bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P2-06-01: Molecular characterization of human malignant phyllodes tumors reveals potential targeted approaches
Authors: Moon H-G , Yun J , Hong BS , Lee E , Lee H-B , Han W , Kim J-I , Noh D-Y , Heo W , Hur S , Kang W , Lee C 
Published: February 2018

Abstract
Malignant phyllodes tumor (MPT) which belong to the fibroepithelial neoplasm spectrum is a rare type of breast malignancy, and currently there is no effective targeted approach available for MPT. In this study, we tried to identify key genomic alterations and biologic pathways in MPT by whole exome and RNA sequencing of nine MPT tissues. Whole exome sequencing revealed somatic alterations in EGFR, MED12, PIK3CA, PIK3R1, PDGFRA, PDGFRB, PTEN, and TP53. Transcriptome sequencing showed dysregulation of ECM-receptor interaction, focal adhesion, and PI3K-Akt signaling in MPTs when compared to normal breast or invasive breast cancer tissues. Based on the transcriptome profiles, the MPTs were classified into two subtypes; fibrous subtype with upregulation of stromal genes such as collagens and epithelial subtype with upregulation of E-cadherin and Claudins. The molecular classification of fibrous and epithelial subtypes was validated in 28 paraffin-embedded MPT tissues. The fibrous subtype showed higher mitotic index and increased risk for recurrence when compared to the epithelial subtype. We established a patient-derived xenograft model from one fibrous subtype MPT which harbored somatic mutation in PIK3R1 and PDGFRB. In that model, targeted treatment against PIK3CA/mTOR and PDGFR pathways effectively suppressed the tumor growth in vivo. Our data provide insights on the biologic understanding of MPT and suggest a clinically relevant molecular classification. Furthermore, we show that developing effective targeted approaches in MPT can be possible with genomic profiles and patient-derived xenograft models. The clinical efficacy of targeting PDGFR and PIK3CA/mTOR pathways in MPT should be tested in future clinical trials.
Citation Format: Moon H-G, Yun J, Hong BS, Lee E, Lee H-B, Han W, Kim J-I, Noh D-Y, Heo W, Hur S, Kang W, Lee C. Molecular characterization of human malignant phyllodes tumors reveals potential targeted approaches [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-06-01.
Cardiovascular and Patient Phenotype of Extended Haemodialysis: A Critical Analysis of Studying a Unique Patient Population
Authors: Mitsides Nicos , Cornelis Tom , Broers Natascha J.H. , Diederen Nanda M.P. , Brenchley Paul , van der Sande Frank M. , Schalkwijk Casper , Kooman Jeroen P. , Mitra Sandip 
Published: February 2018

<b><i>Background:</i></b> Extended haemodialysis (EHD) has been associated with better outcomes compared to conventional (CHD) regimes. The cardiovascular (CV) profile of these patients has not been assessed in detail. <b><i>Methods:</i></b> We report baseline demographic and CV phenotype of 36 CHD and 36 EHD participants to a longitudinal multicentre study. We measured pulse wave velocity (PWV), 24-h ambulatory blood pressure, sublingual dark-field capillaroscopy and vascular biomarkers. <b><i>Results:</i></b> EHD patients were younger (<i>p</i> &#x3c; 0.01), with less CV comorbidity (<i>p</i> = 0.04) and higher dialysis vintage (<i>p</i> &#x3c; 0.01). Higher PWV in CHD (<i>p</i> = 0.02) was not independent of demographic differences in the 2 groups. Biomarker profiles were similar in EHD and CHD but abnormal compared to healthy controls. <b><i>Conclusion:</i></b> Although CV profiles in these 2 cohorts were similar, EHD patients were distinct from the CHD population in terms of age and dialysis vintage and appear to comprise a unique group. Direct comparison of outcomes in these groups is challenging due to clinical bias.
High-Resolution Infrared Thermography of Esophageal Temperature During Radiofrequency Ablation of Atrial Fibrillation
Authors: Daly Matthew G. , Melton Iain , Roper Graham , Lim Gary , Crozier Ian G. 
Published: February 2018

Background:
Catheter ablation for atrial fibrillation has potential to cause esophageal thermal injury. Esophageal temperature monitoring during ablation is commonly used; however, it has not eliminated thermal injuries, possibly because conventional sensors have poor spatial sampling and response characteristics. To enhance understanding of temperature dynamics that may underlie esophageal injury, we tested a high-resolution, intrabody, infrared thermography catheter to continuously image esophageal temperatures during ablation.

