bluuebunny/crossref_metadata_2025_split huggingface dataset:
An unusual case of stent thrombosis: a case report
Authors: Rahman Atifur , Wong Sophia 
Published: July 2019

Abstract

Background
Stent thrombosis is a serious and potentially life-threatening complication of percutaneous coronary intervention. It often presents dramatically, typically resulting in ST-elevation myocardial infarction which is associated with a high mortality rate. Premature discontinuation of antiplatelet therapy in the initial 30 days after stenting is arguably the most important predictor of stent thrombosis. In some cases, discontinuation of therapy is unintentional, such as in patients with short-bowel length or malabsorption syndromes.

Case summary
A 70-year-old man presented to our hospital with stent thrombosis due to non-absorption of antiplatelet agents, 3 days after an elective percutaneous intervention to the right coronary artery. The patient, who had had a laparoscopic high anterior resection due to previous colorectal cancer, had noticed tablets passing whole into his colostomy bag. Repeat balloon angioplasty and stenting were performed and the patient received further antiplatelet therapy in a crushed form.

Discussion
Drug absorption in the gastrointestinal tract is altered when a significant length of the gut has been resected. Reduced intestinal luminal transit time and insufficient contact time with intestinal mucosa leads to reduced bioavailability of drugs and increased risk of stent thrombosis. The aetiology of stent thrombosis can be investigated with intravascular imaging techniques and platelet function testing. Management includes using different drug formulations and doses and monitoring the outcomes of therapy. In some cases, it may also be appropriate to involve a gastroenterology team, preferably in the multidisciplinary environment of an intestinal rehabilitation centre.
The left atrial appendage in humans: structure, physiology, and pathogenesis
Authors: Karim Nabeela , Ho Siew Yen , Nicol Edward , Li Wei , Zemrak Filip , Markides Vias , Reddy Vivek , Wong Tom 
Published: July 2019

AbstractFor many years, the left atrial appendage (LAA) was considered a dormant embryological remnant; however, it is a structurally complex and functional organ that contributes to cardiac haemodynamic changes and volume homeostasis through both its contractile properties and neurohormonal peptide secretion. When dysfunctional, the LAA contributes to thrombogenesis and subsequent increased predisposition to cardioembolic events. Consequently, the LAA has gained much attention as a therapeutic target to lower this risk. In addition, attention has focused on the LAA in its role as an electrical trigger for atrial tachycardia and atrial fibrillation with ablation of the LAA to achieve electrical isolation showing promising results in the maintenance of sinus rhythm. This in-depth review explores the structure, physiology and pathophysiology of the LAA, as well as LAA intervention and their sequelae.
Reconstruction of the disturbance history of a temperate coniferous forest through stand-level analysis of airborne LiDAR data
Authors: Sanchez-Lopez Nuria , Boschetti Luigi , Hudak Andrew T 
Published: July 2019

AbstractSpatially explicit information about stand-level Time Since the last stand-replacing Disturbance (TSD) is fundamental for modelling many forest ecosystem processes, but most of the current satellite remote sensing mapping approaches are based on change detection and time series analysis, and can detect only disturbances that have occurred since the start of the optical satellite data record. The spatial legacy of stand-replacing disturbances can however persist on the landscape for several decades to centuries, in the form of distinct horizontal and vertical stand structure features. We propose a new approach to reconstruct the long-term disturbance history of a forest, estimating TSD through stand-level analysis of LiDAR data, which are highly sensitive to the three-dimensional forest canopy structure. The study area is in the Nez Perce-Clearwater National Forest in north-central Idaho, where airborne LiDAR covering about 52,000 ha and ancillary TSD reference data for a period of more than 140 years were available. The root mean square difference (RSMD) between predicted and reference TSD was 17.5 years with a BIAS of 0.8 years; and on 72.8% of the stands the predicted TSD was less than 10 years apart from the reference TSD (78.2% of the stands when considering only disturbances occurred in the last 100 years). The results demonstrate that airborne LiDAR-derived data have enough explanatory power to reconstruct the long-term, stand-replacing disturbance history of temperate forested areas at regional scales.
Joint effect of pre-operative anemia and perioperative blood transfusion on outcomes of colon-cancer patients undergoing colectomy
Authors: Liu Zheng , Luo Jia-Jun , Pei Kevin Y , Khan Sajid A , Wang Xiao-Xu , Zhao Zhi-Xun , Yang Ming , Johnson Caroline H , Wang Xi-Shan , Zhang Yawei 
Published: July 2019

