bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Time Delay of Flow and Sediment in the Middle and Lower Yangtze River and Its Response to the Three Gorges Dam
Authors: Li Yangyang , Zhu Yingxin , Chen Lei , Shen Zhenyao 
Published: January 2018

Abstract
As the largest hydropower project in the world, the Three Gorges Dam (TGD) has drawn extensive concern in terms of its impact on downstream areas. In this study, an improved time delay estimation and wavelet analysis were used to investigate the influence of the TGD on the streamflow and sediment in the middle and lower Yangtze River, using time series of the daily discharge and sediment concentration data from three hydrological stations downstream of the dam. The results indicated that all of the time series at the three stations have prominent annual cycles, but the cycle of daily mean sediment concentration was nearly nonexistent after the impoundment of the TGD. Changes in discharge and sediment between the Yichang and the Hankou stations are larger than those between the Hankou and the Datong stations, which is mainly attributed to the streamflows of tributaries and Dongting Lake and the flood diversion area of Jingjiang. The transmission time of discharge for the whole Yichang–Datong river section is approximately 6 days. In addition, the attenuation of discharge from the Yichang station to the Datong station is 20%–30%. In contrast, the transmission of suspended sediment is slower than that of discharge, which takes 7–7.5 days to move from the Yichang station to the Datong station. The attenuation of sediment is approximately 30% in the Yichang–Datong river section and shows a clear increasing trend after 2006, mainly because a large amount of sediment was trapped by the TGD, and the dynamic balance of sediment was disturbed.
Topiramate-Induced Chest Pain: A Case Report
Authors: Ostroff Jared L. , LeClair (Barnet) Jessica N. , Ostroff Marissa L. , Laskey Corey S. 
Published: January 2018

Background: Topiramate, an anticonvulsant used for prophylaxis of migraines and epilepsy, is commonly associated with adverse effects of cognitive dulling and fatigue. Chest pain is a potential adverse effect that to our knowledge has not been reported with the use of topiramate. Case Presentation: We present the case of a 38-year-old female with a seizure disorder who experienced chest pain after the first dose of topiramate. On day 1, she presented to the emergency department, was admitted, and over the course of 3 days had a chest X-ray, electrocardiogram (ECG), and echocardiogram, and her vitals, basic metabolic panel, complete blood counts, troponin, and d-dimer levels were monitored. The chest pain improved when the topiramate was held. No identifiable causes of chest pain were apparent, other than the topiramate. Discussion: The Naranjo probability scale was utilized to determine the causality of topiramate. The resulting score of 3 indicates that it is possible that the chest pain was due to the topiramate. Conclusion: This report demonstrates an example of a patient who experienced chest pain possibly caused by the initiation of topiramate. The objective of this case report is to increase the awareness of chest pain as an adverse effect of topiramate.
A prospective study on the diagnosis of peripheral lung cancer using endobronchial ultrasonography with a guide sheath and computed tomography-guided transthoracic needle aspiration
Authors: Zhu Jun , Tang Feng , Gu Ye 
Published: January 2018

Background: It is difficult to collect peripheral lung cancer samples. This study analyzed the applicability of endobronchial ultrasonography with a guide sheath (EBUS-GS) and computed tomography-guided transthoracic needle aspiration (CT-TTNA) for the diagnosis of peripheral lung cancer. Methods: A prospective analysis of peripheral lung cancer patients was performed. The study included 150 cases in the EBUS-GS group and 177 cases in the CT-TTNA group. The diagnostic rate, pathological type, genetic status and complications were analyzed. Results: The diagnosis rates were 64.0% and 97.7% in the EBUS-GS and CT-TTNA groups, respectively. The EBUS-GS group had undergone the most operations of the upper lobes of both lungs, while there was no significant difference in the operation distribution among the lobes in the CT-TTNA group. Adenocarcinoma (64 cases versus 51 cases) was most commonly observed in both groups, followed by squamous cell carcinoma. The detection rates of patients who were given a genetic test were 96.1% and 98.9% in the EBUS-GS and CT-TTNA groups, respectively. The incidence of complications in the EBUS-GS group was significantly less than that in the CT-TTNA group. Conclusions: EBUS-GS and CT-TTNA both had operational limitations. The diagnostic rate of EBUS-GS was lower than that of CT-TTNA, but there were fewer complications. CT-TTNA had better tolerance. According to the specific location of the lesion, we recommend EBUS-GS for lesions with a diameter ⩽30 mm and CT-TTNA for lesions with a diameter >30 mm. CT-TTNA specimens were advantageous for genetic testing.
A prospective analysis of emphysematous pyelonephritis at a tertiary care centre
Authors: Puvvada Sandeep , Arjun N , Mylarappa Prasad , Gowda Ramesh Desi 
Published: January 2018

