive weighting ratio [RPW]) revealed lower leg proprioceptive decreases (RPW 240 Hz) in NSLBP compared to NLBP.

Study Design.
A cross-sectional, observational study.

Objective.
The aim of this study was to determine a specific proprioceptive control strategy during postural balance in elderly patients with non-specific low back pain (NSLBP) and non-LBP (NLBP).

Summary of Background Data.
Proprioceptive decline is an important risk factor for decreased balance control in elderly patients with NSLBP. The resulting reduction in proprioception in the trunk or lower legs may contribute to a reduction in postural sway. This study aims to determine the specific proprioceptive control strategy used during postural balance in elderly patients with NSLBP and NLBP and to assess whether this strategy is related to proprioceptive decline in NSLBP.

Methods.
Pressure displacement centers were determined in 28 elderly patients with NSLBP and 46 elderly patients with NLBP during upright stances on a balance board without the benefit of vision. Gastrocnemius and lumbar multifidus muscle vibratory stimulations at 30, 60, and 240 Hz, respectively, were applied to evaluate the relative contributions of the different proprioceptive signals (relative proprioceptive weighting ratio, RPW) used in postural control.

Results.
Compared to elderly patients with NLBP, those with NSLBP had a lower RPW at 240 Hz and significantly higher RPW at 30 Hz. A logistic regression analysis showed that RPW at 240 Hz was independently associated with NSLBP after controlling for confounding factors.

Conclusion.
Elderly patients with NSLBP decreased their reliance on ankle strategy (RPW at 240 Hz) and hip strategy (RPW at 30 Hz) proprioceptive signals during balance control. The inability to control hip and ankle strategies indicates a deficit of postural control and is hypothesized to result from proprioceptive impairment. Moreover, elderly patients with NSLBP are at higher risk for lower leg proprioceptive decrease (240 Hz) through the NSLBP exacerbation.

Level of Evidence: 4
Endonasal Approach to Orbital Pathology
Authors: Curragh David S. , Halliday Luke , Selva Dinesh 
Published: July 2018

Purpose:
Transnasal endoscopic orbital surgery in an emerging surgical field. The surgical field has expanded from orbital decompression to excision of tumours from the medial orbit and over the last 20 years. As instrumentation has improved, the nature, location and size of tumours being excised has changed.

Methods:
This article discusses the salient surgical considerations when approaching an orbital lesion via a transnasal endoscopic route and reviews the literature.

Results:
An endonasal approach offers a potential space surgeons can utilise to access the orbit, possibly providing additional exposure, illumination and magnification to the medial and apical aspects of selected lesions.

Conclusions:
An endonasal approach may be useful as a sole or adjunctive approach in selected cases of orbital tumour excision.
Minimally Invasive Corneal Neurotization With Acellular Nerve Allograft: Surgical Technique and Clinical Outcomes
Authors: Leyngold Ilya M. , Yen Michael T. , Tian James , Leyngold Mark M. , Vora Gargi K. , Weller Christopher 
Published: July 2018

Purpose:
To describe a minimally invasive surgical technique and its clinical outcomes with the use of acellular nerve allograft to re-establish corneal sensibility in patients with neurotrophic keratopathy.

Methods:
Acellular nerve allograft was coapted to an intact supraorbital, supratrochlear, or infraorbital nerve and transferred to the affected eye. Donor nerve pedicles were isolated through a transpalpebral or transconjunctival approach. Retrospective evaluation of preoperative and postoperative corneal sensibility, ocular surface, and best-corrected visual acuity was performed in all patients. Mean follow-up period was 6 months (range: 3–10 months).

Results:
Corneal neurotization with acellular nerve allograft was successfully performed in 7 patients with restoration of corneal sensibility and corneal epithelial integrity. In vivo confocal microscopy demonstrated increased nerve density in corneal stroma at 4 months after surgery.

