bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endobronchial ultrasound‐guided transbronchial needle aspiration in sarcoidosis: Beyond the diagnostic yield
Authors: Trisolini Rocco , Baughman Robert P. , Spagnolo Paolo , Culver Daniel A. 
Published: March 2019

ABSTRACTEndobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) is the commonly used technique for pathological confirmation of clinically suspected sarcoidosis, mostly owing to its consistently high success rate in the detection of granulomas. However, other possible advantages, which are less appreciated and often poorly studied, may also contribute to the wider use of EBUS‐TBNA in the future. These advantages include refinement of differential diagnoses through the study of lymph node characteristics during B‐mode examination; reduction of complications associated with bronchoscopy, as well as improved triage of the specimen for ancillary studies with the use of rapid on‐site evaluation; optimization of the quality of the sample through the selection of a target area for biopsy with minimal vascularity and absence of calcifications by using the colour Doppler and the B‐mode; and prediction of the presence of extensive lymph node fibrosis by using the strain elastography module. Yet, limitations and possible clinical drawbacks should also be acknowledged. Indeed, due to the lack of specificity of the pathology findings in EBUS‐derived samples, the diagnosis of sarcoidosis is one of the exclusion and should remain essentially clinical. The external validity of EBUS‐TBNA results in sarcoidosis is questionable, as they mainly derive from studies in populations with a high disease prevalence. Finally, the risk exists that the low morbidity and high diagnostic yield of EBUS‐TBNA may lead to its overuse in patients with clinical/radiological findings specific enough to secure a clinical diagnosis of sarcoidosis.
Correlation of changes in serum level of VEGF and peripapillary retinal thickness in patients with POEMS syndrome
Authors: Yokouchi Hirotaka , Baba Takayuki , Misawa Sonoko , Oshitari Toshiyuki , Kuwabara Satoshi , Yamamoto Shuichi 
Published: March 2019

AimTo determine whether changes in the serum levels of vascular endothelial growth factor (VEGF) after thalidomide therapy will affect the peripapillary retinal thickness (pRT) associated with optic disc oedema (ODE) in patients with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes (POEMS) syndrome.MethodsThis was a retrospective, observational case series of 23 right eyes of 23 treatment-naïve patients with POEMS syndrome and ODE whose intracranial pressure was within the normal range. The pRT was determined by spectral-domain optical coherence tomography, and the serum level of VEGF was determined by ELISA at baseline and 6 months after the thalidomide therapy. We determined whether a change in the pRT from baseline was significantly correlated with the serum level of VEGF from that at 6 months after the thalidomide treatment.ResultsSix months after treatment, the mean serum level of VEGF was significantly reduced from 7153±4214 pg/mL to 1067±769 pg/mL (p<0.001), and the pRT was significantly decreased from 471.2±203 µm to 318.1±53.9 µm (p<0.001). The change in the pRT from baseline was signiﬁcantly and linearly correlated with the change in the serum level of VEGF from that at 6 months after treatment (r=0.67, p=0.00039).ConclusionsThe close relationship between the pRT and the serum level of VEGF may offer clues on the pathogenesis of POEMS syndrome and potentially add a new candidate cause for the pathogenesis of ODE.
Structural weakening of the colonic mucus barrier is an early event in ulcerative colitis pathogenesis
Authors: van der Post Sjoerd , Jabbar Karolina S , Birchenough George , Arike Liisa , Akhtar Noreen , Sjovall Henrik , Johansson Malin E V , Hansson Gunnar C 
Published: March 2019

