bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dose‐intensified bendamustine and melphalan (BenMel) conditioning before second autologous transplantation in myeloma patients
Authors: Farag Sarah , Jeker Barbara , Bacher Ulrike , Mansouri Taleghani Behrouz , Mueller Beatrice U. , Novak Urban , Pabst Thomas 
Published: August 2018

AbstractConsolidation in myeloma patients with high‐dose melphalan chemotherapy (Mel HDCT) and autologous transplantation (ASCT) is standard of care since more than 2 decades. However, definite cure remains exceptional despite intensive treatment, and improving effectiveness of HDCT remains an unmet clinical need. Combining intensified bendamustine with melphalan may represent an option. We analyzed safety and efficacy of combining dose‐intensified bendamustine (200 mg/m2 on days −4/−3) with high‐dose melphalan (100 mg/m2 on days −2/−1) before a second (tandem) ASCT in adverse risk myeloma patients after Mel HDCT/ASCT1. Twelve patients received BenMel conditioning before ASCT2 because of high‐risk cytogenetics and/or failure to achieve complete remission (CR) after Mel HDCT/ASCT1. Comparing Mel HDCT/ASCT1 and BenMel HDCT/ASCT2, we observed no differences in hematologic recovery and tolerance. Acute renal injury after BenMel conditioning occurred in 3 (25%) patients, but was reversible in all patients, and there were no treatment related deaths. Complete remission rates were increasing from 42% after Mel/ASCT1 to 75% after BenMel/ASCT2. PFS 1 year after ASCT2 was 67%, and OS was 83%. These data suggest that dose‐intensified bendamustine with melphalan conditioning is safe and warrants a prospective randomized comparison to standard melphalan HDCT in myeloma patients.
International variations in trust in health care systems
Authors: Zhao Dahai , Zhao Hongyu , Cleary Paul D. 
Published: August 2018

SummaryPublic trust in health care systems has been measured in many countries, but there have been few studies of the intercountry variability in trust, or the degree to which such variability is because of population or structural characteristics.We used data from the health care survey conducted by the International Social Survey Program from 2011 to 2013 in 31 countries to assess whether intercountry variability was significantly greater than intracountry variability using general linear models in which country was treated as a fixed factor. We also assessed the extent to which intercountry variability was because of respondent and economic circumstances (gross national income per capita).Public trust in the health care system varied significantly across countries (P < .001), even after adjustment for 8 within‐country predictors and gross national income per capita. One of the strongest predictors of trust was the respondents' most recent health care experience. Higher respondent education, urban residence, and a lower country's gross national income predicted less trust in the health care system.After countries with the 10% highest health expenditures per capita (United States) and the 10% lowest health care expenditures per capita (China and the Philippines) were removed, public trust in the health care system was positively associated with the remaining countries' health care expenditures per capita (Pearson correlation coefficient, 0.490; P = .008) and gross national income per capita (Pearson correlation coefficient, 0.495; P = .007).There is significant variation in public trust in health care across the countries studied. The intercountry differences are due, in part to economic circumstances.
Success factors for universal access to antiretroviral treatments in South Africa
Authors: Guillon Marlène 
Published: August 2018

SummaryThis article studies the epidemiological and economic impacts of a universal testing and treatment policy of Human Immunodeficiency Virus (HIV) in South Africa. A model of disease transmission is built to simulate several implementation scenarios of the policy. Different behavioral responses in the general population are considered. The results show that the success of a large‐scale HIV testing and treatment program in South Africa depends on its implementation conditions. The policy can lead to a reduction of the HIV epidemic, even in the case of a large relapse in preventive behaviors in the general population, if implementation conditions are favorable. This is the case if the number of infected individuals who are infectious is greatly reduced. From an economic point of view, taking into account the positive externality of antiretroviral (ARV) treatments changes the traditional framework of cost–benefit analyses. A large‐scale testing and treatment program would be cost‐saving in the case of favorable implementation conditions, even following a large increase in risk behaviors after the scaling up of ARV treatments. By contrast, the analysis stresses out the potential perverse effects of scaling up ARV treatments in South Africa if the intervention is set up without ensuring enough resources for patients' monitoring and the availability of effective ARV drugs. Indeed, if the number of treated patients rises while adherence of patients to treatments decreases and the rate of loss to follow‐up increases, the policy could extend the pool of infectious patients and lead to a long‐term amplification of the epidemic.
The effect of the latest health care reforms on the quality of community health services in China
Authors: Gong Yanhong , Xu Juan , Chen Ting , Sun Na , Lu Zuxun , Yin Xiaoxv 
Published: August 2018

