bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strong temporal dynamics of QTL action on plant growth progression revealed through high‐throughput phenotyping in canola
Authors: Knoch Dominic , Abbadi Amine , Grandke Fabian , Meyer Rhonda C. , Samans Birgit , Werner Christian R. , Snowdon Rod J. , Altmann Thomas 
Published: May 2019

SummaryA major challenge of plant biology is to unravel the genetic basis of complex traits. We took advantage of recent technical advances in high‐throughput phenotyping in conjunction with genome‐wide association studies to elucidate genotype–phenotype relationships at high temporal resolution. A diverse Brassica napus population from a commercial breeding programme was analysed by automated non‐invasive phenotyping. Time‐resolved data for early growth‐related traits, including estimated biovolume, projected leaf area, early plant height and colour uniformity, were established and complemented by fresh and dry weight biomass. Genome‐wide SNP array data provided the framework for genome‐wide association analyses. Using time point data and relative growth rates, multiple robust main effect marker–trait associations for biomass and related traits were detected. Candidate genes involved in meristem development, cell wall modification and transcriptional regulation were detected. Our results demonstrate that early plant growth is a highly complex trait governed by several medium and many small effect loci, most of which act only during short phases. These observations highlight the importance of taking the temporal patterns of QTL/allele actions into account and emphasize the need for detailed time‐resolved analyses to effectively unravel the complex and stage‐specific contributions of genes affecting growth processes that operate at different developmental phases.
Attachment in donor‐conceived adults: Curiosity, search, and contact
Authors: Lozano Elizabeth B. , Fraley R. Chris , Kramer Wendy 
Published: May 2019

AbstractDonor‐conceived (DC) people represent a unique population with atypical family structures. This study examined whether individual differences in attachment predict adults' self‐reported curiosity about their donor conception identity, as well as attempts to find the donor and establish contact. Data were collected from 488 DC people from the Donor Sibling Registry (DSR). People who were high in attachment‐related anxiety were more curious than others about their donor conception. Despite this curiosity, however, highly anxious people were more disengaged from donor conception and were not more likely than others to search for or have made contact with their donor. These findings suggest that insecure attachment—particularly attachment anxiety—may contribute to people's willingness to incorporate donor conception into their identities.
Denying renal transplantation to an adolescent medical cannabis user: An ethical case study
Authors: Ryan Jennie E. , Noeder Maia , Burke Christine , Stubblefield Samuel C. , Sulieman Salwa , Miller Elissa G. 
Published: May 2019

AbstractMedical cannabis is now legal in over half of the United States. As more patients adopt this unconventional therapy, it is inevitable that potential transplant recipients will disclose their cannabis use during transplant evaluation. Transplant teams are tasked with the decision to utilize a pressure resource, often with little guidance from international and national professional organizations. Many healthcare providers remain uniformed or misinformed about the risks of cannabis use and organ transplantation. In order to illustrate the multifaceted and complex evaluation of transplant patients using medical cannabis, this article presents the case of a 20‐year‐old woman recommended for renal transplant who was originally denied active listing due to her medical cannabis use. A review of the literature explores the perceived and actual risks of cannabis use in the immunocompromised patient. Furthermore, a discussion of the ethics of medical cannabis use and organ transplantation is included with recommendations for multidisciplinary transplant teams.
The difficult abdominal closure after paediatric intestinal transplantation: Use of abdominal rectus muscle fascia and literature review
Authors: Cassar Noel , Cortes‐Cerisuelo Miriam , Bambridge Carly , Ali Amir , Heaton Nigel , Vilca‐Melendez Hector 
Published: May 2019

AbstractPrimary abdominal wall closure after intestinal and multivisceral transplantation may not be possible because of loss of abdominal domain and/or graft size/abdominal cavity mismatch. Traditional closure techniques for the open abdomen may not be valid in these circumstances because of severe scarring of the abdominal wall from multiple previous surgeries in this particular group of patients. We present our initial experience with the use of non‐vascularized abdominal rectus muscle fascia in two patients who underwent deceased donation and living‐related combined liver and small bowel transplantation, respectively, and who could not be closed primarily. The donor fascia was attached to the recipient fascia in both patients. In either case, there was not enough skin cover for closure, the wound was left open, and a negative pressure dressing was applied. In both cases, over a period of 6 months after placement of the non‐vascularized abdominal rectus muscle fascia, the wound contracted, granulation tissue gradually covered the wound, and healing occurred, giving an intact abdominal wall. The abdominal rectus muscle fascia from a deceased donor can be used in a definite procedure for closure of the abdominal wall either at the time of transplant or later when a suitable rectus muscle fascia graft becomes available.
Coronary artery involvement in chronic graft‐versus‐host disease presenting as sudden cardiac arrest
Authors: Kim Da Hyun , You Jung Jin , Im Ho Joon , Ko Jae Kon 
Published: May 2019