Methods and Results:
Atrial fibrillation ablation patients were instrumented with a flexible, 9F infrared temperature catheter inserted nasally (n=8) or orally (n=8) into the esophagus adjacent to the left atrium. Ablation was performed while the infrared catheter continuously recorded surface temperatures from 7680 points per second circumferentially over a 6-cm length of esophagus. Physicians were blinded to temperature data. Endoscopy was performed within 24 hours to document esophageal injury. Thermal imaging showed that most patients (10/16) experienced ≥1 events where peak esophageal temperature was >40°C. Three patients experienced temperatures >50°C; and 1 experienced >60°C. Analysis of temperature data for each subject’s maximum thermal event revealed high gradients (2.3±1.4°C/mm) and rates of change (1.5±1.3°C/s) with an average length of esophageal involvement of 11.0±5.4 mm. Endoscopy identified 3 distinct thermal lesions, all in patients with temperatures >50°C; all resolved within 2 weeks.

Conclusions:
Infrared thermography provided dynamic, high-resolution mapping of esophageal temperatures during cardiac ablation. Esophageal thermal injury occurred with temperatures >50°C and was associated with large spatiotemporal gradients. Additional studies are warranted to determine the relationships between thermal parameters and esophageal injury.
Immunosuppressive Therapy Improves Both Short- and Long-Term Prognosis in Patients With Virus-Negative Nonfulminant Inflammatory Cardiomyopathy
Authors: Merken Jort , Hazebroek Mark , Van Paassen Pieter , Verdonschot Job , Van Empel Vanessa , Knackstedt Christian , Abdul Hamid Myrurgia , Seiler Michael , Kolb Julian , Hoermann Philipp , Ensinger Christian , Brunner-La Rocca Hans-Peter , Poelzl Gerhard , Heymans Stephane 
Published: February 2018

Background:
Inflammatory cardiomyopathy (infl-CMP) is characterized by increased cardiac inflammation in the absence of viruses, ischemia, valvular disease, or other apparent causes. Studies addressing the efficacy of immunosuppressive therapy in patients with infl-CMP are sparse. This study retrospectively investigates whether immunosuppressive agents on top of heart failure therapy according to current guidelines improves cardiac function and long-term outcome in patients with infl-CMP.

Methods and Results:

Within the Innsbruck and Maastricht Cardiomyopathy Registry, a total of 209 patients fulfilled the criteria for infl-CMP using endomyocardial biopsy (≥14 infiltrating inflammatory cells/mm
2
). A total of 110 (53%) patients received immunosuppressive therapy and 99 (47%) did not. To correct for potential selection bias, 1:1 propensity score matching was used on all significant baseline parameters, resulting in a total of 90 patients per group. Baseline characteristics did not significantly differ between both patient groups, reflecting optimal propensity score matching. After a median follow-up of 31 (15–47) months, immunosuppressive therapy resulted in an improved long-term outcome (eg, heart transplantation–free survival) as compared with standard heart failure therapy alone (Log-rank
P
=0.043; hazard ratio, 0.34 [95% CI, 0.17–0.92]) and in a significant larger increase of left ventricular ejection fraction after a mean of 12 months follow-up, as compared with patients receiving standard heart failure treatment only (12.2% versus 7.3%, respectively;
P
=0.036).