SummaryThe Chinese government initiated a new round health care reform in 2009 to provide universal primary health care to the country's population. The aim of this study was to evaluate and compare the quality of community health services before and after the latest health care reforms in China. A series of nationwide surveys were conducted in 2008 and in 2011to assess the development of the community health services. A total of 2274 and 2501 community health centers, 38 200 and 42 200 prescriptions, and 12 163 and 12 386 outpatients visited community health centers (CHCs) were investigated in 2008 and in 2011, respectively. Multivariable regressions and Kruskal‐Wallis tests were applied to analyze the differences before and after health care reforms. Quality of community health services has been improved significantly at the first stage of health care reforms in China. CHCs were larger and better equipped after health care reforms in terms of average building area and average number of medical equipment. Patient satisfaction increased, and patient payments per visit decreased after health care reforms. But there was no significant improvement in health human resource, and overuse of injections remains prevalent, pointing to the need for further reforms to improve quality of community health services, such as general practitioner cultivation and supervision over prescribing behaviors.
Comparing costs of a senior wellness care redesign in group and independent physician practices of an accountable care organization
Authors: Bustamante Arturo Vargas , Martinez Ana , Rich Jeremy , Chen Xiao , Rodriguez Hector P. 
Published: August 2018

SummaryPrimary care redesign for older adult patients is currently ongoing in countries with aging populations. One of the main challenges of this type of transformations is how to estimate implementation costs in different types of health care delivery organizations. This study compares start‐up and incremental expenses of implementing a primary care redesign across 2 organization types: integrated group (n = 31) practices and independent practice association (IPA) sites (n = 213). Administrators involved with implementing the redesign completed a cost capture template to quantifying expenses. The potential impact of measurement error, recollection bias, and implementation models across sites and geographic regions was examined in sensitivity analyses. Marginal start‐up and incremental expenses were higher for Group sites ($122‐$328) compared to IPA sites ($31‐$227). Group and IPA sites, however, implemented the redesign with different intensities. According to our analyses, if IPA sites implemented the redesign with the same intensity as Group sites, marginal costs would have been $5 to $13 higher for IPA sites than for Group sites. This study shows how a flexible approach to estimate the cost of a wellness care redesign is needed when the intensity of the transformation differs across 2 different types of health care organizations.
Extremely stable high molecular mass soluble multiprotein complex from eggs of sea urchin Strongylocentrotus intermedius with phosphatase activity
Authors: Soboleva Svetlana E. , Burkova Evgeniya E. , Dmitrenok Pavel S. , Bulgakov Dmitrii V. , Menzorova Natalia I. , Buneva Valentina N. , Nevinsky Georgy A. 
Published: August 2018

