bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of aplastic anaemia with lower‐dose anti‐thymocyte globulin produces similar response rates and survival as per standard dose anti‐thymocyte globulin schedules
Authors: Scott A. , Morris K. , Butler J. , Mills A. K. , Kennedy G. A. 
Published: July 2016

BackgroundAplastic anaemia (AA) is a rare acquired bone marrow failure syndrome resulting from the immune‐mediated destruction of haemopoietic stem cells. For adults in whom first‐line haemopoietic progenitor cell transplantation is not feasible, combination anti‐thymocyte globulin (ATGAM) plus cyclosporine A is standard therapy; however, there are minimal data available regarding the optimal ATGAM dosage in terms of efficacy and survival.AimsOur institutions have historically used different dosing protocols of ATGAM in the treatment of AA. We aimed to review the outcome of AA patients treated with these protocols and compare them to the published literature.MethodsWe conducted a retrospective study of 31 adults who received first‐line ATGAM for AA and compared response rates and survival between cohorts who received standard (40 mg/kg/day D1–4) versus lower‐dose (15 mg/kg/day D1–5) ATGAM schedules.ResultsThere were similar rates of response (64 vs 71%, P = 1.0), relapse (33 vs 33%, P = 1.0), transformation (14 vs 24%, P = 0.66) or infection (43 vs 47%, P = 1.0), respectively, between standard and lower‐dose cohorts. At a median follow up of 24 months, there was no statistical difference between standard and lower‐dose cohorts in either event‐free (42.2 vs 64.7%, P = 0.91) or overall survival (73.1 vs 88.2%, P = 0.75).ConclusionOur experience suggests that lower‐dose ATGAM at 15 mg/kg/day D1–5 as treatment of AA produces similar responses and outcomes as per standard‐dose ATGAM schedules. Prospective trials comparing ATGAM dose schedules in AA are warranted.
Lipopeptides: a novel antigen repertoire presented by major histocompatibility complex class I molecules
Authors: Morita Daisuke , Sugita Masahiko 
Published: July 2016

SummaryPost‐translationally modified peptides, such as those containing either phosphorylated or O‐glycosylated serine/threonine residues, may be presented to cytotoxic T lymphocytes (CTLs) by MHC class I molecules. Most of these modified peptides are captured in the MHC class I groove in a similar manner to that for unmodified peptides. N‐Myristoylated 5‐mer lipopeptides have recently been identified as a novel chemical class of MHC class I‐presented antigens. The rhesus classical MHC class I allele, Mamu‐B*098, was found to be capable of binding N‐myristoylated lipopeptides and presenting them to CTLs. A high‐resolution X‐ray crystallographic analysis of the Mamu‐B*098:lipopeptide complex revealed that the myristic group as well as conserved C‐terminal serine residue of the lipopeptide ligand functioned as anchors, whereas the short stretch of three amino acid residues located in the middle of the lipopeptides was only exposed externally with the potential to interact directly with specific T‐cell receptors. Therefore, the modes of lipopeptide–ligand interactions with MHC class I and with T‐cell receptors are novel and fundamentally distinct from that for MHC class I‐presented peptides. Another lipopeptide‐presenting MHC class I allele has now been identified, leading us to the prediction that MHC class I molecules may be separated on a functional basis into two groups: one presenting long peptides and the other presenting short lipopeptides. Since the N‐myristoylation of viral proteins is often linked to pathogenesis, CTLs capable of sensing N‐myristoylation may serve to control pathogenic viruses, raising the possibility for the development of a new type of lipopeptide vaccine.
Better Late than Never? On the European Commission's Rule of Law Framework and its First Activation
Authors: Kochenov Dimitry , Pech Laurent 
Published: July 2016

