bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vitamin D and Cytokine Profiles in Patients With Systemic Sclerosis
Authors: Hax Vanessa , Gasparin Andrese Aline , Schneider Laiana , Monticielo Odirlei André , Soares Helena Margot Flores , Streit Marianna do Amaral , Pfaffenseller Bianca , Xavier Ricardo Machado , Chakr Rafael Mendonça da Silva 
Published: August 2019

Introduction
Hypovitaminosis D has been frequently described in systemic sclerosis (SSc). Cytokines are important mediators of tissue damage and clinical dysfunction in SSc and may be influenced by vitamin D levels.

Objective
To evaluate the serum levels of vitamin D and its correlation with the clinical features and cytokine profiles in SSc patients.

Methods
Case-control study, including 50 SSc patients and 35 healthy non matched controls. Serum levels of 25(OH) vitamin D were measured by chemiluminescence assay, and serum concentrations of interleukin 2 (IL-2), IL-4, IL-6, IL-10, tumor necrosis factor, and interferon γ were determined by flow cytometry.

Results
Fourteen patients (28%) had diffuse cutaneous SSc, 94% were female, 80% European derived, with a mean age of 57.2 ± 12.8 years. The serum vitamin D levels in SSc patients were 23.9 ± 8.5 ng/mL and 30.2 ± 6.2 ng/mL in the control group (standardized mean difference −6.19; 95% confidence interval, −9.9 to −2.3; p = 0.002), despite the more frequent supplementation of vitamin D in SSc patients (p = 0.014). No significant associations were found among vitamin D concentrations and cytokine levels. Serum levels of IL-6 were significantly elevated in SSc patients (p = 0.024) and were positively correlated with the modified Rodnan skin score (r
s = 0.291, p =0.041).

Conclusions
Despite lower vitamin D levels in SSc patients, there was no clear association with any cytokine. Serum levels of IL-6 were significantly elevated and positively correlated with the extent of skin involvement in SSc patients.
Scalp Avulsion Injuries and Replantation
Authors: Kashyap Nitin , Singhal Maneesh , Tiwari Raja , Chauhan Shashank , Manas Raj 
Published: August 2019

Abstract
Scalp avulsion injuries are usually attributed to entrapment of long hair or clothing in agricultural or industrial machinery or traffic accidents. Though rare, these injuries may be dangerous, and resulting cosmetic defect and alopecia lead to social stigma and poor self-esteem. Early intervention in the form of microvascular repair and replantation prevent morbidity and improve outcome. In this case series, we have discussed 3 cases of scalp replantation, 2 complete and 1 partial. Immediate microvascular reconstruction was planned in each case. Single surgical team approach was followed, vessels were identified and operated under an operative microscope. No vein grafts were used. Operative outcome was good, and scalp healed well. Cosmetic outcome was excellent, and there was no need for secondary revisions or use of tissue expanders. Immediate referral of such cases to institutes with facility for microvascular repair is recommended to reduce ischemia time. Superficial temporal artery is the first choice for microvascular repair in scalp replants, and a single artery anastomosis is sufficient to perfuse the entire scalp. Deep temporal artery is a viable alternative in cases where repair with superficial temporal vessels will require use of vein graft, cutting short operative time and associated complications.
Resuscitative endovascular balloon occlusion of the inferior vena cava is made hemodynamically possible by concomitant endovascular balloon occlusion of the aorta—A porcine study
Authors: Wikström Maria B. , Krantz Johannes , Hörer Tal M. , Nilsson Kristofer F. 
Published: August 2019

BACKGROUND
Resuscitative endovascular balloon occlusion of the vena cava inferior (REBOVC) may provide a minimal invasive alternative for hepatic vascular and inferior vena cava isolation in severe retrohepatic bleeding. However, circulatory stability may be compromised by the obstruction of venous return. The aim was to explore which combinations of arterial and venous endovascular balloon occlusions, and the Pringle maneuver, are hemodynamically possible in a normovolemic pig model. The hypothesis was that lower-body venous blood pooling from REBOVC can be avoided by prior resuscitative endovascular aortic balloon occlusion (REBOA).