AbstractGraft‐versus‐host disease (GVHD) is related to considerable morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). Cardiac complications associated with GVHD are uncommon, and coronary artery involvement is even more unusual. We report on a male pediatric patient with chronic GVHD who developed a fatal ventricular arrhythmia caused by coronary artery obstruction after HSCT. At 30 months after HSCT, he suddenly collapsed with ventricular fibrillation. After resuscitation, electrocardiography showed abnormal q‐wave and ST changes in the inferior leads, suggesting a coronary event. Coronary angiography revealed complete obstruction of the proximal left anterior descending artery, subtotal obstruction of the mid left circumflex artery, and mild narrowing at the right coronary artery. This boy had none of the risk factors for coronary artery disease, and the only possible explanation for the cardiac event is GVHD. Coronary artery disease only rarely occurs as a cardiac event in children. However, coronary artery involvement should be recognized as one of the important manifestations of chronic GVHD in children.
Renal injury and recovery in pediatric patients after ventricular assist device implantation and cardiac transplant
Authors: Hollander Seth A. , Cantor Ryan S. , Sutherland Scott M. , Koehl Devin A. , Pruitt Elizabeth , McDonald Nancy , Kirklin James K. , Ravekes William J. , Ameduri Rebecca , Chrisant Maryanne , Hoffman Timothy M. , Lytrivi Irene D. , Conway Jennifer 
Published: May 2019

AbstractBackgroundThe use of ventricular assist devices (VADs) in children with heart failure may be of particular benefit to those with accompanying renal failure, as improved renal function is seen in some, but not all recipients. We hypothesized that persistent renal dysfunction at 7 days and/or 1 month after VAD implantation would predict chronic kidney disease (CKD) 1 year after heart transplantation (HT).MethodsLinkage analysis of all VAD patients enrolled in both the PEDIMACS and PHTS registries between 2012 and 2016. Persistent acute kidney injury (P‐AKI), defined as a serum creatinine ≥1.5× baseline, was assessed at post‐implant day 7. Estimated glomerular filtration rate (eGFR) was determined at implant, 30 days thereafter, and 12 months post‐HT. Pre‐implant eGFR, eGFR normalization (to ≥90 mL/min/1.73 m2), and P‐AKI were used to predict post‐HT CKD (eGFR <90 mL/min/1.73 m2).ResultsThe mean implant eGFR was 85.4 ± 46.5 mL/min/1.73 m2. P‐AKI was present in 19/188 (10%). Mean eGFR at 1 month post‐VAD implant was 131.1 ± 62.1 mL/min/1.73 m2, significantly increased above baseline (P < 0.001). At 1 year post‐HT (n = 133), 60 (45%) had CKD. Lower pre‐implant eGFR was associated with post‐HT CKD (OR 0.99, CI: 0.97‐0.99, P = 0.005); P‐AKI was not (OR 0.96, CI: 0.3‐3.0, P = 0.9). Failure to normalize renal function 30 days after implant was highly associated with CKD at 1 year post‐transplant (OR 12.5, CI 2.8‐55, P = 0.003).ConclusionsRenal function improves after VAD implantation. Lower pre‐implant eGFR and failure to normalize renal function during the support period are risk factors for CKD development after HT.
Bayesian Uncertainty-Directed Dose Finding Designs
Authors: Domenicano I. , Ventz S. , Cellamare M. , Mak R. H. , Trippa L. 
Published: May 2019