AbstractIt was proposed that most biological processes are performed by different protein complexes. In contrast to individual proteins and enzymes, their complexes usually have other biological functions, and their formation may be important system process for the expansion of diversity and biological functions of different molecules. Identification and characterization of embryonic components including proteins and their multiprotein complexes seem to be very important for an understanding of embryo function. We have isolated and analyzed for the first time a very stable multiprotein complex (SPC; approximately 1100 kDa) from the soluble fraction of extracts of the sea urchin embryos. By fast protein liquid chromatography (FPLC) gel filtration the SPC was well separated from other extract proteins. Stable multiprotein complex is stable in different drastic conditions but dissociates moderately in the presence of 8M urea + 1.0M NaCl. According to sodium dodecyl sulfate polyacrylamide gel electrophoresis data, this complex contains many major, moderate and minor proteins with molecular masses from 10 to 95 kDa. The SPC was destroyed by 8M urea or SDS, and its components were separated using thin layer chromatography, ion‐exchange chromatography, gel filtration, and reverse phase chromatography. Using matrix‐assisted laser desorption/ionization mass spectrometry of partially dissociated SPC, it was shown that the complex contains not only proteins (10‐95 kDa) but also few dozens of peptides with molecular masses from 2 to 9.5 kDa. Short peptides form very strong complexes, which at the treatment of SPC with urea or SDS can be partially break down into smaller complexes having different peptide compositions. Reverse phase chromatography of these complexes after all type of abovementioned chromatographies led to detection from 6 to 11 distinct peaks corresponding to new complexes containing up to a few dozens of peptides. The SPCs possess alkaline phosphatase activity. Progress in the study of embryos protein complexes can help to understand their biological functions.
A built‐in surface‐enhanced Raman scattering‐active microneedle for sampling in vivo and surface‐enhanced Raman scattering detection ex vivo of NO
Authors: Han Shuyan , Sun Jie , Wang Jieyu , Qian Weiping , Dong Jian 
Published: August 2018

AbstractFor sampling in vivo and surface‐enhanced Raman scattering (SERS) detection ex vivo, a built‐in SERS‐active microneedle is fabricated by adsorbing gold nanoshells (GNSs; as built‐in SERS‐active materials) in a corroded groove on an acupuncture needle. 3,4‐diaminobenzene‐thiol adsorbed on the GNSs is used as a selective SERS probe to detect nitric oxide (NO). The SERS‐active microneedles take SERS probes into the tissues of living mice with minimal invasion to react with NO selectively and then they are pulled out for direct and rapid SERS detection without any pretreatment steps or tedious operations. The built‐in SERS‐active microneedle would become a versatile platform for sampling in vivo and SERS detection ex vivo, taking SERS beyond culture cells to living animals.
Predictors of survival after resection of primary sarcomas of the chest wall—A large, single‐institution series
Authors: Shewale Jitesh B. , Mitchell Kyle G. , Nelson David B. , Conley Anthony P. , Rice David C. , Antonoff Mara B. , Hofstetter Wayne L. , Walsh Garrett L. , Swisher Stephen G. , Roth Jack A. , Mehran Reza J. , Vaporciyan Ara A. , Weissferdt Annikka , Sepesi Boris 
Published: August 2018

Background and ObjectivesChest wall sarcomas are rare and may demonstrate heterogeneous features. Surgery remains the mainstay of treatment with chemotherapy and radiotherapy used as adjuncts. Herein, we report outcomes of a large cohort of patients with primary chest wall sarcoma who underwent resection.MethodsRecords of 121 patients who underwent resection for primary chest wall sarcoma between 1998 and 2013 were reviewed. A thoracic pathologist reexamined all tumors and categorized them according to grade. Univariable and multivariable Cox analyses were conducted to identify predictors of overall survival (OS).ResultsThe median age was 45.0 (range, 11‐81) years, and most tumors (63.6%, 77) were high grade. The median tumor size was 7 cm (range, 1‐21 cm). Fifty‐nine (48.8%) patients received neoadjuvant chemotherapy and 12 (9.9%) received neoadjuvant radiotherapy. A complete resection was achieved in 103 (85.1%) patients. Neoadjuvant chemotherapy (P = 0.532) and radiation (
P = 1.000) were not associated with a complete resection. Five‐year OS among patients undergoing R0 and R1 resections was 61.9% and 27.8%, respectively. Multivariable analysis identified high grade (HR, 15.21; CI, 3.57‐64.87; P < 0.001), R1 (HR, 3.10; CI, 1.40‐6.86;
P = 0.005), R2 resection (HR, 5.18; CI, 1.91‐14.01; P = 0.001), and age (HR, 1.02; CI, 1.01‐1.03;
P = 0.002) as predictors of OS.ConclusionsIn this series of resected chest wall sarcomas, complete resection and tumor grade remain the most important survival predictors. Individual decisions are required for the utilization of neoadjuvant therapy.
Effect of hydrological variability on the biogeochemistry of estuaries across a regional climatic gradient
Authors: Montagna Paul A. , Hu Xinping , Palmer Terence A. , Wetz Michael 
Published: August 2018