Abstract

Background
Both pre-operative anemia and perioperative (intra- and/or post-operative) blood transfusion have been reported to increase post-operative complications in patients with colon cancer undergoing colectomy. However, their joint effect has not been investigated. The purpose of this study was to evaluate the joint effect of pre-operative anemia and perioperative blood transfusion on the post-operative outcome of colon-cancer patients after colectomy.

Methods
We identified patients from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database 2006–2016 who underwent colectomy for colon cancer. Multivariate logistic regression analysis was employed to assess the independent and joint effects of anemia and blood transfusion on patient outcomes.

Results
A total of 35,863 patients—18,936 (52.8%) with left-side colon cancer (LCC) and 16,927 (47.2%) with right-side colon cancer (RCC)—were identified. RCC patients were more likely to have mild anemia (62.7%) and severe anemia (2.9%) than LCC patients (40.2% mild anemia and 1.4% severe anemia). A total of 2,661 (7.4%) of all patients (1,079 [5.7%] with LCC and 1,582 [9.3%] with RCC) received a perioperative blood transfusion. Overall, the occurrence rates of complications were comparable between LCC and RCC patients (odds ratio [OR] = 1.01; 95% confidence interval [CI] = 0.95–1.07; P = 0.750). There were significant joint effects of anemia and transfusion on complications and the 30-day death rate (P for interaction: 0.010). Patients without anemia who received a transfusion had a higher risk of any complications (LCC, OR = 3.51; 95% CI = 2.55–4.85; P &lt; 0.001; RCC, OR = 3.74; 95% CI = 2.50–5.59; P &lt; 0.001), minor complications (LCC, OR = 2.54; 95% CI = 1.63–3.97; P &lt; 0.001; RCC, OR = 2.27; 95% CI = 1.24–4.15; P = 0.008), and major complications (LCC, OR = 5.31; 95% CI = 3.68–7.64; P &lt; 0.001; RCC, OR = 5.64; 95% CI = 3.61–8.79; P &lt; 0.001), and had an increased 30-day death rate (LCC, OR = 6.97; 95% CI = 3.07–15.80; P &lt; 0.001; RCC, OR = 4.91; 95% CI = 1.88–12.85; P = 0.001) than patients without anemia who did not receive a transfusion.

Conclusions
Pre-operative anemia and perioperative transfusion are associated with an increased risk of post-operative complications and increased death rate in colon-cancer patients undergoing colectomy.
Outcomes of mitral valve repair in acute native mitral valve infective endocarditis
Authors: El Gabry Mohamed , Haidari Zaki , Mourad Fanar , Nowak Janine , Tsagakis Konstantinos , Thielmann Matthias , Wendt Daniel , Jakob Heinz , Shehada Sharaf-Eldin 
Published: July 2019

AbstractOBJECTIVESMitral valve repair (MVR) is considered the treatment of choice for mitral valve (MV) regurgitation. However, MVR in acute native MV infective endocarditis is technically challenging and not commonly performed. Our goal was to report our outcomes of MVR in acute native MV infective endocarditis.METHODSBetween January 2016 and December 2017, 35 patients presenting with acute native MV infective endocarditis underwent MVR. Primary end points were successful MVR and freedom from recurrent endocarditis. Secondary end point was the postoperative incidence of major adverse events.RESULTSThe mean age was 58 ± 13 years (74% men) and the median logistic EuroSCORE was 17.1%. Twenty patients underwent isolated MVR; the other 15 patients underwent concomitant procedures. MVR was performed with removal of the vegetation (vegectomy), limited resection of the infected tissue, direct closure of the defect, besides annuloplasty in all patients. Mean intensive care and hospital stays were 5 and 17 days, respectively. All-cause mortality was 11% (4/35) at 30 days and a total of 23% (8/35) within a follow-up period of 10 ± 7.7 months. Endocarditis recurred in 2 patients 15 and 8 months after surgery, respectively. Both underwent successful MV re-repair. Follow-up echocardiography indicated none-to-trace, mild or moderate regurgitation in 15, 10 and 2 patients, respectively.CONCLUSIONSAlthough MVR in acute native MV infective endocarditis is a complex procedure, it offers a treatment option for such patients with acceptable short-term results. Limited resection in addition to annuloplasty is our preferred method of repair. Nevertheless, long-term results in a larger cohort are still mandatory.
Intimal sarcoma in an ascending aortic Dacron graft mimicking a thrombus
Authors: Natsume Kayoko , Shiiya Norihiko , Tsuchida Takashi , Nagakura Yuka 
Published: July 2019

