bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shifting Priorities for the Survival of My Child
Authors: Tsimicalis Argerie , Stevens Bonnie , Ungar Wendy J. , Castro Aimee , Greenberg Mark , Barr Ronald 
Published: April 2019

Background
Parents are confronted with a range of direct costs and intense caregiving demands following their child’s cancer diagnosis, which may potentially threaten the financial stability of the family.

Objective
The aims of this study were to explore the financial impact of a new childhood cancer diagnosis on families and understand the strategies families use to manage these financial impacts.

Methods
As part of the mixed-methods Childhood Cancer Cost Study, a descriptive qualitative design was conducted. Parents discussed costs and their impact in a semistructured, audio-taped interview. A qualitative content analysis was used to analyze the transcribed data.

Results
Seventy-eight parents participated. Parents used several strategies to maintain financial stability. These strategies consisted of managing expenses, which entailed reducing living expenses and cutting unexpected cancer costs. Efforts to absorb these expenses required families to increase their debt while seeking ways to tap into available resources, including relying on their savings and leveraging their benefits and assets, increasing their paid work hours, relying on their support networks, and seeking help from philanthropy and government agencies for financial help.

Conclusion
Parents used several strategies to manage the increased out-of-pocket expenses and reduced household income.

Implications for Practice
Our findings of the financial impact of cancer costs on families provide insight into needed practice and policy changes aimed at lessening the economic impact of a childhood cancer diagnosis on the family and allow healthcare professionals and researchers to pursue more in-depth cost assessments in the future.
Influence of Age, Sex, and Body Mass Index on the Thickness of the Gluteal Subcutaneous Fat: Implications for Safe Buttock Augmentation Procedures
Authors: Frank Konstantin , Casabona Gabriela , Gotkin Robert H. , Kaye Kai O. , Lorenc Paul Z. , Schenck Thilo L. , Lachman Nirusha , Green Jeremy B. , Duran-Vega Héctor , Cotofana Sebastian 
Published: April 2019

Background:
The deep intramuscular approach during buttock augmentation with fat grafting has been associated with a significantly increased risk for pulmonary fat embolism. This study was designed to provide guidance for injection into the subcutaneous fat.

Methods:
The authors investigated 150 Caucasian individuals with an equal distribution of men and women (n = 75 each) and a balanced distribution of age (n = 30 per decade: 20 to 29, 30 to 39, 40 to 49, 50 to 59, and 60 to 69 years) and body mass index (n = 50 per group: ≤24.9 kg/m2, between 25.0 and 29.9kg/m2, and ≥30 kg/m2). Ultrasound-based measurements were conducted of the thickness of the total, superficial, and deep gluteal fatty layers.

Results:
An increase in body mass index of 1.0 kg/m2 corresponded to an increase of 3 mm of the total gluteal subcutaneous fat of men and a 4-mm increase of the total gluteal subcutaneous fat in women. With increasing age, the thickness of the deep fatty layer increased, whereas with increasing body mass index the thickness of the superficial layer primarily increased. Formulas were generated to estimate the total thickness of the gluteal subcutaneous fatty layer for men [total thickness (in millimeters) = −33.56 + (age × 0.078) + (body mass index × 3.042)] and women [total thickness (in millimeters) = −56.997 + (age × 0.1) + (body mass index × 3.86)].

Conclusions:
Knowing the total thickness of the gluteal subcutaneous fat (i.e., the safe space) allows surgeons to estimate their operating range for cannula motion even if no ultrasound machine is available during buttock augmentation with fat grafting. This can increase safety, potentially reducing the number of adverse events.
Sumatriptan Increases Skin Flap Survival through Activation of 5-Hydroxytryptamine 1b/1d Receptors in Rats: The Mediating Role of the Nitric Oxide Pathway
Authors: Dehdashtian Amir , Afshari Khashayar , Zarifeh Jazaeri Seyedeh , Haddadi Nazgol-Sadat , Sheikhi Mehdi , Abbaszadeh-Kasbi Ali , Tavangar Seyed Mohammad , Jazaeri Farahnaz , Amirlak Bardia , Dehpour Ahmad Reza 
Published: April 2019

Background:
Random pattern skin flaps are applicable for reconstructing any defect in plastic surgery. However, they are difficult to apply because of necrosis. Sumatriptan, a selective 5-hydroxytryptamine 1b/1d agonist, is routinely used to offset acute migraine attacks. Recent studies have suggested that sumatriptan may induce vasodilation at lower concentrations. The authors’ aim is to investigate the effect of sumatriptan on skin flap survival and the role of nitric oxide in this phenomenon.

