bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Mitochondrial Aldehyde Dehydrogenase in Nitroglycerin-Mediated Vasodilation: Observations Concerning the Dose–Response Relationship
Authors: He Jerry D. , Lytvyn Yuliya , Zhou Kangbin , Parker John D. 
Published: June 2019

Abstract:
The mechanism of the bioactivation of nitroglycerin has long been controversial, with a number of suggested enzymatic pathways. More recently, aldehyde dehydrogenase-2 (ALDH-2) has been reported as the important enzyme involved in the bioactivation of nitroglycerin at therapeutically relevant concentrations. Other previously described enzyme systems can also bioactivate nitroglycerin, but only at concentrations, which are significantly higher than achieved in clinical practice. This study investigated the vascular response to nitroglycerin given over a wide range of concentrations in subjects with and without the ALDH-2 Glu504Lys polymorphism, a common genetic variant that greatly reduces the activity of ALDH-2 (n = 10 in both groups). Forearm blood flow (FBF) responses to a brachial artery infusion of nitroglycerin were assessed using venous occlusion plethysmography. Intra-arterial infusion of nitroglycerin caused a significant increase in FBF beginning at 0.464 µg/min with increasing responses seen in both groups at all infusion rates. However, there were no differences in the FBF responses to nitroglycerin in those with and without the ALDH-2 polymorphism, suggesting that ALDH-2 is not solely responsible for the bioactivation of nitroglycerin at either low (therapeutically relevant) or high concentrations of nitroglycerin.
Obstructive Sleep Apnea in Patients With Primary-open Angle Glaucoma: No Role for a Screening Program
Authors: Wozniak Dariusz , Bourne Rupert , Peretz Gil , Kean Jane , Willshire Catherine , Harun Shabbir , Villar Sofia , Chiu Yi-Da , Smith Ian 
Published: June 2019

Précis:
In this study, we found a high prevalence of obstructive sleep apnea (OSA) among patients with primary open-angle glaucoma (POAG) but this was not different (nor was OSA more severe) to matched people without glaucoma.

Rationale:
It has been proposed that OSA might be a contributing factor in the development of POAG and by extension that there could be a role for screening people with POAG for OSA.

Objectives:
To assess whether the prevalence of OSA among patients with POAG is different from that in people without glaucoma and to examine for associations between apnea-hypopnea index (AHI) and markers of functional and structural changes in POAG.

Methods:
Unselected POAG patients and control subjects were consecutively recruited in a single center. A comprehensive ocular assessment and nocturnal multichannel cardiorespiratory monitoring were performed.

Results:
Data from 395 participants, 235 POAG patients, and 160 controls were analyzed. The prevalence of OSA was 58% [95% confidence interval (CI), 52-65] in POAG patients and 54% (95% CI, 47-62) in controls, with 22% (95% CI, 16-27) of POAG patients and 16% (95% CI, 11-22) of controls diagnosed with moderate or severe OSA. A total of 160 POAG participants were matched to the controls using propensity score matching. There was no significant difference in OSA prevalence between the matched groups (P=0.91 for AHI≥5 and P=0.66 for AHI≥15). The AHI was not associated with the severity of visual field defect or retinal nerve fiber layer thinning after adjustment for confounders.

Conclusions:
This study confirms a high prevalence of OSA among patients with POAG which is, however, not higher than in people without glaucoma matched for known OSA risk factors. Our results do not support screening for OSA in patients with POAG.
Highlights From Clinical Practice Guidelines by the Infectious Diseases Society of America for the Diagnosis and Treatment of Seasonal Influenza
Authors: File Thomas M. 
Published: June 2019

Abstract
Seasonal influenza remains a significant cause of morbidity and mortality. The Infectious Diseases Society of America has published an update of the clinical practice guideline for the diagnosis and treatment of seasonal influenza. The guideline provides new recommendations for management of this infection. Clinicians should use rapid molecular assays for diagnosis. Antiviral therapy of patients with severe or progressive illness should be started regardless of illness duration.
Alveolar Hydatid
Authors: Choh Naseer A. , Ilyas Mohd , Ahmad Zubair , Shafi Fahad , Yattoo Ghulam Nabi , Kazimi Mir Junaid Ahmad , Gojwari Tariq A. , Shaheen Feroze A. 
Published: June 2019

Background
The aim of the present study was to study the different imaging appearances on proven cases of hepatic alveolar hydatid, which is often misdiagnosed as a tumor.