Conclusions:
The use of acellular nerve allograft allows for a minimally invasive approach to successful corneal neurotization.
Quality Improvement Bedside Rounding Audits Enhance Protein Provision for Pediatric Patients Receiving Continuous Renal Replacement Therapy*
Authors: Vega Molly Wong , Juarez Marisa , Lee Ji Yeon , Srivaths Poyyapakkam , Williams Eric , Akcan Arikan Ayse 
Published: July 2018

Objectives:
Describe quality improvement process improvements in protein delivery of continuous renal replacement therapy initiation.

Design:
Prospective study.

Setting:
PICU and cardiovascular ICU within a quaternary care children’s hospital.

Patients:
PICU and cardiovascular ICU patients receiving continuous renal replacement therapy for greater than 48 hours. Inborn errors of metabolism were excluded.

Interventions:
Plan-Do-Study-Act cycles were initiated. Cycle 1 developed interdisciplinary quality improvement group continuously monitoring nutrition care with thrice weekly bedside safety rounds and protein prescriptions within nephrologist’s notes. Cycle 2 included education to intensivists. Cycle 3 initiated monthly quality improvement meetings reviewing nutritional care goals.

Measurements and Main Results:
Primary outcome was percentage of time patients met protein goals in the first 5 days of continuous renal replacement therapy. Secondary outcome was percentage of time patients met protein goals for duration of continuous renal replacement therapy. Cohort (n = 55) mean age was 8.1 years (sd ± 6.8), 62% male, and 31% malnutrition at baseline. Percent of time meeting protein goals by day 5 was 22%, 33%, and 71% and percent of time meeting protein goals throughout was 35%, 39%, and 75% of groups 1, 2, and 3, respectively. Significant improvement occurred after Plan-Do-Study-Act 3 (group 2 vs group 3; p < 0.01) for primary and secondary outcomes.

Conclusions:
Implementation of an interprofessional quality improvement team significantly decreased number of continuous renal replacement therapy days with unmet protein goals and improved protein delivery.
Therapeutic Responses and Survival Effects of 177Lu-PSMA-617 Radioligand Therapy in Metastatic Castrate-Resistant Prostate Cancer
Authors: Kim Yong Joong , Kim Yong-il 
Published: July 2018

Purpose
We performed a meta-analysis on the therapeutic effects of prostate-specific membrane antigen (PSMA)–617 labeled with lutetium-177 (177Lu-PSMA-617) in patients with metastatic castration-resistant prostate cancer (mCRPC).

Patients and Methods
The primary outcome was the therapeutic responses after the first cycle of 177Lu-PSMA-617 radioligand therapy. The parameters studied were the pooled proportions of any prostate-specific antigen (PSA) decline and a greater than 50% PSA decline. The secondary outcome was the survival effects after 177Lu-PSMA-617 radioligand therapy. Studied parameters were pooled hazard ratios of the overall survival according to any PSA decline and a greater than 50% PSA decline after the first cycle of 177Lu-PSMA-617 radioligand therapy.

Results
In total, 10 eligible studies with 455 patients were finally included in this meta-analysis. The pooled proportions of any PSA decline was 68.00% (95% confidence interval [CI], 63.55%–72.22%], and those with a greater than 50% PSA decline was 34.45% (95% CI, 30.14%–38.97%). The pooled hazard ratios for the overall survival of any PSA decline was 0.29 (95% CI, 0.21–0.40) with significance (P < 0.00001); however, a greater than 50% PSA decline was 0.82 (95% CI, 0.54–1.25) with no significance (P = 0.39).