Conclusions:
To conclude, this study suggests that immunosuppressive therapy in infl-CMP patients results in an improved heart transplantation–free survival as compared with standard heart failure therapy alone, underscoring the urgent need for a large prospective multicenter trial.
Design and Rationale of the RIPCORD 2 Trial (Does Routine Pressure Wire Assessment Influence Management Strategy at Coronary Angiography for Diagnosis of Chest Pain?)
Authors: Elguindy Mostafa , Stables Rod , Nicholas Zoe , Kemp Ian , Curzen Nick 
Published: February 2018

Background:
Investigation of anginal chest pain has traditionally involved either assessment of the coronary anatomy by angiography or noninvasive testing for reversible ischemia. Invasive pressure wire assessment at the time of angiography offers information on both anatomy and physiology. Fractional flow reserve–guided percutaneous coronary intervention is associated with lower resource utilization and improved clinical outcome compared with angiographic guidance alone. However, the value of routine fractional flow reserve of all major coronary vessels at the time of diagnostic angiography has not been established in a randomized trial despite persuasive observational data. A change in practice to routine fractional flow reserve assessment of all major vessels during diagnostic angiography would require evidence not just of clinical benefit but also of cost effectiveness. This randomized trial aims to test that strategy.

Methods and Results:
RIPCORD 2 (Does Routine Pressure Wire Assessment Influence Management Strategy at Coronary Angiography for Diagnosis of Chest Pain?) is an 1100 patient prospective, multicenter, randomized trial. Participants are randomized, after initial coronary angiography, and in equal proportion, to assessment and management according to (1) conventional angiography only or (2) additional routine pressure wire assessment in all epicardial vessels of sufficient size to be amenable to revascularization. The primary economic outcome measure will be a comparison of healthcare costs at 1 year. The primary quality-of-life outcome measure analysis will compare patient-reported quality-of-life scores at 1 year. Secondary outcome measures include clinical events at 1 year, management strategy (optimal medical therapy with or without revascularization), and angina status at 1 year according to Canadian Cardiovascular Society angina grade.

Conclusions:
The aim of the RIPCORD 2 trial is to assess whether a strategy of routine fractional flow reserve–guided assessment and management of all major coronary arteries will be associated with more effective resource utilization, improved quality of life, and better clinical outcome, compared with angiographic guidance alone.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02892903.
Role of the South in the Development of International Environmental Law
Authors: Hassan Parvez 
Published: February 2018

Abstract
In the post-colonial era, the newly emerging and independent states of Asia and Africa, supported by the developing world in South America, questioned the validity and legitimacy of norms of international law. Those norms were perceived to serve only the interests of the developed Western nations and were alien to the aspirations of the developing countries. International law has evolved over time, with a willingness to accept the viewpoint of new participants in the global process in a variety of contexts. These include the international protection of human rights and international law regarding the permanent sovereignty of nations over their natural wealth and resources. The interests of developing countries have been assimilated, though the extent to which this is done varies. A central message advanced is that the ultimate integrity of international law is the commonality and synthesis of the interests of all states, rich and poor, agricultural and industrial. The continuing contribution of developing countries, through their participation in conferences, negotiation of treaties and soft law texts, adds immeasurable strength to the current state and future development of international environmental law.
Hydrography of the Gulf of Mexico Using Autonomous Floats
Authors: Hamilton Peter , Leben Robert , Bower Amy , Furey Heather , Pérez-Brunius Paula 
Published: February 2018

ABSTRACTFourteen autonomous profiling floats, equipped with CTDs, were deployed in the deep eastern and western basins of the Gulf of Mexico over a four-year interval (July 2011–August 2015), producing a total of 706 casts. This is the first time since the early 1970s that there has been a comprehensive survey of water masses in the deep basins of the Gulf, with better vertical resolution than available from older ship-based surveys. Seven floats had 14-day cycles with parking depths of 1500 m, and the other half from the U.S. Argo program had varying cycle times. Maps of characteristic water masses, including Subtropical Underwater, Antarctic Intermediate Water (AAIW), and North Atlantic Deep Water, showed gradients from east to west, consistent with their sources being within the Loop Current (LC) and the Yucatan Channel waters. Altimeter SSH was used to characterize profiles being in LC or LC eddy water or in cold eddies. The two-layer nature of the deep Gulf shows isotherms being deeper in the warm anticyclonic LC and LC eddies and shallower in the cold cyclones. Mixed layer depths have an average seasonal signal that shows maximum depths (~60 m) in January and a minimum in June–July (~20 m). Basin-mean steric heights from 0–50-m dynamic heights and altimeter SSH show a seasonal range of ~12 cm, with significant interannual variability. The translation of LC eddies across the western basin produces a region of low homogeneous potential vorticity centered over the deepest part of the western basin.
Simulating Radiative Fluxes through Southeastern Pacific Stratocumulus Clouds during VOCALS-REx
Authors: Verlinden Kathryn L. , de Szoeke Simon P. 
Published: February 2018

