bluuebunny/crossref_metadata_2025_split huggingface dataset:
15. Eosinophilic pneumonitis secondary to baricitinib
Authors: Yein Khin , Ahmed Azeem 
Published: September 2019

Abstract

Introduction
We present a case of drug-induced pneumonitis in a patient taking baricitinib.

Case description
A 63-year-old patient with longstanding sero-positive erosive RA (anti-CCP >340) on long term methotrexate started taking baricitinib for his poorly-controlled arthritis 5 weeks prior to the hospital admission with two-week history of increasingly short of breath, productive cough with yellow sputum and right sided pleuritic chest pain.
On examination, he was febrile with temperature 38.2, tachypnoeic, respiratory rate 22/min and O2 saturation 92% on room air, with stable blood pressure 130/75 and normal sinus rhythm. He had some crepitations and reduced air entry in both lung bases on auscultation. He had no rash. CRP was > 190, total white cell 4.5, neutrophils 2.9, and eosinophils 0.56 (0.02-0.5). He had a transient rise in liver enzyme ALT (52) and bilirubin (22), both normalised on discharge. Kidney functions remained normal.
Influenza A, B and respiratory virus PCR, urinary legionella and pneumococcal antigen, blood, urine and sputum cultures were negative.
CXR showed no obvious consolidations or acute changes. CT angiogram to exclude pulmonary embolism showed scattered ground glass opacification throughout both lungs affecting multiple zones with no architectural distortion and no confluent consolidation.
Despite treatment with IV antibiotics for suspected community acquired pneumonia, he continued to spike temperatures and was dependent on oxygen. When we reviewed him, our impression was that his symptoms, clinical findings and CT changes were consistent with drug-induced pneumonitis, most likely due to baricitinib.
Methotrexate and baricitinib were suspended. He responded well to 40 mg of prednisolone; his fever subsided and he became less dyspnoeic and CRP and eosinophil counts improved. He went home after 7 days of admission. A repeat CT chest 8 weeks later showed a complete resolution of the pneumonitis. He was still on a low but reducing dose of prednisolone and methotrexate was restarted and tolerated well.

Discussion
We believe this is one of the first few reported cases of drug-induced pneumonitis to baricitinib. The patient had been treated in the community with antibiotics for 2 weeks as well as during admission with very poor response.
Baricitinib was the only new medication he took 4-5 weeks before the symptoms developed. Previously, he had been stable on his usual medications including methotrexate for over 10 years.
The temporal relationship between the start of the new medication and the onset of the symptoms, clinical and laboratory findings and radiological changes suggested that this was baricitinib-induced pneumonitis.

Key learning points
It is important to have a high index of suspicion for hypersensitivity pneumonitis in patients presenting with acute lung injury shortly after starting a new treatment as early diagnosis and treatment can lead to the complete resolution of the condition.

Conflict of interest
The authors declare no conflicts of interest.
The Cultural Origin of CEOs’ Attitudes toward Uncertainty: Evidence from Corporate Acquisitions
Authors: Pan Yihui , Siegel Stephan , Yue Wang Tracy 
Published: September 2019

Abstract
We examine the role of cultural heritage in shaping U.S. CEOs’ attitudes toward uncertainty, in the context of their corporate acquisition decisions. We find that CEOs with a more uncertainty-avoiding cultural heritage are less likely to engage in acquisitions. Conditional on making an acquisition, uncertainty-averse CEOs prefer targets in familiar industries and targets that can be more easily integrated. The emphasis on cultural identity by CEOs’ parents and the ethnic composition of CEOs’ early life environment significantly influence the cultural transmission process. Cultural differences about uncertainty attitudes persist over multiple generations, but become less pronounced over time. (JEL G34, G4, G40, G41)
Mutual Funding
Authors: Gil-Bazo Javier , Hoffmann Peter , Mayordomo Sergio 
Published: September 2019

Abstract
Using data on Spanish mutual funds, we show that bank-affiliated funds provide funding support to their parent company via purchases of bonds in the primary market. Support from affiliated funds is more sizeable in crisis times and for riskier banks. These trades generate negative abnormal returns and thus benefit banks at the expense of fund investors. To minimize negative effects on their asset management business, banks concentrate the burden of funding support in funds without performance fees and those catering to retail investors. We provide evidence consistent with funding support helping to limit credit rationing over the 2008–2012 period.
Predicting stress resilience and vulnerability: brain-derived neurotrophic factor and rapid eye movement sleep as potential biomarkers of individual stress responses
Authors: Sweeten Brook L W , Sutton Amy M , Wellman Laurie L , Sanford Larry D 
Published: September 2019

Abstract

Study Objectives
To examine the rapid eye movement sleep (REM) response to mild stress as a predictor of the REM response to intense stress and brain-derived neurotrophic factor (BDNF) as a potential biomarker of stress resilience and vulnerability.

