bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between Biomarkers of Low-grade Inflammation and Sex Hormones in Women with Polycystic Ovary Syndrome
Authors: Hatziagelaki Erifili , Pergialiotis Vasilios , Kannenberg Julia M. , Trakakis Eftihios , Tsiavou Anastasia , Markgraf Daniel F. , Carstensen-Kirberg Maren , Pacini Giovanni , Roden Michael , Dimitriadis George , Herder Christian 
Published: August 2019

AbstractObjective Women with polycystic ovary syndrome (PCOS) have higher circulating levels of C-reactive protein, but the relationship between inflammation and endocrine function in PCOS remains poorly understood. Thus, this study aimed to investigate the association between low-grade inflammation and sex hormones in women with PCOS.Design and Patients A comprehensive panel of biomarkers of inflammation was measured in serum of 63 women with PCOS using proximity extension assay technology. Associations of 65 biomarkers with sex hormones were assessed without and with adjustment for age and body mass index (BMI).Results In the unadjusted analysis, 20 biomarkers were positively correlated with 17-OH-progesterone (17-OH-P), 14 with prolactin and 6 with free testosterone, whereas inverse associations were found for 16 biomarkers with sex hormone-binding globulin (SHBG), 6 with luteinizing hormone (LH) and 6 with estrogen (all p<0.05). Among the positive associations, correlations were mainly found for five chemokines (CXCL11, CCL4, MCP-4/CCL13, CXCL5, CXCL6) and for VEGF-A, LAP-TGFβ1, TNFSF14 and MMP-1. Inverse associations with sex hormones were mainly present for two chemokines (CXCL1, MCP-2/CCL8), CDCP1, CST5 and CSF-1. Adjustment for age and BMI reduced the number of biomarker associations for SHBG and estrogen, but had hardly any impact on associations with 17-OH-P, prolactin, free testosterone and LH.Conclusion Women with PCOS feature BMI-independent associations between biomarkers of inflammation and certain sex steroid and hypophyseal hormones. Most of these inflammation-related biomarkers were chemokines, which may be relevant as potential mediators of the increased cardiometabolic risk of women with PCOS.
Serum CA 19–9 Level is Correlated to the Clinical Characteristics and Chronic Complications of Patients Newly Diagnosed with Type 2 Diabetes Mellitus
Authors: Cui Limei , Lv Naqiang , Li Bin , Tao Jing , Zheng Xiaomin , Yan Yehua , Liu Cuiping 
Published: August 2019

AbstractAim This study investigated the relation of serum carbohydrate antigen 199 (CA 19–9) levels to the clinical characteristics and chronic complications of patients newly diagnosed with type 2 diabetes mellitus (T2DM).Methods A total of 371 patients newly diagnosed with T2DM and 133 healthy people with consecutively matched age were compared. The 371 patients with T2DM were divided into four groups by quartiles based on their serum CA 19–9 levels, in which clinical characteristics and chronic complications, such as diabetic retinopathy (DR), diabetic nephropathy, and macrovascular complications were compared. Logistic regression analysis was used to evaluate the risk factors of DR.Results Among the 371 patients newly diagnosed with T2DM, 60 had elevated CA 19–9 levels (16.17%). The frequencies of elevated serum CA 19–9 were 24.39% (30 of 123) for females and 12.10% (30 of 248) for males, in which the values for females were higher than those for males (P<0.01).Differences were observed among the serum CA 19–9 levels, hemoglobin A1c (HbA1c), and DR (P<0.05). Logistic regression analysis showed that serum CA 19–9 levels, fasting blood glucose (FBG) and fasting C-peptide (FC-P) were risk factors for DR (P<0.05).Conclusions Serum CA 19–9 levels were correlated with HbA1c and DR in patients newly diagnosed with T2DM. The elevated serum CA 19–9 levels, high FC-P, and FBG levels were important risk factors for DR in patients newly diagnosed with T2DM.
Gastrointestinal Stromal Tumors of Small Intestine
Authors: Huda Tanweerul , Singh Mahendra Pratap 
Published: August 2019