ObjectiveThe colonic inner mucus layer protects us from pathogens and commensal-induced inflammation, and has been shown to be defective in active UC. The aim of this study was to determine the underlying compositional alterations, their molecular background and potential contribution to UC pathogenesis.DesignIn this single-centre case–control study, sigmoid colon biopsies were obtained from patients with UC with ongoing inflammation (n=36) or in remission (n=28), and from 47 patients without colonic disease. Mucus samples were collected from biopsies ex vivo, and their protein composition analysed by nanoliquid chromatography-tandem mass spectrometry. Mucus penetrability and goblet cell responses to microbial stimulus were assessed in a subset of patients.ResultsThe core mucus proteome was found to consist of a small set of 29 secreted/transmembrane proteins. In active UC, major structural mucus components including the mucin MUC2 (p<0.0001) were reduced, also in non-inflamed segments. Active UC was associated with decreased numbers of sentinel goblet cells and attenuation of the goblet cell secretory response to microbial challenge. Abnormal penetrability of the inner mucus layer was observed in a subset of patients with UC (12/40; 30%). Proteomic alterations in penetrable mucus samples included a reduction of the SLC26A3 apical membrane anion exchanger, which supplies bicarbonate required for colonic mucin barrier formation.ConclusionCore mucus structural components were reduced in active UC. These alterations were associated with attenuation of the goblet cell secretory response to microbial challenge, but occurred independent of local inflammation. Thus, mucus abnormalities are likely to contribute to UC pathogenesis.
Genomic Signatures Predict the Immunogenicity of BRCA-Deficient Breast Cancer
Authors: Kraya Adam A. , Maxwell Kara N. , Wubbenhorst Bradley , Wenz Brandon M. , Pluta John , Rech Andrew J. , Dorfman Liza M. , Lunceford Nicole , Barrett Amanda , Mitra Nandita , Morrissette Jennifer J.D. , Feldman Michael , Nayak Anupma , Domchek Susan M. , Vonderheide Robert H. , Nathanson Katherine L. 
Published: March 2019

Abstract

Purpose:
Breast cancers with BRCA1/2 alterations have a relatively high mutational load, suggesting that immune checkpoint blockade may be a potential treatment option. However, the degree of immune cell infiltration varies widely, and molecular features contributing to this variability remain unknown.

Experimental Design:
We hypothesized that genomic signatures might predict immunogenicity in BRCA1/2 breast cancers. Using The Cancer Genome Atlas (TCGA) genomic data, we compared breast cancers with (89) and without (770) either germline or somatic BRCA1/2 alterations. We also studied 35 breast cancers with germline BRCA1/2 mutations from Penn using WES and IHC.

Results:
We found that homologous recombination deficiency (HRD) scores were negatively associated with expression-based immune indices [cytolytic index (P = 0.04), immune ESTIMATE (P = 0.002), type II IFN signaling (P = 0.002)] despite being associated with a higher mutational/neoantigen burden, in BRCA1/2 mutant breast cancers. Further, absence of allele-specific loss of heterozygosity (LOH negative; P = 0.01) or subclonality (P = 0.003) of germline and somatic BRCA1/2 mutations, respectively, predicted for heightened cytolytic activity. Gene set analysis found that multiple innate and adaptive immune pathways that converge on NF-κB may contribute to this heightened immunogenicity. IHC of Penn breast cancers demonstrated increased CD45+ (P = 0.039) and CD8+ infiltrates (P = 0.037) and increased PDL1 expression (P = 0.012) in HRD-low or LOH-negative cancers. Triple-negative cancers with low HRD had far greater CD8+ T cells (P = 0.0011) and Perforin 1 expression (P = 0.014) compared with hormone receptor-positive HRD-high cancers.

Conclusions:
HRD scores and hormone receptor subtype are predictive of immunogenicity in BRCA1/2 breast cancers and may inform the design of optimal immune therapeutic strategies.
Calamus pseudoerectus (Arecaceae), a new species from the eastern Himalaya, India
Authors: Mondal Sujit , Basu Shyamal K. , Chowdhury Monoranjan 
Published: March 2019

Calamus pseudoerectus (Arecaceae or Palmae), a new species of rattan from the hilly slopes of Mukti and Mahananda rivers at Darjeeling District of West Bengal in the eastern Indian Himalaya, is described and illustrated. This species closely resembles two Indo-Myanmar species, C. erectus Roxb. and C. arborescence Griff. It, however, is distinguished by its short and extremely slender stem, spine ornamentation, pendulous, long-branched inflorescence, and minute fruits with fimbriate scales. A comparative study among C. pseudoerectus sp. nov., C. erectus Roxb., and C. arborescence Griff. is provided. Conservation status of this species is proposed as Endangered (EN) as per IUCN.
Estimating Leopard Panthera pardus fusca (Mammalia: Carnivora: Felidae) abundance in Kuno Wildlife Sanctuary, Madhya Pradesh, India
Authors: Pawar Devavrat , Nelson Howard P. , Pawar Divya R.L. , Khanwilkar Sarika 
Published: March 2019

