bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spontaneous gall bladder infarction in a dog with a congenital extrahepatic portosystemic shunt
Authors: Olivares Gerard , Fernández Yordan , Di Palma Stefano , Murgia Daniela 
Published: March 2018

A two‐year‐old entire female miniature dachshund was referred with a 10‐day‐history of polyuria, polydipsia, vomiting and inappetence and she was diagnosed with a left gastro‐azygos portosystemic shunt. The dog underwent surgical attenuation of the shunt with a 5 mm ameroid ring constrictor and recovered uneventfully from the procedure. Two days after surgery, the dog developed acute abdominal pain. Abdominal ultrasonography revealed free peritoneal effusion and analysis of the fluid was consistent with biliary effusion. Diagnosis of biliary peritonitis was therefore made. On exploratory coeliotomy an evident leak of bile from the extrahepatic biliary tree was not detected. However, the gall bladder appeared macroscopically abnormal and a cholecystectomy was performed. Histopathological examination revealed gall bladder infarction characterised by intravascular fibrin thrombi and transmural coagulative necrosis. There was no overt inflammation and the bile was aseptic. The dog recovered uneventfully and was discharged from the hospital 10 days after surgery.
Hereditary selective cobalamin malabsorption and concurrent pancreatitis in a young Border collie
Authors: McCallum Katie Elizabeth , Watson Penny J 
Published: March 2018

A one‐year‐old neutered male Border collie presented with failure to gain weight, lethargy, intermittent leucopenia, borderline anaemia and intermittent gastrointestinal symptoms. He was diagnosed with pancreatitis based on blood results and abdominal ultrasonography and hereditary selective cobalamin malabsorption based on hypocobalaminaemia, methylmalonic aciduria and genetic testing for cubilin mutation. The dog responded to oral cobalamin supplementation with resolution of clinical signs and normalisation of serum cobalamin. There was no recurrence of signs after 27 months of follow‐up. An association between organic acidaemias and pancreatitis has been reported in humans but to the authors’ knowledge, this is the first report of hereditary selective cobalamin malabsorption and concurrent pancreatitis in a dog. Furthermore, this is the first report of inherited canine cobalamin deficiency responding to oral cobalamin supplementation.
Broadband pulsed difference frequency generation laser source centered 3326 nm based on ring fiber lasers
Authors: Chen Guangwei , Li Wenlei 
Published: March 2018

A broadband pulsed mid-infrared difference frequency generation (DFG) laser source based on MgO-doped congruent LiNbO3 bulk is experimentally demonstrated, which employs a homemade pulsed ytterbium-doped ring fiber laser and a continuous wave erbium-doped ring fiber laser to act as seed sources. The experimental results indicate that the perfect phase match crystal temperature is about 74.5[Formula: see text]C. The maximum spectrum bandwidth of idler is about 60 nm with suitable polarization states of fundamental lights. The central wavelength of idlers varies from 3293 nm to 3333 nm over the crystal temperature ranges of 70.4–76[Formula: see text]C. A jump of central wavelength exists around crystal temperature of 72[Formula: see text]C with variation of about 30 nm. The conversion efficiency of DFG can be tuned with the crystal temperature and polarization states of fundamental lights.
Genetic Mechanisms of Immune Evasion in Colorectal Cancer
Authors: Grasso Catherine S. , Giannakis Marios , Wells Daniel K. , Hamada Tsuyoshi , Mu Xinmeng Jasmine , Quist Michael , Nowak Jonathan A. , Nishihara Reiko , Qian Zhi Rong , Inamura Kentaro , Morikawa Teppei , Nosho Katsuhiko , Abril-Rodriguez Gabriel , Connolly Charles , Escuin-Ordinas Helena , Geybels Milan S. , Grady William M. , Hsu Li , Hu-Lieskovan Siwen , Huyghe Jeroen R. , Kim Yeon Joo , Krystofinski Paige , Leiserson Mark D.M. , Montoya Dennis J. , Nadel Brian B. , Pellegrini Matteo , Pritchard Colin C. , Puig-Saus Cristina , Quist Elleanor H. , Raphael Ben J. , Salipante Stephen J. , Shin Daniel Sanghoon , Shinbrot Eve , Shirts Brian , Shukla Sachet , Stanford Janet L. , Sun Wei , Tsoi Jennifer , Upfill-Brown Alexander , Wheeler David A. , Wu Catherine J. , Yu Ming , Zaidi Syed H. , Zaretsky Jesse M. , Gabriel Stacey B. , Lander Eric S. , Garraway Levi A. , Hudson Thomas J. , Fuchs Charles S. , Ribas Antoni , Ogino Shuji , Peters Ulrike 
Published: March 2018

