bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Case of Critical Calcified Innominate Artery Stenosis Successfully Treated With the Shockwave Lithoplasty
Authors: Tripolino Cesare , Grillo Placido , Tassone Eliezer Joseph , Morabito Gaetano , Maselli Daniele , Missiroli Bindo 
Published: February 2019

Purpose: The Shockwave Lithoplasty System represents a novel technology combining a balloon angioplasty catheter with the use of sound waves. Evidences suggest that it is a reliable tool to overcome calcified stenosis in both peripheral and coronary arteries. Here, we describe the case of a patient with calcified innominate artery stenosis successfully treated with the Shockwave Lithoplasty System. Case Report: A 78-year-old woman with hypertension, and dyslipidemia, came to our observation for dizziness. Instrumental examinations showed critical calcified stenosis of the innominate artery. The lesion was successfully treated with the Shockwave Lithoplasty System and subsequent stent apposition. Final angiography demonstrated excellent position of the stent, good wall apposition, and confirmed patency of the right common and right vertebral artery origins. Conclusion: Our clinical experience demonstrates that Lithoplasty is safe and effective also for the treatment of supra-aortic vessels.
Genetic testing for familial hypercholesterolemia: Impact on diagnosis, treatment and cardiovascular risk
Authors: Lee Seohyuk , Akioyamen Leo E , Aljenedil Sumayah , Rivière Jean-Baptiste , Ruel Isabelle , Genest Jacques 
Published: February 2019

Aims Familial hypercholesterolemia (FH) is the most common genetic disorder in medicine, with a prevalence of 1/250. Affected individuals have elevated low-density lipoprotein cholesterol (LDL-C) and an increased lifetime risk of atherosclerotic cardiovascular disease (ASCVD). The diagnosis of FH is based on algorithms that include LDL-C levels, physical manifestations, family history of high LDL-C and premature ASCVD, and, more recently, genetic testing. We sought to determine the impact of genetic testing on the: 1) diagnosis of ‘definite familial hypercholesterolemia’, 2) initiation and adherence of lipid-lowering therapy and 3) risk of ASCVD. Methods We performed a systematic review and meta-analysis, pooling odds ratios and 95% confidence intervals for ASCVD from studies comparing risk estimates in individuals harboring FH-causing variants and unaffected individuals. Results After screening 3304 unique publications, 56 studies were included in the analysis. 1) Genetic testing provided confirmation of FH in 28–80%, over clinical criteria alone, depending on the diagnostic algorithm and the method of analysis. In two large population-based studies comprising 76,751 individuals, an FH-causing variant was identified in only 1.7–2.5% of subjects with an LDL-C > 4.9 mmol/L (190 mg/dL). 2) A confirmed molecular diagnosis increased lipid-lowering therapy adherence (five studies, n = 4181 definite FH). 3) Loss-of-function variant of the LDLR were at a markedly increased risk of myocardial infarction (odds ratio 6.77, 95% confidence interval 4.75–9.66), and patients with a milder (hypomorphic) pathogenic LDLR change had a 4.4-fold increase in risk (odds ratio 4.4, 95% confidence interval 2.34–8.26), compared with controls. Conclusion DNA sequencing confirms the diagnosis of FH but has a poor yield in unselected patients whose sole criterion is an elevated LDL-C. Initiation and adherence to treatment is improved. The risk of ASCVD is 4.4- to 6.8-fold increased in patients with an FH-causing variant compared with controls, depending on the severity of the DNA change.
Isocapnic buffering period: From physiology to clinics
Authors: Carriere Cosimo , Corrà Ugo , Piepoli Massimo , Bonomi Alice , Salvioni Elisabetta , Binno Simone , Magini Alessandra , Sciomer Susanna , Pezzuto Beatrice , Gentile Piero , Schina Mauro , Sinagra Gianfranco , Agostoni Piergiuseppe 
Published: February 2019