Materials and Methods
We studied ultrasonography, computed tomography, and magnetic resonance imaging findings in 21 histopathologically proven cases of hepatic alveolar hydatid disease over a period of 1½ year. The ultrasonography findings were heterogeneous hyperechoic mass in 14 cases, multilocular cystic mass in 3 cases, and hyperechoic mass with calcification giving dense acoustics in 4 cases. Computed tomography findings were a sheet-like hypodense, infiltrative, nonenhancing mass without biliary or portal encasement or infiltration in 16 cases, biliary infiltration in 4 cases, and portal encasement in 3 cases. The magnetic resonance imaging findings showed that all 21 patients had a characteristic microvesicular appearance of the parasitic mass on T2-weighted images corresponding to the microvesicles demonstrated on histopathology. The portal encasement and biliary infiltration were also demonstrated on magnetic resonance (MR) images.

Conclusions
T2-weighted MR images correlate with the histologic characteristic of the hepatic alveolar hydatid disease. Ultrasonography and computed tomography may help in initial assessment of the extent of the disease, but MR helps in exact diagnosis.
Transverse Myelitis Caused by Varicella Zoster Virus
Authors: Ari Buse Cagla , Karaci Rahsan , Mayda Domac Fusun , Ulker Mustafa , Bolluk Basak , Ofluoglu Demet , Ozgen Kenangil Gulay 
Published: June 2019

Introduction
The varicella zoster virus (VZV) infection causes chickenpox and herpes zoster. Primary infection occurs more frequently in the pediatric age as chickenpox. Virus can be latent in cranial nerve or dorsal root ganglia and reactivate several decades later as the form of herpes zoster generally in immunosuppressed patients. Varicella zoster virus is associated with severe neurological complications, including post herpetic neuralgia, aseptic meningitis, polyneuropathy, cranial nerve palsy, meningoencephalitis, vasculopathy, encephalitis, and transverse myelitis. The transverse myelitis caused by VZV is reported rarely.

Case Report
A 77-year-old immunocompetent patient presented with muscle weakness and sensation loss due to the demyelinating lesion caused by VZV on C5 dermatome. Proprioception and vibratory sensation loss were also marked. Cervical spinal magnetic resonance imaging showed expansive intramedullary high-signal intensity lesion on C5 with focal swelling on T2-weighted images and gadalinium enhancement on T1-weighted images. cerebrospinal fluid viral antibody test was positive for immunoglobulin G of VZV but negative for VZV DNA. The patient was treated with oral valacyclovir (1 g) 3 times daily for 7 days and with methylprednisolone (1.0 g) every day for 5 days. After treatment, his muscle strength increased but sensorial loss and neuropathic pain did not recover.

Conclusions
About 40% of transverse myelitis cases are caused by viral infections, some of them are herpes viruses and poliovirus. Varicella zoster infection is a common disease but not a common cause of transverse myelitis particularly in immuncompetent patients. The clinicians must be aware of this rare complication of VZV.
Scale-free amplitude modulation of low-frequency fluctuations in episodic migraine
Authors: Hodkinson Duncan J. , Lee Danielle , Becerra Lino , Borsook David 
Published: June 2019

Abstract
Arrhythmic fluctuations in neural activity occur at many levels of the nervous system. Such activity does not have a characteristic temporal periodicity but can exhibit statistical similarities, most commonly power-law scaling behavior, which is indicative of scale-free dynamics. The recurrence of scaling laws across many different systems and its manifestation in behavior has prompted a search for unifying principles in human brain function. With this in mind, a focused search for abnormities in scale-free dynamics is of considerable clinical relevance to migraine and other clinical pain disorders. Here, we examined the scale-free properties of the resting-state functional magnetic resonance imaging (fMRI) signal in the broadband frequency range known to be related to spontaneous neural activity (0.01-0.1 Hz). In a large cohort of episodic migraine patients (N = 40), we observed that the strength of long-range temporal correlations in the fMRI signal (captured by the scaling exponent α) was significantly higher in the sensorimotor network compared with healthy controls. Increases in the scaling exponent were positively correlated with fMRI signal variance and negatively correlated with the patient's self-reported headache intensity. These changes in the fMRI signal suggest that the temporal structure of amplitude fluctuations carries valuable information about the dynamic state of the underlying neuronal networks and ensuing sensory impairments in migraine. The demonstrated scaling laws pose a novel quantitative approach for examining clinically relevant interindividual variability in migraine and other pain disorders.
Age-Specific Distribution of Diagnosis and Outcomes of Children Admitted to ICUs: A Population-Based Cohort Study*
Authors: Jung Minyoung , Park Hyejeong , Kang Danbee , Park Jinkyeong , Jeon Kyeongman , Chung Chi Ryang , Yang Jeong Hoon , Cho Yang Hyun , Suh Gee Young , Guallar Eliseo , Cho Juhee , Cho Joongbum 
Published: June 2019

Objectives:
Although several studies have reported outcome data on critically ill children, detailed reports by age are not available. We aimed to evaluate the age-specific estimates of trends in causes of diagnosis, procedures, and outcomes of pediatric admissions to ICUs in a national representative sample.