AbstractTo understand the genetic drivers of immune recognition and evasion in colorectal cancer, we analyzed 1,211 colorectal cancer primary tumor samples, including 179 classified as microsatellite instability–high (MSI-high). This set includes The Cancer Genome Atlas colorectal cancer cohort of 592 samples, completed and analyzed here. MSI-high, a hypermutated, immunogenic subtype of colorectal cancer, had a high rate of significantly mutated genes in important immune-modulating pathways and in the antigen presentation machinery, including biallelic losses of B2M and HLA genes due to copy-number alterations and copy-neutral loss of heterozygosity. WNT/β-catenin signaling genes were significantly mutated in all colorectal cancer subtypes, and activated WNT/β-catenin signaling was correlated with the absence of T-cell infiltration. This large-scale genomic analysis of colorectal cancer demonstrates that MSI-high cases frequently undergo an immunoediting process that provides them with genetic events allowing immune escape despite high mutational load and frequent lymphocytic infiltration and, furthermore, that colorectal cancer tumors have genetic and methylation events associated with activated WNT signaling and T-cell exclusion.Significance: This multi-omic analysis of 1,211 colorectal cancer primary tumors reveals that it should be possible to better monitor resistance in the 15% of cases that respond to immune blockade therapy and also to use WNT signaling inhibitors to reverse immune exclusion in the 85% of cases that currently do not. Cancer Discov; 8(6); 730–49. ©2018 AACR.This article is highlighted in the In This Issue feature, p. 663
Cardiopulmonary Exercise Testing in Patients Following Massive and Submassive Pulmonary Embolism
Authors: Albaghdadi Mazen S. , Dudzinski David M. , Giordano Nicholas , Kabrhel Christopher , Ghoshhajra Brian , Jaff Michael R. , Weinberg Ido , Baggish Aaron 
Published: March 2018

Background

Little data exist regarding the functional capacity of patients following acute pulmonary embolism. We sought to characterize the natural history of symptom burden, right ventricular (
RV
) structure and function, and exercise capacity among survivors of massive and submassive pulmonary embolism.

Methods and Results

Survivors of submassive or massive pulmonary embolism (n=20, age 57±13.3 years, 8/20 female) underwent clinical evaluation, transthoracic echocardiography, and cardiopulmonary exercise testing at 1 and 6 months following hospital discharge. At 1 month, 9/20 (45%) patients had New York Heart Association
II
or greater symptoms, 13/20 (65%) demonstrated either persistent
RV
dilation or systolic dysfunction, and 14/20 (70%) had objective exercise impairment as defined by a peak oxygen consumption (

V
˙

O
2
) of <80% of age‐sex predicted maximal values (16.25 [13.4–20.98] mL/kg per minute). At 6 months, no appreciable improvements in symptom severity,
RV
structure or function, and peak

V
˙

O
2
(17.45 [14.08–22.48] mL/kg per minute,
P
=
NS
) were observed. No patients demonstrated an exercise limitation attributable to either
RV
/pulmonary vascular coupling, as defined by a
VE
/
VCO
2
slope >33, or a pulmonary mechanical limit to exercise at either time point. Similarly, persistent
RV
dilation or dysfunction was not significantly related to symptom burden or peak

V
˙

O
2
at either time point.

Conclusions

Persistent symptoms, abnormalities of
RV
structure and function, and objective exercise limitation are common among survivors of massive and submassive pulmonary embolism. Functional impairment appears to be attributable to general deconditioning rather than intrinsic cardiopulmonary limitation, suggesting an important role for prescribed exercise rehabilitation as a means toward improved patient outcomes and quality of life.
Adipose‐Derived Exosomes Exert Proatherogenic Effects by Regulating Macrophage Foam Cell Formation and Polarization
Authors: Xie Zulong , Wang Xuedong , Liu Xinxin , Du Huaan , Sun Changbin , Shao Xin , Tian Jiangtian , Gu Xia , Wang Hailong , Tian Jinwei , Yu Bo 
Published: March 2018

Background

Obesity is causally associated with atherosclerosis, and adipose tissue (
AT
)–derived exosomes may be implicated in the metabolic complications of obesity. However, the precise role of
AT
‐exosomes in atherogenesis remains unclear. We herein aimed to assess the effect of
AT
‐exosomes on macrophage foam cell formation and polarization and subsequent atherosclerosis development.