Methods:
Seventy-two male Sprague-Dawley rats were divided into eight groups. Increasing doses of sumatriptan (0.1, 0.3, and 1 mg/kg) were given intraperitoneally to three different groups after dorsal random pattern skin flaps were performed. To assess the exact role of 5-hydroxytryptamine 1b/1d receptors, GR-127935 was administered solely and with sumatriptan. N-ω-nitro-
l
-arginine methyl ester (l-NAME, a nonselective nitric oxide synthase inhibitor) was used to evaluate any possible involvement of nitric oxide in this study. All rats were examined 7 days later.

Results:
The authors’ results demonstrated that flap survival was increased by lower doses of sumatriptan compared to a control group for both 0.3 mg/kg (p = 0.03, mean difference = 32, SE = 8) and 0.1 mg/kg (p = 0.02, mean difference = 26, SE = 8). This protective effect was eliminated by coadministration of GR-127935 or N-ω-nitro-
l
-arginine methyl ester with sumatriptan. Histopathologic studies revealed a significant increase in capillary count and collagen deposition and a decreased amount of edema, inflammation, and degeneration.

Conclusions:
Sumatriptan in lower concentration increases skin flap survival by means of activation of 5-hydroxytryptamine 1b/1d receptors. This effect is mediated through the nitric oxide synthase pathway.
Complement Deposition on the Surface of RBC After Trauma Serves a Biomarker of Moderate Trauma Severity: A Prospective Study
Authors: Satyam Abhigyan , Andreo Kostas , Lapchak Peter H. , Dalle Lucca Jurandir J. , Davis Roger B. , Tsokos Maria G. , Shapiro Nathan I. , Tsokos George C. 
Published: April 2019

ABSTRACT

Background:
Activation of the complement system and complement deposition on red blood cells (RBCs) contribute to organ damage in trauma. We conducted a prospective study in subjects with traumatic injuries to determine the pattern of complement deposition on RBC and whether they are associated with clinical outcomes.

Method:
A total of 124 trauma patients and 42 healthy controls were enrolled in this prospective study. RBC and sera were collected at 0, 6, 24, and 72 h from trauma patients and healthy controls during a single draw. Presence of C4d, C3d, C5b-9, phosphorylation of band 3 and production of nitric oxide were analyzed by flow cytometry.

Results:
RBC from trauma patients at all time points up to 24 h displayed significantly higher deposition of C4d on their RBC membrane as compared with healthy donors. Incubation of normal RBC with sera from trauma patients resulted in significant increase of C4d deposition (at 0, 6, 24, and 72 h), C5b-9 deposition (at 0 and 6 h), phosphorylation of band 3 (at 0 and 24 h), and nitric oxide production up to 24 h compared with sera from healthy subjects. Deposition of C4d and C5b-9 in patients with an Injury Severity Score (ISS) of 9 and above remained elevated up to 72 h.

Conclusions:
Our study demonstrates that the presence of C4d, C3d, and C5b-9 on the surface of RBC is linked to increased phosphorylation of band 3 and increased production of nitric oxide. Deposition of C4d and C5b-9 decreased faster over course of 3-day study in subjects with ISS less than 9.
Review of Existing Scoring Systems for Massive Blood Transfusion in Trauma Patients: Where Do We Stand?
Authors: El-Menyar Ayman , Mekkodathil Ahammed , Abdelrahman Husham , Latifi Rifat , Galwankar Sagar , Al-Thani Hassan , Rizoli Sandro 
Published: April 2019

ABSTRACT

Background:
Uncontrolled bleeding is the main cause of the potential preventable death in trauma patients. Accordingly, we reviewed all the existing scores for massive transfusion posttraumatic hemorrhage and summarized their characteristics, thus making it easier for the reader to have a global view of these scores—how they were created, their accuracy and to which population they apply.

Methods:
A narrative review with a systematic search method to retrieve the journal articles on the predictive scores or models for massive transfusion was carried out. A literature search using PubMed, SCOPUS, and Google scholar was performed using relevant keywords in different combinations. The keywords used were “massive transfusion,” “score,” “model,” “trauma,” and “hemorrhage” in different combinations. The search was limited for full-text articles published in English language, human species and for the duration from January 1, 1998 to November 30, 2018.