Reliable population estimate of apex predators, such as the Leopard Panthera pardus fusca, is important as they indicate ecosystem health, enable evaluation of the effectiveness of conservation efforts and provide a benchmark for future management decisions. The present study is the first to estimate abundance of Leopard along with possible prey profile in Kuno Wildlife Sanctuary (KWLS), in central Madhya Pradesh (M.P.), India. For systematic sampling, two study habitats, 15km² each, were identified, one close to the park entrance and the other away from the park entrance. Sampling was carried out between March and April 2017, for a period of 18 days in each of the two study habitats, ‘good’ and ‘poor’, initially based on situation in reference to park-entry. Each habitat was divided into five blocks each, and each block subdivided into three, 1km² observation units. In all, 16 trail cameras were placed in pairs, one set at a time in five of the blocks, over a six–day period. The total sampling effort was 180 trap-nights. The trigger speed was set to 3 frames per 10 seconds, and repeated only after 20 minutes interval on infra-red detection of object. The data was analysed using closed population capture–recapture analyses in Program MARK, to estimate Leopard abundance. Seventy-eight Leopard detections representing eight unique individuals were found in the 30km² study site. Seven Leopards were detected in the good habitat and one in the poor habitat. The estimate for Leopard abundance for the good habitat was 11 Leopards (SE 4.6, 95% CI = 8 – 31 individuals). Due to limited captures/recaptures in the poor habitat, abundance could not be estimated for this habitat class.
Effects of Maternal Singing Style on Mother–Infant Arousal and Behavior
Authors: Cirelli Laura K. , Jurewicz Zuzanna B. , Trehub Sandra E. 
Published: March 2019

Abstract
Mothers around the world sing to infants, presumably to regulate their mood and arousal. Lullabies and playsongs differ stylistically and have distinctive goals. Mothers sing lullabies to soothe and calm infants and playsongs to engage and excite infants. In this study, mothers repeatedly sang Twinkle, Twinkle, Little Star to their infants (n = 30 dyads), alternating between soothing and playful renditions. Infant attention and mother–infant arousal (i.e., skin conductivity) were recorded continuously. During soothing renditions, mother and infant arousal decreased below initial levels as the singing progressed. During playful renditions, maternal and infant arousal remained stable. Moreover, infants exhibited greater attention to mother during playful renditions than during soothing renditions. Mothers' playful renditions were faster, higher in pitch, louder, and characterized by greater pulse clarity than their soothing renditions. Mothers also produced more energetic rhythmic movements during their playful renditions. These findings highlight the contrastive nature and consequences of lullabies and playsongs.
The Ice Particle and Aggregate Simulator (IPAS). Part I: Extracting Dimensional Properties of Ice–Ice Aggregates for Microphysical Parameterization
Authors: Przybylo Vanessa M. , Sulia Kara J. , Schmitt Carl G. , Lebo Zachary J. , May William C. 
Published: March 2019

AbstractAggregation, the process by which two or more ice particles attach to each other, is typically observed in clouds that span a range of temperatures and is influenced by the crystal shape (habit). In this study, the resulting characteristics of ice–ice two-monomer aggregation is investigated, which is expected to improve microphysical parameterizations through more precise aggregate characteristics and in turn better predict the rate of aggregation and snow development. A systematic way to determine the aspect ratio of the aggregate was developed, which takes into account the expected falling orientations, overlap of each monomer, and any contact angle that may form through so-called constrained randomization. Distributions were used to obtain the most frequent aspect ratio, major axis, and minor axis of aggregated particles with respect to the monomer aspect ratio. Simulations were completed using the Ice Particle and Aggregate Simulator (IPAS), a model that uses predefined three-dimensional geometries, (e.g., hexagonal prisms) to simulate ice crystal aggregation and allows for variation in crystal size, shape, number, and falling orientation. In this study, after collection in a theoretical grid space, detailed information is extracted from the particles to determine the properties of aggregates. It was found that almost all monomer aspect ratios aggregate to less extreme aggregate aspect ratios at nearly the same rate. Newly formed aggregate properties are amenable to implementation into more sophisticated bulk microphysical models designed to predict and evolve particle properties, which is crucial in realistically evolving cloud ice mass distribution and for representing the collection process.
Effects of higher habitual protein intake on resistance-training-induced changes in body composition and muscular strength in untrained older women: A clinical trial study
Authors: Nabuco Hellen CG , Tomeleri Crisieli M , Junior Paulo Sugihara , Fernandes Rodrigo R , Cavalcante Edilaine F , Nunes João Pedro , Cunha Paolo F , dos Santos Leandro , Cyrino Edilson S 
Published: March 2019