Conclusions
We suggest that approximately two-thirds of any PSA decline and one-third of a greater than 50% PSA decline can be expected after the first cycle of 177Lu-PSMA-617 radioligand therapy in patients with mCRPC. Moreover, any PSA decline showed survival prolongation after the first cycle of the 177Lu-PSMA-617 radioligand therapy.
An Incidental Finding of Subcutaneous Hemangioma During 99mTcO4 Salivary Gland Scintigraphy
Authors: Zhao Zhen , Chen Yu , Liu Bin 
Published: July 2018

Abstract
A 43-year-old woman with papillary thyroid cancer prepared for 131I ablation after total thyroidectomy. With a history of type 2 diabetes for 10 years, she recently presented with periodontitis, candidiasis, and mouth dryness. 99mTcO4 scintigraphy was ordered to evaluate function of the salivary glands. The scintigraphy incidentally found a focal 99mTcO4 uptake in the left supraclavicular region. The subsequent neck ultrasonography showed a hypoechoic soft tissue mass with heterogeneous hypervascularity, suggestive of hemangioma.
177Lu-DOTATATE Therapy in Radioiodine-refractory Differentiated Thyroid Cancer
Authors: Roll Wolfgang , Riemann Burkhard , Schäfers Michael , Stegger Lars , Vrachimis Alexis 
Published: July 2018

Introduction
Patients with radioiodine-refractory differentiated thyroid cancer (RrDTC) have a rather poor prognosis and are in need of novel treatments. As RrDTCs can in some cases express somatostatin receptors (SSRT), targeting of these receptors by 68Ga/177Lu-DOTATATE could evolve as a novel theranostic option.

Methods
Five RrDTC patients with limited further therapeutic options and documented expression of SSRT using 68Ga-DOTATATE-PET/CT received 2 to 4 cycles of PRRT with 177Lu-DOTATATE. Response to therapy was assessed by thyroglobulin (Tg) and morphological and metabolic criteria based on interim and follow-up 68Ga-DOTATATE-PET/CTs. Analysis was performed on a per-patient basis.

Results
In the post-therapy evaluation, only one out of five patients showed a partial response, whereas three patients had a progressive disease. One patient had discordant findings between stable imaging results albeit rising Tg levels.

Conclusion
In this case study of five patients, 177Lu-DOTATATE therapy showed only heterogeneous response and efficacy in RrDTC patients despite good lesional uptake in pre-therapeutic PET.
Targeted Therapy With Anaplastic Lymphoma Kinase Inhibitor (Alectinib) in Adolescent Metastatic Non–Small Cell Lung Carcinoma
Authors: Usmani Sharjeel , Marafi Fahad , Rasheed Rashid , Al Maraghy Muneera , al Kandari Fareeda 
Published: July 2018

Abstract
Primary lung adenocarcinoma is extremely rare in the pediatric age group. We report an 18-year-old man with non–small cell lung carcinoma stage IV with brain and bone metastatic. Lung biopsy showed expression of PDL1 along with rearrangement of ALK gene at chromosome 2p23. However, neither mutation of ROS1 nor epidermal growth factor receptor overexpression was seen. Second-generation anaplastic lymphoma kinase (ALK) inhibitor (alectinib) is initiated as first line of treatment. After 8 months of treatment with alectinib, 18F-NaF PET/CT demonstrated resolution of bone lesions. The present case show rapid and good response to alectinib in metastatic ALK-positive non–small cell lung carcinoma.
Multiple Subcutaneous Nodules as Initial Presentation of Diffuse Large B-cell Non-Hodgkin Lymphoma (DLBCL) Detected by PET/CT
Authors: Shen Guohua , Kou Ying , Liu Bin , Kuang Anren 
Published: July 2018

Abstract
Subcutaneous tissue as a manifestation of generalized disease is commonly involved in lymphomas. However, only skin involvement without other sites of extracutaneous disease was rarely presented, especially in diffuse large B-cell lymphoma (DLBCL). Herein, we reported an unusual case of primary cutaneous DLBCL, solely presenting with multiple subcutaneous nodules in the abdomen and back, and these nodules showed increased FDG uptake on PET/CT images. PET/CT is very helpful for diagnosing primary cutaneous DLBCL.
Assessing Patient Satisfaction Among Transgender Individuals Seeking Medical Services
Authors: Smith Jesse R. , Washington Arthur Zayne , Morrison Shane D. , Gottlieb Lawrence J. 
Published: July 2018

Background
Gender dysphoria is estimated to occur in up to 0.4% of the US population. Gender-confirming surgery (GCS) has been shown to improve the quality of life of transgender patients. However, a dearth of standardized and reliable measures specific to transgender individuals exists to objectively gauge sensitivity and competency among providers caring for these patients.