Purpose: To evaluate the presentation and diagnostic criteria of emphysematous pyelonephritis and different modalities of their management at our instititute. Methods: A prospective study of 5 years in which patients who were diagnosed to have emphysematous pyelonephritis confirmed by a non contrast CT presenting at our centre were included in this study and baseline information, a brief clinical history with a written consent was collected from each patient. The course of the patient along with investigations and interventions done from admission were recorded. Results: 72 patients were included in this study with a mean age of 55.4 +/-12.1 years (30 to 75 years ), comprising of 47 females and 25 males. Common presentation was tachycardia (94.5 %) and fever associated with burning micturition (75.3%) followed by loin pain on the affected side (71%). 31 cases which formed a majority were diagnosed to have right sided emphysematous pyelonephritis (41.9%), 28 had left sided (38.35%) and 14 bilateral (19.17%) in our series. 90.41 % of the patient were diagnosed to have diabetes mellitus of which 34 patients (46.57 %) presented with high sugars. Urine cultures were positive in only 41% of the patients with the most common organism being E. coli (68%) followed by Klebsiella pneumoniae (14%). 64.8% of the patients diagnosed were treated conservatively with IV antibiotics and 34.24% by endoscopic management. Conclusions: In this study we have shown that a medical line of management with appropriate endoscopic intervention is the present choice of management of emphysematous pyelonephritis irrespective of the CT grade of the disease. Level of evidence: Not applicable for this multicentre audit.
Health services research
Authors: Warner Ross M , Bastianpillai Christopher , Lamb Benjamin W , Sevdalis Nick , Green James SA 
Published: January 2018

Health services research (HSR) is the science of the evaluation and improvement of health care provision. HSR can be used by health care organisations to develop and understand administrative, financial and organisational processes in order to improve efficacy of clinical treatments, efficiency of their delivery, and ultimately patient outcomes. HSR applies both quantitative and qualitative methodology, utilising data collected from real-life clinical practice, rather than the confines of more controlled traditional efficacy trials. With new and developing therapies, HSR provides an opportunity to enhance the delivery of cost-effective and efficient health care. Level of evidence: Not applicable (educational article).
Strategies to activate NK cells to prevent relapse and induce remission following hematopoietic stem cell transplantation
Authors: Cooley Sarah , Parham Peter , Miller Jeffrey S. 
Published: January 2018

AbstractNatural killer (NK) cells are lymphocytes of innate immunity that respond to virus infected and tumor cells. After allogeneic transplantation, NK cells are the first reconstituting lymphocytes, but are dysfunctional. Manipulating this first wave of lymphocytes could be instrumental in reducing the 40% relapse rate following transplantation with reduced-intensity conditioning. NK cells express numerous activating and inhibitory receptors. Some recognize classical or nonclassical HLA class I ligands, others recognize class I–like ligands or unrelated ligands. Dominant in the NK-cell transplant literature are killer cell immunoglobulin-like receptors (KIRs), encoded on chromosome 19q. Inhibitory KIR recognition of the cognate HLA class I ligand is responsible for NK-cell education, which makes them tolerant of healthy cells, but responsive to unhealthy cells having reduced expression of HLA class I. KIR A and KIR B are functionally distinctive KIR haplotype groups that differ in KIR gene content. Allogeneic transplant donors having a KIR B haplotype and lacking a recipient HLA-C epitope provide protection against relapse from acute myeloid leukemia. Cytomegalovirus infection stimulates and expands a distinctive NK-cell population that expresses the NKG2C receptor and exhibits enhanced effector functions. These adaptive NK cells display immune memory and methylation signatures like CD8 T cells. As potential therapy, NK cells, including adaptive NK cells, can be adoptively transferred with, or without, agents such as interleukin-15 that promote NK-cell survival. Strategies combining NK-cell infusions with CD16-binding antibodies or immune engagers could make NK cells antigen specific. Together with checkpoint inhibitors, these approaches have considerable potential as anticancer therapies.
Extracellular vesicle–mediated transfer of constitutively active MyD88L265P engages MyD88wt and activates signaling
Authors: Manček-Keber Mateja , Lainšček Duško , Benčina Mojca , Chen Jiaji G. , Romih Rok , Hunter Zachary R. , Treon Steven P. , Jerala Roman 
Published: January 2018

