bluuebunny/crossref_metadata_2025_split huggingface dataset:
Procalcitonin Clearance at 24, 48, 72, and 96 Hours and Mortality in Patients With Cancer and Sepsis: A Retrospective Cohort Study
Authors: Nassar Antonio Paulo , Nassif Beatriz Nicolau , Santos Daniel Vitório Veiga dos , Caruso Pedro 
Published: July 2019

Introduction: Previous studies have evaluated procalcitonin clearance (PCTc) as a marker of sepsis severity but at different time points and cutoffs. We aimed to assess the predictive performance of PCTc at different time points of sepsis management in patients with cancer. Methods: This retrospective cohort study included patients with cancer admitted to an intensive care unit between 2013 and 2016. We calculated PCTc at 24, 48, 72, and 96 hours after admission. Its predictive performance for hospital and 90-day mortality was analyzed with receiver operating characteristic curves and areas under the curves (AUCs). Sensitivity and specificity were calculated for different time points using different cutoffs. Results: We included 301 patients. Areas under the curves ranged from 0.62 for PCTc at 24 hours to 0.68 for PCTc at 72 and 96 hours for hospital mortality prediction, and from 0.61 for PCTc at 24 hours to 0.68 for PCTc at 72 hours for 90-day mortality prediction. For hospital mortality prediction, PCTc at 72 hours ≤80% showed the best sensitivity (96.0%; 95% confidence interval [CI]: 90.8%-98.7%), and PCTc at 96 hours ≤50% showed the best specificity (70.7%; 95% CI: 54.5%-83.9%). Conclusions: Procalcitonin clearance at 24, 48, 72, and 96 hours poorly predicted hospital and 90-day mortality. Therefore, daily PCT measurement should not be used to predict mortality for patients with cancer and sepsis.
Training Texas Public Health Professionals and Professionals-In-Training in Genomics
Authors: Chen Lei-Shih , Yeh Yu-Lyu , Goodson Patricia , Zhao Shixi , Jung Eunju , Muenzenberger Amber , Kwok Oi-Man , Ma Ping 
Published: July 2019

Purpose: The purpose of this study is to evaluate the effects of genomics training workshops for public health professionals and professionals-in-training. Design: A pre- and post-test evaluation design with 3-month follow-up. Setting and Participants: Thirteen genomics training workshops were delivered across Texas to 377 public health professionals and professionals-in-training (66.7% were ethnic minorities). Intervention: Three-hour theory-based, face-to-face genomics training workshops focusing on family health history practice were delivered. Methods: We administered surveys prior to the workshops, immediately post-workshops, and at 3-month follow-up to examine the changes in participants’ knowledge, attitudes, intention, self-efficacy, and behavior in adopting genomics into public health practice. Linear mixed modeling analyses were used to analyze the quantitative survey data. A content analysis was also conducted for qualitative survey data analysis. Results: Genomics practice significantly improved among public health professionals at 3-month follow-up ( P < .01). For all participants, knowledge, attitudes, intention, and self-efficacy scores increased significantly immediately post-workshop compared to the pre-workshop scores (all Ps < .01). Knowledge and attitudes scores at the 3-month follow-up remained significantly higher than those scores at the pre-workshop (all Ps < .01). The feedback from workshop participants was positive. Conclusion: Our genomics training workshop is an effective program that can be disseminated at a national level to establish genomic competencies among public health professionals and professionals-in-training in the United States.
Human papillomavirus infection among male adolescents and young adults with perinatally-acquired HIV and without HIV in Thailand
Authors: Wittawatmongkol Orasri , Gatechompol Sivaporn , Kerr Stephen J , Chalermchockcharoenkit Amphan , Teeratakulpisarn Nipat , Lermankul Watcharee , Thamkhantho Manopchai , Phanuphak Nittaya , Sohn Annette H , Chokephaibulkit Kulkanya ,   on behalf of the HPV in Adolescents Study
Published: July 2019

