bluuebunny/crossref_metadata_2025_split huggingface dataset:
A COMPREHENSIVE CHARACTERISTIC OF 222Rn ACTIVITY CONCENTRATION CHANGES AND IONISING RADIATION EXPOSURE IN NEWLY DISCOVERED PARTS OF BEAR CAVE IN KLETNO, POLAND
Authors: Fijałkowska-Lichwa Lidia , Przylibski Tadeusz A 
Published: October 2019

Abstract
The article presents the results of research into 222Rn activity concentration changes and ionising radiation exposure in newly discovered parts of Bear Cave in Kletno, unknown until 2012. 222Rn activity concentration was registered at three measurement points located inside over 500-m-long newly discovered cave passages. The air in these parts of the cave is characterised by a stable temperature of about 5°C and a relative humidity of 100%. The measurements started in September 2013 and were completed by mid-July 2016. The measured data were recorded continuously, including hourly registration of 222Rn activity concentration with the use of three Polish semiconductor detectors SRDN-3a. Three data sets were obtained. Two of them, containing the same numbers of data, were recorded between 4 September 2013 and 10 July 2016 by SRDN-3a detectors no 7 and 9 located at sites no 1 and no 3, respectively. The third set comprises data registered between 27 October 2014 and 10 July 2016 by SRDN-3a probe no 8 at site no 2. Distinct daily changes in 222Rn activity concentration in the new parts of Bear Cave occur in early spring (from March to May) and in autumn (October). This observation confirms the notion that radon concentration changes depend on natural convective air exchange between the cave and the atmosphere. It has been shown that daily radon concentration changes in other seasons are irregular and rather small. The highest values of 222Rn activity concentration inside the cave are more frequent in daytime, i.e. from the morning to midday. The recorded annual mean values of 222Rn activity concentration in successive measurement years are comparable for all the three sites and range from 2690 to 3179 Bqm−3 in 2013, from 2676 to 2973 Bqm−3 in 2014, from 2587 to 2917 Bqm−3 in 2015 and from 2581 to 3719 Bqm−3 in 2016. These values exceed those recommended as maximum allowable radon concentrations in such spaces (0.5–1.5 kBqm−3) and are many times as high as the values recommended for workplaces (0.3 kBqm−3). The recorded values of 222Rn activity concentration in the air of the new parts of Bear Cave in Kletno result in a risk of exposure to a radiation dose higher than the national standard of 1 mSv per year adopted for the general public. In the most unfavourable conditions, it appears as early as after 25 hours spent inside the cave. The minimum effective dose to which a person staying inside the cave is exposed within 1 hour is 0.002 mSv, and the maximum dose is 0.04 mSv. The results of the conducted measurements demonstrate the necessity of introducing appropriate solutions, crucial in terms of radiological protection and legislation, that would minimise the risk of exposure to ionising radiation in the new parts of Bear Cave.
ESTIMATION OF RADIATION DOSE IN CT VENOGRAPHY OF THE LOWER EXTREMITIES: PHANTOM EXPERIMENTS USING DIFFERENT AUTOMATIC EXPOSURE CONTROL SETTINGS AND SCAN RANGES
Authors: Inoue Yusuke , Itoh Hiroyasu , Nagahara Kazunori , Takahashi Yuka 
Published: October 2019

Abstract
We performed phantom experiments to assess radiation dose in computed tomography (CT) venography of the lower extremities. CT images of a whole-body phantom were acquired using different automatic exposure control settings and scan ranges, simulating CT venography. Tube current decreased in the lower extremities compared to the trunk. The scout direction and dose modulation strength affected tube current, dose length product (DLP) and effective dose. The middle and distal portions of the lower extremities contributed substantially to DLP but not to effective dose. When effective dose was estimated by multiplying DLP by a single conversion factor, overestimation was evident; this became more pronounced as the scan range narrowed. In CT venography of the lower extremities, the scout direction and modulation strength affect radiation dose. Use of DLP severely overestimates radiation dose and underestimates effects of scan range narrowing.
Comparative anatomy and phylogeny of the Forcipulatacea (Echinodermata: Asteroidea): insights from ossicle morphology
Authors: Fau Marine , Villier Loïc 
Published: October 2019