Results:
The database search yielded 295 articles. The search was then restricted to the inclusion criteria which retrieved 241 articles. Duplicates were removed and full-texts were assessed for the eligibility to include in the review which resulted in inclusion of 24 articles. These articles identified 24 scoring systems including modified or revised scores. Different models and scores for identifying patients requiring massive transfusion in military and civilian settings have been described. Many of these scorings were complex with difficult calculation, while some were simple and easy to remember.

Conclusions:
The current prevailing practice that is best described as institutional or provider centered should be supplemented with score-based protocol with auditing and monitoring tools to refine it. This review summarizes the current scoring models in predicting the need for MT in civilian and military trauma. Several questions remain open; i.e., do we need to develop new score, merge scores, modify scores, or adopt existing score for certain trauma setting?
Adverse Outcomes After Bile Spillage in Incidental Gallbladder Cancers
Authors: Horkoff Michael J. , Ahmed Zubir , Xu Yuan , Sutherland Francis R. , Dixon Elijah , Ball Chad G. , Bathe Oliver F. 
Published: April 2019

Objective:
To determine the effect of bile spillage during cholecystectomy on oncological outcomes in incidental gallbladder cancers.

Background:
Gallbladder cancer (GBC) is rare, but lethal. Achieving complete resection offers the best chance of survival. About 30% of GBCs are discovered incidentally after cholecystectomy for benign pathology. There is an anecdotal association between peritoneal dissemination and bile spillage during the index cholecystectomy. However, no population-based studies are available that measure the consequences of bile spillage on patient outcomes.

Methods:
We conducted a retrospective cohort comparison of patients with incidental GBC. All cholecystectomies and cases of GBC in Alberta, Canada, from 2001 to 2015, were identified. GBCs discovered incidentally were included. Operative events leading to bile spillage were reviewed. Patient outcomes were compared between cases of bile spillage versus no contamination.

Results:
In all, 115,484 cholecystectomies were performed, and a detailed analysis was possible in 82 incidental GBC cases. In 55 cases (67%), there was bile spillage during the index cholecystectomy. Peritoneal carcinomatosis occurred more frequently in those with bile spillage (24% vs 4%; P = 0.0287). Patients with bile spillage were less likely to undergo a radical re-resection (25% vs 56%; P = 0.0131) and were less likely to achieve an R0 resection margin [odds ratio 0.19, 95% confidence interval (CI) 0.06–0.55]. On Cox regression modeling, bile spillage was an independent predictor of shorter disease-free survival (hazard ratio 1.99, 95% CI 1.07–3.67).

Conclusion:
For incidentally discovered GBC, bile spillage at the time of index cholecystectomy has measureable adverse consequences on patient outcomes. Early involvement of a hepatobiliary specialist is recommended where concerning features for GBC exist.
Microscopic Hematuria as a Screening Tool for Urologic Malignancies in Women
Authors: Jeppson Peter C. , Jakus-Waldman Sharon , Yazdany Tajnoos , Schimpf Megan O. , Ferzandi Tanaz R. , Yurteri-Kaplan Ladin A. , Knoepp Leise , Mamik Mamta , Resnick Helaine E. , Ward Renee M. 
Published: April 2019

Introduction
Most causes of microscopic hematuria (MH) are benign but may indicate an underlying malignancy. Current MH evaluation guidelines are reflective of male urologic malignancy risks. The objective of this systematic review was to evaluate whether the finding of MH predicts subsequent urologic malignancy in women.

Methods
MEDLINE was searched between January 1990 and June 8, 2018. The positive predictive value (PPV) of MH as a screening tool for urologic malignancy was calculated for each study individually and collectively. The pooled relative risk of urologic malignancy associated with MH was calculated.

Results
Seventeen studies were included. Eight studies included only women. In total, 300 urinary tract cancers were identified in 110,179 women with MH. The PPV of MH as a screening tool for cancer ranged from approximately 0.6% to 2.8%; confidence intervals (CIs) suggested this is a relatively unstable performance indicator because of small sample sizes. Average PPV across all studies was 2.13%, but the weighted average PPV was 0.24%. The risk of urologic malignancies among women with relative those without MH was 2.01 (95% CI, 1.61–2.51). Based on these limited data, we estimate that 859 (95% CI, 654–1250) women with MH would require complete evaluation to identify 1 urinary tract malignancy.