METHODS
Nine anesthetized, ventilated, instrumented, and normovolemic pigs were used to explore the hemodynamic effects of 11 combinations of REBOA and REBOVC, with or without the Pringle maneuver, in randomized order. The occlusions were performed for 5 minutes but interrupted if systolic blood pressure dropped below 40 mm Hg. Hemodynamic variables were measured.

RESULTS
Proximal REBOVC, isolated or in combination with other methods of occlusion, caused severely decreased systemic blood pressure and cardiac output, and had to be terminated before 5 minutes. The decreases in systemic blood pressure and cardiac output were avoided by REBOA at the same or a more proximal level. The Pringle maneuver had similar hemodynamic effects to proximal REBOVC.

CONCLUSION
A combination of REBOA and REBOVC provides hemodynamic stability, in contrast to REBOVC alone or with the Pringle maneuver, and may be a possible adjunct in severe retrohepatic venous bleedings.
Frailty as a Predictor of Mortality in Patients With Interstitial Lung Disease Referred for Lung Transplantation
Authors: Montgomery Elyn , Macdonald Peter S. , Newton Phillip J. , Chang Sungwon , Jha Sunita R. , Hannu Malin K. , Thomson Claire , Havryk Adrian , Malouf Monique 
Published: August 2019

Background.
Frailty is a clinically recognized syndrome of decreased physiological reserve and a key contributor to suboptimal clinical outcomes in various lung disease groups. Interstitial lung disease (ILD) is fast approaching chronic obstructive pulmonary disease as the number one indication for lung transplantation worldwide. Our aim was to assess whether frailty is a predictor of mortality in patients with ILD referred for lung transplantation in an Australian cohort.

Methods.
Consecutive patients with ILD referred or on the waiting list for lung transplantation from May 2013 to December 2017 underwent frailty assessment using the modified Fried’s frailty phenotype. Frailty was defined as a positive response to ≥3 of the following 5 components: weak grip strength, slowed walking speed, poor appetite, physical inactivity, and exhaustion.

Results.
One hundred patients (82 male:18 female; age, 59 ± 7 y; range, 30–70) underwent frailty assessment. Twenty-four of 100 (24%) were assessed as frail. Frailty was associated with anemia, hypoalbuminemia, low creatinine, and the use of supplemental oxygen (all P < 0.05). Frailty was independent of age, gender, measures of pulmonary dysfunction (Pao
2, forced vital capacity percentage predicted, total lung capacity, total lung capacity percentage predicted, Dlco, or Dlco percentage predicted), cognitive impairment, or depression. Frailty and Dlco % predicted were independent predictors of increased all-cause mortality: 1-year actuarial survival was 86 ± 4% in the nonfrail group compared with 58 ± 10% for the frail group (P = 0.002).

Conclusions.
Frailty is common among patients referred for lung transplant with a diagnosis of ILD and is associated with a marked increase in mortality.
Bone Metabolism Impairment in Heart Transplant: Results From a Prospective Cohort Study
Authors: Seguro Luis F.B.C. , Pereira Rosa M.R. , Seguro Luciana P.C. , Caparbo Valeria F. , Avila Monica S. , Mangini Sandrigo , Campos Iascara W. , Gaiotto Fabio A. , Marcondes-Braga Fabiana G. , Bacal Fernando 
Published: August 2019

Background.
Data on the prevention of fractures after heart transplant (HTx) are controversial in the literature. Understanding the effects of HTx on bone may guide appropriate treatments in this high-risk population.

Methods.
Seventy adult HTx patients were followed for 12 months. Clinical and laboratory parameters, bone mineral density, microarchitecture, and vertebral fractures were assessed at baseline (after intensive care unit discharge) and at 6 and 12 months. Patients received recommendations regarding calcium intake and vitamin D supplementation after HTx.