AbstractGastrointestinal stromal tumor (GIST) is defined as mesenchymal tumors of the gastrointestinal tract expressing proto-oncogene protein CD117. They are the most common sarcomatous tumors of the gastrointestinal tract. GISTs are presumed to arise from interstitial cells of Cajal or gastrointestinal pacemaker cells which control gut motility. They have unpredictable biological behavior. Prognosis is dependent on tumor size as well as mitotic count. Radical surgical excision is the treatment of choice. They rarely metastasize to lymph nodes. Imatinib therapy is used as an adjuvant therapy. The follow-up of patients postsurgery is not standardized.
Laparoscopic Ventral Hernia Repair Combined with Sleeve Gastrectomy in Morbidly Obese Patients: Early Outcomes
Authors: Marzouk Ahmed M.S.M. , Ali Heba O.E. 
Published: August 2019

Background Morbid obesity is a serious chronic condition with, among other symptoms, increased intra-abdominal pressure and subsequent abdominal wall hernias. The optimal management of these manifestations is still controversial. The objective of this study was to assess the early postoperative outcomes of a surgical approach combining laparoscopic ventral hernia repair (LVHR) with sleeve gastrectomy in morbidly obese patients.
Methods In this retrospective study, we reviewed the files of patients who are obese with a primary ventral hernia of less than 10 cm in diameter who received simultaneous laparoscopic sleeve gastrectomy and LVHR at our institution between February 2016 and July 2018. LVHR was performed using an intraperitoneal only mesh. The individual mesh size was chosen based on the number and size of the defects. Clinical and radiological follow-ups were performed between 9 and 15 months.
Results A total of 15 patients were included. Five of them were males. The mean body mass index was 45.2 kg/m2 (range: 38.7–56.2 kg/m2). The mean hernia defect size was 2.6 cm (range: 1.3–4.2 cm). Mesh size was 10 × 15 cm in five, 20 × 15 cm in seven, and 25 cm× 20 cm in three patients. All patients were discharged without complications on the second postoperative day. Mean follow-up was at 12 months. One patient presented with hernia recurrence 14 months after surgery and four patients presented with self-limited seroma.
Conclusion Despite ambiguous guidelines and ongoing debate regarding simultaneous bariatric surgery and ventral hernia repair, the short-term outcomes of this approach appeared promising, provided that patients are carefully selected and receive an individually tailored approach.
Metformin Intoxication with Severe Renal Damage: An Adolescent Case Report
Authors: Yontem Ahmet , Aslan Nagehan , Horoz Ozden Ozgur , Beyazit Aysun Karabay , Melek Engin , Yildizdas Dincer 
Published: August 2019

AbstractMetformin is an oral antidiabetic medication which belongs to the class biguanide. Its most hazardous and life-threatening side effect is lactic acidosis which has been increasingly reported in recent years. Early diagnosis and aggressive treatment approaches have significantly reduced morbidity and mortality rates in metformin intoxication. In this case report, we emphasize the importance of early continuous renal replacement therapy in metformin-associated lactic acidosis in a 16-year-old patient who developed severe renal damage during the follow-up period of renal replacement therapy due to lactic acidosis after taking metformin in a suicide attempt.
The Impact of Resident Involvement on Surgical Outcomes following Anterior Cruciate Ligament Reconstruction
Authors: Lebedeva Kate , Bryant Dianne , Docter Shgufta , Litchfield Robert B. , Getgood Alan , Degen Ryan M. 
Published: August 2019

AbstractHands-on participation in the operating room (OR) is an integral component of surgical resident training. However, the implications of resident involvement in many orthopaedic procedures are not well defined. This study aims to assess the effect of resident involvement on short-term outcomes following anterior cruciate ligament reconstruction (ACLR). The National Surgical Quality Improvement Program (NSQIP) database was queried to identify all patients who underwent ACLR from 2005 to 2012. Demographic variables, resident participation, 30-day complications, and intraoperative time parameters were assessed for all cases. Resident and nonresident cases were matched using propensity scores. Outcomes were analyzed using univariate and multivariate regression analyses, as well as stratified by resident level of training. Univariate analysis of 1,222 resident and 1,188 nonresident cases demonstrated no difference in acute postoperative complication rates between groups. There was no significant difference in the incidence of overall complications based on resident level of training (p = 0.109). Operative time was significantly longer for cases in which a resident was involved (109.5 vs. 101.7 minutes; p < 0.001). Multivariate analysis identified no significant predictors of major postoperative complications, while patient history of chronic obstructive pulmonary disease was the only independent risk factor associated with minor complications. Resident involvement in ACLR was not associated with 30-day complications despite a slight increase in operative time. These findings provide reassurance that resident involvement in ACLR procedures is safe, although future investigations should focus on long-term postoperative outcomes.
Cost Analysis of Medicare Patients with Varying Complexities Who Underwent Total Knee Arthroplasty
Authors: Anis Hiba K. , Sodhi Nipun , Vakharia Rushabh M. , Scuderi Giles R. , Malkani Arthur L. , Roche Martin W. , Mont Michael A. 
Published: August 2019

