bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cell and chloroplast anatomical features are poorly estimated from 2D cross‐sections
Authors: Harwood Richard , Goodman Elinor , Gudmundsdottir Marin , Huynh Minh , Musulin Quinn , Song Magnolia , Barbour Margaret M. 
Published: September 2019

Summary

Leaf function is intimately related to the size, shape, abundance and position of cells and chloroplasts. Anatomy has long been assessed and quantified in two dimensions with 3D structure inferred from 2D micrographs.

Serial block face scanning electron microscopy (SBF‐SEM) was used to reconstruct 95 cells and 1173 chloroplasts from three wheat and nine chickpea leaves (three samples each from three chickpea genotypes).

Wheat chloroplast volume was underestimated by 61% in mesophyll cells and 45% in bundle sheath cells from 2D micrographs, whereas chickpea mesophyll chloroplast volume was underestimated by 60% using simple geometrical models. Models of chickpea spongy and palisade cells both under‐ and overestimated surface area and volume by varying degrees. These models did not adequately capture irregular shapes such as flattening of chloroplasts or lobed spongy mesophyll cells.

It is concluded that simple geometrical models to estimate chloroplast and cell 3D volume and surface area from 2D micrographs are inadequate, and that SBF‐SEM has strong potential to contribute to improved understanding of leaf form and function.
Bimodal modulation of background activity in an identified descending interneuron
Authors: Lepreux Gaëtan , Haupt Stephan Shuichi , Dürr Volker 
Published: September 2019

In the absence of any obvious input, sensory neurons and interneurons can display resting or spontaneous activity. This is often regarded as noise and removed through trial averaging, although it may reflect history-dependent modulation of tuning or fidelity and, thus, be of functional relevance to downstream interneurons. We investigated the history dependence of spontaneous activity in a pair of identified, bimodal descending interneurons of the stick insect, called contralateral ON-type velocity-sensitive interneurons (cONv). The bilateral pair of cONv conveys antennal mechanosensory information to the thoracic ganglia, where it arborizes in regions containing locomotor networks. Each cONv encodes the movement velocity of the contralateral antenna, but also substrate vibration as induced by discrete tapping events. Moreover, cONv display highly fluctuating spontaneous activity that can reach rates similar to those during antennal movement at moderate velocities. Hence, cONv offer a unique opportunity to study history-dependent effects on spontaneous activity and, thus, encoding fidelity in two modalities. In this work, we studied unimodal and cross-modal effects as well as unilateral and bilateral effects, using bilateral recordings of both cONv neurons, while moving one antenna and/or delivering taps to induce substrate vibration. Tapping could reduce spontaneous activity of both neurons, whereas antennal movement reduced spontaneous activity of the contralateral cONv neuron only. Combination of both modalities showed a cooperative effect for some parameter constellations, suggesting bimodal enhancement. Since both stimulus modalities could cause a reduction of spontaneous activity at stimulus intensities occurring during natural locomotion, we conclude that this should enhance neuronal response fidelity during locomotion.NEW & NOTEWORTHY The spontaneous activity in a pair of identified, descending insect interneurons is reduced depending on stimulus history. At rest, spontaneous activity levels are correlated in both interneurons, indicating a common drive from background activity. Whereas taps on the substrate affect both interneurons, antennal movement affects the contralateral interneuron only. Cross-modal interaction occurs, too. Since spontaneous activity is reduced at stimulus intensities encountered during natural locomotion, the mechanism could enhance neuronal response fidelity during locomotion.
Clinically Significant Bleeding With Ticagrelor Versus Clopidogrel in Korean Patients With Acute Coronary Syndromes Intended for Invasive Management
Authors: Park Duk-Woo , Kwon Osung , Jang Jae-Sik , Yun Sung-Cheol , Park Hanbit , Kang Do-Yoon , Ahn Jung-Min , Lee Pil Hyung , Lee Seung-Whan , Park Seong-Wook , Choi Si Wan , Lee Sang-Gon , Yoon Hyuck-Jun , Ahn Taehoon , Kim Moo Hyun , Nah Deuk Young , Lee Sung Yun , Chae Jei Keon , Park Seung-Jung ,   On behalf of the TICAKOREA Investigators
Published: September 2019

Background:
Owing to the differential propensity for bleeding and ischemic events with response to antiplatelet therapy, the safety and effectiveness of potent P2Y12 inhibitor ticagrelor in East Asian populations remain uncertain.