SummaryWe introduce Bayesian uncertainty-directed (BUD) designs for phase I–II dose finding trials. This class of designs assigns patients to candidate dose levels with the aim of maximizing explicit information metrics at completion of the trial, while avoiding the treatment of patients with toxic or ineffective dose levels during the trial. Explicit information metrics provide, at completion of the clinical study, accuracy measures of the final selection of optimal or nearly optimal dose levels. The BUD approach utilizes the decision theoretic framework and builds on utility functions that rank candidate dose levels. The utility of a dose combines the probabilities of toxicity events and the probability of a positive response to treatment. We discuss the application of BUD designs in two distinct settings; dose finding studies for single agents and precision medicine studies with biomarker measurements that allow dose optimization at the individual level. The approach proposed and the simulation scenarios used in the evaluation of BUD designs are motivated by a stereotactic body radiation therapy study in lung cancer at our institution.
Physicians’ gender bias in the diagnostic assessment of medically unexplained symptoms and its effect on patient–physician relations
Authors: Claréus Benjamin , Renström Emma A. 
Published: May 2019

Nonspecific, functional, and somatoform (NFS) syndromes is an umbrella term for various diagnoses with medically unexplained symptoms. These syndromes are more prevalent among women than among men, and associated with negative preconceptions that can impede rehabilitation. In two studies, we quantitatively assess how patients’ gender affects the diagnostic assessment of NFS syndromes, as well as the healthcare experiences of individuals diagnosed with NFS syndromes. In the first study, our vignette‐based experiment showed that Swedish general practitioners (N = 90) were gender biased in their diagnostic assessment of NFS syndromes, such that a female patient with back pain was more likely to be assigned a NFS syndrome compared to an otherwise identical male patient. In the second study, a large community sample of Swedish individuals with medically explained (n = 432) and unexplained pain (n = 521) evaluated their treating physician's relational conduct. Even after accounting for a variety of sociodemographic variables and other pain characteristics, women with at least one NFS syndrome percieved their physician's relational conduct as significantly poorer than other women as well as men with and without NFS syndromes. When women's pain is more likely than men's to be assessed as NFS, their rehabilitation could be prolonged as pertient alternative diagnoses and treatments are omittied and their negative healthcare experiences lower their volition to partake and persevere in treatment.
Bordetella pertussis in a four‐time kidney transplant recipient: A call for immunization programs at transplant centers
Authors: Hovel Elizabeth M. , Pease Robert C. , Scarano Andrew J. , Chen Derrick J. , Saddler Christopher M. 
Published: May 2019

AbstractPertussis, or whooping cough, is a highly contagious respiratory illness caused most frequently by Bordetella pertussis. Clinical presentation ranges in severity, but life‐threatening illness disproportionately affects children and immunocompromised individuals. Acellular vaccines for pertussis have been available for decades, and they are recommended throughout the lifespan. A patient who had received a kidney transplant presented with respiratory distress and dry cough as manifestations of co‐infection with B pertussis and Bordetella parapertussis/bronchiseptica. The goal of this case report was to highlight the importance of immunization programs at transplant centers, which are in the unique position to care for patients both with end‐stage organ disease and in the post‐transplant setting.
Sex‐mismatched red blood cell transfusions and mortality: A systematic review and meta‐analysis
Authors: Zeller Michelle P. , Rochwerg Bram , Jamula Erin , Li Na , Hillis Christopher , Acker Jason P. , Runciman Ryan J. R. , Lane Shannon J. , Ahmed Naveen , Arnold Donald M. , Heddle Nancy M. 
Published: May 2019

Background and ObjectivesSelection of a compatible red blood cell (RBC) unit does not include matching for donor sex. This systematic review and meta‐analysis aims to summarize the evidence examining the impact of sex‐mismatched RBC transfusion on recipient mortality.Materials and MethodsOvid MEDLINE, Ovid EMBASE, CINAHL, PubMed, Web of Science and the Cochrane Database of Systematic Reviews were searched from inception up to 23 November 2018. Randomized controlled trials and observational studies were included in the search. Eligible studies reported on the impact of sex‐matched compared to sex‐mismatched RBC transfusion on recipient mortality. Two investigators independently extracted data and assessed study quality. A three‐level meta‐analytic model was applied to emphasize the unknown dependence among the effect sizes.ResultsFive retrospective observational studies (n = 86 737) were included; no RCTs were found. Sex‐mismatched RBC transfusions were associated with a higher risk of death compared with sex‐matched transfusions (pooled hazard ratio [HR]: 1·13; 95% confidence interval [CI]: 1·02–1·24). In the subgroup of cardiovascular surgery (n = 57 712), there was no significant increase in mortality with sex‐mismatched transfusions (pooled HR: 1·08; 95% CI: 0·95–1·22). The data were prone to confounding, selection bias and reporting bias. Certainty of the evidence was very low.ConclusionSex‐mismatched RBC transfusions were associated with an increased risk of death in this pooled analysis. However, the certainty of the evidence was very low from observational studies. The need to match donor and recipient sex for transfusions requires further investigation because of the potential widespread impact.
Enterotoxic Clostridia:Clostridioides difficileInfections
Authors: Mileto S. , Das A. , Lyras D. 
Published: May 2019