Background During cardiopulmonary exercise test, the isocapnic buffering period ranges between anaerobic threshold (AT) and respiratory compensation point (RCP). We investigated whether oxygen uptake (VO2) increase during the isocapnic buffering period (ΔVO2AT-RCP) is related to heart failure severity and prognosis. Methods We retrospectively analysed reduced ejection fraction heart failure patients who attained RCP at cardiopulmonary exercise test. The study endpoint was the composite of cardiovascular mortality and urgent heart transplantation/left ventricular assist device implantation. Hazard ratio was assessed to identify the increase of risk associated with ΔVO2AT-RCP (below and above the median of ΔVO2AT-RCP). Results AT and RCP were both identified in 782 (39.2%) out of 1995 reduced ejection fraction heart failure cases. Left ventricular ejection fraction and peak VO2 were 33 ± 9% and 16.5 ± 4.5 mL/kg per min (61 ± 16% of predicted value), suggesting moderate heart failure. At five years, endpoint did not vary between patients below and above the median ΔVO2AT-RCP (3.85 mL/min per kg (25–75th interquartile range = 2.69–5.46)). ΔVO2AT-RCP correlated with several parameters associated to heart failure prognosis, such as peak VO2, VE/VCO2 slope, brain natriuretic peptide and left ventricular ejection fraction. The ΔVO2AT-RCP value was associated with prognosis at univariate but not at multivariable analysis, where only VE/VCO2 slope endured. Conclusion ΔVO2AT-RCP correlates with several parameters linked to heart failure severity. Isocapnic buffering period stratifies heart failure patients, but not more than other prognostic indices.
Left ventricular hypertrophy in world class elite athletes is associated with signs of improved cardiac autonomic regulation
Authors: Oggionni Gianluigi , Spataro Antonio , Pelliccia Antonio , Malacarne Mara , Pagani Massimo , Lucini Daniela 
Published: February 2019

Abstract

Aim
In this study we sought to assess whether in elite athletes the physiological increase in cardiac mass attending severe long-term training leading to athlete's heart is accompanied by an improvement of autonomic performance, as assessed by post exercise vagal indices and a novel unitary Autonomic Nervous System Index for sports (ANSIs).

Methods
The study involved 500 elite athletes (23.9 ± 6.4 years) participating in a screening organised by the National Italian Olympic Committee. All subjects underwent a complete medical examination, rest and stand autonomic assessment (heart rate variability) as well as bicycle exercise. ANSIs was also derived as radar plot from rest, stand and heart rate recovery individual proxies of autonomic nervous system regulation. All subjects were grouped into those with left ventricular hypertrophy present (LVH(+)), or not (LVH(–)), according to recognised thresholds.

Results
We observed that LVH(+) athletes (24.8%) showed a marked increase of post-exercise vagal indices (p &lt; 0.001) and of ANSIs (p &lt; 0.001), while no difference was observed for heart-rate variability indices. These changes were contingent upon sport intensity categories.

Conclusions
Elite athletes with physiological cardiac hypertrophy (LVH(+)) present a selective profile of indices of autonomic nervous system performance, characterised by increases of markers of vagal recovery and of the novel unitary autonomic index for sports while RR variance and spectral indices seem to be unmodified. Athlete's heart may be characterised by a specific combination of anatomical and neurocardiac remodeling. This approach might furnish potential warning signs differentiating normal training induced physiology from pathological adaptation.
Body image transformation after breast cancer diagnosis and treatment in southern Thai women
Authors: Peerawong Thanarpan , Phenwan Tharin , Mahattanobon Somrit , Tulathamkij Kandawsri , Pattanasattayavong Uraiwan 
Published: February 2019

Objective: To understand the transition of changed body image after the diagnosis and surgery in women with breast cancer. Methods: Semi-structured interview and focus group with narrative approach. Thematic analysis was performed using methodological and investigator triangulation methods. Results: Participants’ body image transformation was categorized into three phases: (1) the moment of diagnosis and changed self, (2) transition and recovery, and (3) normalization. Conclusion: The truth-telling process of breast cancer diagnosis and the freedom to choose their treatment options have a profound impact on body image transformation of women with breast cancer. Family support, social construction, and social support could help women with breast cancer pass through these transitional process faster, while inappropriate truth-telling by their surgeons and not having any choice in their treatment options will delay the transitional process.
Preoperative Comorbidities and Postoperative Complications Do Not Influence Patient-Reported Satisfaction Following Humeral Head Resurfacing: Mid- to Long-term Follow-up of 106 Patients
Authors: Beck Andrea , Lee Hannah , Fourman Mitchell , Giugale Juan , Zlotnicki Jason , Rodosky Mark , Lin Albert 
Published: February 2019