Methods
A comprehensive literature search of PubMed, MEDLINE, ISI Web of Science, and Cochrane databases using search terms related to provider competency and sensitivity during consultation for GCS was conducted for studies published through December 2017. Data were gathered from the publications that met inclusion criteria.

Results
The total number of articles focusing on transgender persons was 14 of more than 75,000 patient satisfaction–oriented published articles (<0.001%). Only 8 (57%) of the 14 represented original research. After applying the inclusion criteria, only 2 were found to discuss measures of patient satisfaction specific to transgender individuals. Of these 2, none evaluated patient satisfaction specific to the time of surgical consultation.

Conclusions
With increasing awareness and decreasing stigma surrounding transgender issues, it is likely that more transgender individuals will begin to seek GCS. There is a need for patient-reported experience measures specific to transgender individuals in order to appropriately gauge the interactions they experience with their surgeons. However, current instruments are neither standardized nor reliable for transgender patients to gauge provider sensitivity and competency.
Detecting clinically actionable variants in the 3’ exons of PMS2 via a reflex workflow based on equivalent hybrid capture of the gene and its pseudogene
Authors: Gould Genevieve M. , Grauman Peter V. , Theilmann Mark R. , Spurka Lindsay , Wang Irving E. , Melroy Laura M. , Chin Robert G. , Hite Dustin H. , Chu Clement S. , Maguire Jared R. , Hogan Gregory J. , Muzzey Dale 
Published: July 2018

AbstractBackgroundHereditary cancer screening (HCS) for germline variants in the 3’ exons of PMS2, a mismatch repair gene implicated in Lynch syndrome, is technically challenging due to homology with its pseudogene PMS2CL. Sequences of PMS2 and PMS2CL are so similar that next-generation sequencing (NGS) of short fragments—common practice in multigene HCS panels—may identify the presence of a variant but fail to disambiguate whether its origin is the gene or the pseudogene. Molecular approaches utilizing longer DNA fragments, such as long-range PCR (LR-PCR), can definitively localize variants in PMS2, yet applying such testing to all samples can have logistical and economic drawbacks.MethodsTo address these drawbacks, we propose and characterize a reflex workflow for variant discovery in the 3’ exons of PMS2. We cataloged the natural variation in PMS2 and PMS2CL in 707 samples and designed hybrid-capture probes to enrich the gene and pseudogene with equal efficiency. For PMS2 exon 11, NGS reads were aligned, filtered using gene-specific variants, and subject to standard diploid variant calling. For PMS2 exons 12-15, the NGS reads were permissively aligned to PMS2, and variant calling was performed with the expectation of observing four alleles (i.e., tetraploid calling). In this reflex workflow, short-read NGS identifies potentially reportable variants that are then subject to disambiguation via LR-PCR-based testing.ResultsApplying short-read NGS screening to 299 HCS samples and cell lines demonstrated >99% analytical sensitivity and >99% analytical specificity for single-nucleotide variants (SNVs) and short insertions and deletions (indels), as well as >96% analytical sensitivity and >99% analytical specificity for copy-number variants. Importantly, 92% of samples had resolved genotypes from short-read NGS alone, with the remaining 8% requiring LR-PCR reflex.ConclusionOur reflex workflow mitigates the challenges of screening in PMS2 and serves as a guide for clinical laboratories performing multigene HCS. To facilitate future exploration and testing of PMS2 variants, we share the raw and processed LR-PCR data from commercially available cell lines, as well as variant frequencies from a diverse patient cohort.
Multiscale analysis of structurally conserved motifs
Authors: Cazals F. , Tetley R. 
Published: July 2018