Design:
A population-based retrospective cohort study.

Setting:
Three hundred forty-four hospitals in South Korea.

Patients:
All pediatric admissions to ICUs in Korea from August 1, 2009, to September 30, 2014, were covered by the Korean National Health Insurance Corporation, with virtually complete coverage of the pediatric population in Korea. Patients less than 18 years with at least one ICUs admission between August 1, 2009, and September 30, 2014. We excluded neonatal admissions (< 28 days), neonatal ICUs, and admissions for health status other than a disease or injury. The final sample size was 38,684 admissions from 32,443 pediatric patients.

Intervention:
None.

Measurements and Main Results:
The overall age-standardized admission rate for pediatric patients was 75.9 admissions per 100,000 person-years. The most common primary diagnosis of admissions was congenital malformation (10,897 admissions, 28.2%), with marked differences by age at admission (5,712 admissions [54.8%] in infants, 3,994 admissions [24.6%] in children, and 1,191 admissions [9.9%] in adolescents). Injury was the most common primary diagnosis in adolescents (3,248 admissions, 27.1%). The overall in-hospital mortality was 2,234 (5.8%) with relatively minor variations across age. Neoplasms and circulatory and neurologic diseases had both high frequency of admissions and high in-hospital mortality.

Conclusions:
Admission patterns, diagnosis, management, and outcomes of pediatric patients admitted to ICUs varied by age groups. Strategies to improve critical care qualities of pediatric patients need to be based on the differences of age and may need to be targeted at specific age groups.
Clinical Applications of Arterial Spin Labeling in Brain Tumors
Authors: Abdel Razek Ahmed Abdel Khalek , Talaat Mona , El-Serougy Lamiaa , Gaballa Gada , Abdelsalam Mohamed 
Published: June 2019

Abstract
The aim of this review was to review the basic background, technique, and clinical applications of arterial spin labeling in brain tumors. Arterial spin labeling is used for differentiation of brain tumors from nonneoplastic lesions such as infarction and infection. It has a role in the grading of gliomas and in the differentiation of gliomas from lymphomas and metastasis. It is used for detection of the best biopsy site and prediction of treatment response. Arterial spin labeling is used for the assessment of extra-axial tumors and pediatric tumors. Last, it has a role in the differentiation of tumor recurrence from postradiation changes and in monitoring patients after therapy.
Magnetic Resonance Imaging Characteristics of Papillary Thyroid Carcinoma for the Prediction of Cervical Central Compartment Lymph Node Metastasis
Authors: Wang Hao , Liu Kefu , Ren Jiliang , Liu Weiyan , Chen Yongqi , Song Bin 
Published: June 2019

Objective
Cervical lymph node metastasis (LNM) is associated with local recurrence and distant metastasis in papillary thyroid carcinoma (PTC). This study was to assess magnetic resonance imaging (MRI) characteristics for predicting cervical LNM in PTC.

Materials and Methods
A total of 119 patients with 154 PTC examined by MRI were assessed. According to inclusion and exclusion criteria, 78 subjects (78 tumors) were included in the final analysis. Conventional MRI findings and apparent diffusion coefficient were recorded. Descriptive statistics for LNM, sensitivity, specificity, and accuracy of various features were obtained. Multivariate logistic regression was performed for identifying independent variables for predicting LNM. Receiver operating characteristic curves were used to assess the diagnostic performance of the independent variables and model.

Results
There were 31 node-positive and 47 node-negative PTCs in this study. Node-positive patients significantly differed from the node-negative group in age (P = 0.039), long/short diameter of lymph nodes (both P < 0.001), lymph nodes cystic change (P = 0.005), tumor size (P < 0.001), poorly defined tumor margin in contrast-enhanced imaging (P < 0.001), and thyroid contour protrusion sign (P < 0.001). Satisfactory interobserver agreement was obtained between the 2 examiners (Cohen κ of 0.871 and 0.872). Thyroid contour protrusion sign and poorly defined tumor margin were identified as independent predictive factors of LNM in PTC (both P < 0.05), with area under the curves of 0.813 and 0.851, and accuracies of 0.810 and 0.838. When the independent factors were combined, the diagnostic performance was improved with an area under the curve of 0.944 and an accuracy of 0.884.