AbstractThe effort to reduce overall healthcare costs may affect more complex patients, as their pre- and postoperative care can be substantially involved. Therefore, the purpose of this study was to use a large nationwide insurance database to compare (1) costs, (2) reimbursements, and (3) net losses of 90-day episodes of care (EOC) for total knee arthroplasty (TKA) patients according to Elixhauser's Comorbidity Index (ECI) scores. All TKAs performed between 2005 and 2014 in the Medicare Standard Analytic Files were extracted from the database and stratified based on ECI scores, ranging from 1 to 5. ECI 1 patients served as the control cohort, while ECI 2, 3, 4, and 5 patients were considered study cohorts. Each study cohort and control cohort were matched based on age and sex, resulting in a total of 715,398 patients included for analysis. Total EOC costs, reimbursements, and total net losses (defined as total EOC costs minus total EOC reimbursements) were compared between the cohorts. Overall, total EOC costs increased with ECI. For example, compared with the matched ECI 1 cohorts, the total EOC costs for ECI 5 patients ($56,589.19 vs. $51,747.54) were significantly greater (p < 0.01). Although reimbursements increased with increasing ECI, so did net losses. The net losses for ECI 5 patients were greater than that for ECI 1 patients ($42,309.39 vs. $40,007.82). The bundled payments for care improvement (BPCI) and comprehensive care for joint replacement (CJR) are alternative payment models that might de-incentivize treatment of more complex patients. Our study found that despite increasing reimbursements, overall costs, and therefore net losses, were greater for more complex patients with higher ECI scores.
DNA analysis of low‐ and high‐density fractions defines heterogeneous subpopulations of small extracellular vesicles based on their DNA cargo and topology
Authors: Lázaro‐Ibáñez Elisa , Lässer Cecilia , Shelke Ganesh Vilas , Crescitelli Rossella , Jang Su Chul , Cvjetkovic Aleksander , García‐Rodríguez Anaís , Lötvall Jan 
Published: August 2019

ABSTRACTExtracellular vesicles have the capacity to transfer lipids, proteins, and nucleic acids between cells, thereby influencing the recipient cell's phenotype. While the role of RNAs in EVs has been extensively studied, the function of DNA remains elusive. Here, we distinguished novel heterogeneous subpopulations of small extracellular vesicles (sEVs) based on their DNA content and topology. Low‐ and high‐density sEV subsets from a human mast cell line (HMC‐1) and an erythroleukemic cell line (TF‐1) were separated using high‐resolution iodixanol density gradients to discriminate the nature of the DNA cargo of the sEVs. Paired comparisons of the sEV‐associated DNA and RNA molecules showed that RNA was more abundant than DNA and that most of the DNA was present in the high‐density fractions, demonstrating that sEV subpopulations have different DNA content. DNA was predominately localised on the outside or surface of sEVs, with only a small portion being protected from enzymatic degradation. Whole‐genome sequencing identified DNA fragments spanning all chromosomes and mitochondrial DNA when sEVs were analysed in bulk. Our work contributes to the understanding of how DNA is associated with sEVs and thus provides direction for distinguishing subtypes of EVs based on their DNA cargo and topology.
Photon interference of second- and third-order correlation generated by two fluorescence sources
Authors: Zhang Siqiang , Raza Faizan , Ahmed Irfan , Li Wei , Jin Kaichao , Zhang Yanpeng 
Published: August 2019

