bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Fractional Flow Reserve Assessment With Demand Stress Myocardial Contrast Echocardiography in Angiographically Intermediate Coronary Stenoses
Authors: Wu Juefei , Barton David , Xie Feng , O’Leary Edward , Steuter John , Pavlides Gregory , Porter Thomas R. 
Published: August 2016

Background—
Real-time myocardial contrast echocardiography (RTMCE) directly measures capillary flow (CBF), which in turn is a major regulator of coronary flow and resistance during demand or hyperemic stress. Although fractional flow reserve (FFR) was developed to assess the physiological relevance of an epicardial stenosis, it assumes maximal microvascular vasodilation and minimal resistance during vasodilator stress. Therefore, we sought to determine the relationship between CBF assessed with RTMCE during stress echocardiography and FFR in intermediate coronary lesions.

Methods and Results—
Sixty-seven vessels with 50% to 80% diameter stenoses by quantitative coronary angiography in 58 consecutive patients were examined with FFR and RTMCE (mean age, 60±13 years). RTMCE was performed using an incremental dobutamine (n=32) or exercise (n=26) stress protocol, and myocardial perfusion was assessed using a continuous infusion of ultrasound contrast. The presence or absence of inducible perfusion defects and wall motion abnormalities were correlated with FFR. Mean percent diameter stenosis was 60±9%. Eighteen stenoses (27%) had an FFR ≤ 0.8. Although 17 of the 18 stenoses that were FFR+ had abnormal CBF during RTMCE, 28 of the 49 stenoses (57%) that were FFR had abnormal CBF, and 24 (49%) had abnormal wall motion in the corresponding coronary artery territory during stress echocardiography.

Conclusions—
In a significant percentage of intermediate stenoses with normal FFR values, CBF during demand stress is reduced, resulting in myocardial ischemia.
Occult Transthyretin Cardiac Amyloid in Severe Calcific Aortic Stenosis
Authors: Treibel Thomas A. , Fontana Marianna , Gilbertson Janet A. , Castelletti Silvia , White Steven K. , Scully Paul R. , Roberts Neil , Hutt David F. , Rowczenio Dorota M. , Whelan Carol J. , Ashworth Michael A. , Gillmore Julian D. , Hawkins Philip N. , Moon James C. 
Published: August 2016

Background—
Calcific aortic stenosis (cAS) affects 3% of individuals aged >75 years, leading to heart failure and death unless the valve is replaced. Wild-type transthyretin cardiac amyloid is also a disorder of ageing individuals. Prevalence and clinical significance of dual pathology are unknown. This study explored the prevalence of wild-type transthyretin amyloid in cAS by myocardial biopsy, its imaging phenotype and prognostic significance.

Methods and Results—

A total of 146 patients with severe AS requiring surgical valve replacement underwent cardiovascular magnetic resonance and intraoperative biopsies; 112 had cAS (75±6 years; 57% men). Amyloid was sought histologically using Congo red staining and then typed using immunohistochemistry and mass spectrometry; patients with amyloid underwent clinical evaluation including genotyping and
99m
TC-3,3-diphosphono-1,2-propanodicarboxylic-acid (DPD) bone scintigraphy. Amyloid was identified in 6 of 146 patients, all with cAS and >65 years (prevalence 5.6% in cAS >65). All 6 patients had wild-type transthyretin amyloid (mean age 75 years; range, 69–85; 4 men), not suspected on echocardiography. Cardiovascular magnetic resonance findings were of definite cardiac amyloidosis in 2, but could be explained solely by AS in the other 4. Postoperative DPD scans demonstrated cardiac localization in all 4 patients who had this investigation (2 died prior). At follow-up (median, 2.3 years), 50% with amyloid had died (versus 7.5% in cAS; 6.9% in age >65 years). In univariable analyses, the presence of transthyretin amyloidosis amyloid had the highest hazard ratio for death (9.5 [95% confidence interval, 2.5–35.8];
P
=0.001).

