bluuebunny/crossref_metadata_2025_split huggingface dataset:
The drug use to treat community-acquired pneumonia in children
Authors: Mi Xue , Li Wenrui , Zhang Lingli , Li Jialian , Zeng Linan , Huang Liang , Chen Lina , Song Haoxin , Huang Zongyao , Lin Mao 
Published: November 2018

Abstract
To evaluate the rationality of drug use to treat community-acquired pneumonia (CAP) in children of a Chinese hospital using a set of developed indicators.
We performed a retrospective cross-sectional study in West China Second University Hospital. Hospitalized children (0–18 years old) diagnosed with CAP from October 2015 to January 2016 were included. A set of developed indicators for assessing rational drug use (RDU) to treat CAP in children were used to evaluate the rationality of drug use. The data of the indicators were compared with the recommendations of the available guidelines, analyzing the situation of drug use in the children diagnosed with CAP.
Eight hundred ninety-four children were included, 99.4% of them received antibiotics and 87.4% received more than 1 antibiotic. Antibiotics were administered intravenously in 880 (99.0%) children. About 20 (2.2%) children received antiviral agents and 19 (2.1%) children received antiviral drugs combined with antibiotics. About 208 (23.3%) children received traditional Chinese medicines and the injection of traditional Chinese medicines was given in 20 (2.2%) children.
This study illustrated that drug use was partly not consistent with the recommendations of current guidelines, especially antibiotics. The drug use of CAP in children needs to pay more attention to.
An estrogen receptor-positive locally aggressive smooth muscle neoplasm of the transverse colon
Authors: Usui Genki , Hashimoto Hirotsugu , Watanabe Kazuteru , Sugiura Yoshiya , Kusakabe Masashi , Sakai Eiji , Harihara Yasushi , Horiuchi Hajime , Morikawa Teppei 
Published: November 2018

Abstract

Rationale:
Extrauterine leiomyomas (LMs) in women are often positive for the estrogen receptor (ER); however, almost all extrauterine leiomyosarcomas (LMSs) are negative for ER. Invasive smooth muscle neoplasms (SMNs) of the gastrointestinal tract walls are very rare and those ER statuses have not been well studied.

Patient concerns:
A 48-year-old woman presented to our hospital with a 10 years history of recurrent severe abdominal pain and diarrhea lasting about an hour, with frequency of about twice per year. She was clinically diagnosed with a submucosal tumor (SMT) of the transverse colon and underwent a partial transverse colectomy.

Diagnosis:
A colonoscopy revealed a 30-mm SMT in the transverse colon. A contrast abdominal computed tomography detected a 21-mm mass with significant late phase enhancement in the transverse colon and the lesion was clinically diagnosed as an SMT. Post-operative pathology confirmed a diagnosis of ER-positive locally aggressive SMN.

Interventions:
The patient underwent laparoscopic partial transverse colectomy.

Outcomes:
The patient received no adjuvant therapy postoperatively. The patient has remained disease-free without recurrence 13 months after the surgery.

Lessons:
This is the first case of an ER-positive invasive SMN in the gastrointestinal tract. It highlights the difficulty in classifying some gastrointestinal SMNs as either LMs or LMSs and the importance of ER status in SMNs.
Successful conservative treatment of acute traumatic occlusions of the celiac artery and superior mesenteric artery
Authors: Lim Kyoung Hoon , Park Jinyoung 
Published: November 2018

Abstract

Rationale:
Blunt injury of major visceral arteries such as celiac artery (CA) and superior mesenteric artery (SMA) are very rare but fatal, therefore, these injuries are challenging to trauma surgeons. The patient with occlusion of CA or SMA is theoretically viable by visceral collateral circulation. However, there are very rare cases in clinics. To date, there have been few reports of both CA and SMA occlusions after blunt trauma. Herein we describe our successful conservative treatment of patients with both CA and SMA occlusions.

Patient concerns:
Fifteen-year-old girl suffering from schizophrenia was transferred to our hospital after a fall from 3-floor-height with a purpose of suicide.

Diagnoses:
An abdominal computed tomography (CT) scan with contrast enhancement showed proximal CA and proximal SMA occlusions with surrounding retroperitoneal hematoma, however, distal parts of occlusion were supplied by the collateral vessels (enlarged marginal artery of left colon from inferior mesenteric artery and pancreaticoduodenal arcade).

Interventions:
She was treated by only supportive care without anticoagulant due to retroperitoneal hematoma.