Abstract
We demonstrate the second- and third-order temporal correlation of two independent pseudo-thermal fluorescence (FL) sources. The two distinguishable sources become indistinguishable following the delay in Feynman’s path. The second- and third-order correlation demonstrates the strong bunching amplitude surrounded by variable oscillations and interfering side bands (beats). Specifically, three-photon bunching is overlapped by two-photon bunching, and further decomposed into multiple lower order correlation functions. Here, the strong interference arises from source and path indistinguishable terms (varying time offset, laser frequency and the bandwidth of FL sources); The support for this idea comes from Feynman’s path integral theory and sub wavelength interference for such kind of sources with appropriate detection schemes. Such phenomena may serve as modulation and carrier for quantum communication channels.
Medication-related harm: a geriatric syndrome
Authors: Stevenson Jennifer M , Davies J Graham , Martin Finbarr C 
Published: August 2019

Abstract
The WHO Global Patient Safety Challenge: Medication Without Harm recognises medication-related harm (MRH) as a global public health issue. Increased life-expectancy coupled with multimorbidity and polypharmacy leads to an increased incidence of MRH, especially in older adults: at a cost of approximately £400 million to the National Health Service (NHS) in England. Harm from medicines has long been recognised by geriatricians, and strategies have been developed to mitigate harm. In general, these have focused on the challenges of polypharmacy and appropriateness of medicines, but impact on the quality of life, clinical and economic outcomes has been variable and often disappointing. The problem of MRH in older adults will continue to grow unless a new approach is adopted. Emerging evidence suggests that we need to take a broader approach as described in our conceptual model, where well-recognised physiological changes are incorporated, as well as other rarely considered psychosocial issues that influences MRH. Parallels may be drawn between this approach and the management of geriatric syndromes. We propose there must be a greater emphasis on MRH, and it, of itself, should be considered as a geriatric syndrome, to bring the spotlight onto the problem and to send a clear signal from geriatric experts that this is an important issue that needs to be addressed using a co-ordinated and tailored approach across health and social care boundaries. This requires a more proactive approach to monitor and review the medicines of older adults in response to their changing need.
Flow Cytometric, Morphologic, and Laboratory Comparative Study in Patients With Leukocytosis and Cytopenia
Authors: Rivas Estafani , Plapp Fred V , Cui Wei 
Published: August 2019

Abstract

Objectives
We wanted to evaluate the effectiveness of flow cytometry immunophenotyping (FCI) as a screening test for patients with leukocytosis and cytopenia.

Methods
We identified 320 patients during August 2016 to December 2016 and evaluated FCI and morphology of peripheral blood smears (PBSs).

Results
The most common indications for FCI included history of hematologic malignancy (HHM, n = 126), leukocytosis (n = 80), and cytopenia (n = 53). Positive FCI rate was low with a range of 4.4% to 12.5% in patients with absolute neutrophilia regardless of HHM, if cases with circulating blasts were excluded. Patients with absolute lymphocytosis had a 93% positive FCI rate. Patients with HHM and pancytopenia showed a higher incidence of positive FCI findings than patients without HHM and with isolated cytopenia. PBS morphology correlated strongly with FCI (P = .0001).

Conclusion
PBS evaluation is an accurate and cost-effective screening test. FCI for patients with mature neutrophilia and isolated cytopenia has a very low yield.
Six co-occurring conifer species in northern Idaho exhibit a continuum of hydraulic strategies during an extreme drought year
Authors: Baker Kathryn V , Tai Xiaonan , Miller Megan L , Johnson Daniel M 
Published: August 2019

AbstractAs growing seasons in the northwestern USA lengthen, on track with climate predictions, the mixed conifer forests that dominate this region will experience extended seasonal drought conditions. The year of 2015, which had the most extreme drought for the area on record, offered a potential analogue of future conditions. During this period, we measured the daily courses of water potential and gas exchange as well as the hydraulic conductivity and vulnerability to embolism of six dominant native conifer species, Abies grandis, Larix occidentalis, Pinus ponderosa, Pinus monticola, Pseudotsuga menziesii and Thuja occidentalis, to determine their responses to 5 months of record-low precipitation. The deep ash-capped soils of the region allowed gas exchange to continue without significant evidence of water stress for almost 2 months after the last rainfall event. Midday water potentials never fell below −2.2 MPa in the evergreen species and −2.7 MPa in the one deciduous species. Branch xylem was resistant to embolism, with P50 values ranging from −3.3 to −7.0 MPa. Root xylem, however, was more vulnerable, with P50 values from −1.3 to −4.6 MPa. With predawn water potentials as low as −1.3 MPa, the two Pinus species likely experienced declines in root hydraulic conductivity. Stomatal conductance of all six species was significantly responsive to vapour pressure only in the dry months (August–October), with no response evident in the wet months (June–July). While there were similarities among species, they exhibited a continuum of isohydry and safety margins. Despite the severity of this drought, all species were able to continue photosynthesis until mid-October, likely due to the mediating effects of the meter-deep, ash-capped silty-loam soils with large water storage capacity. Areas with these soil types, which are characteristic of much of the northwestern USA, could serve as refugia under drier and warmer future conditions.
Interaction of stomatal behaviour and vulnerability to xylem cavitation determines the drought response of three temperate tree species
Authors: Chen Zhicheng , Liu Shirong , Lu Haibo , Wan Xianchong 
Published: August 2019