Conclusions
Thyroid contour protrusion sign and poorly defined tumor margin in contrast-enhanced imaging could be 2 important predicted findings for cervical LNM in PTC.
Clinical and Payer-Based Analysis of Value of Dual-Energy Computed Tomography for Workup of Incidental Abdominal Findings
Authors: Itani Malak , Bresnahan Brian W. , Rice Kenneth , Gunn Martin L. , Wang Sherry S. , Revels Jonathan W. , Mileto Achille 
Published: June 2019

Objective
To perform a clinical and payer-based analysis of the value of dual-energy computed tomography (DECT) for workup of incidental abdominal findings.

Methods
This was a single-center, retrospectively designed, Health Insurance Portability and Accountability Act–compliant study approved by our institutional review board. Sixty-nine examinations in 69 patients (45 men, 24 women; mean age, 57.7 years) who underwent single-phase postcontrast abdominal DECT studies between January 1, 2011, and December 31, 2017, were included. Two radiologists, blinded to study objective and design, reviewed all cases and identified incidental abdominal findings needing further imaging. All incidental findings were reviewed by 2 other investigators, who determined whether an imaging-based diagnosis could be made using DECT virtual noncontrast images and iodine maps. Additional studies and associated payer-reimbursement amounts avoided by use of DECT were estimated. All imaging costs were estimated based on the US Centers for Medicare & Medicaid Services reimbursement amounts.

Results
Thirty-four incidental findings (renal mass, n = 20; adrenal nodule, n = 8; pancreatic cystic lesions, n = 3; others, n = 3) were identified in 19 (27.5%) of 69 patients. Dual-energy computed tomography characterized 27 incidental findings in 15 patients and accounted for cost savings of 15 additional imaging examinations (abdominal magnetic resonance imaging, n = 11; abdominal computed tomography, n = 4). Based on Centers for Medicare & Medicaid Services reimbursement amounts, we estimated that, by abolishing the need for additional imaging use, DECT saved US $84.95 per patient.

Conclusions
Dual-energy computed tomography can provide an imaging-based diagnosis of incidental abdominal findings, otherwise incompletely characterized on routine abdominal computed tomography, in approximately 21% of patients. In select patients, the monetary savings from abolishing additional imaging may reduce payer costs associated with use of DECT.
Rapidly Lethal Ruptured Hepatocellular Carcinoma With Disseminated Peritoneal Carcinomatosis on FDG PET/CT
Authors: Islam Zulqar , Hausauer Brett , Keshavamurthy Jayanth , Pucar Darko 
Published: June 2019

Abstract
Hepatocellular carcinoma (HCC) is the fourth most common cause of cancer-related death worldwide. Hepatocellular carcinoma commonly metastasizes to lungs, lymph nodes, and bone. Although HCC usually occurs in setting of chronic liver disease due to alcoholism or HBV/HCV infection, the incidence of HCC arising from nonalcoholic steatohepatitis is increasing. We present a very unusual initial presentation of occult HCC with peritoneal carcinomatosis secondary to liver rupture in a 70-year-old man with known nonalcoholic steatohepatitis–cirrhosis, best appreciated on FDG PET/CT. Our patient died a few days later. Tumor rupture is a rare but usually rapidly lethal complication of HCC.
Risk Factors for Indeterminate Response After Radioactive Iodine Therapy in Patients With Differentiated Thyroid Cancer
Authors: Jeong Eugene , Yoon Joon-Kee , Lee Su Jin , Soh Euy Young , Lee Jeonghun , An Young-Sil 
Published: June 2019

PurposeWe investigated the risk factors of indeterminate response (IDR) in patients who underwent recombinant human thyroid-stimulating hormone (rhTSH)–aided radioactive iodine therapy (RAIT).MethodsA total of 128 patients with papillary thyroid cancer were included in this retrospective study. The patients were classified into excellent response and IDR groups based on follow-up diagnostic whole-body scintigraphy (WBS) and TSH-stimulated thyroglobulin (Tg). Indeterminate response was defined as the presence of a faint uptake in the thyroid bed on the diagnostic WBS or a TSH-stimulated Tg detectable, but less than 10 ng/mL. Parameters that act as significant risk factors for IDR, including age, sex, stage, surgeon, time interval between surgery and RAIT, post-treatment WBS finding, urine iodine-to-creatinine ratio, TSH-unstimulated Tg, and rhTSH-stimulated Tg, were analyzed using a Cox proportional hazards regression method.ResultsAfter treatment, 64 patients showed IDR. Recombinant human TSH–stimulated Tg was the only independent risk factor for predicting IDR. Patients with an rhTSH-stimulated Tg greater than 2 ng/mL prior to RAIT were 3.75 times more likely (95% confidence interval, 1.61–8.72) to have an IDR than those with a lower rhTSH-stimulated Tg (≤2 ng/mL).ConclusionsPre-RAIT TSH-stimulated Tg levels are a risk factor for IDR after RAIT.
A Case of Sarcoidosis After Lymphoma
Authors: Bando-Delaunay Aurélie , Luporsi Marie , Huchet Virginie , Cassou-Mounat Thibaut , Jehanno Nina 
Published: June 2019