Methods:
In this multicenter trial, 800 Korean patients hospitalized for acute coronary syndromes with or without ST elevation and intended for invasive management were randomly assigned to receive, in a 1:1 ratio, ticagrelor (180 mg loading dose, 90 mg twice daily thereafter) or clopidogrel (600 mg loading dose, 75 mg daily thereafter). The primary safety outcome was clinically significant bleeding (a composite of major bleeding or minor bleeding according to PLATO (Platelet Inhibition and Patient Outcomes) criteria at 12 months.

Results:

At 12 months, the incidence of clinically significant bleeding was significantly higher in the ticagrelor group than in the clopidogrel group (11.7% [45/400] vs 5.3% [21/400]; hazard ratio [HR], 2.26; 95% confidence interval [CI], 1.34 to 3.79;
P
=0.002). The incidences of major bleeding (7.5% [29/400] vs 4.1% [16/400],
P
=0.04) and fatal bleeding (1% [4/400] vs 0%,
P
=0.04) were also higher in the ticagrelor group. The incidence of death from cardiovascular causes, myocardial infarction, or stroke was not significantly different between the ticagrelor group and the clopidogrel group (9.2% [36/400] vs 5.8% [23/400]; HR, 1.62; 95% CI, 0.96 to 2.74;
P
=0.07). Overall safety and effectiveness findings were similar with the use of several different analytic methods and in multiple subgroups.

Conclusions:
In Korean acute coronary syndrome patients intended to receive early invasive management, standard-dose ticagrelor as compared with clopidogrel was associated with a higher incidence of clinically significant bleeding. The numerically higher incidence of ischemic events should be interpreted with caution, given the present trial was underpowered to draw any conclusion regarding efficacy.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02094963.
Association Between Occupational Exposure to Pesticides and Cardiovascular Disease Incidence: The Kuakini Honolulu Heart Program
Authors: Berg Zara K. , Rodriguez Beatriz , Davis James , Katz Alan R. , Cooney Robert V. , Masaki Kamal 
Published: September 2019

Background
Previously, Kuakini Honolulu Heart Program researchers reported that occupational exposure to pesticides was significantly associated with total mortality. The current study examines occupational exposure to pesticides in relation to incident cardiovascular disease, defined as coronary heart disease or cerebrovascular accident.

Methods and Results

With the Occupational Safety Health Administration exposure scale used as an estimate of exposure, statistical analyses were performed on a cohort of 7557 Japanese‐American men from the Kuakini Honolulu Heart Program. Hazard ratios for cardiovascular disease incidence were calculated for various levels of pesticide exposure using Cox proportional hazards models. In the first 10 years of follow‐up, a positive association was observed between age‐adjusted cardiovascular disease incidence and high levels of pesticide exposure (hazard ratio=1.46, 95%
CI
=1.10‐1.95,
P
=0.009). This relationship remained significant after adjustment for other cardiovascular disease risk factors (hazard ratio=1.42, 95%
CI
=1.05‐1.92,
P
=0.021). No significant association for coronary heart disease or cerebrovascular accident incidence with pesticide exposure was observed when examined separately, possibly due to a smaller number of events.

Conclusions
These findings suggest that occupational exposure to pesticides may play a role in the development of cardiovascular diseases. The results are novel, as the association between occupational exposure to pesticides and cardiovascular disease incidence has not been examined previously in this unique cohort.
Safety and efficacy of high-intensity focused ultrasound in severe or refractory glaucoma
Authors: Hugo Juliette , Matonti Frederic , Beylerian Marie , Zanin Emilie , Aptel Florent , Denis Danièle 
Published: September 2019