Results.
At baseline, 27% of patients had osteoporosis, associated with the length of hospitalization before HTx (P = 0.001). Bone mineral density decreased in the first 6 months, with partial recovery later. Bone microarchitecture deteriorated, mainly in the trabecular bone in the first 6 months and cortical bone in the subsequent 6 months. At baseline, 92.9% of patients had vitamin D levels <30 ng/mL and 20.0% <10 ng/mL. Patients also had calcium at the lower limit of normal, high alkaline phosphatase, and high bone resorption biomarker. These abnormalities were suggestive of impaired bone mineralization and normalized at 6 months with correction of vitamin D deficiency. The majority of vertebral fractures were identified at baseline (23% of patients). After multivariate analyses, only a lower fat mass persisted as a risk factor for vertebral fractures (odds ratio, 1.23; 95% confidence interval, 1.04-1.47; P = 0.012).

Conclusions.
High frequencies of densitometric osteoporosis, vitamin D deficiency, bone markers abnormalities, and vertebral fractures were observed shortly after HTx. Calcium and vitamin D supplementation should be the first step in correcting bone mineralization impairment before specific osteoporosis treatment.
Patient Survival After Kidney Transplantation: Important Role of Graft-sustaining Factors as Determined by Predictive Modeling Using Random Survival Forest Analysis
Authors: Scheffner Irina , Gietzelt Matthias , Abeling Tanja , Marschollek Michael , Gwinner Wilfried 
Published: August 2019

Background.
Identification of the relevant factors for death can improve patient’s individual risk assessment and decision making. A well-documented patient cohort (n = 892) in a renal transplant program with protocol biopsies was used to establish multivariable models for risk assessment at 3 and 12 months posttransplantation by random survival forest analysis.

Methods.
Patients transplanted between 2000 and 2007 were observed for up to 11 years. Loss to follow-up was negligible (n = 15). A total of 2251 protocol biopsies and 1214 biopsies for cause were performed. All rejections and clinical borderline rejections in protocol biopsies were treated.

Results.
Ten-year patient survival was 78%, with inferior survival of patients with graft loss. Using all pre- and posttransplant variables until 3 and 12 months (n = 65), the obtained models showed good performance to predict death (concordance index: 0.77–0.78). Validation with a separate cohort of patients (n = 349) showed a concordance index of 0.76 and good discrimination of risks by the models, despite substantial differences in clinical variables. Random survival forest analysis produced robust models over a wide range of parameter settings. Besides well-established risk factors like age, cardiovascular disease, type 2 diabetes, and graft function, posttransplant urinary tract infection and rejection treatment were important factors. Urinary tract infection and rejection treatment were not specifically associated with death due to infection or malignancy but correlated strongly with inferior graft function and graft loss.

Conclusions.
The established models indicate the important areas that need special attention in the care of renal transplant patients, particularly modifiable factors like graft rejection and urinary tract infection.
What's New in the Treatment of Migraine?
Authors: Digre Kathleen B. 
Published: August 2019

Background:Migraine is very common. In addition to affecting visual quality of life, migraine can be seen in the neuro-ophthalmology office with regularity. Treatment is critical to assist in the reduction of disability and symptoms. Knowing the evidence-based new treatments is important for every neuro-ophthalmologist.Methods:Using PubMed, and using the term migraine as it related to the terms treatment, evidence-based, calcitonin gene-related peptide (CGRP) inhibitor or antibody, electrical stimulation, vagal nerve stimulation, a literature review was performed.Results:Aside from standard well-described and evidence-based therapies for the acute treatment and prevention of migraine, many new therapies have received FDA approval. In this review, we summarize the contribution of new classes of migraine-specific therapies: CGRP antibodies (erenumab, fremanezumab, galcanezumab, and eptinezumab) for prevention and inhibitors referred to as gepants (ubrogepant and rimegepant) for acute treatment. We also cover newer medications about to be approved, such as lasmitiditan. Devices, including the hand-held vagal nerve stimulator, supraorbital stimulation, transmagnetic stimulation, and remote electrical stimulation, are now approved by the FDA for treatment of migraine.Conclusion:Many new and exciting therapies exist for the treatment of migraine. Keeping up with this rapidly evolving field is important in reducing disability from the common disease of migraine.
A Novel Approach to Treating Moderate to Severe Incontinence-Associated Dermatitis and Intertriginous Dermatitis
Authors: Tammel Karyl , Benike Deborah , Sievers Beth 
Published: August 2019