Abstract
A new phylogenetic analysis of the superorder Forcipulatacea is presented. Forcipulatacea is one of the three major groups of sea stars (Asteroidea: Echinodermata), composed of 400 extant species. The sampled taxa are thought to represent the morphological diversity of the group. Twenty-nine forcipulate taxa were sampled belonging to Asteriidae, Stichasteridae, Heliasteridae, Pedicellasteridae, Zoroasteridae and Brisingida. Specimens were dissected with bleach. Detailed description of the skeleton and the anatomy of the ossicles were investigated using scanning electron microscopy. Comparative anatomy allowed the scoring of 115 phylogenetically informative characters. The consensus tree resulting from the analysis recovers Asteriidae, Stichasteridae, Zoroasteridae and Brisingida as monophyletic. All types of morphological features contribute to tree resolution and may be appropriate for taxon diagnosis. The synapomorphies supporting different clades are described and discussed. Brisingida and Zoroasteridae are the best-supported clades. The potentially challenging position of Brisingida in the tree may be explained by homoplastic changes, but also by the presence of numerous non-applicable characters.
Evolution of an Accelerated 3-Year Pathway to the MD Degree: The Experience of New York University Grossman School of Medicine
Authors: Cangiarella Joan , Cohen Elisabeth , Rivera Rafael , Gillespie Colleen , Abramson Steven 
Published: October 2019

The revision of the curriculum at New York University Grossman School of Medicine in 2010, with a reduction of the preclerkship curriculum to 18 months, made it possible to offer an accelerated 3-year pathway in 2013 for students who know their career path. The goals of the program include individualizing education, reducing student debt, and integrating undergraduate and graduate medical education. This accelerated 3-year doctor of medicine (3YMD) pathway is the first program of its kind in the United States to offer conditional acceptance to residency programs in all specialties through the National Resident Matching Program. Since inception of the pathway 6 years ago, 81 students have graduated. Critical components to successfully launch and implement the program are described.
Unwavering commitment to the program as a high institutional priority by the dean and vice dean for education facilitated the support required by department chairs and residency program directors and the flexibility needed for success. Alignment between the 3- and 4-year pathways has made it possible to add points of entry into the 3-year pathway during the second and third years and to shift back into the 4-year pathway, as warranted. Modifications to how 3YMD students are mentored included changing the role of the departmental advisor and adding a dedicated 3YMD pathway advisor who serves as an advocate for both the students and the program. Having a relatively large number of 3YMD students has contributed to the success of the program and facilitated acceptance by the residencies.
N-acetyl cysteine inhibits lipopolysaccharide-mediated synthesis of interleukin-1β and tumor necrosis factor-α in human periodontal ligament fibroblast cells through nuclear factor-kappa B signaling
Authors: Zheng Rui , Tan Yujie , Gu Mengqin , Kang Ting , Zhang Hui , Guo Ling 
Published: October 2019

Abstract

Background:
The aim of this study was to investigate the role of n-acetyl cysteine (NAC) in the lipopolysaccharide (LPS)-mediated induction of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) synthesis by human periodontal ligament fibroblast cells (hPDLFs). In addition, we aimed to determine the involvement of the nuclear factor-kappa B (NF-κB) pathway in any changes in IL-1β and TNF-α expression observed in response to LPS and NAC.

Methods:
HPDLFs were obtained by primary culture. The culture medium used in this experiment was Dulbecco's Modified Eagle Medium (DMEM low-glucose). Cells were stimulated with various concentrations of NAC or LPS. Cell proliferation was measured at various time-points with the cell Counting Kit 8 (CCK-8) assay. mRNA levels of IL-1β and TNF-α were determined by real-time quantitative polymerase chain reaction (RT-qPCR) analysis. Protein levels of IL-1β and TNF-α were measured by enzyme-linked immunosorbent assay (ELISA). Protein and mRNA expression levels of NF-κB were measured by western blot and RT-qPCR.

Results:
The results showed that LPS treatment in hPDLFs induced mRNA and protein expression of IL-1β, TNF-α, and NF-κB. However, these effects were eliminated by pretreatment with NAC. Pretreatment with both NAC (1 mmol/L) and BAY11-7082 (10 μmol/L) significantly inhibited the NF-κB activity induced by LPS.