Purpose: The aim of this study was to evaluate the efficacy and safety of ultrasonic cyclocoagulation in severe or refractory glaucoma, and to analyze the procedure-related inflammation. Patients and Methods: In this retrospective study, 15 eyes of 13 patients suffering from severe or refractory glaucoma with uncontrolled intraocular pressure of ⩾21 mmHg underwent 8-s ultrasonic cyclocoagulation. A complete ophthalmic evaluation, quality of life assessment using Glau-Qol-17, endothelial cell count, and flare measurement were performed. Primary outcome was qualified surgical success (defined as intraocular pressure reduction from baseline ⩾20% and intraocular pressure >5 mmHg without hypotensive medication adjunction). Secondary outcomes were flare, endothelial cell loss, and quality of life. Results: Qualified success was achieved in 67% of eyes at 6 months (mean intraocular pressure reduction = 42% in these eyes). During the first month after the procedure, the mean flare reached its maximum value when the intraocular pressure was minimal; the flare slowly decreased until normalization at month 3 when the maximal intraocular pressure was noted. At month 3, there was moderate but significant endothelial cell loss (11%), and no significant alteration in quality of life was demonstrated. Conclusion: The efficacy of ultrasonic cyclocoagulation in the present study is comparable to that reported in the literature. The kinetics of intraocular pressure and flare suggest that postoperative inflammation could be partly responsible for the early intraocular pressure decrease. The moderate endothelial cell loss, which could be caused by localized heating, and the preservation of quality of life confirm the safety of ultrasonic cyclocoagulation.
Comparison Between Size and Stage of Preoperative Tumor Defined by Preoperative Magnetic Resonance Imaging and Postoperative Specimens After Radical Resection of Esophageal Cancer
Authors: Gao Zhenzhen , Hua Beibei , Ge Xiaolin , Liu Jinyuan , Xue Lei , Zhen Fuxi , Luo Jinhua 
Published: September 2019

Background: Our objective is to explore the accuracy of magnetic resonance imaging in determining the preoperative T and N staging, pathological stage, and the length of esophageal tumor in patients with esophageal cancer. Methods: This retrospective analysis included 57 patients admitted to the Department of Thoracic Surgery of The First Affiliated Hospital of Nanjing Medical University between January 2015 and December 2016. Postoperative pathological results were used as the reference to verify the accuracy of magnetic resonance imaging in evaluating tumor T and N staging, pathological stage, and tumor length. The correlation between tumor lengths—measured using magnetic resonance imaging and the surgical specimen measurements—was evaluated. Results: The mean age of the patients was 64.6 ± 7.2 years, with a range of 47 to 77 years. The overall accuracy rate of magnetic resonance imaging in T staging of esophageal cancer was 63.2%; magnetic resonance imaging was generally consistent in the N staging of esophageal cancer. Magnetic resonance imaging and surgical evaluation of tumor length were in excellent agreement (κ = .82, P < .001), while that of gastroscopy and postoperative pathology was moderate (κ = .63, P < .001). Conclusion: Magnetic resonance imaging is highly accurate in determining the preoperative T and N staging, pathologic stage, and tumor length in patients with esophageal cancer, which is important in deciding the choice of preoperative treatment and the surgical approach.
Outcomes of ulnotriquetral split tear repair: a report of 96 patients
Authors: Clark Nicholas J. , Munaretto Nicholas , Ivanov David , Berger Richard A. , Kakar Sanjeev 
Published: September 2019

Ninety-six wrists (56 right and 40 left) in 96 patients (36 males and 60 females, mean age 38, range 15–77 years) underwent repair of ulnotriquetral ligament split tears between 2007 and 2016. Mayo wrist scores, visual analogue scale pain scores, and objective measures including grip strength and range of motion were obtained. Patients were assessed after a mean follow-up of 21 months (range 6–112 months). Ulnotriquetral split tear repair resulted in substantial improvements in pain and function. The mean Mayo wrist score improved from 57 preoperatively to 81 postoperatively, with 84% of patients achieving a good or excellent outcome. Pain scores decreased from 5.8 to 1.2. Grip improved from 25 kg to 29 kg. There was no significant change in range of motion of the wrist. Complications were noted in eight patients, with three experiencing continued pain, four with dysaesthesia of the dorsal sensory ulnar nerve, and one superficial infection. Arthroscopic ulnotriquetral split tear repair significantly reduced pain and improved Mayo wrist scores. Level of evidence: IV
Net benefit of statins for primary prevention of cardiovascular disease in people 75 years or older: a benefit–harm balance modeling study
Authors: Yebyo Henock G. , Aschmann Hélène E. , Menges Dominik , Boyd Cynthia M. , Puhan Milo A. 
Published: September 2019