ABSTRACTTime series of solar and thermal infrared radiative flux profiles are simulated with the Rapid Radiative Transfer Model (RRTM) using a hierarchy of constraints from radar reflectivity and passive microwave cloud remote sensing measurements collected over a ship in the southeastern tropical Pacific Ocean (20°S) during the second leg of the Variability of American Monsoon Systems (VAMOS) Ocean–Cloud–Atmosphere–Land Study Regional Experiment (VOCALS-REx). Incorporating additional constraints results in simulations of physically consistent radiative profiles throughout the atmosphere, especially within the cloud, where they are difficult to observe precisely. Simulated surface radiative fluxes are compared with those observed on the ship and by aircraft.Due to the strong Rayleigh scattering of drizzle drops compared to cloud droplets that absorb, emit, and scatter natural radiation, cloud radar reflectivity overestimates cloud liquid water content (LWC). As a result, clouds are optically too thick and transmission ratios are too low in simulations using radar LWC. Imposing a triangular (increasing linearly with height from zero at cloud base) LWC profile in agreement with microwave liquid water path (LWP) improves the simulation of the transmission ratio. Constraining the corresponding microphysical cloud effective radius to that retrieved from optical depth, LWP, and cloud thickness results in additional improvements to the simulations. Time series, averages, and composite diurnal cycles of radiative fluxes, heating rates, and cloud radiative forcing are presented.
Discretionary Powers of Governor—III: An Interpretation from Federal Perspective
Authors: Pankaj Ashok 
Published: February 2018

This article examines the scope of discretionary powers of governor of a state in India from federal perspective and argues that they are against the principle of ‘cabinet responsibility’, an essential feature of parliamentary form of government that India intertwined with the federal constitution. These apparent anachronistic constitutional provisions were inherited from the Government of India Act, 1935, and retained with some modifications in the Constitution of Independent India as an institutional safeguard for the unity and integrity of Union of India that was formed by the merger of more than 500 princely states and a number of British administered provinces. As against the intentions of the constitution makers, the use of discretionary powers by governors has remained short of constitutional propriety, and it has been a major source of tension in centre–state relations. This has been partly because of the scope of powers itself and partly because of political factors. This article adds to various attempts of defining the scope of discretionary powers of the governor. A governor, appointed on political considerations, flippantly sets aside norms, values and constitutional propriety, expected of him in exercise of his/her powers. The lack of tenurial security makes him susceptible to the pressure of the union government. Only through political consensus, a solution can be found out to resolve this tricky issue of Indian federalism.
Refinement of in vivo optical imaging: Development of a real-time respiration monitoring system
Authors: Gomes Ana L , Gilchrist Stuart , Kersemans Veerle , Westcott Marcus , Smart Sean 
Published: February 2018

In vivo optical imaging enables detection and quantification of light-emitting compounds from the whole body in small animals such as the mouse, but it typically requires the use of anaesthetics for subject immobilisation due to long exposure times. Excessively deep anaesthesia can result in unacceptably compromised physiology, whilst excessively light anaesthesia can result in animals waking up. Here we report a respiratory monitoring setup for an in vivo bioluminescence and fluorescence imaging device which simultaneously allows real-time adaptive control of anaesthesia depth in multiple animals to (i) potentially increase the consistency between animals, (ii) ensure animals are maintained within minimally intrusive, adequate anaesthetic plane and (iii) provide a valuable refinement strategy for a common challenge within animal-based research.
A Selection of Recent Literature on Human Sexuality with Special Reference to Marriage Counseling Practice
Authors: Hunter William F. 
Published: February 2018