AbstractThis article first offers an overview of the European Commission's Rule of Law Framework, which was adopted in March 2014. The mechanism's potential effectiveness and the Commission's reasoning to justify its first activation against Poland in January 2016, when it has failed to do so against Hungary, are subsequently analyzed. While the Commission should be commended for seeking to address increasing rule of law backsliding at Member State level, our main submission is that reliance on the Rule of Law Framework alone, if only because of its soft and discursive nature, will not remedy a situation where systemic violations of EU values form part of a governmental plan to set up an ‘illiberal’ regime.
Is furcation involvement affected by adjunctive systemic amoxicillin plus metronidazole? A clinical trials exploratory subanalysis
Authors: Eickholz Peter , Nickles Katrin , Koch Raphael , Harks Inga , Hoffmann Thomas , Kim Ti‐Sun , Kocher Thomas , Meyle Jörg , Kaner Doğan , Schlagenhauf Ulrich , Doering Stephan , Gravemeier Martina , Ehmke Benjamin 
Published: July 2016

AbstractObjectivesEvaluation of the clinical effect of systemic amoxicillin and metronidazole adjunctively to mechanical debridement at furcation sites.Material and MethodsThis is an exploratory per‐protocol collective subanalysis from a prospective, randomized, double‐blind, multi‐centre trial (ClinicalTrials.gov NCT00707369) on the effect of adjunctive systemic amoxicillin 500 mg plus metronidazole 400 mg (3×/day, 7 days) use on furcation involvement in moderate to severe periodontitis. Outcome was the change in frequency of classes of furcation involvement after 27.5 months. Therapy comprised mechanical debridement in conjunction with antibiotic or placebo administration, and maintenance therapy at three months intervals.ResultsThree hundred and forty‐five patients (175 placebo, 170 antibiotics) with 6576 furcation sites (class 0 2956; class I 2370; class II 886; class III 364) were examined (3472 placebo, 3104 antibiotics). Pocket reduction/attachment gain at the furcation sites was noticeably better after antibiotics (1.2/0.6 mm) than after placebo (0.7/0.2 mm) 27.5 months after therapy. However, most furcation degrees were unchanged (placebo 61.5%/antibiotics 62.2%), more sites improved than deteriorated (20.3%/18.2%, 22.1%/15.7% respectively) and no differences in the change of furcation degrees between treatments could be detected.ConclusionCompared to placebo, prescription of adjunctive systemic antibiotics failed to show clinically relevant benefit with regard to furcation class involvement.
Causality evaluation of bacterial species isolated from patients with community‐acquired lower leg cellulitis
Authors: Chaniotakis I. , Gartzonika C.G. , Gaitanis G. , Levidiotou‐Stefanou S. , Bassukas I.D. 
Published: July 2016

AbstractIntroductionLower leg cellulitis is a diffuse inflammation of the cutaneous connective tissue following invasion of microorganisms and with potential to recur. The causative agent is not routinely identified in clinical practice, and the empirical therapy initiated primarily targets the ‘conventional’ disease pathogens, Streptococcus pyogenes and Staphylococcus aureus.ObjectiveTo evaluate at case level, the role of bacterial species isolated from lesional skin in the pathogenesis of community‐acquired lower leg cellulitis.MethodsTwo sampling methods (superficial swab and biopsy) were applied to isolate bacterial species from 40 patients hospitalized for first (N = 24 cases) and recurrent (N = 16 patients) lower leg cellulitis episodes. Subsequently, a clinical‐laboratory heuristic algorithm was employed to interpret causality associations of isolated species with disease episodes at case level.ResultsIn 37/40 cases (92.5%), at least one bacterial species was identified with either sampling method. The number of different species/specimen isolated from superficial swabs compared to punch biopsies was significantly more (P < 0.001). A causative agent was identified in 16 cases (40%); it was a ‘conventional’ pathogen in seven patients and strains belonging to one of six ‘non‐conventional’ pathogens in nine cases. There was no concordance in the spectrum of isolated pathogens with the two sampling methods (kappa‐index = 0.028). Another four species may have participated in five patients as co‐pathogens in mixed infections. There was also no difference in microbiological disease features between patients with first and recurrent cellulitis episodes.ConclusionsThe application of a clinical‐laboratory causality algorithm coupled with pooled culture results of more than one sampling methods in patients with lower leg cellulitis is anticipated to permit the identification of responsible bacterial species at case level and offer incentive for therapeutic intervention studies.
Regression in cutaneous melanoma: a comprehensive review from diagnosis to prognosis
Authors: Ribero S. , Moscarella E. , Ferrara G. , Piana S. , Argenziano G. , Longo C. 
Published: July 2016