Key Points
MyD88L265P is present in the EVs secreted by WM cancer cells and triggers signaling in the recipient cells. MyD88-containing EVs shape the proinflammatory microenvironment in the bone marrow.
An introduction to instrumental variable assumptions, validation and estimation
Authors: Lousdal Mette Lise 
Published: January 2018

AbstractThe instrumental variable method has been employed within economics to infer causality in the presence of unmeasured confounding. Emphasising the parallels to randomisation may increase understanding of the underlying assumptions within epidemiology. An instrument is a variable that predicts exposure, but conditional on exposure shows no independent association with the outcome. The random assignment in trials is an example of what would be expected to be an ideal instrument, but instruments can also be found in observational settings with a naturally varying phenomenon e.g. geographical variation, physical distance to facility or physician’s preference. The fourth identifying assumption has received less attention, but is essential for the generalisability of estimated effects. The instrument identifies the group of compliers in which exposure is pseudo-randomly assigned leading to exchangeability with regard to unmeasured confounders. Underlying assumptions can only partially be tested empirically and require subject-matter knowledge. Future studies employing instruments should carefully seek to validate all four assumptions, possibly drawing on parallels to randomisation.
Anti-tumor effects of ONC201 in combination with VEGF-inhibitors significantly impacts colorectal cancer growth and survival in vivo through complementary non-overlapping mechanisms
Authors: Wagner Jessica , Kline C. Leah , Zhou Lanlan , Khazak Vladimir , El-Deiry Wafik S. 
Published: January 2018

Abstract
Background
Small molecule ONC201 is an investigational anti-tumor agent that upregulates intra-tumoral TRAIL expression and the integrated stress response pathway. A Phase I clinical trial using ONC201 therapy in advanced cancer patients has been completed and the drug has progressed into Phase II trials in several cancer types. Colorectal cancer (CRC) remains one of the leading causes of cancer worldwide and metastatic disease has a poor prognosis. Clinical trials in CRC and other tumor types have demonstrated that therapeutics targeting the vascular endothelial growth factor (VEGF) pathway, such as bevacizumab, are effective in combination with certain chemotherapeutic agents.

Methods
We investigated the potential combination of VEGF inhibitors such as bevacizumab and its murine-counterpart; along with other anti-angiogenic agents and ONC201 in both CRC xenograft and patient-derived xenograft (PDX) models. We utilized non-invasive imaging and immunohistochemistry to determine potential mechanisms of action.

Results
Our results demonstrate significant tumor regression or complete tumor ablation in human xenografts with the combination of ONC201 with bevacizumab, and in syngeneic MC38 colorectal cancer xenografts using a murine VEGF-A inhibitor. Imaging demonstrated the impact of this combination on decreasing tumor growth and tumor metastasis. Our results indicate that ONC201 and anti-angiogenic agents act through distinct mechanisms while increasing tumor cell death and inhibiting proliferation.