Outcomes:
The patient was discharged 25 days after admission without complications.

Lessons:
We think that our patient could survive because her vascular status was healthy and collateral circulations were plenty according to the young age. We believe that this case can provide a basis for ligation in these forbidding and handless major visceral arterial injuries such as CA or SMA.
Changes in choriocapillaris and retinal morphology after laser photocoagulation by OCT angiography
Authors: Iwase Takeshi , Ueno Yoshitaka , Ra Eimei , Ito Yasuki , Terasaki Hiroko 
Published: November 2018

Abstract

Rationale:
Earlier studies have shown that laser photocoagulation treatments are associated with good long-term visual acuity in most patients with severe nonproliferative diabetic retinopathy (S-NPDR). Histopathologic studies of autopsied eyes have demonstrated defects in the choriocapillaris beneath the retinal laser lesions secondary to photocoagulation for S-NPDR. These lesions have been observed to expand centrifugally over time especially in the posterior pole, and the atrophy of the retinal pigment epithelium (RPE) can be significantly enlarged. There are, however, limited studies detailing the in vivo changes that occur in the RPE and choriocapillaris following laser photocoagulation.

Patient concerns:
A 46-year-old woman presented with visual disturbances in both eyes.

Diagnoses:
Fundus examinations showed many retinal hemorrhages and soft exudates in the four quadrants due to S-NPDR.

Interventions:
Laser photocoagulations with a 532-nm wavelength argon laser with power of 170 to 230 mW and spot size of 200 μm were performed to treat the S-NPDR. The changes in the choriocapillaris and retinal vasculature were followed by optical coherence tomography (OCT) angiography.

Outcomes:
The choriocapillaris beneath the laser spots was disrupted from 1 hour following the photocoagulation but it was restored at week 2. The choriocapillaris appeared almost normal at some laser spots, but they were still some spots that were altered at 1 year. The outer retina and RPE were disrupted beneath the laser spots at 1 year. On the contrary, there were no visible retinal vascular changes in the superficial and deep plexuses of retinal vasculature determined by OCT angiography with manual and automated segmentation.

Lessons:
The choriocapillaris in human eyes can recover after laser photocoagulation although the outer retina and RPE remain disrupted and do not recover.
Test Characteristics of Cerebrospinal Fluid Gram Stain to Identify Bacterial Meningitis in Infants Younger Than 60 Days
Authors: Balamuth Fran , Cruz Andrea T. , Freedman Stephen B. , Ishimine Paul T. , Garro Aris , Curtis Sarah , Grether-Jones Kendra L. , Miller Aaron S. , Uspal Neil G. , Schmidt Suzanne M. , Shah Samir S. , Nigrovic Lise E. ,   for the Pediatric Emergency Medicine Collaborative Research Committee (PEMCRC) HSV Study Group
Published: November 2018

Abstract
In our cohort of 20,947 infants aged 60 days or younger, cerebrospinal fluid Gram stain had a sensitivity of 34.3% (95% confidence interval, 28.1%–41.1%) and a positive predictive value of 61.4% (95% confidence interval, 52.2%–69.8%) for positive cerebrospinal fluid culture, suggesting that Gram stain alone may lead to both underdiagnosis and overdiagnosis of bacterial meningitis.
Perceived Versus Calculated HIV Risk: Implications for Pre-exposure Prophylaxis Uptake in a Randomized Trial of Men Who Have Sex With Men
Authors: Blumenthal Jill , Jain Sonia , Mulvihill Evan , Sun Shelly , Hanashiro Marvin , Ellorin Eric , Graber Sara , Haubrich Richard , Morris Sheldon 
Published: November 2018

Background:
Inaccurate HIV risk perception by men who have sex with men is a barrier to HIV prevention. Providing information about objective HIV risk could improve pre-exposure prophylaxis (PrEP) uptake.

Methods:
PrEP Accessibility Research & Evaluation 2 (PrEPARE2) was a randomized controlled trial of men who have sex with men to determine whether an objective risk score affects future PrEP uptake. Participants completed a baseline survey to assess demographics, risk behaviors, and HIV self-perceived risk (SPR). The survey generated a calculated HIV risk (CalcR) score, estimating HIV risk based on reported condomless anal intercourse and sexually transmitted infections, and was provided to individuals in the intervention arm. Participants were contacted 8 weeks later to determine whether they initiated PrEP.