Conclusion:
NAC inhibits the LPS-mediated synthesis of tumor TNF-α and IL-1β in hPDLFs, through the NF-κB pathway.
Gitelman syndrome combined with growth hormone deficiency
Authors: Huang Ke , Dai Yang-Li , Zhang Jian-Wei , Zhang Li , Wu Wei , Dong Guan-Ping , Ullah Rahim , Fei Yue , Fu Jun-Fen 
Published: October 2019

Abstract

Rationale:
Gitelman syndrome (GS) is a rare autosomal recessive hereditary salt-losing tubulopathy caused by loss-of-function mutations in the SLC12A3 gene. It is usually characterized by hypokalemia, metabolic alkalosis, hypomagnesemia, and hypocalciuria. There are only a few reports on GS combined with growth hormone deficiency (GHD).

Patient concerns:
Three patients presented with weakness, spasm, and growth retardation, respectively.

Diagnoses:
GS was diagnosed based on the clinical symptoms, laboratory test results, and genetic analysis. GH stimulation tests were performed when the magnesium level returned to normal under magnesium oxide (MgO) therapy.

Interventions:
Initially, all patients received oral replacement of MgO and potassium chloride, and 2 of them received simultaneous spironolactone therapy. Recombinant human growth hormone (rhGH) therapy was initiated after they were diagnosed with GHD.

Outcomes:
All 3 patients exhibited satisfactory growth velocity and normal serum magnesium level, although the potassium level was still slightly lower than normal.

Lessons:
We suggest that all GS patients should undergo genetic evaluation, especially regarding SLC12A3 gene mutation. GHD should be considered if these patients have short stature. rhGH therapy is useful for stimulating the patients’ growth, and it may increase the serum magnesium level.
Prognostic significance of long non-coding RNAs in clear cell renal cell carcinoma
Authors: Wang Yan , Li Zhan , Li Wei , Zhou Le , Jiang Yuehua 
Published: October 2019

Abstract

Background:
Clear cell renal cell carcinoma (ccRCC) is the most common form of kidney cancer in adults, and patients with advanced ccRCC have a 5-year survival rate of <30%. The poor prognosis of ccRCC is closely related to its lacking of potential therapeutic and prognostic biomarkers. This meta-analysis aimed to elucidate the precise prognostic value of long non-coding RNAs (lncRNAs) in patients with ccRCC.

Methods:
A literature search was performed in related databases up to January 31, 2019. Hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were calculated to explore the relationship between special lncRNAs expression and survival in patients with ccRCC.

Results:
After literature researching, a total of 16 studies, including 13 lncRNAs were identified. The data from studies that investigated the association between lncRNA expression and survival outcomes in patients with ccRCC were extracted. Results revealed that lncRNAs expression was significantly associated with poor overall survival (OS) outcome in patients with ccRCC (HR = 1.71, 95%CI = 1.40–2.01 in up-regulated subgroup; HR = 0.53, 95% CI = 0.25–0.80 in down-regulated subgroup). The overexpression of PVT1 was significantly associated with poor OS in ccRCC (HR = 1.51, 95% CI = 1.02–2.00). Meanwhile, up-regulation of LUCAT1 was significantly related to worse OS in ccRCC patients (HR = 1.51, 95% CI = 1.01–2.00).

Conclusions:
These results suggest that lncRNAs could be used to predict unfavorable prognosis and function as potential prognostic biomarkers in ccRCC.
Large tumor size is a poor prognostic factor of gastric cancer with signet ring cell
Authors: Zhou Liyuan , Li Weihua , Cai Shaoxin , Yang Changshun , Liu Yi , Lin Zhizun 
Published: October 2019