Methods
Outbred Wistar rats were surgically implanted with electrodes for recording electroencephalography (EEG) and electromyogram (EMG) and intraperitoneal Data loggers to record body temperature. Blood was also obtained to measure circulating BDNF. After recovery, rats were exposed to mild stress (novel chamber, NC) and later intense stress (shock training, ST), followed by sleep recording. Subsequently, rats were separated into resilient (Res; n=27) or vulnerable (Vul; n = 15) based on whether or not there was a 50% or greater decrease in REM after ST compared to baseline. We then compared sleep, freezing, and the stress response (stress-induced hyperthermia, SIH) across groups to determine the effects of mild and intense stress to determine if BDNF was predictive of the REM response.

Results
REM totals in the first 4 hours of sleep after exposure to NC predicted REM responses following ST with resilient animals having higher REM and vulnerable animals having lower REM. Resilient rats had significantly higher baseline peripheral BDNF compared to vulnerable rats.

Conclusions
These results show that outbred rats display significant differences in post-stress sleep and peripheral BDNF identifying these factors as potential markers of resilience and vulnerability prior to traumatic stress.
A new ichthyosaur from the Late Jurassic of north-west Patagonia (Argentina) and its significance for the evolution of the narial complex of the ophthalmosaurids
Authors: Campos Lisandro , Fernández Marta S , Herrera Yanina 
Published: September 2019

AbstractOphthalmosaurids were highly derived and the youngest clade of ichthyosaurs. Their evolutionary history comprises ~76 Myr (from the early Middle Jurassic to the final extinction of the group at the Cenomanian–Turonian boundary). Fossil records indicate that soon after they emerged they achieved a widespread geographical distribution. Analyses of disparity based on craniodental morphologies, and the co-occurrence of different bone histology and microstructure among the members of the group, indicate that ophthalmosaurids are not only taxonomically but also ecologically diverse. A region of the skull that is particularly complex among ophthalmosaurid taxa is the external nares and surrounding areas, but there have been few attempts to explore this topic. We describe a new ophthalmosaurid from the Late Jurassic of Patagonia (Argentina) in the genus Arthropterygius and analyse its phylogenetic relationships. A detailed exploration of the skull, using computed tomography, reveals the division of the external nares by means of a stout bony pillar. This condition was previously known only in some Cretaceous forms and, within a phylogenetic framework, its distribution among ophthalmosaurids indicates that this morphology was the result of convergent evolution. Based on available data on extant (and some extinct) forms, we explore putative soft structures involved in the narial region. We propose that the division of the external nares (complete or partly osseous) was related functionally to the separation of the air passage from the outlet of nasal salt glands in such a way that the salt glands could be evacuated underwater, while the air passage could be closed by a valvular system.
Mohs Micrographic Surgery as the Standard of Care for Nail Unit Squamous Cell Carcinoma
Authors: Gou Darlene , Nijhawan Rajiv I. , Srivastava Divya 
Published: September 2019

BACKGROUND
There is no established standard of care for treatment of nail unit squamous cell carcinoma (SCC).

OBJECTIVE
The aim of the study is to further characterize the clinical characteristics and diagnostic considerations of nail unit SCC and to examine the outcomes of patients with nail unit SCC treated with Mohs micrographic surgery (MMS).

MATERIALS AND METHODS
A retrospective review was conducted of patients treated for nail unit SCC with MMS from January 1, 2006, to December 30, 2016. Demographic data were collected along with lesion characteristics, treatment characteristics, and follow-up results.

RESULTS
Forty-two cases of nail unit SCC were treated with MMS. Recurrences were observed in 3 patients (7.1%). Recurrent cases were treated with MMS. There were no cases of distant metastases, subsequent recurrence, or death. Two of 3 recurrences occurred in patients with histologic features of verruca vulgaris.