ABSTRACTClostridioides difficileis a Gram-positive, anaerobic, spore forming pathogen of both humans and animals and is the most common identifiable infectious agent of nosocomial antibiotic-associated diarrhea. Infection can occur following the ingestion and germination of spores, often concurrently with a disruption to the gastrointestinal microbiota, with the resulting disease presenting as a spectrum, ranging from mild and self-limiting diarrhea to severe diarrhea that may progress to life-threating syndromes that include toxic megacolon and pseudomembranous colitis. Disease is induced through the activity of theC. difficiletoxins TcdA and TcdB, both of which disrupt the Rho family of GTPases in host cells, causing cell rounding and death and leading to fluid loss and diarrhea. These toxins, despite their functional and structural similarity, do not contribute to disease equally.C. difficileinfection (CDI) is made more complex by a high level of strain diversity and the emergence of epidemic strains, including ribotype 027-strains which induce more severe disease in patients. With the changing epidemiology of CDI, our understanding ofC. difficiledisease, diagnosis, and pathogenesis continues to evolve. This article provides an overview of the current diagnostic tests available for CDI, strain typing, the major toxinsC. difficileproduces and their mode of action, the host immune response to each toxin and during infection, animal models of disease, and the current treatment and prevention strategies for CDI.
Attack-related damage of thalamic nuclei in neuromyelitis optica spectrum disorders
Authors: Papadopoulou Athina , Oertel Frederike Cosima , Gaetano Laura , Kuchling Joseph , Zimmermann Hanna , Chien Claudia , Siebert Nadja , Asseyer Susanna , Bellmann-Strobl Judith , Ruprecht Klemens , Chakravarty M. Mallar , Scheel Michael , Magon Stefano , Wuerfel Jens , Paul Friedemann , Brandt Alexander Ulrich 
Published: May 2019

ObjectivesIn neuromyelitis optica spectrum disorders (NMOSD) thalamic damage is controversial, but thalamic nuclei were never studied separately. We aimed at assessing volume loss of thalamic nuclei in NMOSD. We hypothesised that only specific nuclei are damaged, by attacks affecting structures from which they receive afferences: the lateral geniculate nucleus (LGN), due to optic neuritis (ON) and the ventral posterior nucleus (VPN), due to myelitis.MethodsThirty-nine patients with aquaporin 4-IgG seropositive NMOSD (age: 50.1±14.1 years, 36 women, 25 with prior ON, 36 with prior myelitis) and 37 healthy controls (age: 47.8 ± 12.5 years, 32 women) were included in this cross-sectional study. Thalamic nuclei were assessed in magnetic resonance images, using a multi-atlas-based approach of automated segmentation. Retinal optical coherence tomography was also performed.ResultsPatients with ON showed smaller LGN volumes (181.6±44.2 mm3) compared with controls (198.3±49.4 mm3; B=−16.97, p=0.004) and to patients without ON (206.1±50 mm3; B=−23.74, p=0.001). LGN volume was associated with number of ON episodes (Rho=−0.536, p<0.001), peripapillary retinal nerve fibre layer thickness (B=0.70, p<0.001) and visual function (B=−0.01, p=0.002). Although VPN was not smaller in patients with myelitis (674.3±67.5 mm3) than controls (679.7±68.33; B=−7.36, p=0.594), we found reduced volumes in five patients with combined myelitis and brainstem attacks (B=−76.18, p=0.017). Volumes of entire thalamus and other nuclei were not smaller in patients than controls.ConclusionThese findings suggest attack-related anterograde degeneration rather than diffuse thalamic damage in NMOSD. They also support a potential role of LGN volume as an imaging marker of structural brain damage in these patients.
Selective neuronal damage and blood pressure in atherosclerotic major cerebral artery disease
Authors: Yamauchi Hiroshi , Kagawa Shinya , Takahashi Masaaki , Kusano Kuninori , Okuyama Chio 
Published: May 2019