Conclusion
With the use of both a murine VEGF inhibitor in syngeneic models, and bevacizumab in human cell line-derived xenografts, we demonstrate that ONC201 in combination with anti-angiogenic therapies such as bevacizumab represents a promising approach for further testing in the clinic for the treatment of CRC.
Antimicrobial effect of copper alloys on Acinetobacter species isolated from infections and hospital environment
Authors: Różańska Anna , Chmielarczyk Agnieszka , Romaniszyn Dorota , Majka Grzegorz , Bulanda Małgorzata 
Published: January 2018

Abstract
Background
An increased proportion of Gram-negative bacteria have recently been reported among etiologic agents of infection. In Poland, Acinetobacter baumannii is a big problem for hospitals, especially intensive care units. Touch surfaces made from materials with antimicrobial properties, especially copper alloys, are recommended as a supplementary method of increasing biological safety in the hospital environment.

Aim of the study
The objective of this study is to determine the susceptibility to selected copper alloys of three clinical Acinetobacter baumannii strains, one Acinetobacter lwoffi and an A. pittii strain isolated from the hospital environment.

Material and method
The modification of the Japanese Standard, which the ISO 22196:2011 norm was used for testing antimicrobial properties of CuZn37, CuSn6 and CuNi18Zn20 and Cu-ETP and stainless steel as positive and negative control, respectively.

Results
The highest cidal efficiency, expressed as both time and the degree of reduction of the initial suspension density, against all of the tested Acinetobacter strains was found for ETP copper. But, the results of our study also confirmed effective activity (bacteriocidal or bacteriostatic) of copper alloys selected for the study, contrary to the stainless steel. The reduction in bacterial suspension density is significantly different depending on the strain and copper alloy composition.

Conslusions
The results of our study confirmed the effective antibacterial activity of copper and its selected alloys against clinical Acinetobacter baumannii and Acinetobacter lwoffii strains, and Acinetobacter pittii strain isolated from the hospital environment.
Does hyperthyroidism worsen prognosis of thyroid carcinoma? A retrospective analysis on 2820 consecutive thyroidectomies
Authors: Medas Fabio , Erdas Ernico , Canu Gian Luigi , Longheu Alessandro , Pisano Giuseppe , Tuveri Massimiliano , Calò Pietro Giorgio 
Published: January 2018

Background Hyperthyroidism is associated with high incidence of thyroid carcinoma; furthermore, tumors arisen in hyperthyroid tissue show an aggressive behavior. Thyroid Stimulating Hormone (TSH) and Thyroid-stimulating antibodies, present in Graves's disease, seem to play a key role in carcinogenesis and tumoral growth. Methods We retrospectively reviewed our series of patients who underwent thyroidectomy for thyroid carcinoma. We compared pathological features and surgical outcomes of hyperthyroid versus euthyroid patients. Results From 2007 to 2015, 909 thyroidectomies were performed at our institution for thyroid cancer: 87 patients were hyperthyroid and 822 euthyroid. We observed, in hyperthyroid patients, a higher rate of transient hypoparathyroidism (28.1% vs 13.2%; p < 0.01) and of node metastases (12.6% vs 6.1%; p = 0.03); also local recurrence rate was higher (5.7% vs 2.5%) even if not statistically significant ( p = 0.17). Five-year disease free survival rate was significant lower in the same group (89.1% vs 96.6%; p = 0.03). Conclusion Thyroid cancers in hyperthyroid patients have an aggressive behavior, with high incidence of local invasion and a worse prognosis than euthyroid patients. All hyperthyroid patients should undergo a careful evaluation with ultrasound and scintigraphy; in case of suspicious nodules, an aggressive approach, including thyroidectomy and lymphectomy, is justified. In patients with toxic adenoma, thyroid cancer is uncommon, thus a loboisthmectomy can be safely performed. Trial registration number Research registry n. 2670 registered 19 June 2017 (retrospectively registered).
Effects of Aerobic and Resistance Exercise on Metabolic Syndrome, Sarcopenic Obesity, and Circulating Biomarkers in Overweight or Obese Survivors of Breast Cancer: A Randomized Controlled Trial
Authors: Dieli-Conwright Christina M. , Courneya Kerry S. , Demark-Wahnefried Wendy , Sami Nathalie , Lee Kyuwan , Buchanan Thomas A. , Spicer Darcy V. , Tripathy Debu , Bernstein Leslie , Mortimer Joanne E. 
Published: January 2018