Background Humeral head resurfacing (HHR) has emerged as an alternative treatment for glenohumeral osteoarthritis. We investigated the outcomes of HHR using validated patient-reported outcome (PRO) measures. Methods A retrospective review was performed on 213 patients who underwent HHR. A PRO follow-up was performed by administering a questionnaire including the American Shoulder and Elbow Society (ASES) score, Brophy activity survey, short form of the Disabilities of the Arm, Shoulder and Hand (quickDASH) survey, and general shoulder function. PRO scores were stratified by comorbidities and complications. Results Survey responses were received from 106 patients (51%), with a mean follow-up of 5.6 ± 1.8 years (range: 9 months to 6.1 years). Preoperative comorbidities were associated with significantly higher quickDASH scores. Postoperative complications were associated with significantly higher rates of current pain, higher visual analog scale scores, night pain, lower subjective shoulder values, and lower ASES pain and total scores. No differences in patient satisfaction were identified between the cohorts with and without preoperative comorbidities and between the cohorts with and without postoperative complications. Conclusion In our cross-sectional analysis of mid- to long-term outcomes following HHR, preoperative comorbidities, or postoperative complications had no impact on patient-perceived postoperative satisfaction or most PROs. HHR is clinically viable in a wide variety of patients. Future work is necessary to compare the efficacy of HHR compared with more traditional total shoulder arthroplasty and stemmed hemiarthroplasty regarding long-term outcomes and appropriate indications.
Disorganization of Retinal Inner Layers in Retinal Vein Occlusions: New Insights From Anti-VEGF Treatment
Authors: Nguyen Minh T. , Martins Aline L.B. , Heiligenstein Mia A. , Blodi Barbara A. , Mititelu Mihai 
Published: February 2019

Purpose: The purpose of this study is to determine the significance of disorganization of the retinal inner layers (DRIL) in patients with retinal vein occlusions (RVOs) and whether this is influenced by the choice of antivascular endothelial growth factor (anti-VEGF) agent used. Methods: A retrospective chart study was conducted on patients with RVO and center-involved macular edema (ME) presenting to the University of Wisconsin with a minimum follow-up time of 12 months. Medical records were reviewed for demographics, vision, and imaging at baseline and 2 study visits over the course of 1 year. Two masked graders evaluated spectral-domain optical coherence tomography scans for DRIL and other features within the 1-mm-wide area centered on the foveal depression. Results: Twenty-two eyes had DRIL at baseline. DRIL resolved in 10 eyes at the first study visit, and in 2 more eyes at the second study visit. Although we could not establish an association between visual acuity (VA) and DRIL at baseline, we found a more robust correlation between DRIL extent and VA at baseline in eyes with central retinal vein occlusion/hemicentral vein occlusion compared to eyes with branch retinal vein occlusion. There was an association between DRIL improvement at the first study visit and VA improvement at the second study visit ( P = .049). However, this effect was smaller than the effect of initial VA improvement on final VA improvement. No significant difference in DRIL change was observed between the 3 anti-VEGF treatment algorithms: bevacizumab only, aflibercept only, and bevacizumab followed by aflibercept. Additionally, there was no significant correlation between RVO risk factors and change in DRIL over time. Conclusions: In our study, DRIL was not associated with VA in RVO-ME, but its resolution was predictive of VA improvement in response to anti-VEGF therapy. The choice of anti-VEGF agent (bevacizumab, aflibercept or a combination of the 2) did not affect the magnitude of DRIL resolution in RVO.
Phase 2 study using oral thalidomide-cyclophosphamide-prednisone for idiopathic multicentric Castleman disease
Authors: Zhang Lu , Zhao Ai-lin , Duan Ming-hui , Li Zhi-yuan , Cao Xin-xin , Feng Jun , Zhou Dao-bin , Zhong Ding-rong , Fajgenbaum David C. , Li Jian 
Published: February 2019