AbstractHistological regression in primary cutaneous melanoma occurs in 10–35% of cases. Although a large body of literature exists to suggest that histological regression serves very little purpose in predicting biologic behaviour with melanoma, recognizing the presence of regression at clinical and histological ground may still retain some value in grading melanoma aggressiveness. In the current review, a comprehensive overview of the main aspects of regression will be provided. Histologically, many classifications have been reported so far, but all of them only agreed on the presence of an infiltrate of lymphocytes admixed with pigment‐laden macrophages underlying an atrophic epidermis with flattened rete ridges. Upon dermoscopy, regression is also named Blue White Scar‐like areas and could be variably admixed with granularity or peppering. Almost fully regressed lesions represent a main diagnostic issue in dermoscopy, and thus, confocal microscopy can be of help to identify whether the tumour is melanocytic or not. The clinical utility of regression as a prognostic factor has been challenged recently. Nowadays, evidences showed that it is less likely associated to SLN metastases.
Predicting 2‐Year Risk of Developing Pneumonia in Older Adults without Dementia
Authors: Jackson Michael L. , Walker Rod , Lee Sei , Larson Eric , Dublin Sascha 
Published: July 2016

ObjectivesTo develop three prognostic indices of varying degree of required detail for 2‐year pneumonia risk in older adults.DesignRetrospective cohort study.SettingGroup Health (GH), an integrated healthcare delivery system.ParticipantsCommunity‐dwelling dementia‐free individuals aged 65 and older who had been GH members for at least 2 years before start of follow‐up and were enrolled in the Adult Changes in Thought study (N = 3,375; development cohort, n = 2,250; validation cohort, n = 1,125.MeasurementsPotential pneumonia risk factors were identified from questionnaire data and interviewer assessments of functional status, medical history, smoking and alcohol use, cognitive function, personal care, and problem solving. Risk factors were also identified based on physical measures such as grip strength and gait speed and administrative database information on comorbid illnesses, laboratory tests, and prescriptions dispensed. Incident community‐acquired pneumonia was defined presumptively from administrative data and validated using medical record review.ResultsParticipants (59% female) contributed 12,998 visits at which risk factors were assessed; 642 pneumonia events were observed during follow‐up. Age, sex, chronic obstructive pulmonary disease, congestive heart failure, body mass index, and use of inhaled or oral corticosteroids were critical predictors in all prognostic indices. A risk score based on these seven variables, information on which is commonly available in electronic medical records (EMRs), had equal or better performance (c‐index = 0.69 in the validation cohort) than scores including more‐detailed data such as functional status.ConclusionData commonly available in EMRs can stratify older adults into groups with varying subsequent 2‐year pneumonia risk.
A potential relationship between skin hydration and stamp‐type microneedle intradermal hyaluronic acid injection in middle‐aged male face
Authors: Seok Joon , Hong Ji Yeon , Choi Sun Young , Park Kui Young , Kim Beom Joon 
Published: July 2016

SummaryThere is an increasing interest in skin rejuvenation using hyaluronic acid (HA) fillers beyond the improvement of deep wrinkles and volume deficiencies, which have been primary research foci in the past. We conducted a pilot study using a sample of six middle‐aged male subjects. Using an automatic intradermal injector with 0.020 mL of material contained in each injection point with a total of 100 points, 2 mL of non‐cross‐HA filler was injected into the entire face at every treatment session. We administered injections of HA for a total of three sessions per subject at 2‐week intervals and evaluated the results using a corneometer, TEWL, cutometer, measures of patient satisfaction, and the global aesthetic improvement scale (GAIS). Corneometer values increased steadily at each measurement, while the average value of TEWL increased in comparison with baseline after each application of the procedure. However, values returned to readings similar to those at 4 weeks after complete termination of the procedures. Cutometer values differed between the baseline and after procedures. All patients were assessed as “very much improved” or “much improved” according to GAIS, and all were pleased with the outcomes of treatment in terms of the enhancement of moisture, elasticity, and brightness.
Tele‐aesthetics in South Asia
Authors: Tian Brian 
Published: July 2016

