bluuebunny/crossref_metadata_2025_split huggingface dataset:
Higher frequency of the CTLA‐4+LAG‐3+ T‐cell subset in patients with newly diagnosed acute myeloid leukemia
Authors: Chen Youchun , Tan Jiaxiong , Huang Shuxin , Huang Xin , Huang Jingying , Chen Jie , Yu Zhi , Lu Yuhong , Weng Jianyu , Du Xin , Li Yangqiu , Zha Xianfeng , Chen Shaohua 
Published: October 2019

AbstractAimImmune suppression based on alternative regulation of immune checkpoint proteins, for example, programmed cell death receptor‐1 (PD‐1) and cytotoxic T lymphocyte–associated molecule‐4 (CTLA‐4), which results in T‐cell exhaustion, contributes to cancer development and progression. In this study, we sought to characterize the distribution of CTLA‐4 and T‐cell lymphocyte activation gene‐3 (LAG‐3) expression on exhausted T cells in different T‐cell subsets from patients with acute myeloid leukemia (AML).MethodsThe coexpression of CTLA‐4 and LAG‐3 on exhausted CD244+ and CD57+ T cells from the CD3+, CD4+, and CD8+ T‐cell subsets in peripheral blood from 12 patients with newly diagnosed AML was analyzed by multicolor flow cytometry assay.ResultsA significantly higher percentage of CTLA‐4+CD3+, CD4+ and CD8+ T cells was found in patients with AML. In addition, higher numbers of both CTLA‐4+CD244+ and CTLA‐4+CD57+CD3+ T cells were detected. Interestingly, the increased CTLA‐4+CD244+ T cells were predominantly CD4+ T cells. In contrast, the increased CTLA‐4+CD57+ T cells primarily consisted of the CD8+ T‐cell subset. A high proportion of LAG‐3+ T cells was found in only a few cases with AML; however, a significantly higher proportion of coexpression of CTLA‐4 and LAG‐3 in the CD3+ and CD8+ T‐cell subsets was detected.ConclusionWe for the first time observed higher CTLA‐4+CD244+CD4+, CTLA‐4+CD57+CD8+, CTLA‐4+LAG‐3+CD3+ and CTLA‐4+LAG‐3+CD8+ T cells in patients with AML, whereas the upregulated expression of LAG‐3 on T cells was only found in a subset of the cases. These data may provide further information by complementing the heterogeneity of immune checkpoints expression in AML.
Faecal microbiota transplant decreases mortality in severe and fulminant Clostridioides difficile infection in critically ill patients
Authors: Tixier Emily N. , Verheyen Elijah , Ungaro Ryan C. , Grinspan Ari M. 
Published: October 2019

SummaryBackgroundSevere and fulminant Clostridioides difficile infection is associated with high mortality rates. While faecal microbiota transplant has been shown to be effective for recurrent C difficile infection, there is little data on the utility of faecal microbiota transplant in severe or fulminant C difficile infection.AimTo compare the outcomes of antibiotics and faecal microbiota transplantation vs antibiotics alone (standard of care) in critically ill patients with severe or fulminant C difficile infection.MethodsThis was a retrospective, matched cohort study in one urban tertiary academic care centre including 48 patients hospitalised with severe or fulminant C difficile infection who required care in intensive care unit.ResultsPatients who received faecal microbiota transplantation (n = 16) had a 77% decrease in odds for mortality (OR 0.23, 95% CI 0.06‐0.97) with a number needed to treat of 3 to prevent one death.ConclusionsFaecal microbiota transplantation provides mortality benefit over standard of care for severe and fulminant C difficile infection and should be considered in critically ill patients.
Induction of labor versus expectant management after successful external cephalic version
Authors: Barbash‐Hazan Shiri , Nattiv Noga , Salzer‐Sheelo Liat , Bergel Riki , Hadar Eran , Osovsky Micky , Shmueli Anat 
Published: October 2019