Abstract
Idiopathic multicentric Castleman disease (iMCD) is a rare lymphoproliferative disorder. The anti–interleukin 6 (IL-6) therapy siltuximab is not available everywhere, and is not effective for over one-half of patients. Alternative treatment approaches are urgently needed. In the first iMCD clinical trial directed against a target other than IL-6 signaling, we investigated a thalidomide-cyclophosphamide-prednisone (TCP) regimen in newly diagnosed iMCD patients. This single-center, single-arm, phase 2 study enrolled 25 newly diagnosed iMCD patients between June 2015 and June 2018. The TCP regimen (thalidomide 100 mg daily for 2 years; oral cyclophosphamide 300 mg/m2 weekly for 1 year; prednisone 1 mg/kg twice a week for 1 year) was administered for 2 years or until treatment failure. The primary end point was durable tumor and symptomatic response for at least 24 weeks. Twelve patients (48%) achieved the primary end point with no relapse, 3 patients (12%) demonstrated stable disease, and 10 patients (40%) were evaluated as treatment failure. Even when considering all patients, there were significant (P &lt; .05) improvements in median symptom score, IL-6 level, hemoglobin, erythrocyte sedimentation rate, albumin, and immunoglobulin G. Among responders, the median levels of all evaluated parameters significantly improved, to the normal range, after treatment. The regimen was well tolerated. One patient died of pulmonary infection and 1 patient had a grade 3 adverse event (rash); 2 patients died following disease progression. Estimated 1-year progression-free survival and overall survival were 60% and 88%, respectively. The TCP regimen is an effective and safe treatment of newly diagnosed iMCD patients, particularly when siltuximab is unavailable. This trial was registered at www.clinicaltrials.gov as #NCT03043105.
Prognostic significance of p16 immunohistochemical expression in urothelial carcinoma
Authors: Hashmi Atif Ali , Hussain Zubaida Fida , Irfan Muhammad , Hashmi Shumaila Kanwal , Asif Huda , Faridi Naveen 
Published: February 2019

Abstract
Background
p16 is the protein product of most commonly involved gene in bladder carcinogenesis. Therefore, we performed an immunohistochemical study to evaluate association of p16 overexpression with prognostic parameters in bladder cancer.

Methods
p16 immunohistochemistry was performed on 121 cases of bladder cancer and association with tumor grade, lamina propria invasion, muscularis propria invasion and survival status was noted.

Results
Low expression of p16 was noted in 86% (104 cases), whereas 14% (17 cases) revealed high p16 expression. We found significant association of p16 expression with tumor grade (p = 0.000), muscularis propria invasion (p = 0.001), lamina propria invasion (p = 0.001) and survival status (p = 0.020). Univariate binary logistics showed that low grade tumors were less likely to express high p16 expression as compared to high grade tumors. Similarly, patients with lamina propria and muscularis propria invasion were more likely to exhibit high p16 expression. Significant association of high p16 expression was noted with worse long term survival (p = 0.020), while univariate logistic regression showed that patients with low p16 expression were at low risk (HR = 0.194) to die of disease as compared to patients with high p16 expression.

Conclusion
p16 is an important biomarker in bladder cancer as it can be used for prognostic stratification of patients with bladder cancer. Moreover, we suggest that molecular studies should be performed in our population in order to correlate abnormal p16 expression with underlying gene mutations.
ATML1 activity is restricted to the outermost cells of the embryo through post-transcriptional repressions
Authors: Iida Hiroyuki , Yoshida Ayaka , Takada Shinobu 
Published: February 2019

ABSTRACT
Cell fate determination in plants relies on positional cues. To investigate the position-dependent gene regulation in plants, we focused on shoot epidermal cell specification, which occurs only in the outermost cells. ATML1, which encodes an HD-ZIP class IV transcription factor, is a positive regulator of shoot epidermal cell identity. Despite the presence of a weak ATML1 promoter activity in the inner cells, ATML1 protein was detected mostly in the outermost cells, which suggests that ATML1 accumulation is inhibited in the inner cells. ATML1 nuclear localization was reduced in the epidermis and there was a positive, albeit weak, correlation between the amount of ATML1 in the nuclei and the expression of a direct target of ATML1. Nuclear accumulation of ATML1 was more strongly inhibited in the inner cells than in the outermost cells. Domain deletion analyses revealed that the ZLZ-coding sequence was necessary and partially sufficient for the post-transcriptional repression of ATML1. Our results suggest that post-transcriptional repressions contribute to the restriction of master transcriptional regulator activity in specific cells to enable position-dependent cell differentiation.
Alternative use of miRNA-biogenesis co-factors in plants at low temperatures
Authors: Ré Delfina A. , Lang Patricia L. M. , Yones Cristian , Arce Agustin L. , Stegmayer Georgina , Milone Diego , Manavella Pablo A. 
Published: February 2019