SummaryBackgroundTelemedicine is becoming increasingly popular. The best use for it is in the field of aesthetic dermatology – where conditions are not life‐threatening, and treatments can be topical and very safe.AimsIn this study, we demonstrate that a simple store‐and‐forward telemedicine system can be applied safely to the field of aesthetic dermatology.Methods and MaterialsThis was a prospective study was carried out in Singapore. A total of 102 patients filled up a medical questionnaire and submitted photographs via our online system. Upon submission, there was an independent doctor on the back‐end who would review their medical details and their photographs and make diagnoses and recommendations based on this information. There was another doctor who examined the patients face‐to‐face. Diagnoses made by the online doctor and by the face‐to‐face doctor were compared for congruency.ResultsA total of 358 diagnoses were made by the face‐to‐face doctor from 102 patients; 346 diagnoses were made by the teleconsultation doctor. For the purpose of this study, the diagnoses made by the FTFD were presumed to be correct. There was total agreement between both doctors in 342 diagnoses, giving a concordance rate of 95.5%. There were 12 missed diagnoses by the teleconsultation doctor and four discordant diagnoses.DiscussionOur system demonstrates that a store‐and‐forward system enables our doctor to make accurate skin diagnoses. Our system was also able to detect dangerous conditions such as melanomas, skin cancers, actinic keratosis, and other dangerous diagnoses. There were discordant or missed diagnoses. This was mostly attributed to poor photograph quality.ConclusionEmerging telemedicine technologies should be rigorously evaluated before they become widely implemented. Any system of value must uphold certain principles. It has to be fundamentally sound, safe, and clearly beneficial to the patient. With current technological limitations, the best use of such a system would be in aesthetics.
Impact of preoperative defecation pattern on postoperative constipation for patients undergoing cardiac surgery
Authors: Iyigun Emine , Ayhan Hatice , Demircapar Aslı , Tastan Sevinc 
Published: July 2016

Aims and objectivesTo analyse the impact of preoperative defecation pattern on postoperative defecation pattern for patients undergoing cardiac surgery.BackgroundConstipation is a neglected problem that occurs frequently after cardiac surgery.DesignDescriptive study.MethodThe study sample comprised 102 patients who underwent cardiac surgery. A Descriptive Information Form, Rome III Diagnostic Criteria, Constipation Severity Instrument, Postoperative Defecation Pattern Evaluation Form and Bristol Stool Form Scale were used for data collection and analysis.ResultsThe Constipation Severity Instrument scores of just over one‐third (37·2%) of the patients who were constipated prior to surgery were higher compared to those who were not constipated. Following cardiac surgery, 39·2% of patients developed constipation and 80% of these patients were constipated prior to cardiac surgery. The findings indicate a significantly high relationship between preoperative and postoperative defecation pattern (r = 0·71, p < 0·001).ConclusionPreoperative defecation pattern is a determining factor for the development of postoperative constipation for patients undergoing cardiac surgery.Relevance to clinical practiceDuring the preoperative period, clinical nurses may evaluate the patients' defecation patterns using valid and reliable scales and follow the defecation of the patients, especially patients with defecation problems, during the postoperative period.
Variations in impact effects among IIIE iron meteorites
Authors: Breen John P. , Rubin Alan E. , Wasson John T. 
Published: July 2016