AbstractGiven projected changes in river flow to coastal regions worldwide due to climate change and increasing human freshwater demands, it is necessary to determine the role hydrology plays in regulating the biogeochemistry of estuaries. A climatic gradient exists along the Texas coast where freshwater inflow balance ranges from hydrologically positive to negative (where evaporation exceeds inflow) within a narrow latitudinal band, providing a natural experiment for examining inflow effects. Four Texas estuaries ranging from mesosaline to hypersaline were studied for 3 yr to determine how hydrological changes alter the biogeochemistry within and among the estuaries. Trends in dissolved inorganic nutrients, chlorophyll, dissolved organic matter, and carbonate chemistry indicated that these estuaries had drastically different biogeochemical signatures. Nutrients and chlorophyll patterns illustrated an emerging paradigm where phytoplankton biomass in positive estuaries is supported by “new” nitrogen from riverine input, while high concentrations of reduced nitrogen (organic, ammonium) allowed for high chlorophyll in the negative estuary. For carbonate chemistry, a positive estuary receiving river input from a limestone‐dominated watershed was well‐buffered under moderate to high freshwater inflow conditions. When weathering products were diluted during high‐flow conditions, there is carbonate undersaturation (for aragonite) and decreases in pH. However, “acidification” was not observed in the negative estuary because evaporation concentrated the dissolved species and increased buffering capacity. Hydrological changes over spatial gradients are analogous to climatic changes over time, meaning climate change forecasts of higher temperatures and decreased precipitation can make the biogeochemistry of fresher estuaries change to the patterns of saltier estuaries.
How to use the Pelvic Organ Prolapse Quantification (POP‐Q) system?
Authors: Madhu Chendrimada , Swift Steven , Moloney‐Geany Sophie , Drake Marcus J. 
Published: August 2018

AimsTo set out the basic description of pelvic organ prolapse (POP) using the International Continence Society/International Urogynecology Association Pelvic Organ Prolapse Quantification (POP‐Q) system.MethodsThe basic approach to use of the POP‐Q was identified and summarized.ResultsSix defined points in the vagina are identified; points Aa and Ba for the anterior vagina, Ap and Bp for the posterior vagina, and C and D for the cervix/vault. Point D is not used in women who previously had a hysterectomy. The patient is asked to strain, ideally when in the standing position, to elicit the POP to its maximum extent. The location of the defined points is then gauged relative to the hymenal ring and recorded on a grid. Three additional measurements are taken to achieve a full description; the genital hiatus length, perineal body length, and total vaginal length. Staging a POP relies on identifying the lowest extent of any part of the six defined points; if any point reaches close to the hymenal ring (at least stage 2), the prolapse is usually symptomatic.ConclusionsThe POP‐Q system is readily cataloged and offers detailed description of considerable benefit in clinical practice and research.
Asymptotic convergence of the parallel full approximation scheme in space and time for linear problems
Authors: Bolten Matthias , Moser Dieter , Speck Robert 
Published: August 2018

SummaryFor time‐dependent partial differential equations, parallel‐in‐time integration using the “parallel full approximation scheme in space and time” (PFASST) is a promising way to accelerate existing space‐parallel approaches beyond their scaling limits. Inspired by the classical Parareal method and multigrid ideas, PFASST allows to integrate multiple time steps simultaneously using a space–time hierarchy of spectral deferred correction sweeps. While many use cases and benchmarks exist, a solid and reliable mathematical foundation is still missing. Very recently, however, PFASST for linear problems has been identified as a multigrid method. In this paper, we will use this multigrid formulation and, in particular, PFASST's iteration matrix to show that, in the nonstiff and stiff limit, PFASST indeed is a convergent iterative method. We will provide upper bounds for the spectral radius of the iteration matrix and investigate how PFASST performs for increasing numbers of parallel time steps. Finally, we will demonstrate that the results obtained here indeed relate to actual PFASST runs.
The nuclear receptor superfamily: A structural perspective
Authors: Weikum Emily R. , Liu Xu , Ortlund Eric A. 
Published: August 2018