Background: We determined the risk thresholds above which statin use would be more likely to provide a net benefit for people over the age of 75 years without history of cardiovascular disease (CVD). Methods: An exponential model was used to estimate the differences in expected benefit and harms in people treated with statins over a 10-year horizon versus not treated. The analysis was repeated 100,000 times to consider the statistical uncertainty and produce a distribution of the benefit–harm balance index from which we determined the 10-year CVD risk threshold where benefits outweighed the harms. We considered treatment estimates from trials and observational studies, baseline risks, patient preferences, and competing risks of non-CVD death, and statistical uncertainty. Results: Based on average preferences, statins were more likely to provide a net benefit at a 10-year CVD risk of 24% and 25% for men aged 75–79 years and 80–84 years, respectively, and 21% for women in both age groups. However, these thresholds varied significantly depending on differences in individual patient preferences for the statin-related outcomes, with interquartile ranges of 21–33% and 23–36% for men aged 75–79 years and 80–84 years, respectively, as well as 20–32% and 21–32% for women aged 75–79 years and 80–84 years, respectively. Conclusions: Statins would more likely provide a net benefit for primary prevention in older people taking the average preferences if their CVD risk is well above 20%. However, the thresholds could be much higher or lower depending on preferences of individual patients, which suggests more emphasis should be placed on individual-based decision-making, instead of recommending statins for everyone based on a single or a small number of thresholds.
Pediatric Hand Fracture Referring Practices: A Scoping Review
Authors: Hartley Rebecca L. , Todd Anna R. , Harrop Alan R. , Fraulin Frankie O. G. 
Published: September 2019

Background: Pediatric hand fractures are common, but few require surgery; therefore, these fractures are often perceived to be overreferred. Our objective is to systematically identify and describe pediatric hand fracture referring practices. Method: A scoping review was performed, searching electronic databases and grey literature up to January 2018 to identify referring practices for children (17 years and younger) with hand fractures (defined as radiographically confirmed fractures distal to the carpus) to hand surgeons. All study designs were included, and study selection and data extraction were independently performed in duplicate by 2 reviewers. Outcomes included referring rates, necessity of referral, referring criteria, and management of fractures. Results: Twenty (10 cross-sectional, 7 prospective cohorts, and 3 narrative reviews) studies reporting on referring practices or management of 21,624 pediatric hand fractures were included. Proportion of pediatric hand fractures referred to hand surgeons ranged from 6.5% to 100%. Unnecessary referral, defined as those fractures within the scope of primary care management, ranged from 27% to 78.1%. Ten studies reported referring criteria, with 14 unique criteria identified. The most common referring criteria were displacement (36.4%), loss of joint congruity (36.4%), and instability (36.4%). The most common justification for these criteria was increased likelihood of requiring surgery. The most common initial management was immobilization (66%-100%). Final management was provided by orthopedic or plastic hand surgeons with 0% to 32.9% of fractures requiring surgery. Conclusion: Referring practices vary widely in the literature. Major gaps in the literature include objective measures and justification for referring criteria and primary care education on hand fracture referring practices.
Seasonal influenza vaccination: knowledge, attitude and practice in Varna, Bulgaria
Authors: Ermenlieva Neli M. , Tsankova Gabriela S. , Todorova Tatina T. 
Published: September 2019

Background: Seasonal influenza vaccination is recommended for certain at-risk groups in Bulgaria, but vaccine coverage and the population’s perception of vaccination are currently unknown. The objective of this study was to assess the level of seasonal influenza vaccination in Varna Region, Bulgaria. It also aimed to investigate the status of knowledge and the attitude towards the reliability, safety, and other aspects associated with the use of influenza vaccines. Methods: A cross-sectional survey was conducted among 120 responders in Varna Region, Bulgaria. They completed a questionnaire assessing the practice, knowledge, and attitude towards seasonal influenza vaccination. Results: Nearly 70% of all responders have never been vaccinated against seasonal influenza in their lives. The main reason indicated was a lack of confidence in the vaccine in general (53.7% of nonvaccinated responders). Individuals with insufficient knowledge, or with a negative perception, were more likely to not be vaccinated: being poorly informed and having a negative attitude towards influenza vaccination also decreased the chance of being vaccinated by 29% and 36%, respectively. Conclusions: This study indicates that efforts should be made towards achieving better understanding and knowledge of the vaccine’s mechanism of prevention and effectiveness among the Bulgarian population.
Pattern of lung function decline in patients with amyotrophic lateral sclerosis: implications for timing of noninvasive ventilation
Authors: Panchabhai Tanmay S. , Mireles Cabodevila Eduardo , Pioro Erik P. , Wang Xiaofeng , Han Xiaozhen , Aboussouan Loutfi S. 
Published: September 2019