Abstract
We report the case of a 62-year-old woman with previous history of stage III Hodgkin lymphoma. Routine follow-up CT scan revealed 2 years after end of treatment the appearance of mediastinal nodes, suspected of lymphoma recurrence. An 18F-FDG PET/CT was performed showing hypermetabolic mediastinal lymph nodes with diffuse symmetric osteomedullar hypermetabolism of pelvis and scapulae. In the hypothesis of either recurrence or multisystemic inflammatory disorder, bone marrow and lymph node biopsies were performed, revealing the presence of noncaseating epithelioid cell granulomas, leading to the diagnosis of multisystemic sarcoidosis. This case illustrates the sarcoidosis-lymphoma syndrome.
Whole-Genome Association Analyses of Sleep-disordered Breathing Phenotypes in the NHLBI TOPMed Program
Authors: Cade Brian E. , Lee Jiwon , Sofer Tamar , Wang Heming , Zhang Man , Chen Han , Gharib Sina A. , Gottlieb Daniel J. , Guo Xiuqing , Lane Jacqueline M. , Liang Jingjing , Lin Xihong , Mei Hao , Patel Sanjay R. , Purcell Shaun M. , Saxena Richa , Shah Neomi A. , Evans Daniel S. , Hanis Craig L. , Hillman David R. , Mukherjee Sutapa , Palmer Lyle J. , Stone Katie L. , Tranah Gregory J. ,   NHLBI Trans-Omics for Precision Medicine (TOPMed) Consortium, Abecasis Gonçalo R. , Boerwinkle Eric A. , Correa Adolfo , Cupples L. Adrienne , Kaplan Robert C. , Nickerson Deborah A. , North Kari E. , Psaty Bruce M. , Rotter Jerome I. , Rich Stephen S. , Tracy Russell P. , Vasan Ramachandran S. , Wilson James G. , Zhu Xiaofeng , Redline Susan ,   TOPMed Sleep Working Group
Published: June 2019

AbstractSleep-disordered breathing (SDB) is a common disorder associated with significant morbidity. Through the NHLBI Trans-Omics for Precision Medicine (TOPMed) program we report the first whole-genome sequence analysis of SDB. We identified 4 rare gene-based associations with SDB traits in 7,988 individuals of diverse ancestry and 4 replicated common variant associations with inclusion of additional samples (n=13,257). We identified a multi-ethnic set-based rare-variant association (p = 3.48 × 10−8) on chromosome X with ARMCX3. Transcription factor binding site enrichment identified associations with genes implicated with respiratory and craniofacial traits. Results highlighted associations in genes that modulate lung development, inflammation, respiratory rhythmogenesis and HIF1A-mediated hypoxic response.
Dynamical Patterning Modules and Network Motifs as joint determinants of development: lessons from an aggregative bacterium
Authors: Guzmán-Herrera Alejandra , Angel Juan A. Arias Del , Rivera-Yoshida Natsuko , Benítez Mariana , Franci Alessio 
Published: June 2019

AbstractDevelopment and evolution are dynamical processes under the continuous control of organismic and environmental factors. Generic physical processes, associated with biological materials and certain genes or molecules, provide a morphological template for the evolution and development of organism forms. Generic dynamical behaviors, associated with recurring network motifs, provide a temporal template for the regulation and coordination of biological processes. The role of generic physical processes and their associated molecules in development is the topic of the Dynamical Patterning Module (DPM) framework. The role of generic dynamical behaviors in biological regulation is studied via the identification of the associated Network Motifs (NM). We propose a joint DPM-NM perspective on the emergence and regulation of multicellularity focusing on a multicellular aggregative bacterium,Myxococcus xanthus. UnderstandingM. xanthusdevelopment as a dynamical process embedded in a physical substrate provides novel insights into the interaction between developmental regulatory networks and generic physical processes in the evolutionary transition to multicellularity.