CONCLUSION
Mohs micrographic surgery provides an excellent cure rate for the treatment of nail unit SCC. This technique offers the greatest ability to achieve histological clearance while maximizing tissue sparing, thereby reducing unnecessary amputations and patient morbidity.
The relationship between HbA1c control levels and antituberculosis treatment effects: a meta-analysis
Authors: Song Chao , Xie Wang , Gong Li , Ren Min , Pan Pinhua , Luo Bailing 
Published: September 2019

Background:
Multiple studies of tuberculosis (TB) treatment have indicated that patients with diabetes mellitus (DM) may experience poor outcomes. We performed a meta-analysis to summarize evidence for the relationship between HbA1c control levels and anti-TB treatment effects in patients afflicted with both TB and DM.

Methods:
Both English and Chinese databases were searched. Chinese databases included CNKI, WanFang, SinoMed, and VIP. PubMed, Ovid MEDLINE, Embase, Cochrane Library, and Web of Science were searched for English articles. We included studies that were restricted to the relationship between HbA1c levels and anti-TB treatment effects (sputum conversion rate [SCR] and TB focus absorption) in diabetic patients receiving treatment for TB. We used RevMan 5.3 software to analyze the data.

Results:
We included 12 studies, of which five reported SCR at 2 months, seven reported the conversion at 3 months, and seven reported TB focus absorption. According to the five studies which reported 2 months-SCR, patients with diabetes and TB had an odds ratio (OR) of 2.14 (95% CI: 0.84-5.43) for the 2 months-SCR between controlled (HbA1c <7.0) and uncontrolled diabetes (HbA1c ≥7.0). However, additional seven studies reporting 3 months-SCR showed that controlled diabetics had higher SCR than uncontrolled (OR 3.39, 95% CI: 2.12-5.43). Moreover, seven of the 12 studies demonstrated that there were differences in TB focus absorption between controlled and uncontrolled diabetes (OR 2.69, 95% CI: 1.91-3.79).

Conclusion:
HbA1c control levels influence the SCR at 3 months and the TB focus absorption at the end of the anti-TB intensive treatment phase. This study highlights a need for increased attention to HbA1c or glucose control in patients afflicted with both TB and DM.
Screening key genes and microRNAs in sepsis by RNA-sequencing
Authors: Qin Yanjun , Guo Xuan , Yu Yueqing , Dong Shimin , Yan Yan , Bian Xiaohua , Zhao Caiyan 
Published: September 2019

Background:
Sepsis is a life-threatening organ dysfunction, initiated by a dysregulated host response to infection. This study aimed to determine key genes and microRNAs (miRNAs) correlated with sepsis.

Methods:
Three patients with sepsis and three healthy individuals treated as controls were recruited in the current study. To identify differentially expressed mRNAs (DEmRNAs) and differentially expressed miRNAs (DEmiRNAs) between patients with sepsis and controls, RNA-sequencing and bioinformatics analysis were conducted. DEmiRNA-target DEmRNAs analysis and functional annotation of DEmiRNA-target DEmRNAs were performed. Dataset GSE46955, used to validate the expression of selected DEmRNAs, was downloaded from the Gene Expression Omnibus database.

Results:
Compared with septic patients, a total of 1199 DEmRNAs and 23 DEmiRNAs were identified. Based on DEmiRNA-target DEmRNAs analysis, hsa-miR-106b-5p (degree = 155), hsa-miR-128-3p (degree = 128), and hsa-miR-144-3p (degree = 79) were the top 3 DEmiRNAs that covered most DEmRNAs. The T cell receptor signaling pathway, pathways in cancer, FoxO signaling pathway, and influenza A were the significantly enriched Kyoto Encyclopedia of Genes and Genomes pathways of DEmiRNA-target DEmRNAs in sepsis.

Conclusion:
We identified key genes and miRNAs related to sepsis. Our findings will provide new insights into understanding sepsis pathogenesis.
Ambulatory blood pressure monitoring parameters in obese children and adolescents with masked hypertension
Authors: Yegül-Gülnar Gökçe , Kasap-Demir Belde , Alparslan Caner , Çatli Gönül , Mutlubaş Fatma , Yavaşcan Önder , Özkan Bülent , Dündar Bumin Nuri , Aksu Nejat 
Published: September 2019

Objective
We aimed to compare the demographic, laboratory, and ambulatory blood pressure monitoring (ABPM) parameters of patients with masked hypertension (MHT), define factors predicting MHT, and determine the ABPM parameters affecting left ventricular mass index (LVMI) in obese youth.

