bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient’s Skeletal Muscle Radiation Attenuation and Sarcopenic Obesity are Associated with Postoperative Morbidity after Neoadjuvant Chemoradiation and Resection for Rectal Cancer
Authors: Berkel Annefleur E.M. , Klaase Joost M. , de Graaff Feike , Brusse-Keizer Marjolein G.J. , Bongers Bart C. , van Meeteren Nico L.U. 
Published: June 2018

<b><i>Background/Aims:</i></b> To investigate the relation between skeletal muscle measurements (muscle mass, radiation attenuation, and sarcopenic obesity), postoperative morbidity, and survival after treatment of locally advanced rectal cancer. <b><i>Methods:</i></b> This explorative retrospective study identified 99 consecutive patients who underwent neoadjuvant chemoradiation and surgery between January 2007 and May 2012. Skeletal muscle mass was measured as total psoas area and total abdominal muscle area (TAMA) at 3 anatomical levels using the patient’s preoperative computed tomography scan. Radiation attenuation was measured using corresponding mean Hounsfield units for TAMA. Sarcopenic obesity was defined as body mass index above 25 kg·m<sup>–2</sup> combined with skeletal muscle mass index below the sex-specific median. Postoperative complications were graded by using the ­Clavien-Dindo classification. <b><i>Results:</i></b> Twenty-five patients (25.3%) developed a grade 3–5 complication. Lower radiation attenuation was independently associated with overall (<i>p</i> = 0.003) and grade 3–5 complications (<i>p</i> = 0.002). Sarcopenic obesity was associated with overall complications (all <i>p</i> &#x3c; 0.05). Skeletal muscle measurements and survival were not significantly related. <b><i>Conclusion:</i></b> Radiation attenuation was associated with overall and grade 3–5 postoperative morbidity after neoadjuvant chemoradiation and non-laparoscopic resection for rectal cancer. Sarcopenic obesity was associated with overall complications.
Assessment of Cardiovascular Risk in Older Patients With Gout Initiating Febuxostat Versus Allopurinol
Authors: Zhang MaryAnn , Solomon Daniel H. , Desai Rishi J. , Kang Eun Ha , Liu Jun , Neogi Tuhina , Kim Seoyoung C. 
Published: June 2018

Background:
Hyperuricemia and gout are associated with an increased risk of cardiovascular disease. Xanthine oxidase inhibitors, allopurinol and febuxostat, are the mainstay of urate-lowering treatment for gout and may have different effects on cardiovascular risk in patients with gout.

Methods:
Using US Medicare claims data (2008–2013), we conducted a cohort study for comparative cardiovascular safety of initiating febuxostat versus allopurinol among patients with gout ≥65 years of age. The primary outcome was a composite end point of hospitalization for myocardial infarction or stroke. Secondary outcomes were individual end points of hospitalization for myocardial infarction, stroke, coronary revascularization, new and recurrent heart failure, and all-cause mortality. We used propensity score matching with a ratio of 1:3 to control for confounding. We estimated incidence rates and hazard ratios for primary and secondary outcomes in the propensity score–matched cohorts of febuxostat and allopurinol initiators.

Results:
We included 24 936 febuxostat initiators propensity score–matched to 74 808 allopurinol initiators. The median age was 76 years, 52% were male, and 12% had cardiovascular disease at baseline. The incidence rate per 100 person-years for the primary outcome was 3.43 in febuxostat and 3.36 in allopurinol initiators. The hazard ratio for the primary outcome was 1.01 (95% CI, 0.94–1.08) in the febuxostat group compared with the allopurinol group. Risk of secondary outcomes including all-cause mortality was similar in both groups, except for a modestly decreased risk of heart failure exacerbation (hazard ratio, 0.94; 95% CI, 0.91–0.99) in febuxostat initiators. The hazard ratio for all-cause mortality associated with long-term use of febuxostat (>3 years) was 1.25 (95% CI, 0.56–2.80) versus allopurinol. Subgroup and sensitivity analyses consistently showed similar cardiovascular risk in both groups.