Results:
Of 171 participants (median age 32 years; 37% Hispanic or non-Hispanic Black; median 5 sexual partners in the past 6 months), 81% had heard of PrEP, and 57% believed they were good PrEP candidates. SPR had poor agreement with CalcR (kappa = 0.176) with 38% underestimating their HIV risk. At week 8, only 14 of 135 participants had initiated PrEP with no difference between arms (CalcR 11%, control 10%, P > 0.99). The most common reason for not starting PrEP was low HIV risk perception. There was a relative decrease in SPR over time (P = 0.06) but no difference between arms (P = 0.29).

Conclusion:
Providing an objective HIV risk score alone did not increase PrEP uptake. HIV testing performed at testing sites may be a crucial time to correct misperceptions about risk and initiate same-day PrEP, given enthusiasm for PrEP on the testing day to facilitate greater uptake.
Impact of a Youth-Focused Care Model on Retention and Virologic Suppression Among Young Adults With HIV Cared for in an Adult HIV Clinic
Authors: Griffith David , Snyder Jeremy , Dell Shanna , Nolan Kisten , Keruly Jeanne , Agwu Allison 
Published: November 2018

Background:
Young adults with HIV (YAHIV) are less likely to be retained in care or achieve viral suppression (VS) when seen in adult clinics. We assessed the outcomes of a youth-focused care model versus standard of care (SOC) within a large adult HIV clinic.

Setting:
The Accessing Care Early (ACE) program for YAHIV is embedded within an adult clinic. Eligibility for ACE includes age 18–30 years with ≥1 criteria: transfer from pediatric care, mental health diagnosis, substance use, or identified adherence barriers. Ineligible patients receive SOC.

Methods:
Retrospective analysis of patients entering ACE versus SOC from 2012 to 2014. Multivariable logistic regression assessed variables associated with retention and VS <200 copies per milliliter, and in separate analysis, clinical services utilization.

Results:
One hundred thirty-seven YAHIV entered care (2012–2014), 61 ACE and 76 SOC. Despite higher risk factors, ACE YAHIV were less likely to be lost to follow-up compared with SOC (16% versus 37%, P < 0.01). At 24 months, 49% in ACE versus 26% in SOC met the retention measure (P < 0.01). In adjusted analysis, ACE was associated with retention in care [AOR 3.26 (1.23–8.63)]. Of those meeting the retention measure, 60% of ACE versus 89% of SOC had VS [AOR 0.63 (0.35–1.14)]. Retention was associated with more frequent social work visits, nurse phone calls, and peer navigator interactions.

Conclusions:
Higher risk ACE YAHIV had better retention than SOC YAHIV in an adult clinic. Improved retention did not lead to improved VS, underscoring the need for additional interventions to optimize VS for YAHIV.
Dynamic Volume Change Rate and Aspect Ratio Are Correlated to the Formation of an Irregular Morphology of Unruptured Intracranial Aneurysm
Authors: Gu Yan , Zhang Yonggang , Luo Meng , Zhang Hongwei , Liu Xiguang , Miao Chongchang 
Published: November 2018

Objective
The aim of this research was to study the factors influencing the formation of intracranial aneurysms with irregular morphology by observing the dynamic volume change rate of intracranial unruptured aneurysms and other aneurysm characteristics.

Method
Sixty-five unruptured intracranial aneurysms of 51 consecutive patients from 1 center were included in this study. All patients underwent a dual-source computed tomography electrocardiogram-gated 4-dimensional computed tomography angiography examination. The original data at the end of the scan were reconstructed, and 20 sets of data packages through a cardiac cycle with 5% interval were obtained. Data packages were processed by a 3-dimensional software workstation to obtain 20 sets of images and dynamic diagrams. The volume of each aneurysm in the 20 sets of images was measured, and the volume change was calculated by a specific formula. The other data features of the aneurysm such as aneurysm neck, aneurysm height, aspect ratio (AR), location at bifurcation, and clinical features such as age, sex, hypertension history, type 2 diabetes history, smoking history, family history, multiple aneurysm history, and subarachnoid hemorrhage history, were documented in detail. After single factor analysis data, logistic regression analysis of the meaningful indicator was conducted to study the predictive factors of irregular aneurysms.