Background: Aging is accompanied by progressive and accentuated decline in muscular strength and skeletal muscle mass, affecting health and functional autonomy. Both resistance training (RT) and diet are strategies that may contribute to improvement in the health of the elderly. Aim: The purpose of this study was to evaluate the effects of higher habitual protein intake on RT-induced changes in body composition and strength in untrained postmenopausal women. Methods: Seventy older women were submitted to an RT program. Body composition, muscular strength, and dietary intake (24 h dietary recall) were performed pre- and post-intervention. To verify different intervention effects according to protein intake of the participants, the sample was separated into tertiles according to protein intake: low, moderate, and high protein intake. Results: A time vs. group interaction ( p < 0.05) was observed, with high protein intake presenting greater increases compared with low protein intake, for skeletal muscle mass (5.3% vs. 1.3%), lower limb lean soft tissue (4.9% vs. 1.4%), upper lean soft tissue (4.9% vs. 1.2%), preacher curl (24% vs. 15.2%), and total strength (16.4% vs. 11.7%). A time vs. group interaction ( p < 0.05) was observed, with high protein intake presenting greater increases compared with moderate protein intake, for skeletal muscle mass (5.3% vs. 3.2%). In all groups, a main effect of time ( p < 0.05) was observed for knee extension and chest press. Conclusions: We conclude that intake of >1.0 g/kg/day of protein promotes gains in skeletal muscle mass and muscular strength after RT in untrained older women.
Levosimendan as rescue therapy in low output syndrome after cardiac surgery: effects and predictors of outcome
Authors: Beiras-Fernandez Andres , Kornberger Angela , Oberhoffer Martin , Kur Felix , Weis Marion , Vahl Christian-Friedrich , Weis Florian 
Published: March 2019

Objectives Calcium sensitizers have been shown to improve outcomes in patients with low cardiac output syndrome (LCOS) after cardiac surgery. We assessed the effects of levosimendan on LCOS in cardiac surgical patients to identify outcome predictors. Methods A total of 106 patients in whom LCOS persisted despite conventional therapy additionally received 0.1 µg/kg/min of levosimendan for 24 hours according to a defined treatment algorithm. Baseline and treatment data as well as hemodynamic and outcome parameters were compared between survivors and nonsurvivors, and a multivariate correlation and regression tree analysis was implemented. Results The ejection fraction significantly increased from 27% ± 4% to 38% ± 8% within 24 hours and to 45% ± 10% within 48 hours of starting levosimendan. These changes were accompanied by a significant increase in cardiac output from 5.2 ± 0.6 to 6.2 ± 0.7 L/min within 24 hours and significant dose reductions in vasopressors and inotropes. In contrast to nonsurvivors, survivors’ need for inotropic support decreased after the addition of levosimendan to the therapy. Conclusion In our patients, all of whom were treated according to the same algorithm, the response to levosimendan in terms of the post-levosimendan need for inotropes and vasopressors predicted survival.
Development and validation of the Brabant Hip Fracture Score for 30-day and 1-year mortality
Authors: van de Ree Cornelis LP , Gosens Taco , van der Veen Alexander H , Oosterbos Cees JM , Heymans Martijn W , de Jongh Mariska AC 
Published: March 2019

Background: Hip fractures in the elderly are associated with advanced comorbidities and high mortality rates. Mortality prediction models can support clinicians in tailoring treatment for medical decision making in frail elderly patients. The aim of this study was to develop and internally validate the Brabant Hip Fracture Score, for 30-day (BHFS-30) and 1-year mortality (BHFS-365) after hip fracture. Material and methods: A cohort study was conducted in 2 hospitals on operatively treated patients of 65 years and older with a hip fracture. Manual backward multivariable logistic regression was used to select independent predictors of 30-day and 1-year mortality. Internal validation was performed using bootstrapping techniques. Model performance was assessed with: (1) discrimination via the area under the receiver operating characteristic curve (AUC); (2) explained variance via Nagelkerke’s R2; (3) calibration via Hosmer-Lemeshow (H&L) test and calibration plots. Results: Independent predictors of 30-day mortality were: age, gender, living in an institution, Hb, respiratory disease, diabetes and malignancy. In addition, cognitive frailty and renal insufficiency, were selected in the BHFS-365. Both models showed acceptable discrimination after internal validation (AUC = 0.71 and 0.75). The Hosmer-Lemeshow test indicated no lack of fit ( p > 0.05). Discussion: We demonstrated that the internally validated and easy to use BHFS in surgically treated elderly patients after a hip fracture showed acceptable discrimination and adequate calibration. In clinical practice a cutoff of BHFS-30 ⩾ 24 could identify frail elderly patients at high risk for early mortality and could support clinicians, patients and families in tailoring treatment for medical decision making.
Preoperative serum high-density lipoprotein cholesterol as a predictor of poor survival in patients with clear cell renal cell cancer
Authors: Hao Bo , Peng Xufeng , Bi Baochen , Yu Miaomei , Sang Chen , Chen Zhen 
Published: March 2019