ObjectiveIn patients with atherosclerotic major cerebral artery disease, low blood pressure might impair cerebral perfusion, thereby exacerbate the risk of selective neuronal damage. The purpose of this retrospective study was to determine whether low blood pressure at follow-up is associated with increased selective neuronal damage.MethodsWe retrospectively analysed data from 76 medically treated patients with atherosclerotic internal carotid artery or middle cerebral artery disease with no ischaemic episodes on a follow-up of 6 months or more. All patients had measurements of the distribution of central benzodiazepine receptors twice using positron emission tomography and 11C-flumazenil. Using three-dimensional stereotactic surface projections, we quantified abnormal decreases in the benzodiazepine receptors of the cerebral cortex within the middle cerebral artery distribution and correlated these changes in the benzodiazepine receptors index with blood pressure values at follow-up examinations.ResultsThe changes in the benzodiazepine receptor index during follow-up (mean 27±21 months) were negatively correlated with systolic blood pressure at follow-up. The relationship between changes in benzodiazepine receptor index and systolic blood pressure was different among patients with and without decreased cerebral blood flow at baseline (interaction, p<0.005). Larger increases in benzodiazepine receptor index (neuronal damage) were observed at lower systolic blood pressure levels in patients with decreased cerebral blood flow than in patients without such decreases.ConclusionIn patients without ischaemic stroke episodes at follow-up but with decreased cerebral blood flow due to arterial disease, low systolic blood pressure at follow-up may be associated with increased selective neuronal damage.
Causal relationship between years of education and the occurrence of rheumatoid arthritis
Authors: Bae Sang-Cheol , Lee Young Ho 
Published: May 2019

AbstractObjectiveTo search out whether or not years of education is causally related to rheumatoid arthritis (RA).MethodWe conducted a two-sample Mendelian randomisation (MR) analysis employing inverse-variance weighted (IVW), weighted median and MR-Egger regression analysis. We chose statistic data of years of education from the UK Biobank genome-wide association studies (GWASs) (n=293 723) as the exposure and a meta-analysis of GWASs of RA with autoantibody (n=5539) and European controls (n=20 169) as the outcome.ResultsWe selected a total of 49 single nucleotide polymorphisms as instrumental variables (IVs). The IVW method instructed an inverse causative relationship between years of education and RA (β=− 0.039, SE=0.283, p=0.008). MR-Egger regression test showed that directional pleiotropy seems not to bias the MR results (intercept=0.028; p=0.358). MR-Egger analysis demonstrated no causative relationship between RA and years of education (β=− 2.320, SE=1.709, p=0.181). However, the weighted median approach indicated a causative association between RA and years of education (β=−0.950, SE=0.355, p=0.008).ConclusionsThe MR analysis supported a potential inverse causative relationship between years of education and development of RA.
Time in remission and low disease activity state (LDAS) are associated with a better quality of life in patients with systemic lupus erythematosus: results from LUMINA (LXXIX), a multiethnic, multicentre US cohort
Authors: Ugarte-Gil Manuel Francisco , Pons-Estel Guillermo J , Vila Luis M , McGwin Gerald , Alarcón Graciela S 
Published: May 2019

AimsTo determine whether the proportion of time systemic lupus erythematosus patients achieve remission/low disease activity state (LDAS) is associated with a better quality of life (QoL).Patients and methodsPatients from a well-established multiethnic, multicentre US cohort were included: remission: Systemic Lupus Activity Measure (SLAM) score=0, prednisone≤5 mg/day and no immunosuppressants); LDAS not in remission, SLAM score≤3, prednisone≤7.5 mg/day, no immunosuppressants; the combined proportion of time patients were in these states was the independent variable. The endpoints were the Physical and Mental Components Summary measures (PCS and MCS, respectively) and the individual subscales of the Short Form (SF)-36 at the last visit. Linear regression was used to estimate the association between the proportion of follow-up time in remission/LDAS and the SF-36 measures with and without adjustment for possible confounders.ResultsFour hundred and eighty-three patients were included. The per cent of time on remission/LDAS was associated with better QoL after adjusting for potential confounders; for the PCS the parameter estimate was 9.47 (p<0.0001), for the MCS 5.89 (p=0.0027), and for the subscales they ranged between 7.51 (p=0.0495) for mental health and 31.79 (p<0.0001) for role physical.ConclusionsThe per cent of time lupus patients stay on remission/LDAS is associated with a better QoL as measured by SF-36.