AbstractGroup‐IIIE iron meteorites can be ordered into four categories reflecting increasing degrees of shock alteration. Weakly shocked samples (Armanty, Colonia Obrera, Coopertown, Porto Alegre, Rhine Villa, Staunton, and Tanokami Mountain) have haxonite within plessite, unrecrystallized kamacite grains containing Neumann lines or possessing the ɛ structure, and sulfide inclusions typically consisting of polycrystalline troilite with daubréelite exsolution lamellae. The only moderately shocked sample is NWA 4704, in which haxonite has been partially decomposed to graphite; the majority of the kamacite in NWA 4704 is recrystallized, and its sulfide inclusions were partly melted. Strongly shocked samples (Cachiyuyal, Kokstad, and Paloduro) contain graphite and no haxonite, suggesting that pre‐existing haxonite fully decomposed. Also present in these rocks are recrystallized kamacite and melted troilite. Residual heat from the impact caused annealing and recrystallization of kamacite as well as the decomposition of haxonite into graphite. Severely shocked samples (Aliskerovo and Willow Creek) have sulfide‐rich assemblages consisting of fragmental and subhedral daubréelite crystals, 1–4 vol% spidery troilite filaments, and 30–50 vol% low‐Ni kamacite grains, some of which contain up to 6.0 wt% Co; haxonite in these inclusions has fully decomposed to graphite. The wide range of impact effects in IIIE irons is attributed to one or more major collision(s) on the parent asteroid that affected different group members to different extents depending on their proximity to the impact point.
Adaptive differentiation in floral traits in the presence of high gene flow in scarlet gilia (Ipomopsis aggregata)
Authors: Milano Elizabeth R. , Kenney Amanda M. , Juenger Thomas E. 
Published: July 2016

AbstractPlant–pollinator interactions are thought to be major drivers of floral trait diversity. However, the relative importance of divergent pollinator‐mediated selection vs. neutral processes in floral character evolution has rarely been explored. We tested for adaptive floral trait evolution by comparing differentiation at neutral genetic loci to differentiation at quantitative floral traits in a putative Ipomopsis aggregata hybrid zone. Typical I. aggregata subsp. candida displays slender white tubular flowers that are typical of flowers pollinated by hawkmoths, and subsp. collina displays robust red tubular flowers typical of flowers pollinated by hummingbirds; yet, hybrid flower morphs are abundant across the East Slope of the Colorado Rockies. We estimated genetic differentiation (FST) for nuclear and chloroplast microsatellite loci and used a half‐sib design to calculate quantitative trait divergence (QST) from collection sites across the morphological hybrid zone. We found little evidence for population structure and estimated mean FST to be 0.032. QST values for several floral traits including corolla tube length and width, colour, and nectar volume were large and significantly greater than mean FST. We performed multivariate comparisons of neutral loci to genetic correlations within and between populations and found a strong signal for divergent selection, suggesting that specific combinations of floral display and reward traits may be the targets of selection. Our results show little support for historical subspecies categories, yet floral traits are more diverged than expected due to drift alone. Non‐neutral divergence for multivariate quantitative traits suggests that selection by pollinators is maintaining a correlation between display and reward traits.
A portrait of a sucker using landscape genetics: how colonization and life history undermine the idealized dendritic metapopulation
Authors: Salisbury Sarah J. , McCracken Gregory R. , Keefe Donald , Perry Robert , Ruzzante Daniel E. 
Published: July 2016

AbstractDendritic metapopulations have been attributed unique properties by in silico studies, including an elevated genetic diversity relative to a panmictic population of equal total size. These predictions have not been rigorously tested in nature, nor has there been full consideration of the interacting effects among contemporary landscape features, colonization history and life history traits of the target species. We tested for the effects of dendritic structure as well as the relative importance of life history, environmental barriers and historical colonization on the neutral genetic structure of a longnose sucker (Catostomus catostomus) metapopulation in the Kogaluk watershed of northern Labrador, Canada. Samples were collected from eight lakes, genotyped with 17 microsatellites, and aged using opercula. Lakes varied in differentiation, historical and contemporary connectivity, and life history traits. Isolation by distance was detected only by removing two highly genetically differentiated lakes, suggesting a lack of migration–drift equilibrium and the lingering influence of historical factors on genetic structure. Bayesian analyses supported colonization via the Kogaluk's headwaters. The historical concentration of genetic diversity in headwaters inferred by this result was supported by high historical and contemporary effective sizes of the headwater lake, T‐Bone. Alternatively, reduced allelic richness in headwaters confirmed the dendritic structure's influence on gene flow, but this did not translate to an elevated metapopulation effective size. A lack of equilibrium and upstream migration may have dampened the effects of dendritic structure. We suggest that interacting historical and contemporary factors prevent the achievement of the idealized traits of a dendritic metapopulation in nature.