Abstract
Although aortic sarcomas are extremely rare, they may arise in association with a Dacron graft. Here, we report a case of an intimal sarcoma in an ascending aortic Dacron graft implanted 17 years earlier. The patient presented with multiple cerebral infarctions; clinically, a thrombus was found to cause the embolic stroke. He successfully underwent re-replacement of the ascending aorta. Although the initial postoperative histopathological diagnosis was a thrombus, he died of multiple metastases of the malignant tumour after 5 months of the surgery. A histopathological re-evaluation of the explant using immunohistochemistry revealed that the mass was an intimal sarcoma.
The Differential Effects of Knowledge on Perceptions of Genetically Modified Food Safety
Authors: Hasell Ariel , Stroud Natalie Jomini 
Published: July 2019

Abstract
Despite scientific consensus in the US that genetically modified (GM) foods are generally as safe as conventionally grown foods, the public remains skeptical about their safety. Extant research shows mixed results about the relationship between knowledge and attitudes when it comes to public opinion of GM foods in the US. This study uses data from the Pew American Trends Panel to examine the relationship between knowledge about GM foods and beliefs about their safety, in addition to what may be moderating these relationships. Results show that the relationship between knowledge and belief varies across different types of knowledge and that the effect of knowledge is moderated by perceptions of the immorality of genetic modification, rather than political or religious views.
Saliva Real-Time Polymerase Chain Reaction for Targeted Screening of Congenital Cytomegalovirus Infection
Authors: Eventov-Friedman Smadar , Manor Hili , Bar-Oz Benjamin , Averbuch Diana , Caplan Orit , Lifshitz Aliza , Bdolah-Abram Tali , Wolf Dana G 
Published: July 2019

Abstract

Background
Saliva real-time polymerase chain reaction (PCR) was shown to be sensitive and specific for the detection of congenital cytomegalovirus (cCMV) in universal screening studies. In the current study, we assessed the performance of saliva real-time PCR in newborns undergoing targeted cCMV screening.

Methods
Saliva real-time PCR results were prospectively correlated with reference-standard urine detection in newborns undergoing targeted cCMV screening over a 3-year period, in successive validation (concurrent testing of all saliva and urine specimens) and routine-screening (confirmatory urine testing of positive saliva results) implementation phases.

Results
The sensitivity, specificity, and positive and negative predictive values of saliva real-time PCR were 98.3% (95% confidence interval, 90.8%–99.9%), 91.5% (89.3%–93.3%), 45.6% (36.7%–54.7%), and 99.9% (99.2%–99.9%), respectively, in 856 concurrently tested newborns. True-positive saliva real-time PCR detection (defined in relation to urine detection) was associated with earlier saliva sampling (P = .002) and a higher saliva viral load (P < .001). We further identified a saliva viral load cutoff value that reliably distinguished between true-positive and false-positive saliva results.

Conclusions
In newborns undergoing targeted screening for cCMV, saliva real-time PCR is highly sensitive yet has a low positive predictive value, necessitating confirmatory testing. Early sampling and application of a validated viral load cutoff could improve the assay performance and support its large-scale implementation in this growing clinical setting.
Effect of default order set settings on telemetry ordering
Authors: Rubins David , Boxer Robert , Landman Adam , Wright Adam 
Published: July 2019

Abstract

Objective
To investigate the effects of adjusting the default order set settings on telemetry usage.

Materials and Methods
We performed a retrospective, controlled, before-after study of patients admitted to a house staff medicine service at an academic medical center examining the effect of changing whether the admission telemetry order was pre-selected or not. Telemetry orders on admission and subsequent orders for telemetry were monitored pre- and post-change. Two other order sets that had no change in their default settings were used as controls.