Conclusions—
Occult wild-type transthyretin cardiac amyloid had a prevalence of 6% among patients with AS aged >65 years undergoing surgical aortic valve replacement and was associated with a poor outcome.
UDAN – Playing to Learn the Nuances of Entrepreneurship
Authors: Shankar Raj K. 
Published: August 2016

Background. Entrepreneurship courses are ubiquitous across educational institutions. While pedagogical innovations are being experimented with, using games to teach the nuances of starting up are rare. Problem. A practice-oriented subject like entrepreneurship is difficult to be taught using traditional methods. The elusive nature of the subject (entrepreneurship), its actors (entrepreneurs) and their actions (entrepreneurial) only make it worse. Approach. UDAN (means ‘Flight’ in Hindi) is a game, which solves this challenge. It simulates every aspect of the startup process in an entrepreneur’s journey. While running the game brings energy and enthusiasm amongst participants, it exposes them to the harsh realities, challenges and thrills of creating and running a startup. The Game. Participants are grouped into teams representing startups in an airplane manufacturing industry. Every team selects various key people for roles like CEO, HR, Sales, Finance, workforce etc. There are both government buyers as well as private airlines of different sizes making purchases. Buying raw materials, managing teams and their outputs, marketing, selling airplanes, negotiating prices, signing contracts, raising invoices, collecting payments, meeting quality standards and customer expectations are some experiences the game offers. Selecting a name, registering company with the local authorities, ensuring regulatory compliance, and filing returns are the other organizational activities that get simulated. Number of market and regulatory surprises are thrown in to expose participants to the realities of the business world. A debrief summarizes the lessons that the game offers. Practical Implications. Being an entrepreneur requires one to come to terms with numerous aspects of starting and running an enterprise. It does not entail doing only what you love doing. Entrepreneurship is a socially involved practice. The game gives participants a peek into the varied nuances of running a startup. It highlights the need for exposing themselves to number of aspects of starting and managing an enterprise. It prepares the ground for the faculty to deliver a course on entrepreneurship. Participants will be able to appreciate the variety of tools and techniques that a good entrepreneurship course offers.
Distinctive HLA‐II association with primary biliary cholangitis on the Island of Sardinia
Authors: Clemente Maria Grazia , Frau Fulvia , Bernasconi Matilde , Macis Maria Doloretta , Cicotto Lucia , Pilleri Giampaolo , De Virgiliis Stefano , Castiglia Paolo , Farci Patrizia 
Published: August 2016

BackgroundThe HLA DRB1 *08 allele associated with primary biliary cholangitis (PBC) among Caucasians is of low frequency in the Sardinian population.ObjectiveThe aim of our study was to type a cohort of PBC patients from the island of Sardinia for HLA class II antigens.MethodsTwenty Sardinian patients affected by PBC, 14 with autoimmune hepatitis (AIH) and 89 healthy controls (HCs) were typed for HLA class II alleles by dot‐blot analysis.ResultsThe PBC‐associated HLA DRB1 *08 allele was detected in none of the studied individuals. The DRB1 *0301–DQB1 *0201 was the prevalent HLA haplotype, detected in 19 (47.5%) out of 40 PBC haplotypes (OR = 3.0; 95% CI 1.5–6.2) and in 11 (39.3%) out of 28 AIH haplotypes (OR = 2.2; 95% CI 0.94–5.0), but in only 41 (23%) out of 178 HC haplotypes. Moreover, PBC patients showed an increased frequency of homozygosity for the DQB1 *0201 allele (35% compared with 6.7% of the HCs; OR = 7.5; 95% CI 2.2–25.7). The frequency of the DRB1*11 allele in the PBC group was about half of that seen in the Sardinian HCs (7.5% vs 15.7%) (p  = ns).ConclusionsOur study confirmed the low frequency of the HLA DRB1 *08 allele among Sardinians, either in the general population or PBC patients. The high prevalence of the HLA DRB1 *0301–DQB1 *0201 haplotype is a distinctive genetic feature of PBC among Sardinians. Our study strengthens the hypothesis that still unknown genetic, epigenetic, and environmental factors must be involved in the pathogenesis of different HLA‐associated liver diseases, and it represents a pathfinder that warrants exploration in a future extensive study.
Ethnic variation in acute cerebrovascular disease: Analysis from the Qatar stroke registry
Authors: Akhtar Naveed , Salam Abdul , Kamran Saadat , Bourke Paula , Joseph Sujatha , Santos Mark , Khan Rabia , Irfan Furqan , Deleu Dirk , Malik Rayaz A. , Shuaib Ashfaq 
Published: August 2016