AbstractThis work develops a generic framework to perform a multiscale structural analysis of two structures (homologous proteins, conformations) undergoing conformational changes. Practically, given a seed structural alignment, we identify structural motifs with a hierarchical structure, characterized by three unique properties. First, the hierarchical structure sheds light on the trade-off between size and flexibility. Second, motifs can be combined to perform an overall comparison of the input structures in terms of combined RMSD - an improvement over the classical least RMSD. Third, motifs can be used to seed iterative aligners, and to design hybrid sequence-structure profile HMM characterizing protein families.From the methods standpoint, our framework is reminiscent from the bootstrap and combines concepts from rigidity analysis (distance difference matrices), graph theory, computational geometry (space filling diagrams), and topology (topological persistence).On challenging cases (class II fusion proteins, flexible molecules) we illustrate the ability of our tools to localize conformational changes, shedding light of commonalities of structures which would otherwise appear as radically different.Our tools are available within the Structural Bioinformatics Library (http://sbl.inria.fr). We anticipate that they will be of interest to perform structural comparisons at large, and for remote homology detection.
Adaptive introgression: an untapped evolutionary mechanism for crop adaptation
Authors: Burgarella Concetta , Barnaud Adeline , Ardo Kane Ndjido , Jankowsky Frédérique , Scarcelli Nora , Billot Claire , Vigouroux Yves , Berthouly-Salazar Cécile 
Published: July 2018

ABSTRACTGlobal environmental changes strongly impact wild and domesticated species biology and their associated ecosystem services. For crops, global warming has led to significant changes in terms of phenology and/or yield. To respond to the agricultural challenges of this century, there is a strong need for harnessing the genetic variability of crops and adapting them to new conditions. Gene flow, from either the same species or a different species, may be an immediate primary source to widen genetic diversity and adaptions to various environments. When the incorporation of a foreign variant leads to an increase of the fitness of the recipient pool, it is referred to as “adaptive introgression”. Crop species are excellent case studies of this phenomenon since their genetic variability has been considerably reduced over space and time but most of them continue exchanging genetic material with their wild relatives. In this paper, we review studies of adaptive introgression, presenting methodological approaches and challenges to detecting it. We pay particular attention to the potential of this evolutionary mechanism for the adaptation of crops. Furthermore, we discuss the importance of farmers’ knowledge and practices in shaping wild-to-crop gene flow. Finally, we argue that screening the wild introgression already existing in the cultivated gene pool may be an effective strategy for uncovering wild diversity relevant for crop adaptation to current environmental changes and for informing new breeding directions.
Activin signaling informs the graded pattern of terminal mitosis and hair cell differentiation in the mammalian cochlea
Authors: Prajapati-DiNubila Meenakshi , Benito-Gonzalez Ana , Golden Erin J. , Zhang Shuran , Doetzlhofer Angelika 
Published: July 2018

ABSTRACTThe mammalian auditory sensory epithelium has one of the most stereotyped cellular patterns known in vertebrates. Mechano-sensory hair cells are arranged in precise rows, with one row of inner and three rows of outer hair cells spanning the length of the spiral-shaped sensory epithelium. Aiding such precise cellular patterning, differentiation of the auditory sensory epithelium is precisely timed and follows a steep longitudinal gradient. The molecular signals that promote auditory sensory differentiation and instruct its graded pattern are largely unknown. Here, we identify Activin A as an activator of hair cell differentiation and show, using mouse genetic approaches, that a local gradient of Activin A signaling within the auditory sensory epithelium times the longitudinal gradient of hair cell differentiation. Furthermore, we provide evidence that Activin-type signaling regulates a radial gradient of terminal mitosis within the auditory sensory epithelium, which constitutes a novel mechanism for limiting the number of inner hair cells being produced.