Results
Between January 1, 2017 and May 1, 2018, there were 1, 163 patients admitted using the residency-customized version of the admission order set which initially had telemetry pre-selected. In this group of patients, there was a significant decrease in telemetry ordering in the post-intervention period: from 79.1% of patients in the 8.5 months prior ordered to have telemetry to 21.3% of patients ordered in the 7.5 months after (χ2 = 382; P &lt; .001). There was no significant change in telemetry usage among patients admitted using the two control order sets.

Discussion
Default settings have been shown to affect clinician ordering behavior in multiple domains. Consistent with prior findings, our study shows that changing the order set settings can significantly affect ordering practices. Our study was limited in that we were unable to determine if the change in ordering behavior had significant impact on patient care or safety.

Conclusion
Decisions about default selections in electronic health record order sets can have significant consequences on ordering behavior.
Technical note: concentrations of soluble, insoluble, and total dietary fiber in feed ingredients determined using Method AOAC 991.43 are not different from values determined using Method AOAC 2011.43 with the AnkomTDF Dietary Fiber Analyzer
Authors: Nguyen Nga , Jacobs Marc , Li Juntao , Huang Chengfei , Li Defa , Navarro Diego M D L , Stein Hans H , Jaworski Neil W 
Published: July 2019

AbstractThe primary objective of this experiment was to test the hypothesis that concentrations of soluble (SDF), insoluble (IDF), and total dietary fiber (TDF) in feed ingredients used in diets for pigs and poultry analyzed using Method AOAC 2011.25 are greater than values determined using Method AOAC 991.43. A second objective was to determine the variation that may exist among 3 laboratories using the 2 methods with the AnkomTDF Dietary Fiber Analyzer (Ankom Technology, Macedon, NY). The 3 laboratories were the Ministry of Agriculture Feed Industry Center (MAFIC) at China Agricultural University, Trouw Nutrition, and Hans H. Stein Monogastric Nutrition Laboratory at University of Illinois at Urbana-Champaign (UIUC). All laboratories analyzed SDF and IDF in feed ingredients in duplicate or triplicate using both methods AOAC 991.43 and 2011.25 with the AnkomTDF Dietary Fiber Analyzer. The 9 test ingredients were wheat, soybean meal, rapeseed meal, sugar beet pulp, peas, horse beans, native pea starch, and 2 samples of corn; 1 from Europe and 1 from China. All ingredient samples, with the exception of Chinese corn, were procured by Trouw Nutrition, ground to pass through a 0.5 mm screen, subsampled, and sent to MAFIC and UIUC. Data were analyzed using SDF, IDF, and TDF as response variables, replication as random effect, and method and location as fixed effects over all ingredients and within each ingredient. When averaged among 9 different ingredients, results indicated that SDF, IDF, and TDF values were not different with either method or at any laboratory. However, the concentration of IDF in corn, wheat, peas, and sugar beet pulp determined using Method AOAC 991.43 was greater (P < 0.05) compared with 2011.25. Soluble dietary fiber determined using Method AOAC 2011.25 was greater (P < 0.05) in corn, rapeseed meal, soybean meal, and sugar beet pulp compared with 991.43. There was no difference in TDF determined with either method, except for wheat having greater (P < 0.05) TDF when determined using Method AOAC 991.43. Interlaboratory variation for SDF, IDF, and TDF was 0.38, 0.87, 1.20, respectively, with Method AOAC 991.43 and 0.40, 0.93, and 1.27, respectively, with 2011.25. Therefore, values determined with the AnkomTDF Analyzer are repeatable among laboratories and can be used in feed formulation worldwide. In conclusion, it is recommended that Method AOAC 991.43 be used to determine SDF, IDF, and TDF in feed ingredients and diets for pigs and poultry.
Effects of Bariatric Surgery Observed in Postmortem Toxicology Casework
Authors: Bishop-Freeman Sandra C , Skirnick Olivia , Noble Chelsea N , Eagerton David H , Winecker Ruth E 
Published: July 2019