HIV infection may increase the risk of persistent human papillomavirus (HPV) infection and complications. Male adolescents and young adults (AYAs) with perinatally-acquired HIV (PHIV) and without HIV in Thailand were matched by age and lifetime number of sexual partners. HPV infection at oral, anal, penile, and scrotal sites was detected by polymerase chain reaction. A total of 49 PHIV and 47 HIV-uninfected male AYAs (median age 18 [17–20] years) were enrolled (June 2013–September 2014). Overall, 18 were men who have sex with men (MSM) (12% of PHIV, 26% of HIV-uninfected AYAs; P = 0.12). Among the PHIV, the median (interquartile range) CD4 cell count was 573 (434–747) cells/mm3 and 69% had HIV RNA <40 copies/ml. The prevalence of any HPV infection was 61% in PHIV and 49% in HIV-uninfected AYAs ( P = 0.23) and that of high-risk HPV was 33% in PHIV and 28% in HIV-uninfected AYAs ( P = 0.59). Among those with HPV, 55% had any high-risk HPV type and 28% had HPV-16 and/or HPV-18. In multivariate models, smoking (OR 6.10, 95% CI, 1.19–31.35, P = 0.01) and prior history of STI symptoms (OR 5.01, 95% CI, 1.63–15.40, P = 0.004) were associated with high-risk HPV infection. HPV vaccination in early adolescence presents a valuable but missed prevention opportunity.
Factors affecting professional ethics development in students: A qualitative study
Authors: Dehghani Ali 
Published: July 2019

Background: Ethics development is one of the most important aspects of professional practice in health sciences students. Understanding factors affecting ethics development can enhance clinical and professional performance in students. Objective: This study was conducted to explore students’ perceptions about factors affecting professional ethics development. Research design: This study is a conventional content analysis. Data were collected through 20 semi-structured interviews and two focus group interviews (12 students) during 2017–2018. Data were analyzed concurrently with data gathering, using the conventional content analysis approach of Graneheim and Lundman. Participants and research context: In total, 8 students of nursing, 5 medical students, 4 students of anesthesia and 3 operating room students in individual interviews, and 12 students in two focus group interviews from one university in the south of Iran were selected through purposive sampling. Ethical considerations: The research was approved by the Ethics Committee of one university in the south of Iran. Findings: The findings revealed two themes: personal and background factors. Personal factors consisted of the two categories of individual motivation and tendencies and interpersonal interactions. Background factors consisted of the two categories of role and function of teachers and environmental agents. Discussion and conclusions: According to the findings, both background and individual factors affect development of professional ethics in students. Understanding these factors along with reinforcement of educational planning in this field can improve healthcare services.
Angiotensin AT2 receptor–induced interleukin-10 attenuates neuromyelitis optica spectrum disorder–like pathology
Authors: Khorooshi Reza , Tofte-Hansen Emil Ulrikkaholm , Tygesen Camilla , Montanana-Rosell Roser , Limburg Hannah Liska , Marczynska Joanna , Asgari Nasrin , Steckelings Ulrike Muscha , Owens Trevor 
Published: July 2019

Background: Neuromyelitis optica spectrum disorder (NMOSD) is a relapsing inflammatory central nervous system (CNS) disease for which there is no cure. Immunoglobulin G autoantibodies specific for the water channel aquaporin-4 are a serum biomarker, believed to induce complement-dependent astrocyte damage with secondary demyelination. Objective: To investigate the effect of angiotensin AT2 receptor (AT2R) stimulation on NMOSD-like pathology and its underlying mechanism. Methods: NMOSD-like pathology was induced in mice by intracerebral injection of immunoglobulin-G isolated from NMOSD patient serum, with complement. This mouse model produces the characteristic histological features of NMOSD. A specific AT2R agonist, Compound 21 (C21), was given intracerebrally at day 0 and by intrathecal injection at day 2. Results: Loss of aquaporin-4 and glial fibrillary acidic protein was attenuated by treatment with C21. Administration of C21 induced mRNA for interleukin-10 in the brain. NMOSD-like pathology was exacerbated in interleukin-10-deficient mice, suggesting a protective role. C21 treatment did not attenuate NMOSD-like pathology in interleukin-10-deficient mice, indicating that the protective effect of AT2R stimulation was dependent on interleukin-10. Conclusion: Our findings identify AT2R as a novel potential therapeutic target for the treatment of NMOSD. Interleukin-10 signaling is an essential part of the protective mechanism counteracting NMOSD pathology.
Reliability and validity of the finger flexor dynamometer
Authors: Nestler Kai , Rohde Ulrich , Becker Benjamin , Waldeck Stephan , Veit Daniel A , Leyk Dieter 
Published: July 2019