AbstractBackgroundExternal cephalic version (ECV) is a common procedure for women carrying a breech‐presenting fetus, in an effort to avoid a cesarean birth. The benefit of immediate labor induction after ECV vs. expectant management is undetermined. We aimed to evaluate whether induction of labor immediately after a successful ECV improves the chances of a vaginal delivery compared with expectant management.MethodsRetrospective analysis of 296 women who underwent successful ECV performed in term singleton gestations (2007‐2018) in the Rabin Medical Center. Mode of delivery and other obstetrical and neonatal outcomes were compared between women undergoing immediate labor induction after ECV and those managed expectantly.ResultsOf 296 women after successful ECVs, 54 (18.2%) underwent immediate labor induction and 242 (81.8%) were managed expectantly. Immediate induction was associated with higher parity (2.4 vs 1.7, P = .03) and lower mean birthweight (3128 vs 3346 g, P < .01). Mode of delivery was similar between groups, and no other significant differences in obstetrical and neonatal adverse outcomes were noted.DiscussionIn our cohort, immediate labor induction after successful ECV apparently had no benefits in terms of obstetrical or neonatal complications, and did not reduce the risk of cesarean birth. Therefore, expectant management seems reasonable and safe.
Ultra‐hypofractionated radiation therapy for unfavourable intermediate‐risk and high‐risk prostate cancer is safe and effective: 5‐year outcomes of a phase II trial
Authors: Macias Victor A. , Barrera‐Mellado Inmaculada 
Published: October 2019

ObjectivesTo report toxicity (primary endpoint) and biochemical disease‐free survival (BDFS) outcomes of a phase II trial evaluating ultra‐hypofractionated radiation therapy (UHRT), focusing on patients with unfavourable intermediate‐risk and high‐risk prostate cancer (PCa).Patients and MethodsFrom 2012 to 2017, 154 patients (92 with unfavourable intermediate‐risk or high‐risk PCa) were treated with helical TomoTherapy delivering 43.8–45.2 Gy in eight fractions over 3 weeks. Of these, 73% received hormonotherapy (51% neoadjuvant).ResultsThe median (range) follow‐up was 48 (19–84) months. For the whole series, crude BDFS and 5‐year BDFS rates were 97.4% and 94.3%, respectively. The corresponding figures for unfavourable intermediate‐risk and high‐risk PCa were 96.7% and 90%, respectively. The crude metastasis‐free survival rate was 98% for the unfavourable intermediate‐risk and high‐risk group. For the whole series, the 5‐year cumulative urinary/intestinal grade 2+ late toxicity was 17.8/7.4%. No grade 4–5 toxicity was observed. One patient experienced late grade 3 toxicity (urinary).ConclusionThis eight‐fraction UHRT regimen can be safely delivered to patients with unfavourable intermediate‐risk/high‐risk PCa. Its relapse rates are similar to those reported for the combination of external beam radiotherapy plus brachytherapy, however, the observed toxicity profile is milder. The disease survival rates compare favourably with historical controls in some other forms of radiotherapy, with similar side effects. Since the low rate of biochemical/metastasis relapse is encouraging, further research to confirm these results is justified.
Clinician perspectives on the use of National Institute for Health and Care Excellence guidelines for the process of transition in Attention Deficit Hyperactivity Disorder
Authors: Eke Helen , Janssens Astrid , Newlove‐Delgado Tamsin , Paul Moli , Price Anna , Young Susan , Ford Tamsin 
Published: October 2019

AbstractBackgroundThe UK National Institute for Health and Care Excellence (NICE) clinical guidelines recommends the following steps in the transition from child to adult services for young people with attention deficit hyperactivity disorder (ADHD): reassessment before and after transition, transition planning, formal meeting between services, and involvement from young person and carer, completed by age 18.MethodsA UK surveillance study asked clinicians to report young people on their caseloads with ADHD in need of transition to adult services in 2016 to support their continued access to medication need. Clinicians reported young people as they aged to within 6 months of the transition boundary, a prospective questionnaire prior to transition asked about intended transition and the use of local transition protocols. A retrospective questionnaire sent 9 months later established which steps recommended by NICE were followed during transition. Clinicians (38) working in child or adult services were interviewed about their experiences of transition and the use of NICE guidelines during transition and were analysed using a framework approach.ResultsInformation was shared between services in 85% of the 315 identified transition cases. A joint meeting was planned in 16% of cases; joint working before transfer occurred in 10% of cases. Clinicians were aware of NICE guidelines; they had mixed views on whether (local) guidelines or protocols were helpful. The main reason for not following guidelines was workload and resources: “NICE recommends stuff that is miles above what we will ever be able to provide”.ConclusionsClinicians involved in the transition process of young people with ADHD judged NICE guidelines to be unrealistic given the current limited resources and service organization. More open dialogue is needed for recommendations on service models to bridge the gap between guideline recommendations and what is viewed as feasible and how implementation of guidance is funded, monitored, and prioritized. This may lead to valuable changes in the consultation process, for example, consideration of a layered (gold, standard, and minimal) system for some NICE guidelines.
Fracture rate in women with oestrogen deficiency – Comparison of Turner syndrome and premature ovarian insufficiency
Authors: Cardona Attard Carol , Cameron‐Pimblett Antoinette , Puri Davina , Elliot Jessica , Wilson Jack C. , Talaulikar Vikram S. , Davies Melanie C. , Conway Gerard S. 
Published: October 2019