Conclusions:
Among a cohort of 99 744 older Medicare patients with gout, overall there was no difference in the risk of myocardial infarction, stroke, new-onset heart failure, coronary revascularization, or all-cause mortality between patients initiating febuxostat compared with allopurinol. However, there seemed to be a trend toward an increased, albeit not statistically significant, risk for all-cause mortality in patients who used febuxostat for >3 years versus allopurinol for >3 years. The risk of heart failure exacerbation was slightly lower in febuxostat initiators.
Seasonal changes in the protein profile and enzyme activity of the epididymal luminal fluid in the lizard, Eutropis carinata (Schneider, 1801)
Authors: Medini R. , Bhagya M. , Samson S. 
Published: June 2018

AbstractThe epididymis of the male reproductive system is known to be involved in sperm maturation via the production of polypeptides, glycoproteins, surface proteins, enzymes and other factors. During the annual reproductive cycle, the epididymis of the lizardEutropis carinataundergoes dramatic changes, both morphologically and biochemically, that occur in a well-organized sequence. The present study reveals the sequential changes that occur in the production and concentration of proteins in the epididymal luminal fluid throughout the annual reproductive cycle. A one-dimensional electrophoretic profile of the epididymal luminal proteins revealed a total of 18 bands in the regenerative phase, 22 bands during breeding and 17 bands in the post-breeding as well as regressed phases of the reproductive cycle. By two-dimensional electrophoresis, the protein complexes that are unique to the breeding phase were further resolved based on their pI and the molecular weight of each protein of the protein complex was determined. This is the first study to observe that proteins that are present during the reproductively inactive phase disappear during the reproductively active phase. The Periodic Acid Schiff (PAS) test for protein profiles revealed the presence of proteins with a carbohydrate moiety. Certain enzymes, such as acid phosphatase, alkaline phosphatase, andα-glucosidase, are highly sensitive to seasonal changes and their activity parallels the production of the epididymal proteins. This study provides evidence for androgen-dependent cyclical changes in the pattern of protein profiles and enzyme activity of the epididymal lumen in the lizardE. carinata.
Ethical Dilemmas of Back-Channel Diplomacy: Necessary Secrecy or a Secret Foreign Policy?
Authors: Jones Peter 
Published: June 2018

Summary
Back-channel diplomacy allows participants to hold dialogues with actors with whom they are not prepared to talk openly. The secrecy of back channels can, however, permit a small elite to escape oversight and scrutiny to achieve unaccountable aims. This article examines the ethical dilemmas raised by the secrecy of back channels. It seeks to develop some practical ‘tests’ that can be used to ask whether a back channel is straying, or has strayed, into dangerous ethical territory. The article advances three such tests for further development, but also concludes that they cannot be ‘absolute’; the context in which a back channel operates is the key variable.
Finite Elements Used in the Vertical Discretization of the Fully Compressible Core of the ALADIN System
Authors: Vivoda Jozef , Smolíková Petra , Simarro Juan 
Published: June 2018

Abstract
The finite-element method with B splines is used for definition of vertical operators in the nonhydrostatic fully compressible dynamical core of the ALADIN system. It represents a generalization of the same method used in the hydrostatic dynamical core shared by the ALADIN system and the global forecast system ARPEGE/IFS. The method is shown to be robust enough in idealized academic tests and real simulations. Its theoretical superiority is shown when compared with the finite-difference method.
Correlation among decreased regional cerebral oxygen saturation, blood levels of brain injury biomarkers, and cognitive disorder
Authors: Kumpaitiene Birute , Svagzdiene Milda , Drigotiene Ingrida , Sirvinskas Edmundas , Sepetiene Ramune , Zakelis Rolandas , Benetis Rimantas 
Published: June 2018

Objective This study was performed to investigate the correlation among decreased regional cerebral oxygen saturation (rSO2), blood levels of brain injury biomarkers, and postoperative cognitive disorder (POCD) after cardiac surgery with cardiopulmonary bypass (CPB). Methods This prospective observational study included 59 patients undergoing coronary artery bypass graft surgery with CPB. All patients underwent neuropsychological tests (Mini Mental State Evaluation, Rey Auditory Verbal Learning Test, digit span test, digit symbol substitution test, and Schulte table) the day before and 10 days after the surgery. The blood levels of two brain injury biomarkers, neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP), were measured before and 1 day after the surgery. Results The rSO2 decreased during surgery in 21 (35%) patients. POCD was detected in 22 (37%) patients. After the surgery, no significant changes in the GFAP blood level occurred in any patients. No significant correlations were found among the decreased rSO2, increased NSE blood level, and rate of POCD. Conclusion These results suggest that a decrease in rSO2 during cardiac surgery is not necessarily related to the development of POCD or an increased blood level of the brain injury biomarker NSE.
Effects of divided input on bilingual children with language impairment
Authors: Peña Elizabeth D , Bedore Lisa M , Shivabasappa Prarthana , Niu Luping 
Published: June 2018