BACKGROUND:
Patients with moderate to severe incontinence-associated dermatitis (IAD) and intertriginous dermatitis (ITD) often experience pain that negatively affects activities of daily living. While traditional treatments, such as skin protectants including ointment or cream-based products, cyanoacrylate-based monomers, and wicking agents, help some patients, those with moderate to severe cases require more aggressive treatments to accelerate healing.

CASE SERIES:
This article describes a series of 4 hospitalized patients who presented with moderate to severe IAD and/or ITD with and without fungal infections. These patients were treated with therapies that went beyond routine skin care regimens, which included treatment with a combination of 0.25% acetic acid, a topical steroid agent, or a topical antifungal when necessary. The patients included a 74-year-old woman admitted with hypovolemic shock, an 82-year-old obese woman with pulmonary hypertension and heart failure, an 80-year-old woman with medically complicated obesity, and a 54-year-old morbidly obese woman admitted with sepsis.

CONCLUSION:
The outcome achieved using this novel approach was successful in treating moderate to severe IAD and ITD in these cases.
MIXTURE: an improved algorithm for immune tumor microenvironment estimation based on gene expression data
Authors: Fernández Elmer A. , Mahmoud Yamil D. , Veigas Florencia , Rocha Darío , Balzarini Mónica , Lujan Hugo D. , Rabinovich Gabriel A. , Girotti M. Romina 
Published: August 2019

AbstractRNA sequencing has proved to be an efficient high-throughput technique to robustly characterize the presence and quantity of RNA in tumor biopsies at a given time. Importantly, it can be used to computationally estimate the composition of the tumor immune infiltrate and to infer the immunological phenotypes of those cells. Given the significant impact of anti-cancer immunotherapies and the role of the associated immune tumor microenvironment (ITME) on its prognosis and therapy response, the estimation of the immune cell-type content in the tumor is crucial for designing effective strategies to understand and treat cancer. Current digital estimation of the ITME cell mixture content can be performed using different analytical tools. However, current methods tend to over-estimate the number of cell-types present in the sample, thus under-estimating true proportions, biasing the results. We developed MIXTURE, a noise-constrained recursive feature selection for support vector regression that overcomes such limitations. MIXTURE deconvolutes cell-type proportions of bulk tumor samples for both RNA microarray or RNA-Seq platforms from a leukocyte validated gene signature. We evaluated MIXTURE over simulated and benchmark data sets. It overcomes competitive methods in terms of accuracy on the true number of present cell-types and proportions estimates with increased robustness to estimation bias. It also shows superior robustness to collinearity problems. Finally, we investigated the human immune microenvironment of breast cancer, head and neck squamous cell carcinoma, and melanoma biopsies before and after anti-PD-1 immunotherapy treatment revealing associations to response to therapy which have not seen by previous methods.
Indirect actuation reduces flight power requirements inManduca sextavia elastic energy exchange
Authors: Gau Jeff , Gravish Nick , Sponberg Simon 
Published: August 2019