Introduction Dynamometric measurement is a low-cost, noninvasive method for diagnosing and evaluating traumatic and degenerative disorders. The purpose of this study was to assess the reliability and validity of a new custom-made finger flexor dynamometer and evaluate the feasibility of the measuring procedure. Methods Maximum voluntary isometric contraction force at the distal phalanx of the index finger was measured for 1.5 s in 25 healthy volunteers (18–50 yrs). Test–retest reliability and inter-day reliability were assessed by intraclass correlation coefficient model (2,k) on two and five consecutive days, respectively. Both a single measurement and the mean of three repeated measurements were carried out daily. The standard error of measurement was used to measure the absolute reliability, the smallest detectable change was determined, and the coefficient of variation was calculated for each individual. Construct validity was determined by Pearson coefficient. Results Repeated measurement test–retest reliability was excellent according to Munro’s rating scale, with an intraclass correlation coefficient of 0.99 (95%CI: 0.97–0.99), coefficient of variation of 2.6%, and standard error of measurement of 0.4 N. Single measurement test–retest reliability was high to excellent with an intraclass correlation coefficient of 0.94 (95%CI: 0.86–0.97), coefficient of variation of 4.1%, and standard error of measurement of 1.4 N. Smallest detectable change increased from 1.8 N (repeated measurement) to 3.3 N (single measurement). Inter-day reliability intraclass correlation coefficients exceeded 0.93. High construct validity was indicated by a convergent relationship with grip strength (r = 0.85, p < 0.001). Conclusions The novel dynamometer provides excellent reliability and construct validity and supports an objective diagnosis of finger limitations by quantifying the flexion force magnitude. Traumatic injuries and follow-up of rehabilitative treatment can be monitored more precisely.
The developing athlete's heart: a cohort study in young athletes transitioning through adolescence
Authors: Bjerring Anders W , Landgraff Hege EW , Stokke Thomas M , Murbræch Klaus , Leirstein Svein , Aaeng Anette , Brun Henrik , Haugaa Kristina H , Hallén Jostein , Edvardsen Thor , Sarvari Sebastian I 
Published: July 2019

Background Athlete's heart is a term used to describe physiological changes in the hearts of athletes, but its early development has not been described in longitudinal studies. This study aims to improve our understanding of the effects of endurance training on the developing heart. Methods Cardiac morphology and function in 48 cross-country skiers were assessed at age 12 years (12.1 ± 0.2 years) and then again at age 15 years (15.3 ± 0.3 years). Echocardiography was performed in all subjects including two-dimensional speckle-tracking strain echocardiography and three-dimensional echocardiography. All participants underwent cardiopulmonary exercise testing at both ages 12 and 15 years to assess maximal oxygen uptake and exercise capacity. Results Thirty-one (65%) were still active endurance athletes at age 15 years and 17 (35%) were not. The active endurance athletes had greater indexed maximal oxygen uptake (62 ± 8 vs. 57 ± 6 mL/kg/min, P < 0.05) at follow-up. There were no differences in cardiac morphology at baseline. At follow-up the active endurance athletes had greater three-dimensional indexed left ventricular end-diastolic (84 ± 11 mL/m2 vs. 79 ± 10 mL/m2, P < 0.05) and end-systolic volumes (36 ± 6 mL/m2 vs. 32 ± 3 mL/m2, P < 0.05). Relative wall thickness fell in the active endurance athletes, but not in those who had quit (–0.05 ΔmL/m2 vs. 0.00 mL/m2, P = 0.01). Four active endurance athletes had relative wall thickness above the upper reference values at baseline; all had normalised at follow-up. Conclusion After an initial concentric remodelling in the pre-adolescent athletes, those who continued their endurance training developed eccentric changes with chamber dilatation and little change in wall thickness. Those who ceased endurance training maintained a comparable wall thickness, but did not develop chamber dilatation.
Development and evaluation of a minimally aggressive method of patellofemoral osteoarthritis surgical treatment
Authors: Akilzhanov Kenes R , Zhunusov Ersin T , Asylkhanov Kanat T , Smakov Sovetkhan B , Zhanaspayev Marat A 
Published: July 2019