Aims and objectives: We compare the performance of 600 bilingual children with and without language impairment relative to their level of current English input and output (EIO). Children were tested in both Spanish and English on measures of morphosyntax and semantics. Our aim was to examine whether children’s language performance was differentially affected by the level of EIO and/or language ability. Methodology: Participants were drawn from three different studies of bilingual language impairment where children between the ages of 5 and 10 years were tested using a standardized test of morphosyntax and semantics in both languages. Standard scores were compared for each language in each domain. Data and analysis: Multivariate regression was used to compare main effects of ability (children with typical language development versus children with language impairment) and interactions with EIO. This analysis was followed by a comparison of EIO across the four language measures. Findings/conclusions: There were main effects of language impairment status and EIO. There were ability differences in slope for two measures (English semantics and Spanish morphosyntax), where children with language impairment had a flatter slope as related to EIO compared to children with typical development. For Spanish semantics and English morphosyntax, slopes relative to EIO were similar, although children with language impairment scored lower than those with typical development. Originality: We observed how children with and without language impairment performed on semantics and morphosyntax tasks relative to their EIO. Implications: The similar slopes across language measures of children with and without language impairment suggest that there is no disadvantage to divided input by ability. Where there were differences by ability, children with language impairment showed a flatter slope relative to their typically developing peers, suggesting that bilingual children with primary language impairment (PLI) may be somewhat advantaged relative to more monolingual children with PLI.
Role of top-down language control in bilingual production and comprehension: Evidence from induced oscillations
Authors: Xie Ning , Li Baike , Zhang Man , Liu Huanhuan 
Published: June 2018

Aims: The present study was designed to investigate the role of language control during simultaneous production and comprehension. Design: Participants completed a set of language background and cognitive skills questionnaires and were randomly divided into pairs. Then, the pairs of participants were asked to finish a joint language switching task while their electroencephalogram was recorded. When one participant was naming pictures, the other one was listening. The language to be used in each trial was specified by cues. Data and Analysis: Response latencies were obtained. An analysis was conducted on induced oscillations in a cue-locked period and a stimulus-locked period. Findings: An analysis of induced oscillations showed that production and comprehension exhibited different delta and theta oscillations, suggesting that cross-modality interference may be caused by joint language switching, and bilinguals employed different degrees of language control in comprehension and production. Furthermore, the cross-person condition exhibited stronger oscillations than the within-person condition, indicating that joint language switching involves cross-person interference and that bilinguals use additional oscillations to inhibit such interference. Importantly, the stimulus-locked period showed larger delta and theta oscillations in second language switch trials than in first language switch trials in the within-person condition, indicating that delta and theta may index the inhibition of cross-language interference. Originality: The current study revealed the top-down language control mechanism by analysing induced oscillations, which reflected a mainly cognitively driven process. Significance: Bilinguals’ language control might be used to inhibit complex interference during daily life.
Unspoken ambivalence in kinship obligation in living donation
Authors: Halverson Colin M. E. , Crowley-Matoka Megan , Ross Lainie Friedman 
Published: June 2018

Background: Traditionally, living kidney donors were first-degree relatives due to both greater biological compatibility and concerns about extrafamilial motivation. Because familial relationships often entail distinctive experiences of moral obligation, health-care providers must be attentive to potential undue influences on intrafamilial donor decision-making processes to ensure that decisions are voluntary. Methods: Qualitative interviews were conducted with 20 individuals who donated kidneys to first-degree relatives and subsequently developed end-stage renal disease themselves. Findings: We analyze the different influences kinship obligations had on participants’ decision-making processes. Although participants described their decision to donate as obvious, an appropriate kin response, and free from external pressure, they indirectly expressed some ambivalence—both by their description of the rapidity of the process and in their concern about exposing an intimate to the risks of living donation. Discussion: Our data uncovered an asymmetry. Although our participants claimed that they would donate again, none received a living donor kidney. Our data also highlight the moral significance of the interdependence of donor and recipient in intrafamilial kidney donation and its impact on the range of voluntary choices as perceived by the donor. Their decision-making must be understood as embedded within a network of intimate social relations.
Fecal immunochemical test for hemoglobin in combination with fecal transferrin in colorectal cancer screening
Authors: Gies Anton , Cuk Katarina , Schrotz-King Petra , Brenner Hermann 
Published: June 2018