AbstractIn the vast majority of flying insects, wing movements are generated indirectly via the deformations of the exoskeleton. Indirect measurements of inertial and aerodynamic power requirements suggest that elastic energy exchange in spring-like structures may reduce the high power requirements of flight by recovering energy from one wingstroke to the next. We directly measured deformation mechanics and elastic energy storage in a hawkmothManduca sextathorax by recording the force required to deform the thorax over a frequency range encompassing typical wingbeat frequencies. We found that a structural damping model, not a viscoelastic model, accurately describes the thorax’s linear spring-like properties and frequency independent dissipation. The energy recovered from thorax deformations is sufficient to minimize flight power requirements. By removing the passive musculature, we find that the exoskeleton determines thorax mechanics. To assess the factors that determine the exoskeleton’s spring-like properties, we isolated functional thorax regions, disrupted strain in an otherwise intact thorax, and compared results to a homogeneous hemisphere. We found that mechanical coupling between spatially separated thorax regions improves energy exchange performance. Furthermore, local mechanical properties depend on global strain patterns. Finally, the addition of scutum deformations via indirect actuation provides additional energy recovery without added dissipation.
Membrane-bounded nucleoid discovered in a cultivated bacterium of the candidate phylum ‘Atribacteria’
Authors: Katayama Taiki , Nobu Masaru K. , Kusada Hiroyuki , Meng Xian-Ying , Yoshioka Hideyoshi , Kamagata Yoichi , Tamaki Hideyuki 
Published: August 2019

AbstractA key feature that differentiates prokaryotes from eukaryotes is the absence of an intracellular membrane surrounding the chromosomal DNA. Here, we report isolation of an anaerobic bacterium that possesses an additional intracytoplasmic membrane surrounding a nucleoid, affiliates with the yet-to-be-cultivated ubiquitous phylum ‘Ca. Atribacteria’, and possesses unique genomic features likely associated with organization of complex cellular structure. Exploration of the uncharted microorganism overturned the prevailing dogma of prokaryotic cell structure.
Long-term associative memory in rats: effects of familiarization period in object-place-context recognition test
Authors: Shimoda Shota , Ozawa Takaaki , Ichitani Yukio , Yamada Kazuo 
Published: August 2019

AbstractSpontaneous recognition tests, which utilize rodents’ innate tendency to explore novelty, can evaluate not only simple non-associative recognition memory but also more complex associative memory in animals. In the present study, we investigated whether the length of the object familiarization period (sample phase) improved subsequent novelty discrimination in the spontaneous object, place, and object-place-context (OPC) recognition tests in rats. In the OPC test, rats showed a significant novelty preference only when the familiarization period was 30 min but not when it was 5 min or 15 min. However, the rats exhibited a successful discrimination between the stayed and replaced objects under 15 min and 30 min familiarization period conditions in the place recognition test and between the novel and familiar objects under all conditions of 5, 15 and 30 min in the object recognition test. Our results suggest that the extension of the familiarization period improves performance in the spontaneous recognition paradigms, and a longer familiarization period is necessary for long-term associative recognition memory than for non-associative memory.
Genetic variation in herbivore resistance within a strawberry crop wild relative (Fragaria vesca L.)
Authors: Weber Daniela , Egan Paul A. , Muola Anne , Stenberg Johan A. 
Published: August 2019

AbstractTo decrease the dependency on chemical pesticides, the resistance of cultivated strawberry to pests needs to be increased. While genetic resources within domesticated varieties are limited, wild genotypes are predicted to show high heritable variation in useful resistance traits. We collected 86 wild accessions of Fragaria vesca L. from central Sweden and screened this germplasm for antibiosis (pest survival and performance) and antixenosis (pest preference) traits active against the strawberry leaf beetle (Galerucella tenella L.). First, extensive common garden experiments were used to study antibiosis traits in the sampled plant genotypes. Heritable genetic variation among plant genotypes was found for several antibiosis traits. Second, controlled cafeteria experiments were used to test for plant genetic variation in antixenosis traits. The leaf beetles avoided egg laying on plant genotypes possessing high antibiosis. This indicates a high degree of concordance between antibiosis and antixenosis, and that the beetles’ egg-laying behaviour optimizes the fitness of their offspring. The existence of high genetic variation in key resistance traits suggests that wild woodland strawberry contains untapped resources that are sought to reduce pesticide-dependence in cultivated strawberry. Given that only a very small portion of the species’ distribution area was sampled, even higher variation may be expected at the continental scale. As a whole, the genetic resources identified in this study serve to strengthen the position of woodland strawberry as a key crop wild relative.