Methods and Results

Four types of exosomes isolated from the supernatants of ex vivo subcutaneous
AT
and visceral
AT
(
VAT
) explants that were derived from wild‐type mice and high‐fat diet (
HFD
)–induced obese mice were effectively taken up by
RAW
264.7 macrophages. Both treatment with wild‐type
VAT
exosomes and
HFD
‐
VAT
exosomes, but not subcutaneous
AT
exosomes, markedly facilitated macrophage foam cell generation through the downregulation of
ATP
‐binding cassette transporter (
ABCA
1 and
ABCG
1)–mediated cholesterol efflux. Decreased expression of liver X receptor‐α was also observed. Among the 4 types of exosomes, only
HFD
‐
VAT
exosomes significantly induced M1 phenotype transition and proinflammatory cytokine (tumor necrosis factor α and interleukin 6) secretion in
RAW
264.7 macrophages, which was accompanied by increased phosphorylation of
NF
‐κB‐p65 but not the cellular expression of
NF
‐κB‐p65 or
IκB
‐α. Furthermore, systematic intravenous injection of
HFD
‐
VAT
exosomes profoundly exacerbated atherosclerosis in hyperlipidemic apolipoprotein E–deficient mice, as indicated by the M1 marker (
CD
16/32 and inducible nitric oxide synthase)–positive areas and the Oil Red O/Sudan
IV
–stained area, without affecting the plasma lipid profile and body weight.

Conclusions

This study demonstrated a proatherosclerotic role for
HFD
‐
VAT
exosomes, which is exerted by regulating macrophage foam cell formation and polarization, indicating a novel link between
AT
and atherosclerosis in the context of obesity.
Effect of β‐Blockers Beyond 3 Years After Acute Myocardial Infarction
Authors: Park Jin Joo , Kim Sun‐Hwa , Kang Si‐Hyuck , Yoon Chang‐Hwan , Cho Young‐Seok , Youn Tae‐Jin , Chae In‐Ho , Choi Dong‐Ju 
Published: March 2018

Background

The optimal duration of β‐blocker therapy in patients with acute myocardial infarction (
AMI
) is unknown. We aimed to evaluate the late effect of β‐blockers in patients with
AMI
.

Methods and Results

We enrolled all consecutive patients who presented with
AMI
at Seoul National University Bundang Hospital, between June 3, 2003 and February 24, 2015. The primary end point was 5‐year all‐cause mortality, depending on the use of β‐blockers at discharge, 1 year after
AMI
, and 3 years after
AMI
. Of 2592 patients, the prescription rates of β‐blockers were 72%, 69%, 63%, and 60% at discharge and 1, 3, and 5 years after
AMI
, respectively. The patients who were receiving β‐blocker therapy had more favorable clinical characteristics, such as younger age (62 versus 65 years;
P
<0.001). They received reperfusion therapy more often (92% versus 80%;
P
<0.001) than those without β‐blocker prescription. In the univariate analysis, the patients with β‐blocker prescription had lower 5‐year mortality at all time points. In the Cox model after adjustment for significant covariates, β‐blocker prescription at discharge was associated with a 29% reduced mortality risk (hazard ratio, 0.71; 95% confidence interval, 0.55–0.90;
P
=0.006); however, β‐blocker prescriptions at 1 and 3 years after
AMI
were not associated with reduced mortality.

Conclusions

The beneficial effect of β‐blocker therapy after
AMI
may be limited until 1 year after
AMI
. Whether late β‐blocker therapy beyond 1 year after
AMI
offers clinical benefits should be confirmed in further clinical trials.
Combined Angiotensin Receptor–Neprilysin Inhibitors Improve Cardiac and Vascular Function Via Increased NO Bioavailability in Heart Failure
Authors: Trivedi Rishi K. , Polhemus David J. , Li Zhen , Yoo Daniel , Koiwaya Hiroshi , Scarborough Amy , Goodchild Traci T. , Lefer David J. 
Published: March 2018

Background

There is a paucity of data about the mechanisms by which sacubitril/valsartan (also known as LCZ696) improves outcomes in patients with heart failure. Specifically, the effects of sacubitril/valsartan on vascular function and
NO
bioavailability have not been investigated. We hypothesized that sacubitril/valsartan therapy increases circulating
NO
levels and improves vascular function in the setting of heart failure.