Methods
Data of obese patients were evaluated retrospectively. Patients with ambulatory hypertension (AHT), white-coat hypertension (WCHT), MHT, or normotension (NT) were determined. Demographic and laboratory findings, office and ABPM measurements, blood pressure variability (BPV), and heart rate variability (HRV) were compared between the groups. The factors predicting MHT and the association between LVMI and ABPM, BPV/HRV parameters were analyzed.

Results
None of the 118 patients (M/F: 52/66) had WCHT. Three groups were formed: AHT (n: 60, 51%), MHT (n: 46, 39%), and NT (n: 12, 10%). Striae were significantly more frequent in AHT and MHT groups (P: 0.003). Cut-off levels for office BP measurements predicting MHT were 0.85 and 0.76 for systolic and diastolic BP (SBP and DBP) indexes, respectively. Most of the ABPM parameters of MHT group were as high as those of AHT group. On regression analysis, only daytime MAP had a positive (β: 0.340; P < 0.01) and diastolic dip (β: −0.204; P < 0.01) had a significantly negative association with LVMI.

Conclusion
Stria and cut-off levels for office SBP/DBP indexes, which were defined for the first time in this study, may determine the patients at risk of MHT. Although BPV or HRV had no relation to LVMI, daytime MAP and diastolic dip represented independent associations with LVMI.
18F-choline positron emission tomography/computed tomography for the detection of prostate cancer relapse: assessment of maximum standardized uptake value correlation with prostate-specific antigen levels
Authors: Siminiak Natalia , Wojciechowska Karolina , Miechowicz Izabela , Cholewiński Witold , Ruchała Marek , Czepczyński Rafał 
Published: September 2019

Objective
Patients with prostate cancer are monitored by prostate-specific antigen (PSA) evaluation and PET [PET/computed tomography (CT)]. The aim of our study was to evaluate correlations between PSA levels and standardized uptake values (SUV) in patients with recurrent prostate cancer.

Methods
We analyzed 282 prostate cancer patients undergoing PET-CT due to suspicion of recurrence. Levels of PSA and PSA change per month were analyzed, together with maximum standardized uptake value (SUVmax).

Results
PET/CT results were positive in 175 patients (62.1%) and negative in 107 patients (37.9%). In the positive group, PSA levels were significantly higher. The ROC curve analysis indicated PSA level of 1.70 ng/ml and PSA level change in time of 0.12 ng/ml are the optimal cut-off values. Patients were divided into subgroups: with metastases (M), local relapse (L), and local relapse and metastases (M + L). The latest PSA levels, were similar in subgroups L and M: 5.00 (2.98–10.30) ng/ml and 3.90 (1.27–14.08) ng/ml, but lower than in subgroup M + L: 12.43 (6.08–49.36) ng/ml. PSA level change in time was similar in the subgroups L and M: 0.63 (0.09–1.00) ng/ml/month and 0.33 (0.02–1.73) ng/ml/month, but lower in subgroup M + L: 2.21 (0.22–10.34) ng/ml/month, P < 0.05. SUVmax was significantly (P < 0.05) lower in subgroup L than in M and L + M: 3.00 (2.30–4.00), 4.60 (2.70–7.40), and 4.90 (3.80–8.00), respectively. PSA level significantly correlated with SUVmax in patients from subgroups L (R = 0.424; P < 0.05) and M (R = 0.314; P < 0.01). Positive correlation between PSA change and SUVmax was observed in subgroup M + L (R = 0.561; P < 0.01) and M (R = 0.270; P < 0.05).

Conclusion
The study confirmed that patients with high PSA level and fast PSA increase are likely to be diagnosed with both, local relapse and metastases. Moreover, SUVmax values in metastatic lesions are usually higher.
Outcomes of Infants Supported With Extracorporeal Membrane Oxygenation Using Centrifugal Versus Roller Pumps: An Analysis From the Extracorporeal Life Support Organization Registry
Authors: O’Halloran Conor P. , Thiagarajan Ravi R. , Yarlagadda Vamsi V. , Barbaro Ryan P. , Nasr Viviane G. , Rycus Peter , Anders Marc , Alexander Peta M. A. 
Published: September 2019

Objectives:
To determine whether mortality differs between roller and centrifugal pumps used during extracorporeal membrane oxygenation in infants weighing less than 10 kg.