ObjectiveFecal transferrin has been suggested as a complementary or even superior marker for early detection of colorectal cancer (CRC) besides fecal hemoglobin. We aimed to evaluate both markers individually and in combination in a large cohort of participants of screening colonoscopy.MethodsPrecolonoscopy stool samples were obtained from participants of screening colonoscopy and frozen at −80°C until blinded analysis, using a dual‐quantitative fecal immunochemical test (FIT) for hemoglobin and transferrin. Sensitivity, specificity and area under the curve (AUC) were calculated for CRC and advanced adenoma (AA).ResultsA total of 1667 participants fulfilled our inclusion criteria. All individuals with advanced neoplasm (AN) (16 CRC, 200 AA) and 300 randomly selected participants without AN were included. Mean age was 63 years and 56% were male. The AUC for CRC and AA was 92% and 68%, respectively, for hemoglobin vs. 79% and 58%, respectively for transferrin. Combination of both markers yielded an AUC for CRC and AA of 92% and 68%, respectively.ConclusionFIT for hemoglobin shows better diagnostic performance than FIT for transferrin for the detection of ANs (both proximal and distal neoplasms), and a combination of both markers does not improve the diagnostic performance.
Risk factors associated with osteoporosis in a cohort of prospectively diagnosed adult coeliac patients
Authors: Galli Gloria , Lahner Edith , Conti Laura , Esposito Gianluca , Sacchi Maria Carlotta , Annibale Bruno 
Published: June 2018

BackgroundUp to 75% of patients with untreated coeliac disease (CD) present with osteopenia or osteoporosis. Guidelines do not express with certainty whether each patient with newly diagnosed CD should undergo a dual‐energy x‐ray absorptiometry (DEXA) scan.AimThe aim of this article is to evaluate the prevalence of bone mineral density (BMD) alterations at diagnosis and risk factors associated with osteoporosis.MethodsA total of 214 adult patients (median age 38 years; female = 71.5%) newly diagnosed with CD underwent DEXA. The patients were divided into three groups: patients with normal BMD, those with osteopenia and those with osteoporosis. Clinical, histological and serological features were assessed and compared among the three groups. Logistic regression including relevant independent variables was performed.ResultsDEXA indicated that 39.7%, 42.5% and 17.8% of the CD patients had normal BMD, osteopenia and osteoporosis, respectively. Logistic regression indicated that features significantly associated with osteoporosis were male gender (OR 4.7; 95%CI 1.1 to 20.8), age ≥45 years (OR 6.5; 95% CI 1.3 to 32.2), underweight (OR 7.4; 95% CI 1.3 to 42.5) and greater histological damage (Marsh 3C; OR 5.8; 95% CI 1.4 to 24.1).ConclusionsBMD alterations were found in 60.3% of newly diagnosed adult coeliac patients. Osteoporosis was significantly associated with age ≥45 years, male gender, underweight and Marsh 3C, suggesting that at CD diagnosis, a DEXA scan might be beneficial, particularly in these subgroups of patients.
Patient perceived changes in sexual dysfunction after initiation of natalizumab for multiple sclerosis
Authors: Robertson Derrick , Aungst Angela , Collier Ryan , Vivar Jhulianna , Moreo Natalie , Casady Lise , Vu Tuan 
Published: June 2018