AbstractObjectiveWomen with early‐onset oestrogen deficiency are at risk of reduced bone mineral density (BMD). We sought to assess fracture history and BMD in women with Turner syndrome (TS) and premature ovarian insufficiency (POI).DesignA cross‐sectional observational study.PatientsTwo hundred and sixty seven women with TS (median age 34.3 years) and 67 women with POI (median age 28.1 years).MeasurementsA questionnaire was used to collect data on fracture history, co‐morbidities and drug history including age at first oestrogen exposure. Clinical data included height, weight, serum vitamin D and hip and spine T‐scores, which were adjusted for height and age. Fractures were subdivided into major osteoporotic fractures (MOF) and ‘other’ fracture types.ResultsOverall fracture rate was similar in women with TS and POI (82 [30.5%] vs 22 [32.8%] respectively, P = .74). Compared to women with POI, those with TS had more fractures at MOF sites (30.2% vs 52.7%, P = .012) and fewer phalangeal fractures (27.9% vs 9.8%, P = .005). There was no difference in BMD between women who sustained a fracture compared to those who did not. Women with TS who fractured were more likely to suffer from hearing impairment compared to those with no fracture (62.2% vs 48.1%, P = .045).ConclusionsTS is not associated with an overall excess risk of bone fracture. The higher rate of fractures at MOF sites in women with TS may be secondary to hearing impairment, thin cortical bone and abnormal bone remodelling.
“We Made a Contribution to the Revolution”: Shifting Scales of Politics and Unity in Ukraine
Authors: Channell‐Justice Emily S. 
Published: October 2019

AbstractBased on ethnographic and interview data from the 2013‐2014 Euromaidan mobilizations in Ukraine, I use the example of the “secondary city” of Cherkasy to show that protest participants used shifting scales to participate in the protests in Cherkasy and in the capital city of Kyiv. This participation showed national unity across Ukraine at the same time that it refocused Cherkasy residents’ attention to local political issues. These processes call into question protesters’ definitions of Europe, democracy, and national identity, all contested across Ukraine during Euromaidan. This article argues for greater attention to secondary cities in the context of mass mobilization, as local instances of protest participation redefined notions of community at multiple scales.
TLE1 expression fails to distinguish between synovial sarcoma, atypical fibroxanthoma, and dermatofibrosarcoma protuberans
Authors: Pukhalskaya Tatsiana , Smoller Bruce R. 
Published: October 2019

AbstractTransducin‐like enhancer of split 1 (TLE1) belongs to the Groucho/TLE/Grg family. It functions as a transcriptional corepressor and is widely used as a biomarker of synovial sarcoma (SS). Within the skin, atypical fibroxanthoma (AFX) and dermatofibrosarcoma protuberans (DFSP) often enter the histopathologic differential diagnosis. TLE1 expression has not been evaluated in these neoplasms. We examined archived tissues sections from the surgical pathology files from 10 adult patients diagnosed with AFX and 10 adult patients diagnosed with DFSP. We found nuclear staining in 10 of 10 AFX and 2 of 10 DFSP. We also noticed three patterns of staining in AFX: predominantly spindle component, predominantly epithelioid component, or mixed pattern of both epithelioid and spindle components. The group with the predominantly spindle pattern expressed the strongest nuclear TLE1 staining. In the DFSP group, one lesion demonstrated staining of epithelioid cells, with strong, diffuse nuclear TLE 1 expression, and the second lesion stained only the spindled cells, with weak nuclear TLE1 marking. In conclusion, TLE1, while a sensitive marker for SS, is not specific. A wide range of cutaneous spindle cell neoplasms also express TLE1. AFX and DFSP should be added to this list. TLE1 might be added to a diagnostic panel in this differential diagnosis.
Habitat type drives the distribution of non‐indigenous species in fouling communities regardless of associated maritime traffic
Authors: Leclerc Jean‐Charles , Viard Frédérique , González Sepúlveda Elizabeth , Díaz Christian , Neira Hinojosa José , Pérez Araneda Karla , Silva Francisco , Brante Antonio 
Published: October 2019