AbstractNuclear receptors (NRs) are a family of transcription factors that regulate numerous physiological processes such as metabolism, reproduction, inflammation, as well as the circadian rhythm. NRs sense changes in lipid metabolite levels to drive differential gene expression, producing distinct physiologic effects. This is an allosteric process whereby binding a cognate ligand and specific DNA sequences drives the recruitment of diverse transcriptional co‐regulators at chromatin and ultimately transactivation or transrepression of target genes. Dysregulation of NR signaling leads to various malignances, metabolic disorders, and inflammatory disease. Given their important role in physiology and ability to respond to small lipophilic ligands, NRs have emerged as valuable therapeutic targets. Here, we summarize and discuss the recent progress on understanding the complex mechanism of action of NRs, primarily from a structural perspective. Finally, we suggest future studies to improve our understanding of NR signaling and better design drugs by integrating multiple structural and biophysical approaches.
Antiinflammation constituents from Curcuma zedoaroides
Authors: Tungcharoen Pattreeya , Wattanapiromsakul Chatchai , Tansakul Pimpimon , Nakamura Seikou , Matsuda Hisashi , Tewtrakul Supinya 
Published: August 2018

Curcuma zedoaroides, a Zingiberaceae species, has been used for snake bite antidote and wound care in Thailand. Seven compounds were isolated from the bioactive chloroform extract consisted of one new guaiane sesquiterpene lactone, 5‐epiphaeocaulisin A (4) and one new diarylheptanoid, 1,2,3,5‐tetrahydroxy‐1‐(4‐hydroxy‐3‐methoxyphenyl)‐7‐(4‐hydroxyphenyl) heptane (7), together with five known guaiane‐type sesquiterpene lactones including gweicurculactone (1), zedoalactone B (2), phaeocaulisin C (3), zedoalactone H (5), and zedoalactone E (6). The antiinflammation was investigated on NO and TNF‐α production using RAW264.7 cells. In addition, the expressions of genes involved in inflammation including iNOS, COX‐2, and TNF‐α were assessed. The results found that Compounds 1–7 presented their antiinflammation against NO production. The most potential effects were demonstrated on Compounds 1 and 7 with IC50 of 27.3 and 32.6 μM, respectively. Although, Compounds 1 and 7 did not inhibit TNF‐α production, their suppression on iNOS and COX‐2 mRNA expression were revealed. These results support the ability of chloroform fraction, Compounds 1 and 7 on antiinflammation, whereas others exhibited moderate and mild effect.
Greater lifetime stress exposure predicts blunted cortisol but heightened DHEA responses to acute stress
Authors: Lam Jovian C.W. , Shields Grant S. , Trainor Brian C. , Slavich George M. , Yonelinas Andrew P. 
Published: August 2018

AbstractAlthough prior research has examined how early adversity and chronic stress exposure relate to hypothalamic–pituitary–adrenal (HPA) axis responses to acute stress, to date, no studies have examined how stressors occurring over the entire lifespan predict such responses. To address this issue, we recruited 61 healthy young adults and measured their exposure to 55 different types of acute life events and chronic difficulties occurring over the lifespan. In addition, we characterized differences in participants' HPA axis responses to acute stress by measuring their salivary cortisol and DHEA responses to the Trier Social Stress Test for Groups. Greater cumulative stress exposure was associated with a blunted cortisol response, but a heightened DHEA response, to the acute stressor. Moreover, it was participants' exposure to these stressors (i.e., lifetime count), not their perceived severity, which predicted their cortisol and DHEA responses to acute stress. Furthermore, differential effects were observed by stress exposure domain. Notably, only adulthood and marital/partner stressors significantly predicted cortisol responses to acute stress, whereas stress was more uniformly associated with DHEA responses to the acute stressor. These results thus reveal how cumulative stress exposure is associated with HPA axis responsivity to acute stress, while highlighting the fact that different stressors may have substantially different associations with these biological outcomes.