Abstract
There has been a steady increase in the incidence of signet ring cell (SRC) carcinoma, a distinct histological type with cells containing abundant intracytoplasmic mucin. We aimed to analyze the clinicopathological characteristics and prognostic value of patients with SRC gastric cancer (GC) who underwent gastrectomy.
Clinical data of 10,312 GC patients who underwent D2 radical gastrectomy were obtained from the Surveillance, Epidemiology, and End Results database and were retrospectively analyzed. X-tile plots were constructed to illustrate the optimal cut-off points using the minimum P-value from the log-rank Chi-squared test. The Kaplan–Meier method was used for the analysis of the overall cumulative probability of survival. Their differences were evaluated using the log-rank test. The Cox multiple factors analysis was performed using the logistic regression method.
In total, 946 (9.17%) SRC GC patients with pT1a-4bN0-3bM0 stage cancer were recruited. The optimal cut-off point for size was 49 mm. The 3-year overall survival (OS) rates of the SRC GC, large-size, and small-size groups were 35.89%, 30.63%, and 44.96%, respectively (P < .05). Cox multivariate analysis showed that tumor size (odds ratio [OR] = 2.032), T3 category (OR = 1.324), T4a category (OR = 1.945), and T4b category (OR = 2.163) were independent hazard prognostic factors.
SRC GC has a distinct biological behavior, presents as a large-sized tumor (≥49 mm), and is associated with worse outcomes. SRC GC patients have 2.032 times risk of mortality. SRC patients with larger tumors are at higher risk for infiltrative growth, lymph node metastasis, and distant metastasis.
The impact of iron chelation therapy on patients with lower/intermediate IPSS MDS and the prognostic role of elevated serum ferritin in patients with MDS and AML
Authors: Yang Yuan , Tang Zengwei , An Tianli , Zhao Li 
Published: October 2019

Abstract
Serum ferritin (SF) has been identified as a potential prognostic factor for patients undergoing stem cell transplantation, but the prognostic value of SF in acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) patients and the impact of iron chelation therapy (ICT) on MDS patients are controversial. The present meta-analysis aimed to better elucidate these relationships.
Three electronic databases were searched systematically to identify reports on the prognostic role of SF in MDS and AML patients, and those investigating the impact of ICT on prognosis of MDS patients. The hazard ratios (HRs) and its 95% confidence interval (95%CI) were extracted from the identified studies using Cox proportional hazard regression model for overall survival (OS) and progression of MDS to AML.
Twenty reports including 1066 AML patients and 4054 MDS patients were included in present study. The overall pooled HRs for OS of AML and MDS patients with elevated SF prior to transplantation was 1.73 (1.40–2.14), subgroup analyses stratified by the cut-off value of SF ≥1400/1000 ng/mL showed that the pooled HRs were 1.45 (0.98–2.15) and 1.65 (1.30–2.10), respectively. The pooled HRs for ICT in MDS patients was 0.30 (0.23–0.40). For ICT, the pooled HRs for the progression of MDS to AML was 0.84 (0.61–1.61).
SF has a negative impact on the OS of AML and MDS patients when it is higher than 1000 ng/mL. ICT can improve the OS of MDS patients with iron overload but it is not associated with the progression of MDS to AML.
Hand-off bundle implementation associated with decreased medical errors and preventable adverse events on an academic family medicine in-patient unit
Authors: Dewar Zachary Ewan , Yurkonis Theresa , Attia Maximos 
Published: October 2019

Abstract
To determine the impact of the implementation of a hand-off bundle on medical errors at an inpatient unit of an academic community teaching hospital. Our secondary objective was to determine the research utility of the use of an all-electronic data collection system for medical errors.
A retrospective review was conducted of 1290 admissions 6 months before and after implementation of an improved computerized hand-off tool and training bundle. The study took place at an academic community teaching hospital on a Family Medicine inpatient service caring for patients of all ages. The comparison focused on preventable and non-preventable adverse events.
A significant decrease in medical errors was noted. Medical error rate dropped from 6.0 (95% CI, 4.2–8.3) to 2.2 (95% CI, 1.2–3.7) per 100 admissions (P < .001). Preventable medical errors dropped from 0.65 (95% CI, 0.18–1.67) to 0.15 (95% CI, 0.03–0.82) per 100 admissions (P = .194). Non-intercepted potential adverse events dropped from 1.30 (95% CI, 0.56–2.57) to 0.44 (95% CI, 0.09–1.30) per 100 admissions (P = .131). Intercepted potential adverse events dropped from 0.98 (95% CI 0.36–2.13) to 0.74 (95% CI 0.24–1.7) per 100 admissions (P = .766) and errors with little potential for harm dropped from 2.77 (95% CI 1.61–4.43) to 0.74 (95% CI 0.24–1.7) per 100 admissions (P = .009).
Implementation of a standardized hand-off bundle was associated with a reduction in medical errors despite a low overall event rate. Further studies are warranted to determine the generalizability of this finding, to examine the overall epidemiology of medical errors and the reporting of such events within general medical teaching units.
Common carotid artery puncture in anterior circulation thrombectomy in patients with unfavorable vascular anatomy
Authors: Yuan Zhengzhou , Li Jinglun , Zhou Muke , Zheng Hongbo , Luo Hua , Chen Xiu , Li Zuoxiao , He Li 
Published: October 2019