AbstractHow the mortality and growth of tree species vary with the iso-anisohydric continuum and xylem vulnerability is still being debated. We conducted a precipitation reduction experiment to create a mild drought condition in a forest in the Baotianman Mountains, China, a sub-humid region. Three main sub-canopy tree species in this region were examined. After rainfall reduction, Lindera obtusiloba showed severe dieback, but two other co-occurring species did not show dieback. The water potential at stomatal closure of Dendrobenthamia japonica, L. obtusiloba and Sorbus alnifolia was −1.70, −2.54 and −3.41 MPa, respectively, whereas the water potential at 88 % loss in hydraulic conductivity of the three species was −2.31, −2.11 and −7.01 MPa, respectively. Taken together, near-anisohydric L. obtusiloba with vulnerable xylem was highly susceptible to drought dieback. Anisohydric S. alnifolia had the most negative minimum water potential, and its xylem was the most resistant to cavitation. Isohydric D. japonica conserved water by rapidly closing its stomata. Ultimately, the hydraulic safety margin (HSM) of L. obtusiloba was the smallest among the three species, especially in precipitation-reduced plots. In terms of the stomatal safety margin (SSM), L. obtusiloba was negative, while S. alnifolia and D. japonica were positive. Of the two species without dieback, rainfall reduction decreased growth of D. japonica, but did not influence growth of S. Alnifolia; meanwhile, rainfall reduction led to a decrease of non-structural carbohydrates (NSCs) in D. japonica, but an increase in S. alnifolia. It is concluded that HSM as well as SSM allow interpreting the sensitivity of the three sub-canopy species to drought. The drought-induced dieback of L. obtusiloba is determined by the interaction of stomatal behaviour and xylem vulnerability, and the species could be sensitive to climate change-caused drought although still in sub-humid areas. The isohydric/anisohydric degree is associated with NSCs status and growth of plants.
Demographic consequences of sexual differences in age at first breeding in Cooper’s Hawks (Accipiter cooperii)
Authors: Millsap Brian A , Madden Kristin , Murphy Robert K , Brennan Mark , Pagel Joel E , Campbell David , Roemer Gary W 
Published: August 2019

AbstractLife-history theory predicts individuals should breed as soon as they are able to reproduce, but many long-lived birds delay breeding. In the Accipitriformes, delayed breeding is the norm, and age when breeding begins is influenced by competing selective pressures. In most Accipitriformes, the reproductive roles of males and females differ; males do most of the foraging and females tend eggs and young. Thus, sexual differences in age at first breeding might be expected, but these differences, possible causes, and implications for individual fitness have received little study. We investigated sexual differences in age at first breeding in a marked population of Cooper’s Hawks (Accipiter cooperii) from 2011 through 2018 in central New Mexico, USA. We hypothesized that males required more experience to pair and breed successfully than females, and we predicted: (1) a lower mean age at first breeding for females than males, and (2) that expected individual fitness of early-breeding males would be lower than for early-breeding females. We found that 79% more females than males bred in their first year (hatching year, HY), and expected individual fitness of HY-breeding females was 21% greater than for HY-breeding males. HY males that attempted to breed settled on nesting territories with exceptionally high prey abundance, nevertheless they experienced 37% lower second-year survival than males that delayed breeding. Females competed for mates based on male age. HY females that paired with relatively older males had 33% higher second-year survival and 16% higher expected individual fitness than HY females that initially paired with relatively younger males. The observed annual rate of growth (λ) of our study population was 1.08, closer to λ predicted by male (1.02) than female (1.21) demographic models. Delayed breeding by males thus had important ramifications for λ, highlighting the need to consider sexual differences in age at first breeding in demographic analyses.