Purpose Metabolic syndrome is associated with an increased risk of cardiovascular disease, type 2 diabetes, and breast cancer recurrence in survivors of breast cancer. This randomized controlled trial assessed the effects of a 16-week combined aerobic and resistance exercise intervention on metabolic syndrome, sarcopenic obesity, and serum biomarkers among ethnically diverse, sedentary, overweight, or obese survivors of breast cancer. Methods Eligible survivors of breast cancer (N = 100) were randomly assigned to exercise (n = 50) or usual care (n = 50). The exercise group participated in supervised moderate-to-vigorous—65% to 85% of heart rate maximum—aerobic and resistance exercise three times per week for 16 weeks. Metabolic syndrome z-score (primary outcome), sarcopenic obesity, and serum biomarkers were measured at baseline, postintervention (4 months), and 3-month follow-up (exercise only). Results Participants were age 53 ± 10.4 years, 46% were obese, and 74% were ethnic minorities. Adherence to the intervention was 95%, and postintervention assessments were available in 91% of participants. Postintervention metabolic syndrome z-score was significantly improved in exercise versus usual care (between-group difference, −4.4; 95% CI, −5.9 to −2.7; P < .001). Sarcopenic obesity (appendicular skeletal mass index, P = .001; body mass index, P = .001) and circulating biomarkers, including insulin ( P = .002), IGF-1 ( P = .001), leptin ( P = .001), and adiponectin ( P = .001), were significantly improved postintervention compared with usual care. At 3-month follow-up, all metabolic syndrome variables remained significantly improved compared with baseline in the exercise group ( P < .01). Conclusion Combined resistance and aerobic exercise effectively attenuated metabolic syndrome, sarcopenic obesity, and relevant biomarkers in an ethnically diverse sample of sedentary, overweight, or obese survivors of breast cancer. Our findings suggest a targeted exercise prescription for improving metabolic syndrome in survivors of breast cancer and support the incorporation of supervised clinical exercise programs into breast cancer treatment and survivorship care plans.
Transcranial Magnetic Stimulation over Left Inferior Frontal and Posterior Temporal Cortex Disrupts Gesture-Speech Integration
Authors: Zhao Wanying , Riggs Kevin , Schindler Igor , Holle Henning 
Published: January 2018

Language and action naturally occur together in the form of cospeech gestures, and there is now convincing evidence that listeners display a strong tendency to integrate semantic information from both domains during comprehension. A contentious question, however, has been which brain areas are causally involved in this integration process. In previous neuroimaging studies, left inferior frontal gyrus (IFG) and posterior middle temporal gyrus (pMTG) have emerged as candidate areas; however, it is currently not clear whether these areas are causally or merely epiphenomenally involved in gesture-speech integration. In the present series of experiments, we directly tested for a potential critical role of IFG and pMTG by observing the effect of disrupting activity in these areas using transcranial magnetic stimulation in a mixed gender sample of healthy human volunteers. The outcome measure was performance on a Stroop-like gesture task (Kelly et al., 2010a), which provides a behavioral index of gesture-speech integration. Our results provide clear evidence that disrupting activity in IFG and pMTG selectively impairs gesture-speech integration, suggesting that both areas are causally involved in the process. These findings are consistent with the idea that these areas play a joint role in gesture-speech integration, with IFG regulating strategic semantic access via top-down signals acting upon temporal storage areas.SIGNIFICANCE STATEMENTPrevious neuroimaging studies suggest an involvement of inferior frontal gyrus and posterior middle temporal gyrus in gesture-speech integration, but findings have been mixed and due to methodological constraints did not allow inferences of causality. By adopting a virtual lesion approach involving transcranial magnetic stimulation, the present study provides clear evidence that both areas are causally involved in combining semantic information arising from gesture and speech. These findings support the view that, rather than being separate entities, gesture and speech are part of an integrated multimodal language system, with inferior frontal gyrus and posterior middle temporal gyrus serving as critical nodes of the cortical network underpinning this system.