Conclusions
A very small proportion of women with MH are likely to have a urologic malignancy. Approximately 859 women require full screening to identify 1 malignancy. Current evidence is limited, and further studies, specifically in women, are needed.
The Last Year Before Graft Failure Negatively Impacts Economic Outcomes and is Associated With Greater Healthcare Resource Utilization Compared With Previous Years in the United Kingdom: Results of a Retrospective Observational Study
Authors: Muduma Gorden , Aluvihare Varuna , Clancy Marc , de Nigris Enrico , Whitlock Carolyn , Landeira Margarita , Nazir Jameel 
Published: April 2019

Background.
Kidney and liver transplantation is the standard of care for end-stage renal or liver disease. However, long-term survival of kidney and liver grafts remain suboptimal. Our study aimed to understand the healthcare resources utilized and their associated costs in the years before graft failure.

Methods.
Two noninterventional, retrospective, observational studies were conducted in cohorts of kidney or liver transplant patients. Once identified, patients were followed using the UK Clinical Practice Research Datalink linked to the Hospital Episode Statistics databases from the date of transplantation to the date of the first graft failure. Total healthcare costs in the year before graft failure (primary endpoint) and during years 2–5 before graft failure (secondary endpoint) were collected.

Results.
A total of 269 kidney and 81 liver transplant patients were analyzed. The mean total costs were highest for all resource components in the last year before graft failure, except for mean costs of immunosuppressive therapy per patient, which decreased slightly by index date (ie, graft failure). The mean total healthcare costs in the last year before graft failure were £8115 for kidney and £9988 for liver transplant patients and were significantly (P < 0.05) higher than years 2–5 before graft failure. Mean healthcare costs for years 2, 3, 4, and 5 before graft failure were £5925, £5575, £5469, and £5468, respectively, for kidney, and £6763, £7042, £6020, and £5651, respectively, for liver transplant patients.

Conclusions.
Total healthcare costs in the last year before graft failure are substantial and statistically significantly higher than years 2–5 before graft failure, in both kidney and liver transplant patients. Our findings show the economic burden placed on healthcare services in the years before graft failure.
Massively parallel single-cell chromatin landscapes of human immune cell development and intratumoral T cell exhaustion
Authors: Satpathy Ansuman T. , Granja Jeffrey M. , Yost Kathryn E. , Qi Yanyan , Meschi Francesca , McDermott Geoffrey P. , Olsen Brett N. , Mumbach Maxwell R. , Pierce Sarah E. , Corces M. Ryan , Shah Preyas , Bell Jason C. , Jhutty Darisha , Nemec Corey M. , Wang Jean , Wang Li , Yin Yifeng , Giresi Paul G. , Chang Anne Lynn S. , Zheng Grace X.Y. , Greenleaf William J. , Chang Howard Y. 
Published: April 2019

AbstractUnderstanding complex tissues requires single-cell deconstruction of gene regulation with precision and scale. Here we present a massively parallel droplet-based platform for mapping transposase-accessible chromatin in tens of thousands of single cells per sample (scATAC-seq). We obtain and analyze chromatin profiles of over 200,000 single cells in two primary human systems. In blood, scATAC-seq allows marker-free identification of cell type-specificcis- andtrans-regulatory elements, mapping of disease-associated enhancer activity, and reconstruction of trajectories of differentiation from progenitors to diverse and rare immune cell types. In basal cell carcinoma, scATAC-seq reveals regulatory landscapes of malignant, stromal, and immune cell types in the tumor microenvironment. Moreover, scATAC-seq of serial tumor biopsies before and after PD-1 blockade allows identification of chromatin regulators and differentiation trajectories of therapy-responsive intratumoral T cell subsets, revealing a shared regulatory program driving CD8+T cell exhaustion and CD4+T follicular helper cell development. We anticipate that droplet-based single-cell chromatin accessibility will provide a broadly applicable means of identifying regulatory factors and elements that underlie cell type and function.
Automated Change Detection Methods for Satellite Data that can Improve Conservation Implementation
Authors: Evans Michael J. , Malcom Jacob W. 
Published: April 2019