There is a staggering volume of literature on human sexuality these days. It is difficult for professionals to have time to assess the value of much of this literature, though much of it would be useful to the Christian marriage and family counselor whether for his own professional growth, for bibliotherapy with clients, or as resource material for teaching and speaking in community service. This article surveys representative literature dealing with different aspects of human sexuality and attempts some assessment of it for professional and client use in marriage and family counseling. Some are very heavy tomes, others fairly frothy, popular-level treatments. All, however, add in some measure depth and perspective to the marriage and family counselor's understanding of sexuality at a time when values are shifting and traditional ideas about sexuality are rapidly changing. Most of the books discussed are relatively recent; that is, from the 1970s. A few, on the other hand, come from the latter part of the 1960s. It was thought that Masters and Johnson's Human Sexual Response was so basic to the whole tenor of contemporary sexual therapy and counseling that it has been included in this brief survey. It is a most encouraging sign that there is a literature on sexuality (cf. Small & Smedes) that is indicative of a new approach to sex and sexuality coming for the Christian in our time. This is a development long overdue and God is to be praised for stirring up gifted men to do the writing at this time. Much solid theological thinking about sexuality is bound to increase in the future. That evangelical writers would see the need and rise to meet it is thrilling beyond measure. New directions in understanding sexuality for Christians are being established in our time.
The Holy Spirit and Human Personality
Authors: Craker Wendel D. 
Published: February 2018

Concepts of an ultimate and eternal reality in the universe can no longer be taken for granted. People living within a contemporary frame of reference often find it difficult even to talk about the Holy Spirit as an interacting personality with the spirit of man. Yet the experience of life for even the most “modern” of men forces him to move outside of his closed system in order to satisfy his underlying quest for meaning. It is at this point that talk about the Holy Spirit once more becomes possible. The search for an understanding of the complex aspects of human personality is by no means over. The conflict model of personality structure generated by Freud and the fulfillment models exemplified in Adler, Maslow, and others have each made their contribution to understanding. Current trends often focus on the consistency models that emphasize the role of interaction with one's environment in the process of becoming. With the theological understanding of God as person, and man as person, not only the possibility, but the necessity of man's personality (spirit) interacting with the personality (Spirit) of God is before us. This is described by H. Wheeler Robinson's phrase, “the pressure of Spirit upon spirit.” Too often this spiritual dimension of man is overlooked when one talks about interaction with the environment. But the “environment of the Spirit” is an ever present factor and in itself may account for personality changes within man. This is reflected in the biblical concept of the goal directed man (andra telion) and his search for integration and completeness.
Role of terminal warm blood cardioplegia in complex congenital heart surgery
Authors: Busro Pribadi Wiranda , Romolo Harvey , Sastroasmoro Sudigdo , Rachmat Jusuf , Sadikin Mohammad , Santoso Anwar , Boom Cindy Elfira , Suwarto Suhendro , Jusuf Ahmad Aulia 
Published: February 2018

Introduction Myocardial protection is vital to ensure successful open heart surgery. Cardioplegic solution is one method to achieve good myocardial protection. Inevitably, ischemia-reperfusion injury occurs with aortic crossclamping. Histidine-tryptophan-ketoglutarate solution is a frequently used cardioplegia for complex congenital heart surgery. We postulated that addition of terminal warm blood cardioplegia before removal of the aortic crossclamp might improve myocardial protection. Method A randomized controlled trial was conducted on 109 cyanotic patients aged, 1 to 5 years who underwent complex biventricular repair. They were divided into a control group of 55 patients who had histidine-tryptophan-ketoglutarate only and a treatment group of 54 who had histidine-tryptophan-ketoglutarate with terminal warm blood cardioplegia. Endpoints were clinical parameters, troponin I levels, and caspase-3 as an apoptosis marker. Results The incidence of low cardiac output syndrome was 34%, with no significant difference between groups (35.2% vs. 33.3%, p = 0.84). The incidence of arrhythmias in our treatment group was lower compared to the control group (36% vs. 12%, p = 0.005). Troponin I and caspase-3 results did not show any significant differences between groups. For cases with Aristotle score ≥ 10, weak expression of caspase-3 in the treatment group post-cardiopulmonary bypass was lower compared to the control group. Conclusion For complex congenital cardiac surgery, the addition of terminal warm blood cardioplegia does not significantly improve postoperative clinical or metabolic markers.