AbstractAimBiological invasions and changes in land and sea use are among the five major causes of global biodiversity decline. Shipping and ocean sprawl (multiplication of artificial structures at the expense of natural habitats) are considered as the major forces responsible for marine invasions and biotic homogenization. And yet, there is little evidence of their interplay at multiple spatial scales. Here, we aimed to examine this interaction and the extent to which the type of artificial habitat alters the distribution of native and non‐indigenous biodiversity.LocationSoutheast Pacific—Central Chilean coastline.MethodsSettlement plates were deployed upon two types of artificial habitats (floating and non‐floating hard substrates) at a total of ten study sites, exposed to either international or local traffic. After colonization periods of 3 and 13 months, plates were retrieved to determine their associated fouling sessile assemblages at an early and late stage of development, respectively. Putative confounding factors (temperature, metal concentrations) were taken into account.ResultsWhile traffic type had no detectable effect, there were strong differences in community structure between habitats, consistent across the study region. These differences were driven by non‐indigenous species which contributed to 58% and 40% of the community structure in floating habitats after 3 and 13 months, respectively—roughly 10 times greater than in their non‐floating counterparts. Assemblages on floating structures also displayed a lower decline in similarity with increasing distance between sampling units, being thus more homogenous than non‐floating habitats at the regional scale.Main conclusionsWith the absence of international traffic effect, the colonization success by non‐indigenous species appears to be mainly habitat‐dependent and driven by local propagules. Floating structures not only provide specific niches but characteristics shared with major introduction and dispersal vectors (notably hulls), and in turn constitute important corridors to invasions and drivers of biotic homogenization at multiple scales.
Novel model‐based clustering reveals ecologically differentiated bacterial genomes across a large climate gradient
Authors: Simonsen Anna K. , Barrett Luke G. , Thrall Peter H. , Prober Suzanne M. 
Published: October 2019

AbstractA pervasive challenge in microbial ecology is understanding the genetic level where ecological units can be differentiated. Ecological differentiation often occurs at fine genomic levels, yet it is unclear how to utilise ecological information to define ecotypes given the breadth of environmental variation among microbial taxa. Here, we present an analytical framework that infers clusters along genome‐based microbial phylogenies according to shared environmental responses. The advantage of our approach is the ability to identify genomic clusters that best fit complex environmental information whilst characterising cluster niches through model predictions. We apply our method to determine climate‐associated ecotypes in populations of nitrogen‐fixing symbionts using whole genomes, explicitly sampled to detect climate differentiation across a heterogeneous landscape. Although soil and plant host characteristics strongly influence distribution patterns of inferred ecotypes, our flexible statistical method enabled us to identify climate‐associated genomic clusters using environmental data, providing solid support for ecological specialisation in soil symbionts.
Extremely divergent host plant acceptance with gene flow between sympatric host races of the phytophagous ladybird beetle Henosepilachna diekei
Authors: Matsubayashi Kei W. , Kahono Sih , Hartini Sri , Katakura Haruo 
Published: October 2019

AbstractEcological divergence alone can prevent the majority of gene flow in the absence of other forms of reproductive isolation. Although the importance of ecological divergence in promoting reproductive isolation has been broadly recognized, its net impact on speciation has rarely been estimated in the wild. The phytophagous ladybird beetle Henosepilachna diekei Jadwiszczak & Wegrzynowicz includes two sympatric host races that are reproductively isolated solely by extreme specialization to either of the host plants Mikania micrantha Kunth (Asteraceae) or Leucas lavandulifolia Sm. (Lamiaceae) in West Java, Indonesia. To investigate the impact of differential host use as an isolating barrier, we carried out adult host acceptance tests and molecular population genetic analyses based on mitochondrial ND2 and nucleic ITS2 gene sequences using 13 wild populations of the host races, including four sympatric population pairs. Almost all individuals of these host races persistently accepted only the original host plant. We detected restricted but a degree of gene flow between these host races. A migration event occurred only in very recent time compared to their divergence time, indicating recent secondary contact of these host races in the surveyed area. These results reveal the remarkably large impact of host‐plant shift over almost the entire process of speciation and illustrate that ecological divergence has been maintained even under the presence of a certain degree of gene flow.
Generalized quasiperiodic epileptiform activity in sleep is associated with cognitive impairment in children with drug‐resistant focal lesional epilepsy
Authors: Novak Vilem , Maulisova Alice , Jezdik Petr , Benova Barbora , Belohlavkova Anezka , Liby Petr , Tichy Michal , Krsek Pavel 
Published: October 2019