Abstract
Bariatric surgery has been on the rise and patients often have multiple indications for pre- and post-operative pharmacotherapy. Procedures target the stomach and/or small intestine and affect weight loss through restriction, malabsorption, or a combination of the two. The absorption and/or metabolism of drugs via the gastrointestinal tract could be altered by different mechanisms. Several cases at the North Carolina Office of the Chief Medical Examiner’s Toxicology Laboratory (NCOCME) have raised questions about the potential impact of these procedures on the disposition of drugs in the body and how that altered disposition may affect cause and manner of death. Overmedication and postmortem redistribution are not enough to explain the phenomena seen in some NCOCME bariatric surgery-related casework. Case examples include a 46-year-old female with a history of Roux-en-Y gastric bypass (RYGB) who suffered a witnessed collapse. Toxicological findings included elevated concentrations of oxymorphone at 0.49 mg/L in vena cava blood. A 67-year-old female, who died from vomiting and bacterial gastritis one day after placement of two intragastric weight-loss balloons, had elevated concentrations of duloxetine at 1.4 mg/L in the iliac vein blood and 9.3 mg/kg in the liver. Her medication was strictly controlled by her sister and gastric contents were without intact tablets or residue at autopsy.
In ovaries with high or low variation in follicle size, granulosa cells of antral follicles exhibit distinct size-related processes
Authors: Costermans N G J , Keijer J , van Schothorst E M , Kemp B , Keshtkar S , Bunschoten A , Soede N M , Teerds K J 
Published: July 2019

AbstractAntral follicle size might be a valuable additive predictive marker for IVF outcome. To better understand consequences of antral follicle size as a marker for reproductive outcome, we aimed to obtain insight in follicle size-related granulosa cell processes, as granulosa cells play an essential role in follicular development via the production of growth factors, steroids and metabolic intermediates. Using the pig as a model, we compared gene expression in granulosa cells of smaller and larger follicles in the healthy antral follicle pool of sows, which had a high variation versus low variation in follicle size. Selected gene expression was confirmed at the protein level. Granulosa cells of smaller antral follicles showed increased cell proliferation, which was accompanied by a metabolic shift towards aerobic glycolysis (i.e. the Warburg effect), similar to other highly proliferating cells. High granulosa cell proliferation rates in smaller follicles might be regulated via increased granulosa cell expression of the androgen receptor and the epidermal growth factor receptor, which are activated in response to locally produced mitogens. While granulosa cells of smaller follicles in the pool are more proliferative, granulosa cells of larger follicles express more maturation markers such as insulin-like growth factor-1 (IGF1) and angiopoietin 1 (ANGPT1) and are therefore more differentiated. As both higher IGF1 and ANGPT1 have been associated with better IVF outcomes, the results of our study imply that including smaller follicles for oocyte aspiration might have negative consequences for IVF outcome.
Infrared nanospectroscopic mapping of a single metaphase chromosome
Authors: Lipiec Ewelina , Ruggeri Francesco S , Benadiba Carine , Borkowska Anna M , Kobierski Jan D , Miszczyk Justyna , Wood Bayden R , Deacon Glen B , Kulik Andrzej , Dietler Giovanni , Kwiatek Wojciech M 
Published: July 2019

Abstract
The integrity of the chromatin structure is essential to every process occurring within eukaryotic nuclei. However, there are no reliable tools to decipher the molecular composition of metaphase chromosomes. Here, we have applied infrared nanospectroscopy (AFM-IR) to demonstrate molecular difference between eu- and heterochromatin and generate infrared maps of single metaphase chromosomes revealing detailed information on their molecular composition, with nanometric lateral spatial resolution. AFM-IR coupled with principal component analysis has confirmed that chromosome areas containing euchromatin and heterochromatin are distinguishable based on differences in the degree of methylation. AFM-IR distribution of eu- and heterochromatin was compared to standard fluorescent staining. We demonstrate the ability of our methodology to locate spatially the presence of anticancer drug sites in metaphase chromosomes and cellular nuclei. We show that the anticancer 'rule breaker' platinum compound [Pt[N(p-HC6F4)CH2]2py2] preferentially binds to heterochromatin, forming localized discrete foci due to condensation of DNA interacting with the drug. Given the importance of DNA methylation in the development of nearly all types of cancer, there is potential for infrared nanospectroscopy to be used to detect gene expression/suppression sites in the whole genome and to become an early screening tool for malignancy.