Objective We analysed the Qatar stroke registry for ethnic variations in patients admitted with cerebrovascular disease at Hamad General Hospital, Qatar. Methods Patients admitted with acute stroke from January 2014 to December 2015, enrolled in the registry were included in the study. We evaluated the clinical presentation, risk factors, and outcome at discharge and 90 days post-discharge in relation to the patient’s ethnic background. Results A total of 1727 patients were enrolled in the Hamad General Hospital stroke registry (Middle Eastern 594 (34.4%), South East Asian 924 (53.5%) and Far Eastern 209 (12.1%)). There were significant differences in risk factors, clinical presentation and prognosis. Compared to Middle Eastern patients, Far Eastern patients were younger (62.8 ± 13.7 vs. 48.9 ± 9.1 years; p < 0.001). Diabetes and hypertension were significantly more common in Middle Eastern patients (358 (60.3%), 458 (77.1%)) compared to South East Asian patients (420 (45.5%), 596 (64.5%)) and Far Eastern patients (57 (27.3%), 154 (73.7%)), respectively (p < 0.001). Stroke was more severe in the Far Eastern group (median (interquartile range) – 5.0 (2–11.5)) compared to the Middle Eastern group (median (interquartile range) – 4.0 (1–8)) and South East Asian (median (interquartile range) – 4.0 (2–9)), p = 0.011. Mortality at 90 days was highest in patients from the Far East (15/209 (8.2%)) compared to the Middle East (35/594 (6.5%)) and South East Asia (33/924 (4.0)), p = 0.028. Patients from the Far East had significantly higher rates of intracranial hemorrhage compared to the Middle East and South East Asia (70/209 (33.5%), 77/594 (13.0%), and 169/924 (18.3%)), respectively (p < 0.001). Conclusion The early age at presentation and the poor control of risk factors, especially in patients from South East Asia and the Far East requires attention.
Regulatory roles of interferon-inducible protein 204 on differentiation and vasculogenic activity of endothelial progenitor cells
Authors: Yang Junjie , Zhang Xiaofei , Zhao Zhenao , Li Xizhe , Wang Xu , Chen Ming , Song Bo , Ii Masaaki , Shen Zhenya 
Published: August 2016

Abstract
Background
Endothelial progenitor cells (EPCs) have shown great potential in angiogenesis either by their differentiation into endothelial cells or by secretion of angiogenic factors. Interferon-inducible protein 204 (Ifi204) has been reported to participate in the regulation of cell growth and differentiation. However, its role in differentiation of EPCs remains unknown. We proposed that Ifi204 could modulate the differentiation and regenerative abilities of EPCs.

Methods
Ifi204-expressing lentivirus and Ifi204 siRNA were introduced into EPCs to overexpress and suppress the expression of Ifi204. Using fluorescence-activated cell sorting, immunocytochemistry, and quantitative PCR, endothelial markers including CD31, VE-cadherin, and vWF were detected in the modified EPCs. An in-vitro incorporation assay and a colony-forming assay were also performed.

Results
Evidence showed that Ifi204 inhibition decreased the endothelial differentiation and vasculogenic activities of EPCs in vitro. In mice with hindlimb ischemia, downregulation of Ifi204 in EPCs, which was tracked by our newly synthesized nanofluorogen, impaired neovascularization, with a corresponding reduction in hindlimb blood reperfusion by postoperative day 14.

Conclusions
Ifi204 is required for EPC differentiation and neovascularization in vitro and in vivo. The regulatory roles of Ifi204 in EPC differentiation may benefit the clinical therapy of ischemic vascular diseases.
Potential role of herbal remedies in stem cell therapy: proliferation and differentiation of human mesenchymal stromal cells
Authors: Udalamaththa Vindya Lankika , Jayasinghe Chanika Dilumi , Udagama Preethi Vidya 
Published: August 2016