AbstractA significant limitation in biodiversity conservation has been the effective implementation of laws and regulations that protect species habitats from degradation. Flexible, efficient, and effective monitoring and enforcement methods are needed to help conservation policies realize their full benefit. As remote sensing data become more numerous and accessible, they can be used to identify and quantify land cover changes and habitat loss. However, these data remain underused for systematic conservation monitoring in part because of a lack of simple tools. We adapted and developed two generalized methods that automatically detect land cover changes in a variety of habitat types using free and publicly available data and tools. We evaluated the performance of these algorithms in two ways. First, we tested the algorithms over 100 sites of known change in the United States, finding these approaches were effective (AUC > 0.90) at distinguishing between areas of land cover change and areas of no change. Second, we evaluated algorithm effectiveness by comparing results to manually identified areas of change in four case studies involving imperiled species habitat: oil and gas development in the range of the Greater Sage Grouse; sand mining operations in the range of the dunes sagebrush lizard; loss of Piping Plover coastal habitat in the wake of hurricane Michael (2018); and residential development in beach mouse habitat. The relative performance of each algorithm differed in each habitat type, but both provided effective means of detecting and delineating habitat loss. Our results show how these algorithms can be used to help close the implementation gap of monitoring and enforcement in biodiversity conservation and we provide a free online tool that can be used to run these analyses.Article impact statementMethods for automating the detection of habitat loss in satellite images that can be used to monitor and enforce conservation policy.
Living cell-only bioink and photocurable supporting medium for printing and generation of engineered tissues with complex geometries
Authors: Jeon Oju , Lee Yu Bin , Jeong Hyeon , Lee Sang Jin , Alsberg Eben 
Published: April 2019

AbstractScaffold-free engineering of three-dimensional (3D) tissue has focused on building sophisticated structures to achieve functional constructs. Although the development of advanced manufacturing techniques such as 3D printing has brought remarkable capabilities to the field of tissue engineering, technology to create and culture individual cell only-based high-resolution tissues, without an intervening biomaterial scaffold to maintain construct shape and architecture, has been unachievable to date. In this report, we introduce a cell printing platform which addresses the aforementioned challenge and permits 3D printing and long-term culture of a living cell-only bioink lacking a biomaterial carrier for functional tissue formation. A biodegradable and photocrosslinkable microgel supporting bath serves initially as a fluid, allowing free movement of the printing nozzle for high-resolution cell extrusion, while also presenting solid-like properties to sustain the structure of the printed constructs. The printed human stem cells, which are the only component of the bioink, couple together via transmembrane adhesion proteins and differentiate down tissue-specific lineages while being cultured in a further photocrosslinked supporting bath to form bone and cartilage tissue with precisely controlled structure. Collectively, this system, which is applicable to general 3D printing strategies, is paradigm shifting for printing of scaffold-free individual cells, cellular condensations and organoids, and may have far reaching impact in the fields of regenerative medicine, drug screening, and developmental biology.
GIGANTEA recruits deubiquitylases, UBP12 and UBP13, to regulate accumulation of the ZTL photoreceptor complex
Authors: Lee Chin-Mei , Li Man-Wah , Feke Ann , Saffer Adam M. , Liu Wei , Gendron Joshua M. 
Published: April 2019

AbstractTo remain synchronous with the environment, plants constantly survey daily light conditions using an array of photoreceptors and adjust their circadian rhythms accordingly. ZEITLUPE (ZTL), a blue light photoreceptor with E3 ubiquitin ligase activity, communicates end-of-day light conditions to the circadian clock. To function properly, ZTL protein must accumulate but not destabilize target clock transcription factors before dusk, while in the dark ZTL mediates degradation of target proteins. It is not clear how ZTL can accumulate to high levels in the light while its targets remain stable. Two deubiquitylating enzymes, UBIQUITIN-SPECIFIC PROTEASE 12 and UBIQUITIN-SPECIFIC PROTEASE 13 (UBP12 and UBP13), which have opposite genetic and biochemical functions to ZTL, were shown to associate with the ZTL protein complex. Here we demonstrate that the ZTL light-dependent interacting partner, GIGANTEA (GI), recruits UBP12 and UBP13 to the ZTL photoreceptor complex. We show that loss ofUBP12andUBP13reduces ZTL and GI protein levels through a post-transcriptional mechanism. Furthermore, the ZTL target protein TOC1 is unable to accumulate to normal levels inubpmutants, indicating that UBP12 and UBP13 are necessary to stabilize clock transcription factors during the day. Our results demonstrate that the ZTL photoreceptor complex contains both ubiquitin-conjugating and -deconjugating enzymes, and that these two opposing enzyme types are necessary for the complex to properly regulate the circadian clock. This work also shows that deubiquitylating enzymes are a core design element of circadian clocks that is conserved from plants to animals.