AbstractObjectiveTo evaluate the impact of generalized quasiperiodic epileptiform discharges (“hurdles”) observed in non–rapid eye movement (NREM) sleep on cognitive function in children with intractable focal epilepsy. “Hurdles” pattern does not meet the criteria of the electrical status epilepticus in slow‐wave sleep (ESES).MethodsIn a retrospective analysis, 24 patients with “hurdles” and their 24 peers matched for demographic and epilepsy‐related variables were compared in terms of neuropsychological domains and electroencephalography (EEG)–derived quantifiers. Both “hurdles” and controls were children between 2 and 19 years of age who had intractable focal epilepsy evaluated as candidates of resective epilepsy surgery.ResultsFull‐scale intelligence quotient/developmental quotient (FSIQ/DQ) (P = .002) and visuoconstructional skills (P = .004) were significantly lower in children with “hurdles” compared to controls. Patients with “hurdles” presented with higher interictal spike indexes in sleep (P < .001, median difference −0.9, 95% confidence interval [CI] −1.4, −0.6) and wakefulness (P < .001, median difference −0.3, 95% CI −0.5, −1). Relative time of sleep spindles in NREM sleep was significantly reduced (P < .001, median difference 0.1, 95% CI 0.0, 0.1) in the “hurdles” group. The time proportion of sleep spindles represented a significant positive (P = .008) and spike index of generalized spikes in sleep a significant negative explanatory variable (P = .004) of FSIQ/DQ scores. The proportion of seizure‐free patients 2 years after epilepsy surgery did not differ significantly between the two groups (P = .19).SignificanceAlthough the “hurdles” pattern does not fulfill the criteria of ESES, it is associated with a pronounced cognitive dysfunction. Disturbed sleep structure marked by reduced sleep spindles and generalized spiking in sleep is associated with worse cognitive performance. Despite having a generalized nature, we did not find a lower probability of postsurgical seizure freedom in patients with “hurdles” pattern.
A score to map the lateral nonprimary motor area: Multispectrum intrinsic brain activity versus cortical stimulation
Authors: Neshige Shuichiro , Kobayashi Katsuya , Matsuhashi Masao , Togo Masaya , Sakamoto Mitsuhiro , Shimotake Akihiro , Hitomi Takefumi , Kikuchi Takayuki , Yoshida Kazumichi , Kunieda Takeharu , Matsumoto Riki , Maruyama Hirofumi , Takahashi Ryosuke , Miyamoto Susumu , Ikeda Akio 
Published: October 2019

AbstractObjectiveMultispectrum electrocorticographic components are critical for mapping the nonprimary motor area (NPMA). The objective of this study was to derive and validate a reliable scoring system for electrocorticography‐based NPMA mapping (NPMA score) to replace electrical cortical stimulation (ECS) during brain surgery.MethodsWe analyzed 14 consecutive epilepsy patients with subdural electrodes implanted in the frontal lobe at Kyoto University Hospital. The NPMA score was retrospectively derived from multivariate analysis in the derivation group (patients = 7, electrodes = 713, during 2010‐2013) and validated in the validation group (patients = 7, electrodes = 772, during 2014‐2017). We assessed the accuracy and reliability of the score relative to ECS in determining the NPMA and predicting postoperative functional outcomes.ResultsMultivariate analysis in the derivation group led to an 8‐point score for predicting ECS‐based NPMA (1 point for anatomical localization of the electrode and 1 or 2 points for movement‐related electrocorticographic components regardless of somatotopy in very slow cortical potential shifts [<0.5 Hz], 40‐80–Hz band power increase, and 8‐24–Hz band power decrease), which was validated in the validation group. The area under the receiver operating characteristic curve (AUC) was 0.89 in the derivation group. Good prediction (specificity = 94%, sensitivity = 100%) and discrimination (AUC = 0.87) were reproduced in the validation group. Overall, higher NPMA scores identified 2 patients with postoperative deficits after frontal lobe resection.SignificanceThe NPMA score is reliable for NPMA mapping, potentially replacing ECS. It is a potential prognostic marker for postoperative functional deficits.