AbstractStem cell therapy has revolutionized modern clinical therapy with the potential of stem cells to differentiate into many different cell types which may help to replace different cell lines of an organism. Innumerous trials are carried out to merge new scientific knowledge and techniques with traditional herbal extracts that may result in less toxic, affordable, and highly available natural alternative therapeutics. Currently, mesenchyamal stromal cell (MSC) lines are treated with individual and mixtures of crude herbal extracts, as well as with purified compounds from herbal extracts, to investigate the mechanisms and effects of these on stem cell growth and differentiation. Human MSCs (hMSCs) possess multilineage, i.e., osteogenic, neurogenic, adipogenic, chondrogenic, and myogenic, differentiation abilities. The proliferative and differentiation properties of hMSCs treated with herbal extracts have shown promise in diseases such as osteoporosis, neurodegenerative disorders, and other tissue degenerative disorders. Well characterized herbal extracts that result in increased rates of tissue regeneration may be used in both stem cell therapy and tissue engineering for replacement therapy, where the use of scaffolds and vesicles with enhanced attaching and proliferative properties could be highly advantageous in the latter. Although the clinical application of herbal extracts is still in progress due to the variability and complexity of bioactive constituents, standardized herbal preparations will strengthen their application in the clinical context. We have critically reviewed the proliferative and differentiation effects of individual herbal extracts on hMSCs mainly derived from bone marrow and elaborated on the plausible underlying mechanisms of action. To be fruitfully used in reparative and regenerative therapy, future directions in this area of study should (i) make use of hMSCs derived from different non-traditional sources, including medical waste material (umbilical cord, Wharton’s jelly, and placenta), (ii) take account of the vast numbers of herbal extracts used in traditional medicine globally, and (iii) investigate the mechanisms and pathways of their effects on hMSCs.
Pore geometry effects on elastic properties of Opalinus Clay
Authors: Keller Lukas M. 
Published: August 2016

Regarding the storage of nuclear waste within clay rock formations requires fundamental understanding of elastic properties of this rock type with regard to the risk evaluation process. The influence of the pore geometry on elastic properties of Opalinus Clay is studied on the basis of realistic pore microstructure, which is reconstructed from image data acquired by focused ion beam nanotomography. These microstructures are used as input pore geometries for linear elastic finite-element modeling to determine Thomsen’s [Formula: see text], [Formula: see text], and [Formula: see text] anisotropy parameters and the effective elastic moduli related to the porous material. The presence of fully drained intergranular pores substantially increases the values of [Formula: see text] and [Formula: see text]. For the investigated sample with an expected porosity of approximately 10 vol.%, the anisotropic pore space contributes similarly to the anisotropy parameters when compared with the contribution related to the preferred orientation of minerals. On the other hand, if the pore space is undrained, the effect of pores is smaller and the anisotropy is largely controlled by the preferred orientation of minerals. It is revealed that the value of [Formula: see text] is most sensitive to changes in water saturation. In case water is drained from the pores, the vertical Young’s modulus [Formula: see text] reduces significantly more when compared with the horizontal modulus [Formula: see text]. Presuming that the drainable porosity corresponds to a volume fraction of 10 vol.%, [Formula: see text] reduces by approximately 15%–20%. The effect of drainage is even more pronounced for the Poisson’s ratios, whereas the shear moduli are not much affected by drainage.
High-resolution seismic geomorphology and stratigraphy of a tunnel valley confined ice-margin fan (Elsterian glaciation, Southern North Sea)
Authors: Benvenuti Antonio , Moscariello Andrea 
Published: August 2016

The deep Middle Pleistocene subglacial incisions of the Southern North Sea (SNS) are commonly infilled by northward gently dipping clinoforms oriented toward the former ice-sheet core. We have focused on the terminal sector of the largest tunnel valley (TV) of the SNS and offer the first high-resolution reconstruction of the geomorphology and stratigraphy of the infill of the glacial incision, as well as the detailed geomorphology of the incision to better understand the genetic mechanisms of these uncommon but peculiar large-scale (up to 13 km in length) bedforms. For this study, high-resolution 3D seismic data, the grain-size distribution from ditch cutting samples, and the gamma-ray wireline log of borehole K14-12 are used. The TV formed in the subglacial environment by steady state flows in a time-transgressive fashion. Meltwater flow transports the eroded material southward and eventually deposits it at the ice-sheet margin, in the lightly grounded ice-sheet environment where the adverse slope forces the flow to wane. The process results in an elongated ice-margin fan made of clinoforms, whose grain-size distribution fines progressively southward, in the downstream direction. The formation and filling of the TV occurred during the retreat of the ice-sheet margin and cyclic fluctuations of the meltwater mass flow rate, which affected the internal stratigraphy and created an undulated top of the clinoforms’ unit. Sparsely distributed, horizontally layered units interpreted as distal proglacial lacustrine deposits filled depressions on the top of the clinoforms-bearing unit. The sequence was then sealed by a chaotic seismic-stratigraphic unit that probably belongs to postglacial times. The ice-sheet-oriented clinoforms were thus formed by sustained meltwater flow resulting from large-size Scandinavian and British convergent ice sheet flows in the freshwater environment of SNS developed between the complex ice margins and the topographic highs inherited from continental Europe.
Comprehensive Human Papillomavirus Genotyping in Cervical Squamous Cell Carcinomas and Its Relevance to Cervical Cancer Prevention in Malawian Women
Authors: Howitt Brooke E. , Herfs Michael , Tomoka Tamiwe , Kamiza Steve , Gheit Tarik , Tommasino Massimo , Delvenne Philippe , Crum Christopher P. , Milner Danny 
Published: August 2016