Purpose: The purpose of this study was to assess the impact of developed minimally invasive operation such as the partial lateral facetectomy (PLFE) with patella thickness resection in patients with lateral patellofemoral (PF) osteoarthritis on short-term clinical and radiographic outcomes. Methods: This is a prospective study of 27 knees in 27 patients (18 females and 9 males, mean aged at surgery 59.1-year old) whom a PLFE with patella thickness resection using developed minimally invasive method was performed. Data of preoperative and postoperative questionnaires, physical examinations, and radiographs were analyzed. The minimum follow-up was 12 months (mean, 24.1 months; range, 12–36 months). Results: The subjective outcomes included the anterior pain relief assessed by scores using the Western Ontario and McMaster Universities Arthritis Index score (scores improved considerably by 2.34 points with respect to pain and by 1.63 points with respect to function), visual analog scale, and Knee Society Score (that improved in 78% of the knees). The majority of these patients experienced improvement in their PF symptoms. The PF index decreased considerably after surgery. The mean patellar width and thickness were decreased after surgery, maintaining a width/thickness ratio of 1.8:1.0 after surgery. Conclusion: PLFE with patella thickness resection aiming to decrease the high pressure in the lateral facet and improving congruence of the patella confirmed frequent pain relief. This surgical procedure is minimally invasive, relatively simple, and effective in selected patients and can be a valid early alternative to more complex operations. Level of Evidence: Level IV Therapeutic study.
Low-dose radiation (4 Gy) with/without concurrent chemotherapy is highly effective for relapsed, refractory mantle cell lymphoma
Authors: Ning Matthew S. , Pinnix Chelsea C. , Chapman Bhavana V. , Gunther Jillian R. , Milgrom Sarah A. , Khoury Joseph D. , Jain Preetesh , Chen Wendy Y. , Oriabure Onyeka N. , Badillo Maria R. , Wang L. Michael , Dabaja Bouthaina S. 
Published: July 2019

Abstract
Mantle cell lymphoma (MCL) generally exhibits an aggressive disease course with poor outcomes. Despite inherent radiosensitivity, radiation therapy (RT) is not commonly used for MCL. This study assesses the role of low-dose RT (LDRT) with concurrent chemotherapy in relapsed, multiply refractory MCL. From 2014 through 2018, 19 patients with relapsed, refractory MCL had 98 sites treated with 4 Gy. Median follow-up from initial LDRT was 15.4 months. Patients had received a median 7 courses of chemotherapy since diagnosis, and 58% were ibrutinib-refractory. Of the 98 sites, 76% were refractory to ongoing chemotherapy, and LDRT was delivered with concurrent chemotherapy for 76%. The complete response (CR) rate was 81% at a median 2.7 months post-LDRT. There were no differences in CR despite ibrutinib-refractory disease, prior chemotherapy courses (&gt;5), or tumor size (&gt;3 cm). There were no RT-related toxicities. Overall survival at 1 year following initial LDRT was 90%, and 1-year progression-free survival following last course was 55%. In summary, LDRT is effective for relapsed, multiply refractory MCL, and may be safely delivered with chemotherapy, to multiple sites, and repeatedly without issue. By treating active sites of disease, LDRT can provide durable local control, help achieve remission, and potentially bridge patients to subsequent novel therapies.
Association Between Vitamin D, Frailty, and Progression of Frailty in Community-Dwelling Older Women
Authors: Buchebner David , Bartosch Patrik , Malmgren Linnea , McGuigan Fiona E , Gerdhem Paul , Akesson Kristina E 
Published: July 2019

Abstract

Context
Vitamin D (25OHD) is involved in many physiological functions that decline with age, contributing to frailty and increased risk for negative health outcomes. Whether 25OHD is a long-term risk marker for frailty over a longer time and whether it is consistent with advancing age is unclear.

Objective
To investigate the association between 25OHD and frailty in older women followed for 10 years.

Design and Setting
Prospective, population-based, cohort study in Malmö, Sweden.

Participants
Community-dwelling women, age 75 years (N = 1044) with reassessments at ages 80 (n = 715) and 85 (n = 382) years.

Methods
Frailty was quantified using a 10-variable frailty index. Women were categorized as 25OHD insufficient (<50 nmol/L) or sufficient (≥50 nmol/L).