Purpose Sexual dysfunction is a common but often overlooked secondary symptom of multiple sclerosis (MS) and can be associated with a decreased health-related quality of life (HRQoL). Natalizumab is a disease-modifying therapy approved for the treatment of relapsing forms of MS. In addition to its efficacy, those using natalizumab have shown improvement in HRQoL parameters, including fatigue and cognition. The idea that improvement in fatigue may also correlate with improvement in sexual dysfunction is the impetus for this study. Methods A single-center, open-label, single-arm, 24-week study was performed to evaluate perceived change in sexual dysfunction in MS patients treated with natalizumab. Adults with relapsing MS initiating natalizumab treatment and had a baseline level of sexual dysfunction were enrolled. The primary endpoint was change in the MS Intimacy and Sexuality Questionnaire-19 (MSISQ-19) score from baseline to week 24. Mean age of patients was 41 years, median disease duration was 7 years, and 73% of patients used at least one prior MS disease-modifying therapy. Results Natalizumab-treated patients experienced improvement in sexual dysfunction within the first 24 weeks of starting therapy, as demonstrated by the primary subscale of the MSISQ-19 questionnaire (–0.6976, p = 0.02). Conclusions Given the high prevalence of sexual dysfunction in MS patients and the significant impact it has on HRQoL, more research on this often overlooked symptom of MS could be very informative for patients that are deciding to initiate a new disease modifying therapy.
Epidemiology of Recurrent Anterior Cruciate Ligament Injuries in National Collegiate Athletic Association Sports: The Injury Surveillance Program, 2004-2014
Authors: Gans Itai , Retzky Julia S. , Jones Lynne C. , Tanaka Miho J. 
Published: June 2018

Background: An anterior cruciate ligament (ACL) rupture is a serious injury that can be career-ending in collegiate athletics. A rerupture after primary ACL reconstruction occurs in 1% to 11% of all athletes. Purpose: To describe the epidemiology of recurrent ACL ruptures in the 25 National Collegiate Athletic Association (NCAA) sports in the NCAA Injury Surveillance Program (ISP) and to identify and compare sport-specific risk factors for a recurrent ACL rupture. Study Design: Descriptive epidemiology study. Methods: Athletes who experienced a primary or recurrent ACL rupture between 2004 and 2014 were identified using data from the NCAA ISP. ACL ruptures occurred in 12 of 25 sports during the study period. We assessed the rates and patterns of primary and recurrent ACL ruptures and reported them as events per 10,000 athlete-exposures (AEs). Sex-comparable sports were compared using rate ratios. Rupture rates were compared using odds ratios, with P values <.05 indicating significance. Regular-season and postseason data were combined because of low counts of postseason events. Results: Of 350,416 AEs, there were 1105 ACL ruptures, 126 of which were recurrent. The highest rates of recurrent ACL ruptures (per 10,000 AEs) were among male football players (15), female gymnasts (8.2), and female soccer players (5.2). Of sports played by athletes of both sexes, women’s soccer had a significantly higher rate of recurrent ACL ruptures than men’s soccer (rate ratio, 3.8 [95% CI, 1.3-15]). Among all sports, men had a significantly higher rate of recurrent ACL ruptures (4.3) than women (3.0) ( P = .04). Overall, the ratio of recurrent to primary ACL ruptures decreased over the 10-year study period. Both women and men had a decreasing trend of recurrent to primary ACL ruptures, although women had a steeper decrease. Conclusion: These data can help identify athletes who are most at risk of recurrent ACL ruptures after ACL reconstruction and who may benefit from injury prevention programs.
Congenital macrothrombocytopenia with focal myelofibrosis due to mutations in human G6b-B is rescued in humanized mice
Authors: Hofmann Inga , Geer Mitchell J. , Vögtle Timo , Crispin Andrew , Campagna Dean R. , Barr Alastair , Calicchio Monica L. , Heising Silke , van Geffen Johanna P. , Kuijpers Marijke J. E. , Heemskerk Johan W. M. , Eble Johannes A. , Schmitz-Abe Klaus , Obeng Esther A. , Douglas Michael , Freson Kathleen , Pondarré Corinne , Favier Rémi , Jarvis Gavin E. , Markianos Kyriacos , Turro Ernest , Ouwehand Willem H. , Mazharian Alexandra , Fleming Mark D. , Senis Yotis A. 
Published: June 2018

Key PointsAutosomal recessive loss-of-function mutations in G6b-B (MPIG6B) cause congenital macrothrombocytopenia with focal myelofibrosis. G6b-B has orthologous physiological functions in human and mice regulating megakaryocyte and platelet production and function.
Blood group ABO gene–encoded A transferase catalyzes the biosynthesis of FORS1 antigen of FORS system upon Met69Thr/Ser substitution
Authors: Cid Emili , Yamamoto Miyako , Yamamoto Fumiichiro 
Published: June 2018

Key PointsMet69Thr/Ser substitutions conferred blood group A glycosyltransferase with weak FS activity to produce FORS1 antigen of the FORS system. Met69Thr and LeuGlyGly266-268GlyGlyAla substitutions synergistically increase the acquired FS activity of A glycosyltransferase.