Abstract
The objective of this study was to compare clinical outcomes in patients who with unfavorable vascular anatomy underwent mechanical thrombectomy (MT) by common carotid artery access versus transfemoral approach.
A retrospective review was performed in our hospital database to identify patients with challenging vascular anatomy who underwent MT for anterior circulation large vessel occlusion (LVO) between August 2015 and November 2018. Transcarotid and transfemoral cohorts were compared. Patient characteristics, procedural techniques, clinical outcomes were recorded.
A total of 52 patients were included, 16 (31%) underwent MT via transcarotid access. There were no significant differences in patient characteristics, intravenously recombinant tissue plasminogen activator therapy, clot location, or carotid tortuosity and presence of aortic arch type. There were significant differences in clinical outcomes between the 2 cohorts, including mean access-to-reperfusion time (84 vs 44 minutes; P = .000), poor clinical outcome (modified Rankin scale >2) at 90 days follow-up (37.5% vs 63.9%; P = .034). But there were no significant differences in successful revascularization rates (thrombolysis in cerebral infarction score ≥2b 87.5% vs 80.6%; P = .541), post-thrombectomy symptomatic intracranial hemorrhage (12.5% vs 13.9%; P = .892), and mortality (12.5% vs 22.2%; P = .412) were similar between transcarotid and transfemoral cohorts.
Our results demonstrate that transcarotid access for MT of anterior circulation LVO in patients with unfavorable vascular anatomy may be considerable. Transcarotid access may be better than transfemoral access in well-selected unfavorable vascular anatomy patients undergoing MT.
Lipid management in people with peripheral artery disease
Authors: Golledge Jonathan , Ward Natalie C. , Watts Gerald F. 
Published: October 2019

Purpose of review
To summarize recent data on the role of dyslipidaemia and the benefit from managing this in people with disease of the abdominal aorta and its peripheral branches (peripheral artery disease, PAD).

Recent findings
Findings from the Further Cardiovascular Outcomes Research with Proprotein convertase subtilisin/kexin type 9 (PCSK9) Inhibition in Subjects with Elevated Risk (FOURIER) trial demonstrate the benefit of intensely lowering low-density lipoprotein-cholesterol (LDL-c) in people with PAD to substantially reduce the incidence of major cardiovascular events (MACE; myocardial infarction, stroke or cardiovascular death) and major adverse limb events (MALE). Despite the evidence of substantial benefits from lowering LDL-c, the uptake of drug therapies to lower LDL-c remains sub-optimal in people with PAD.

Summary
Effective methods to educate physicians and patients on best medical management are needed. Further research is needed to examine the benefit of LDL-c lowering and other lipid therapies for PAD-specific problems like abdominal aortic aneurysm progression and walking impairment. Other novel lipid therapies, such as those that lower lipoprotein (a), maybe particularly beneficial to people with PAD given the evidence indicating high concentrations in this population and the high incidence of MACE in these individuals.
Is proteomics of value in cardiovascular risk assessment?
Authors: Arnold Natalie , Koenig Wolfgang 
Published: October 2019

Purpose of review
To briefly summarize recently published evidence in the field of cardiovascular proteomics, focusing on its ability to improve cardiovascular risk stratification and critically discussing still open and burning issues and future perspectives of proteomics research.

Recent findings
Several epidemiological studies have demonstrated an improvement in cardiovascular risk prediction beyond traditional risk factors by adding novel biomarkers, identified by both discovery and targeted proteomics. However, only a moderate improvement in risk discrimination over clinical variables was observed. Moreover, despite different outcomes there was also a strong overlap of identified candidates, with several of them being already well established cardiovascular risk markers such as growth differentiation factor 15, natriuretic peptides, C-reactive protein, interleukins, and metalloproteases.

Summary
Although proteomics plays a crucial role in biomarker discovery, the modest discriminative ability of this technique raises the possibility that there are still hidden mechanisms in protein regulatory networks, which urgently need to be evaluated to improve a cardiovascular risk assessment to a clinically significant extent.