Results
At ages 75 and 80 years, women with insufficient 25OHD were frailer than women with sufficient 25OHD (0.23 vs 0.18, P < 0.001; and 0.32 vs 0.25, P = 0.001, respectively). At age 80 years, 25OHD insufficiency was associated with subsequent frailty 5 years later (0.41 vs 0.32; P = 0.011). Accelerated progression of frailty was not associated with lower 25OHD levels, and 25OHD level >75 nmol/L was not additionally beneficial with regard to frailty. No association between 25OHD and frailty was observed at age 85 years. Within the frailty index, variables associated with 25OHD were related to muscle strength and function.

Conclusion
In this study, 25OHD insufficiency was associated with increased frailty in all but the oldest old. This study supports the value of maintaining sufficient 25OHD levels for healthy aging.
Quantitative Differences in TGF-β Family Members Measured in Small Antral Follicle Fluids From Women With or Without PCO
Authors: Kristensen Stine Gry , Kumar Ajay , Kalra Bhanu , Pors Susanne Elisabeth , Bøtkjær Jane Alrø , Mamsen Linn Salto , Colmorn Lotte Berdiin , Fedder Jens , Ernst Erik , Owens Lisa Ann , Hardy Kate , Franks Stephen , Andersen Claus Yding 
Published: July 2019

Abstract

Context
Members of the TGF-β family have been implicated in aberrant follicle development in women with polycystic ovaries (PCO).

Objective
Are there quantitative differences in the concentrations of TGF-β family members in fluid from human small antral follicles (hSAFs) in women with or without PCO?

Design and Setting
Follicle fluids (FFs) were collected from 4- to 11-mm hSAFs obtained from women undergoing ovarian tissue cryopreservation for fertility preservation.

Patients
FFs from 16 women with PCO (FF = 93) and 33 women without PCO (FF = 92).

Main Outcome Measures
Intrafollicular concentrations of growth differentiation factor-9 (GDF9); anti-Müllerian hormone (AMH); inhibin-A and inhibin-B; total inhibin; activin-A, activin-B, and activin-AB; follistatin; follistatin-like-3; estradiol; and testosterone.

Results
Activin-B concentrations were reported in hSAFs, and concentrations were 10 times higher than activin-A and activin-AB concentrations. Activin-B showed significant associations with other growth factors. Concentrations of inhibin-A and inhibin-B were significantly lower in FFs from women with PCO, especially in hSAFs <8 mm in diameter. AMH concentrations did not differ between the groups in hSAFs <8 mm; however, AMH remained high in hSAFs >8 mm in women with PCO but decreased in women without PCO. Estradiol was significantly lower in FFs from women with PCO and showed significant associations with AMH. Concentrations of GDF9 showed significantly higher concentrations in PCO FFs of follicles >6 mm.

Conclusions
Altered concentrations of TGF-β family members in hSAFs from women with PCO highlight altered growth factor signaling as a potential mechanism for follicle growth arrest.
PIP degron-stabilized Dacapo/p21Cip1 and mutations inagoact in an anti- versus pro-proliferative manner, yet both trigger an increase in Cyclin E levels
Authors: Bivik Stadler Caroline , Arefin Badrul , Ekman Helen , Thor Stefan 
Published: July 2019

ABSTRACTDuring cell cycle progression, the activity of the CycE-Cdk2 complex gates S-phase entry. CycE-Cdk2 is inhibited by CDK inhibitors (CKIs) of the Cip/Kip family, which include the human p21Cip1 and Drosophila Dacapo (Dap) proteins. Both the CycE and Cip/Kip family proteins are under elaborate control via protein degradation, mediated by the Cullin-RING ligase (CRL) family of ubiquitin ligase complexes. The CRL complex SCFFbxw7/Ago targets phosphorylated CycE, whereas p21Cip1 and Dap are targeted by the CRL4Cdt2 complex, binding to the PIP degron. The role of CRL-mediated degradation of CycE and Cip/Kip proteins during CNS development is not well understood. Here, we analyse the role of ago (Fbxw7)-mediated CycE degradation, and of Dap and p21Cip1 degradation during Drosophila CNS development. We find that ago mutants display over-proliferation, accompanied by elevated CycE expression levels. By contrast, expression of PIP degron mutant Dap and p21Cip1 transgenes inhibit proliferation. However, surprisingly, this is also accompanied by elevated CycE levels. Hence, ago mutation and PIP degron Cip/Kip transgenic expression trigger opposite effects on proliferation, but similar effects on CycE levels.