Purpose Cervical squamous cell carcinoma (SCC) continues to be a significant cause of cancer morbidity and is the third leading cause of cancer-related death in women worldwide. In sub-Saharan Africa, cervical cancer is not only the most common female cancer but also the leading cause of cancer-related deaths in women. Malawi, in particular, has the highest burden of cervical cancer. With the increasing use of human papillomavirus (HPV) vaccination, documenting the prevalent HPV types in those high-risk populations is necessary to both manage expectations of HPV vaccination and guide future vaccine development. Materials and Methods In this study, we performed HPV typing on 474 cervical SCC samples and analyzed the potential impact of HPV vaccination in this population. Results Ninety-seven percent of tumors were positive for at least one HPV type, and 54% harbored more than one HPV type. HPV 16 was the most common type (82%), followed by HPV 18 (34%), HPV 35 (24%), and HPV 31 (12%). A vaccine against HPV 16 and 18 would ideally prevent 53% of cervical SCC, and the nonavalent HPV vaccine (covering HPV 16, 18, 31, 33, 45, 52, and 58) would prevent 71% of cervical SCC in Malawi (assuming 100% vaccine efficacy). The main reason for a lack of coverage was high prevalence of HPV 35, which was also present as a single infection in a small subset of patients. Conclusion Although any HPV vaccination in this population would likely prevent a significant proportion of cervical cancer, the nonavalent vaccine would provide better coverage. Furthermore, investigation of the role of HPV 35 in this population, including possible cross-protection with other HPV types, should be pursued.
Practice and Impact of Multidisciplinary Tumor Boards on Patient Management: A Prospective Study
Authors: Charara Raghid N. , Kreidieh Firas Y. , Farhat Rania A. , Al-Feghali Karine A. , Khoury Katia E. , Haydar Ali , Nassar Lara , Berjawi Ghina , Shamseddine Ali , El Saghir Nagi S. 
Published: August 2016

Purpose Multidisciplinary tumor boards (MTBs) have become commonplace. The use, attendance, and function of MTBs need continued assessment and improvement. Methods We prospectively recorded and assessed all cases presented at MTBs between October 2013 and December 2014. Data were collected before and during each MTB. Data were analyzed using SPSS for Windows version 23 (SPSS, Chicago, IL). Results Five hundred three cases were presented: 234 cases (46%) at GI cancer MTBs, 149 cases (29.6%) at breast cancer MTBs, 69 cases (13.7%) at thoracic/head and neck cancer MTBs, and 51 cases (10.7%) at neuro-oncology MTBs. A total of 86.7% of MTB cases were presented to make plans for management. Plans for upfront management were made in 67% of the breast cancer cases, 63% of GI cases, 59% of thoracic/head and neck cases, and 49% of neuro-oncology cases. Three hundred ninety-four cases (78.3%) were presented by medical oncologists, whereas only 74 cases (14.7%) were presented by surgeons, and 10 cases (2%) were presented by radiation oncologists. The majority of MTBs, with the exception of the neurosurgery MTBs, were led by medical oncologists. Surgeons presented the least number of cases but attended the most, and their contributions to discussions and decision making were essential. Conclusion MTBs enhance the multidisciplinary management of patients with cancer. Upfront multidisciplinary decision making should be considered as an indicator of benefit from MTBs, in addition to changes in management plans made at MTBs. Increasing the contributions of surgeons to MTBs should include bringing more of their own cases for discussion.