Methods and Results

Male spontaneously hypertensive rats underwent myocardial ischemia/reperfusion surgery to induce heart failure and were followed for up to 12 weeks with serial echocardiography. Rats received sacubitril/valsartan (68 mg/kg), valsartan (31 mg/kg), or vehicle starting at 4 weeks after reperfusion. At 8 or 12 weeks of reperfusion, animals were euthanized and tissues were collected for ex vivo analyses of
NO
bioavailability, aortic vascular reactivity, myocardial and vascular histology, and cardiac molecular assays. Left ventricular structure and function were improved by both valsartan and sacubitril/valsartan compared with vehicle. Sacubitril/valsartan resulted in superior cardiovascular benefits, as evidenced by sustained improvements in left ventricular ejection fraction and end‐diastolic pressure. Ex vivo vascular function, as measured by aortic vasorelaxation responses to acetylcholine and sodium nitroprusside, was significantly improved by valsartan and sacubitril/valsartan, with more sustained improvements afforded by sacubitril/valsartan. Furthermore, myocardial
NO
bioavailability was significantly enhanced in animals receiving sacubitril/valsartan therapy.

Conclusions

Sacubitril/valsartan offers superior cardiovascular protection in heart failure and improves vascular function to a greater extent than valsartan alone. Sacubitril/valsartan‐mediated improvements in cardiac and vascular function are likely related to increases in
NO
bioavailability and explain, in part, the benefits beyond angiotensin receptor blockade.
ADP Platelet Hyperreactivity Predicts Cardiovascular Disease in the FHS (Framingham Heart Study)
Authors: Puurunen Marja K. , Hwang Shih‐Jen , Larson Martin G. , Vasan Ramachandran S. , O'Donnell Christopher J. , Tofler Geoffrey , Johnson Andrew D. 
Published: March 2018

Background

Platelet function is associated with adverse events in patients with cardiovascular disease (
CVD
).

Methods and Results

We examined associations of baseline platelet function with incident
CVD
events in the community‐based FHS (Framingham Heart Study). Participants free of prevalent
CVD
and without recent aspirin treatment with available data in the Framingham Offspring cohort (1991–1995) and Omni cohort (1994–1998) were included. Platelet function was measured with light transmission aggregometry using collagen (1.9 μg/mL),
ADP
(0.05–15 μmol/L), and epinephrine (0.01–15 μmol/L). We used proportional hazards models to analyze incident outcomes (myocardial infarction/stroke,
CVD
, and
CVD
mortality) with respect to platelet measures. The study sample included 2831 participants (average age, 54.3 years; 57% women). During follow‐up (median, 20.4 years), we observed 191 composite incident myocardial infarction or stroke events, 432 incident
CVD
cases, and 117
CVD
deaths. Hyperreactivity to
ADP
and platelet aggregation at
ADP
concentration of 1.0 μmol/L were significantly associated with incident myocardial infarction/stroke in a multivariable model (hazard ratio, 1.68 [95% confidence interval, 1.13–2.50] [
P
=0.011] for hyperreactivity across
ADP
doses; and hazard ratio, 1.16 [95% confidence interval, 1.02–1.33] [
P
=0.029] for highest quartile of
ADP
response at 1.0 μmol/L versus others). No association was observed for collagen lag time or any epinephrine measures with incident myocardial infarction or stroke.

Conclusions

Intrinsic hyperreactivity to low‐dose
ADP
in our community‐based sample, who were free of
CVD
and any antiplatelet therapy, is associated with future arterial thrombosis during a 20‐year follow‐up. These findings reinforce
ADP
activation inhibition as a critical treatment paradigm and encourage further study of
ADP
inhibitor‐refractive populations.
Application of Monte Carlo cross-validation to identify pathway cross-talk in neonatal sepsis
Authors: Zhang Yuxia , Liu Cui , Wang Jingna , Li Xingxia 
Published: March 2018

To explore genetic pathway cross-talk in neonates with sepsis, an integrated approach was used in this paper. To explore the potential relationships between differently expressed genes between normal uninfected neonates and neonates with sepsis and pathways, genetic profiling and biologic signaling pathway were first integrated. For different pathways, the score was obtained based upon the genetic expression by quantitatively analyzing the pathway cross-talk. The paired pathways with high cross-talk were identified by random forest classification. The purpose of the work was to find the best pairs of pathways able to discriminate sepsis samples versus normal samples. The results found 10 pairs of pathways, which were probably able to discriminate neonates with sepsis versus normal uninfected neonates. Among them, the best two paired pathways were identified according to analysis of extensive literature.Impact statementTo find the best pairs of pathways able to discriminate sepsis samples versus normal samples, an RF classifier, the DS obtained by DEGs of paired pathways significantly associated, and Monte Carlo cross-validation were applied in this paper. Ten pairs of pathways were probably able to discriminate neonates with sepsis versus normal uninfected neonates. Among them, the best two paired pathways ((7) IL-6 Signaling and Phospholipase C Signaling (PLC); (8) Glucocorticoid Receptor (GR) Signaling and Dendritic Cell Maturation) were identified according to analysis of extensive literature.
Return on investment in blended advanced cardiac life support training compared to face-to-face training in Singapore
Authors: George Pradeep Paul , Ooi Chee Kheong , Leong Edwin , Jarbrink Krister , Car Josip , Lockwood Craig 
Published: March 2018