ABSTRACT
Plants use molecular mechanisms to sense temperatures, trigger quick adaptive responses and thereby cope with environmental changes. MicroRNAs (miRNAs) are key regulators of plant development under such conditions. The catalytic action of DICER LIKE 1 (DCL1), in conjunction with HYPONASTIC LEAVES 1 (HYL1) and SERRATE (SE), produces miRNAs from double-stranded RNAs. As plants lack a stable internal temperature to which enzymatic reactions could be optimized during evolution, reactions such as miRNA processing have to be adjusted to fluctuating environmental temperatures. Here, we report that with decreasing ambient temperature, the plant miRNA biogenesis machinery becomes more robust, producing miRNAs even in the absence of the key DCL1 co-factors HYL1 and SE. This reduces the morphological and reproductive defects of se and hyl1 mutants, restoring seed production. Using small RNA-sequencing and bioinformatics analyses, we have identified specific miRNAs that become HYL1/SE independent for their production in response to temperature decrease. We found that the secondary structure of primary miRNAs is key for this temperature recovery. This finding may have evolutionary implications as a potential adaptation-driving mechanism to a changing climate.
Prevalencia del uso de equipos de protección individual y accidentes en usuarios de bicicletas en São Paulo
Authors: Oliveira dos Santos Rennan Luiz , Hoyos Cadavid Ana María , Gomes Bitu Mariana , Morandi Gabriela , Pena Coto Neide , Campanini Geraldini Cleusa Aparecida 
Published: February 2019

Introducción: las bicicletas son un medio de transporte popular que trae beneficios para la salud, cuando son utilizadas regularmente. Sin embargo, son frecuentes los accidentes que se presentan en sus usuarios. El objetivo de este trabajo fue evaluar la prevalencia de accidentes y el uso de equipos de protección individual (EPI) en usuarios de bicicletas en São Paulo (Brasil), por medio de formularios. Además, la población estudiada fue orientada sobre la importancia del uso de EPI. Materiales y métodos: ciclistas de diferentes regiones de São Paulo respondieron a las preguntas hechas en un formulario y fueron orientados sobre el correcto uso de los EPI. Resultados: la muestra total fue de 608 personas, evaluadas y entrevistadas (210 mujeres y 398 hombres). El porcentaje mayor de entrevistados tenía entre 20 y 40 años. Los EPI más usados fueron casco, tenis y señalización de pedales. El 48% de los encuestados dijo que había sufrido accidentes usando este medio de transporte. Gran parte de los accidentes ocurrieron en momentos de ocio, durante las mañanas y en días de sol. El 69.5 % de las personas entrevistadas escucharon las indicaciones. Conclusiones: la mayoría de los ciclistas de la ciudad de São Paulo son jóvenes, varones y no utilizan los EPI obligatorios. Los accidentes sufridos, relatados por la población encuestada, no estuvieron relacionados con las condiciones meteorológicas ni con el consumo de alcohol. En este estudio, se observó que solo los ciclistas que ya usaban los EPI estaban interesados en las directrices sobre su importancia y uso correcto.
Intervenciones nutricionales para el tratamiento de la diabetes mellitus gestacional
Authors: Perulero Niño Guadalupe , Orozco González Claudia Nelly , Zúñiga Torres María Guadalupe 
Published: February 2019

Introducción: la diabetes mellitus gestacional (DMG) es una alteración del metabolismo de los hidratos de carbono (HC), de severidad variable, que se inicia o se reconoce por primera vez durante la gesta- ción; su frecuencia se ha duplicado en la última década en mujeres con factores de riesgo fácilmente identificables. La terapia de nutrición es una parte integral de la gestión de la dmg. Antiguamente, se utilizaba la restricción de HC; actualmente, se utiliza control de calidad y cantidad de HC, y se está evaluando la eficacia de distintas intervenciones nutricionales. Materiales y métodos: se realizó una búsqueda de artículos originales mediante Pubmed y bases académicas, principalmente ensayos clínicos en los que se demuestra el efecto de la intervención con distintos tipos de dietas en mujeres con DMG. Resultados: se obtuvieron mejores resultados en cuanto a los niveles de glucosa en las dietas altas en HC complejos, grasas saturadas y la utilización de proteína de soja, siendo estas una mejor opción para el control glucémico y evitar repercusiones en el estado nutrición de la madre y del bebé. Conclusión: la terapia nutricional basada en el control de la cantidad, calidad y distribución de hc es el tratamiento inicial para la DMG, pero existe la necesidad de ensayos controlados aleatorios que comparen diferentes intervenciones dietéticas y que evalúen modificaciones en porcentajes de macronutrimentos, valor calórico total, tipo y calidad de nutrimentos que demuestren el papel que cumple la intervención nu- tricional en los resultados de embarazos afectados con DMG.