Design:
Retrospective propensity-matched cohort study.

Setting:
All extracorporeal membrane oxygenation centers reporting to the Extracorporeal Life Support Organization.

Patients:
All patients less than 10 kg supported on extracorporeal membrane oxygenation during 2011–2016 within Extracorporeal Life Support Organization Registry.

Interventions:
Centrifugal and roller pump recipients were propensity matched (1:1) based on predicted probability of receiving a centrifugal pump using demographic variables, indication for extracorporeal membrane oxygenation, central versus peripheral cannulation, and pre-extracorporeal membrane oxygenation patient management.

Measurements and Main Results:
A total of 12,890 patients less than 10 kg were supported with extracorporeal membrane oxygenation within the Extracorporeal Life Support Organization registry during 2011–2016. Patients were propensity matched into a cohort of 8,366. Venoarterial and venovenous extracorporeal membrane oxygenation runs were propensity matched separately. The propensity-matched cohorts were similar except earlier year of extracorporeal membrane oxygenation (standardized mean difference, 0.49) in the roller pump group. Within the propensity-matched cohort, survival to discharge was lower in the centrifugal pump group (57% vs 59%; odds ratio, 0.91; 95% CI, 0.83–0.99; p = 0.04). Hemolytic, infectious, limb injury, mechanical, metabolic, neurologic, pulmonary, and renal complications were more frequent in the centrifugal pump group. Hemorrhagic complications were similar between groups. Hemolysis mediated the relationship between centrifugal pumps and mortality (indirect effect, 0.023; p < 0.001).

Conclusions:
In this propensity score–matched cohort study of 8,366 extracorporeal membrane oxygenation recipients weighing less than 10 kg, those supported with centrifugal pumps had increased mortality and extracorporeal membrane oxygenation complications. Hemolysis was evaluated as a potential mediator of the relationship between centrifugal pump use and mortality and met criteria for full mediation.
Managing Patient Expectations
Authors: Latte-Naor Shelly 
Published: September 2019

Abstract
Expectations and beliefs about complementary and integrative medicine are the main predictors of its use in cancer patients. These expectations are rarely informed by consultation with a health care provider but are, rather, a result of family endorsement and information from nonmedical sources. As a rising number of cancer patients pursue integrative medicine, it is of increasing importance that health care providers understand their patients' expectations and motivations. These can range from symptom management to unrealistic hopes for cure. Complementary and integrative medicine can be used to complement criterion-standard cancer care, but is sometimes dangerously touted as an alternative for it. Awareness of these nuances enables providers to initiate effective communication about complementary and integrative medicine and to intervene when unrealistic expectations stand in the way of lifesaving care. Refining patient-centered communication around integrative medicine is essential to avoid unsupervised, potentially harmful use, delays, or interruptions in cancer care and, ultimately, to maximize the benefits of integrative therapies during cancer treatment.
Imaging Diagnosis of Von Hippel-Lindau Syndrome
Authors: Xu Nan , Duan Wenshuai , Zhang Ruopeng , Yang Bin 
Published: September 2019

Introduction:
Von Hippel-Lindau (VHL) syndrome is a group of rare autosomal dominant hereditary diseases that involve multiple organs. Due to its high recurrence rate and complex and diverse clinical manifestations, VHL is prone to being either misdiagnosed or missed entirely. Therefore, patients with VHL syndrome have a poor prognosis.

Clinical features:
This study reports the details of 2 patients, a 55-year-old male and a 37-year-old female, who were diagnosed as having VHL syndrome with a positive family history. The male patient presented with upper abdominal discomfort 2 years prior to the current study, and was diagnosed in another hospital as having a space-occupying lesion at the head of the pancreas. After undergoing hemangioblastoma resection of the right cerebellar hemisphere 1 month ago, he was admitted to the hospital for recent aggravation of upper abdominal discomfort to receive further diagnosis and treatment. The female patient previously underwent right ovarian cystectomy and T5-T6 intramedullary hemangioblastoma resection. She was diagnosed at another hospital as having pancreatic cancer, and was admitted to the hospital for recent aggravation of upper abdominal discomfort to receive further diagnosis and treatment.

Conclusion:
The diagnosis and treatment of VHL syndrome is currently relatively difficult. It poses a substantial threat to patients and their families. The early and timely diagnosis and treatment of VHL syndrome can improve patients’ prognosis and rates of survival.