Purpose: Numerous studies have suggested that dyslipidemia is closely related to various cancers and the high-density lipoprotein cholesterol (HDL-C) levels are associated with the outcome of cancer patients. However, the predictive value of HDL-C in patients with renal cell carcinoma remains unclear. Our study aims to explore the relationship between the levels of serum HDL-C and the prognosis of renal cell carcinoma. Methods: A total of 308 patients diagnosed with clear cell renal cell carcinoma (CCRCC) who received surgical treatment were retrospectively enrolled in our study. The necessary clinical data of each enrolled patient were collected and the Kaplan–Meier method and the Cox proportional hazards regression model were used to calculate the overall survival and cancer-specific survival. Results: Kaplan–Meier and univariate analysis showed that a lower preoperative serum HDL-C level was a risk factor of CCRCC patients. Multivariate analyses demonstrated that a higher serum HDL-C level was closely associated with better overall survival (hazard ratio = 0.32; 95% confidence interval (0.13, 0.78); P=0.013) and cancer-specific survival (hazard ratio =0.42; 95% confidence interval (0.15, 0.99); P=0.048). Conclusion: Our findings suggest that an increased serum level of HDL-C might predict better overall survival and cancer-specific survival in patients with CCRCC.
Effects of a multi-component educational intervention on nurses’ knowledge and adherence to standard precautions in intensive care units
Authors: Gomarverdi Shiva , Khatiban Mahnaz , Bikmoradi Ali , Soltanian Ali Reza 
Published: March 2019

Background: The standard precautions (SPs) should be disseminated and implemented by healthcare providers. This study aimed to examine the effects of a multi-component educational intervention on nurses’ knowledge and adherence to the SP guidelines in intensive care units (ICUs). Methods: This small-scale study consisted of a cluster randomised trial. Two ICUs, located in different hospitals, participated in the study. Nurses (n = 15) in one ICU received the multi-component educational intervention. The intervention involved an educational (with multiple instructional media) and a behavioural (with hands-on practice) component. Nurses’ knowledge and adherence were assessed at pre-test and two and six weeks after the intervention. Results: Results showed significant group by time interaction effects for both outcomes: a large improvement was found in the experimental group over time, but not in the control group. The experimental nurses’ knowledge improved from 15 ± 2.47 at pre-test to 19 ± 2.65 and 19.53 ± 0.92 at follow-ups. Similarly, their adherence increased from 19.87 ± 4.44 at pre-test to 29.20 ± 5.00 and 28.40 ± 4.37 at two and six weeks post-test, respectively. Conclusions: The multi-component educational interventions had demonstrated initial effectiveness in enhancing ICU nurses’ knowledge and adherence to the SPs guidelines. The intervention is a promising approach for designing effective continuing education initiatives aimed to improve nurses’ practice.
The social attention skills of preschool children with an intellectual disability and children with a hearing loss
Authors: Bortoli Anna M. , Margaret Brown P. 
Published: March 2019

THIRTY PRESCHOOL CHILDREN (10 with typical development, 10 with an intellectual disability and 10 with a hearing impairment) were videotaped during play. Data was collected for each participant group, covering the number, length and nature of social engagement opportunities (SEOs) and the children's attentional states during SEOs. The typically developing group had SEOs of longer duration than did the children with an intellectual disability, although not significantly longer than those of the group with a hearing impairment. The children with intellectual disability were more frequently disengaged during SEOs. The typical group's SEOs were more visual and interactive than those of the other two groups. The typically developing group was more attentive than the group with a hearing impairment, and was more likely to display aware–alert and sustained attention than were the two disability groups. For higher-order attentional states, the typically developing group was more likely to achieve focused and divided attention than was the hearing impaired group, which was more likely to exhibit these states than was the group with an intellectual disability.