Results
Of the 65 aneurysms, 25 possessed an irregular shape and 40 were of regular shape; 51 were anterior circulatory aneurysms and 14 were posterior circulatory aneurysms. Single factor analysis showed that AR (P = 0.001), volume change rate (P = 0.002), and location of aneurysm at the bifurcation (P = 0.038) of the vessel were significantly correlated with irregular aneurysms, but not correlated with age, sex, hypertension history, type 2 diabetes history, smoking history, family history, multiple aneurysm history, and subarachnoid hemorrhage history. Multifactor analysis showed that volume change rate greater than 30% (P = 0.008; odds ratio, 6.934) and AR greater than 1.4 (P = 0.004; odds ratio, 8.258) were independent correlative factors of the formation of intracranial aneurysm with irregular shape.

Conclusion
The volume change rate and AR are independent correlative factors of the formation of intracranial aneurysm with irregular shape.
Coronary Artery Calcium Scoring: Current Status and Review of Literature
Authors: Malguria Nagina , Zimmerman Stefan , Fishman Elliot K. 
Published: November 2018

AbstractCoronary artery calcium is a marker of overall atherosclerotic plaque burden, corresponding to approximately 20% overall atherosclerotic plaque burden. Coronary artery calcium screening, most commonly performed using the Agatston score, has been shown to be a predictor of future cardiovascular risk independent of conventional risk scores such as the Framingham risk score. Coronary artery calcium screening is also recommended on routine nongated, noncontrast chest computed tomography scans using several ordinal and visual scoring systems.
Single particle cryo-EM reconstruction of 52 kDa streptavidin at 3.2 Angstrom resolution
Authors: Fan Xiao , Wang Jia , Zhang Xing , Yang Zi , Zhang Jin-Can , Zhao Lingyun , Peng Hai-Lin , Lei Jianlin , Wang Hong-Wei 
Published: November 2018

AbstractThe fast development of single particle cryo-EM has made it more feasible to obtain the 3D structure of well-behaved macromolecules with molecular weight higher than 300 kDa at ~3 Å resolution. It remains a challenge to obtain high resolution structure of molecules smaller than 100 kDa using single particle cryo-EM, mainly due to the low contrast of the molecules embedded in vitreous ice. In this work, we applied the Cs-corrector-VPP coupled cryo-EM to study 52 kDa streptavidin (SA) protein supported on a thin layer of graphene film and embedded in vitreous ice. We were able to solve both the apo-SA and biotin-bound SA at near-atomic resolution using single particle cryo-EM. We demonstrated that the method is capable to determine the structure of molecule as small as 39 kDa and potentially even smaller molecules. Furthermore, we found that using the graphene film to avoid the adsorption to the air-water interface is critical to maintain the protein’s high-resolution structural information.
Habitat fragmentation compromises the population dynamic of the globally near-threatened Straight-billed Reedhaunter (Limnoctites rectirostris)
Authors: Gonçalves Maycon S. S. , Pons Priscila S. , Bonow Felipe C. , Bastazini Vinicius A. G. , Gil-Delgado José A. , López-Iborra Germán M. 
Published: November 2018

AbstractUnderstanding the consequences of habitat fragmentation to biological populations is crucial to develop sound conservation polices. The Straight-billed Reedhaunter (Limnoctites rectirostris) is a little known and threatened Passeriform that is highly dependent Erygo wetlands patches. Here, we evaluated the effects of habitat fragmentation on populations of the Straight-billed Reedhaunter, during the construction of a water reservoir in southern Brazil. During eight months, we monitored five Eryngo wetlands patches occupied (n=3) and no occupied (n=2) by Straight-billed Reedhaunter individuals, collecting data on their temporal occupancy patterns and registering new fragmentation events in formally continuous habitat patches. We evaluated the consequences of habitat fragmentation on the probabilities of patch occupancy, colonization and extinction of populations of the Straight-billed Reedhaunter using an information-theoretic approach. Out of the three patches occupied by Straight-billed Reedhaunter, two were not altered by construction activities and their populations were present during the entire study period. After fragmentation events, local extinction in one of the wetland patches was observed, and individuals were sporadically observed in two other initially unoccupied sites. The model in which fragmentation affected only the extinction probability was the most plausible among the set of candidate models. Fragmentation greatly increased the chance of local population extinction within patches. Our results indicate that the conservation of populations of the Straight-billed Reedhaunter is highly dependent on continuous and unaltered wetland patches.
Polycomb Cbx2 Condensates Assemble through Phase Separation
Authors: Tatavosian Roubina , Kent Samantha , Brown Kyle , Yao Tingting , Duc Huy Nguyen , Huynh Thao Ngoc , Zhen Chao Yu , Ma Brian , Wang Haobin , Ren Xiaojun 
Published: November 2018