BackgroundThe course of lung function decline in amyotrophic lateral sclerosis (ALS) and the effect of noninvasive positive-pressure ventilation (NIPPV) on that decline are uncertain. We sought to model lung function decline, determine when NIPPV is initiated along that course, and assess its impact on the course of decline.MethodsAn observed sigmoid pattern of forced vital capacity decline was reproduced with a four-parameter nonlinear mixed-effects logistic model.ResultsAnalyses were performed on 507 patients overall and in 353 patients for whom a determination of adherence to NIPPV was ascertained. A sigmoid bi-asymptotic model provided a statistical fit of the data and showed a period of stable vital capacity, followed by an accelerated decline, an inflection point, then a slowing in decline to a plateau. By the time NIPPV was initiated in accordance with reimbursement guidelines, vital capacity had declined by ≥85% of the total range. Nearly half of the total loss of vital capacity occurred over 6.2 months centred at an inflection point occurring 17 months after disease onset and 5.2 months before initiation of NIPPV at a vital capacity of about 60%. Fewer bulbar symptoms and a faster rate of decline of lung function predicted adherence to NIPPV, but the intervention had no impact on final vital capacity.ConclusionsIn patients with ALS, vital capacity decline is rapid but slows after an inflection point regardless of NIPPV. Initiating NIPPV along reimbursement guidelines occurs after ≥85% of vital capacity loss has already occurred.
Subjective swallowing symptoms and related risk factors in COPD
Authors: Gonzalez Lindh Margareta , Malinovschi Andrei , Brandén Eva , Janson Christer , Ställberg Björn , Bröms Kristina , Blom Johansson Monica , Lisspers Karin , Koyi Hirsh 
Published: September 2019

ObjectivesThis study aimed to investigate the prevalence of subjective (i.e.self-reported) swallowing symptoms in a large cohort of patients with stable chronic obstructive pulmonary disease (COPD) and to identify potential related risk factors.MethodsA total of 571 patients with COPD, investigated in a stable phase, participated in this multicentre study (335 females, 236 males; mean age: 68.6 years (sd7.7)). Data were derived from spirometry, a questionnaire and a 30-metre walking test.ResultsIn total, 33% (n=186) patients reported at least some degree of swallowing problem. The most frequently reported symptom was food lodging in the throat (23%). A significant relationship was found between swallowing symptoms and dyspnoea, assessed as modified Medical Research Council (mMRC) ≥2 compared with <2 (46%versus22%; p<0.001) and health-related quality of life, assessed as the COPD Assessment Test (CAT) ≥10 (40%versus19%; p<0.001). Swallowing problems were also related to lower physical capacity (p=0.02) but not to lung function (p>0.28).ConclusionSubjective swallowing symptoms seem to be a common problem in patients with stable COPD. This problem is seen in all stages of the disease, but is more common in symptomatic patients and in patients with lower physical capacity.
Late deep cervical infection after anterior cervical discectomy and fusion: a case report and literature review
Authors: Chen Ying-Chun , Zhang Lin , Li Er-Nan , Ding Li-Xiang , Zhang Gen-Ai , Hou Yu , Yuan Wei 
Published: September 2019

Abstract

Background
Anterior cervical discectomy and fusion (ACDF) is often performed for the treatment of degenerative cervical spine. While this procedure is highly successful, 0.1–1.6% of early and late postoperative infection have been reported although the rate of late infection is very low.

Case presentation
Here, we report a case of 59-year-old male patient who developed deep cervical abscess 30 days after anterior cervical discectomy and titanium cage bone graft fusion (autologous bone) at C3/4 and C4/5. The patient did not have esophageal perforation. The abscess was managed through radical neck dissection approach with repated washing and removal of the titanium implant. Staphylococcus aureus was positively cultured from the abscess drainage, for which appropriate antibiotics including cefoxitin, vancomycin, levofloxacin, and cefoperazone were administered postoperatively. In addition, an external Hallo frame was used to support unstable cervical spine. The patient’s deep cervical infection was healed 3 months after debridement and antibiotic administration. His cervial spine was stablized 11 months after the surgery with support of external Hallo Frame.

Conclusions
This case suggested that deep cervical infection should be considered if a patient had history of ACDF even in the absence of esophageal perforation.