Background Internet adoption during the past decade has provided opportunities for innovation in advanced cardiac life support (ACLS) training. With pressure on budgets across health care systems, there is a need for more cost-effective solutions. Recently, traditional ACLS training has evolved from passive to active learning technologies. The objective of this study is to compare the cost, cost-savings and return on investment (ROI) of blended ACLS (B-ACLS) and face-to-face ACLS (F-ACLS) in Singapore. Methods: B-ACLS and F-ACLS courses are offered in two training institutes in Singapore. Direct and indirect costs of training were obtained from one of the training providers. ROI was computed using cost-savings over total cost if B-ACLS was used instead of F-ACLS. Results: The estimated annual cost to conduct B-ACLS and F-ACLS were S$43,467 and S$72,793, respectively. Discounted total cost of training over the life of the course (five years) was S$107,960 for B-ACLS and S$280,162 for F-ACLS. Annual productivity loss cost account for 52% and 23% of the costs among the F-ACLS and B-ACLS, respectively. B-ACLS yielded a 160% return on the money invested. There would be 61% savings over the life of the course if B-ACLS were to be used instead of F-ACLS. Conclusion: The B-ACLS course provides significant cost-savings to the provider and a positive ROI. B-ACLS should be more widely adopted as the preferred mode of ACLS training. As a start, physicians looking for reaccreditation of the ACLS training should be encouraged to take B-ACLS instead of F-ACLS.
Do peer support groups have an effect on medication adherence? A study among people living with HIV/AIDS in Enugu State, Nigeria
Authors: Chime Onyinye Hope , Arinze-Onyia Sussan Uzoamaka , Obionu Christopher Ndukife 
Published: March 2018

Background: The health benefits of antiretroviral treatment greatly depend on the extent to which people living with HIV/AIDS adhere to the prescribed daily dosing regimens. Peer support groups are expected to have a high impact on adherence to medication among people living with HIV/AIDS. Objectives: This study was designed to determine factors affecting adherence to medication among people living with HIV/AIDS in peer support and non-support groups attending antiretroviral clinics in Enugu State, Nigeria. Method: This was a cross-sectional, comparative study using qualitative and quantitative instruments among 840 people living with HIV/AIDS attending antiretroviral clinics in Enugu, Nigeria. Quantitative data was analysed using IBM SPSS version 22. A Chi-square test of statistical significance, a student t-test and multivariate analysis using binary logistic regression were used in the analysis. Manual content analysis was done for the qualitative data. Results: The mean age of respondents was comparable in both study groups: support group 38.5±9.6; and non-support group 38.5±10.1. A significantly higher proportion of respondents in the support group (91.9%) achieved good adherence compared with those in the non-support group (87.1%). A good medication adherence self-rating was a predictor of adherence in both study groups: support group (AOR 5.8, 95% CI: 2.7–12.2, p=<0.001) and non-support group (AOR 0.2, 95% CI: 0.1–0.4, p=<0.001). Conclusion: The peer-based intervention is a viable and effective tool for maintaining optimal adherence among people living with HIV/AIDS in resource-limited settings; hence, research should concentrate on interventions that do not focus on individuals alone, but rather on those that strengthen the capacity of groups to collectively participate in HIV programmes.
The development of an outcome measure for liaison mental health services
Authors: Guthrie Else , Harrison Mathew , Brown Richard , Sandhu Rajdeep , Trigwell Peter , Abraham Seri , Nawaz Shazada , Kelsall Peter , Thomasson Rachel 
Published: March 2018

Aims and methodTo develop and pilot a clinician-rated outcome scale to evaluate symptomatic outcomes in liaison psychiatry services. Three hundred and sixty patient contacts with 207 separate individuals were rated using six subscales (mood, psychosis, cognition, substance misuse, mind–body problems and behavioural disturbance) plus two additional items (side-effects of medication and capacity to consent for medical treatment). Each item was rated on a five-point scale from 0 to 5 (nil, mild, moderate, severe and very severe).ResultsThe liaison outcome measure was acceptable and easy to use. All subscales showed acceptable interrater reliability, with the exception of the mind–body subscale. Overall, the measure appears to show stability and sensitivity to change.Clinical implicationsThe measure provides a useful and robust way to determine symptomatic change in a liaison mental health setting, although the mind–body subscale requires modification.Declaration of interestNone.