AbstractPolycomb group (PcG) proteins are master regulators of development and differentiation. Mutation and dysregulation of PcG genes cause developmental defects and cancer. PcG proteins form condensates in the nucleus of cells and these condensates are the physical sites of PcG-targeted gene silencing. However, the physiochemical principles underlying the PcG condensate formation remain unknown. Here we show that Polycomb repressive complex 1 (PRC1) protein Cbx2, one member of the Cbx family proteins, contains a long stretch of intrinsically disordered region (IDR). Cbx2 undergoes phase separation to form condensates. Cbx2 condensates exhibit liquid-like properties and can concentrate DNA and nucleosomes. We demonstrate that the conserved residues within the IDR promote the condensate formation in vitro and in vivo. We further indicate that H3K27me3 has minimal effects on the Cbx2 condensate formation while depletion of core PRC1 subunits facilitates the condensate formation. Thus, our results reveal that PcG condensates assemble through liquid-liquid phase separation (LLPS) and suggest that PcG-bound chromatin is in part organized through phase-separated condensates.
Non-monotonic regulation of gene expression, neural progenitor fate and brain growth by the chromatin remodeller CHD8
Authors: Hurley Shaun , Mohan Conor , Suetterlin Philipp , Ellegood Jacob , Rudari Fabrizio , Lerch Jason P. , Fernandes Cathy , Basson M. Albert 
Published: November 2018

SummaryHeterozygous CHD8 mutations are associated with autism and macrocephaly with high penetrance in the human population. The reported mutations may have loss-of-function (haploinsufficient), hypomorphic or dominant negative effects on protein function. To determine the effects of reducing CHD8 protein function below haploinsufficient levels on brain development, we established a Chd8 allelic series in the mouse. Chd8 heterozygous mice exhibited relatively subtle brain overgrowth and little gene expression changes in the embryonic neocortex. In comparison, mild Chd8 hypomorphs displayed significant postnatal lethality, with surviving animals exhibiting more pronounced brain hyperplasia, and significantly altered expression of over 2000 genes. Autism-associated genes were downregulated and neural progenitor proliferation genes upregulated. Severe Chd8 hypomorphs displayed even greater transcriptional dysregulation, affecting genes and pathways that largely overlapped with those dysregulated in the mild hypomorphs. By contrast, homozygous, conditional deletion of Chd8 in early neuronal progenitors resulted in the induction of p53 target genes, cell cycle exit, apoptosis and pronounced brain hypoplasia. Intriguingly, increased progenitor proliferation in hypomorphs was primarily restricted to TBR2+ intermediate progenitors, suggesting critical roles for CHD8 in regulating the expansion of this population. Given the importance of these progenitors in human cortical growth, this observation suggests that human brain development might be more sensitive to CHD8 deficiency than the mouse. We conclude that brain development is acutely sensitive to CHD8 dosage and that the varying sensitivities of different progenitor populations and cellular processes to CHD8 dosage can result in non-linear effects on gene transcription and brain growth.
Design improvements and flap deflection evaluations with considering centrifugal load on active trailing edge flap
Authors: Visconti Umberto , Eun WonJong , Sim JiSoo , Lee SangWoo , Shin SangJoon 
Published: November 2018

Purpose
The purpose of this paper is to present the design, analysis and experiments of the active trailing-edge flap (Seoul National University Flap, SNUF) for vibration reduction in the helicopter rotor prior to the small-scale blades planned to test in a whirl tower.

Design/methodology/approach
The predictions of the hinge moment in both steady and unsteady flows were obtained through computational fluid dynamics calculations. When compared with the results originated from analytical formulations, the proposed method showed improved prediction capabilities. To validate the deflection of the flap under the centrifugal load by rotating, static analysis was conducted using both contact and rotating condition of MSC NASTRAN. The corresponding experiment also was performed using the vertical frame for simulating the effect of the centrifugal force.

Findings
The hinge moment of the flap is predicted through unsteady analysis in the actuation frequency of 3/rev. The material of the guide in the flap mechanism was selected through static analysis under both contact and rotating condition. Finally, reduction of the deflection occurred because of the load in the axial direction of the hinge like the centrifugal load.

Practical implications
The important aspects, such as design, analysis, and experiments for the active trailing-edge flap were shown.

Originality/value
This paper showed the relationship of the displacement, block force and voltage of the piezo-actuator, combined with the hinge moment predicted. The methodology and the experiment were presented for simulating the centrifugal force acting on the flap.