bluuebunny/crossref_metadata_2025_split huggingface dataset:
Belimumab for the treatment of recalcitrant cutaneous lupus
Authors: Vashisht P , Borghoff K , O’Dell J R , Hearth-Holmes M 
Published: April 2017

Background Belimumab is a monoclonal antibody that reduces B lymphocyte survival by blocking the binding of soluble human B lymphocyte stimulator (BLyS) to its B cell receptors. The utility of belimumab for management of resistant systemic lupus erythematosus (SLE) skin manifestations has not been reported. We present our experience of using this novel molecule for the successful management of cutaneous lupus at our center. Methods We studied five patients with significant SLE skin manifestations. All patients met 1997 American College of Rheumatology (ACR) SLE criteria and had failed multiple medications to control their skin disease. SLE disease activity indexes (SLEDAI), Cutaneous LE disease Area and Severity Index (CLASI) and patient’s global assessment (PGA) were recorded before and 16 weeks after belimumab treatment. Belimumab was added to concomitant standard therapy. Results All five patients demonstrated marked clinical improvement subsequent to belimumab treatment. The average time to clinical improvement after treatment initiation was 8–12 weeks. SLEDAI scores (median, range) improved in all the patients ((2, 2–6) to (0, 0–4); p = 0.025). PGA scores (median, range) were better in all patients ((3, 2–3) to (1, 0–1); p = 0.039). CLASI activity scores (median, range) improved dramatically in all patients ((17, 9–31) to (3, 2–14); p = 0.043). There was no worsening of the CLASI damage scores. The mean daily prednisone dose decreased significantly from 31 mg (±18.8) at baseline to 3 mg (± 2.7) ( p = 0.042). Conclusion In this case series, the addition of belimumab to standard therapy improved the signs and symptoms of refractory cutaneous lupus. This is one of the first reports highlighting the potential utility of this medication for the treatment of severe skin involvement in SLE refractory to conventional therapies. Additional studies need to be performed to assess the use of belimumab in the treatment of cutaneous lupus.
A Cross-Sectional Study of Indoor Tanning in Fitness Centres
Authors: Huang Christina M. , Kirchhof Mark G. 
Published: April 2017

Background: Ultraviolet (UV) radiation is a human carcinogen and is associated with the development of skin cancer. The promotion of indoor tanning (IT) at fitness centres is of particular concern as it reinforces the idea that a tan is associated with health and fitness. The purpose of this study was to investigate the prevalence of IT in fitness centres, with an emphasis on determining the financial costs, adherence to regulations, and safety precautions. Methods: Ten cities, representing 9 different Canadian provinces, were chosen for the study. From each province, a minimum of 20 and a maximum of 30 fitness centres were randomly selected from the Yellow Pages website. Each fitness centre was contacted by the principal investigator and inquiries were made from a consumer’s perspective. Results: Of the 203 gyms surveyed, 43% (88/203) offered tanning facilities. Of these, 10.23% (9/88) were found to be noncompliant with the provincial IT regulations for age and/or time between tanning sessions. Interpretation: Despite the known risks of IT, not all fitness centres are compliant with provincial legislations regarding IT, and some continue to promote tanning access to minors.
A “kissing lesion”: In-vivo 7T evidence of meningeal inflammation in early multiple sclerosis
Authors: Kolber Pierre , Droby Amgad , Roebroeck Alard , Goebel Rainer , Fleischer Vinzenz , Groppa Sergiu , Zipp Frauke 
Published: April 2017

Background: The role of cortical lesions (CLs) in disease progression and clinical deficits is increasingly recognized in multiple sclerosis (MS); however the origin of CLs in MS still remains unclear. Objective: Here, we report a para-sulcal CL detected two years after diagnosis in a relapsing-remitting MS (RRMS) patient without manifestation of clinical deficit. Methods: Ultra-high field (7T) MR imaging using magnetization-prepared 2 rapid acquisition gradient echoes (MP2RAGE) sequence was performed. Results: A para-sulcal CL was detected which showed hypointense rim and iso- to hyperintense core. This was detected in the proximity of the leptomeninges in the left precentral gyrus extending to the adjacent postcentral gyrus. Conclusion: This finding indicates that inflammatory infiltration into the cortex through the meninges underlies cortical pathology already in the early stage of disease and in mild disease course.
Does Social Interaction Matter Psychological Well-Being in Persons With Dementia?
Authors: Lee Kyung Hee , Boltz Marie , Lee Hana , Algase Donna L. 
Published: April 2017

Background: Social interaction between residents and staff is an important factor influencing sense of well-being. This study examined the relationship between staff–resident interactions and psychological well-being of persons with dementia. Methods: A total of 831 observations of 110 persons with dementia in 17 nursing homes and 6 assisted living facilities were included. Psychological well-being was measured by observed displays of positive and negative emotional expressions. Social interaction was determined by the type of social interaction (ie, verbal interaction, nonverbal interaction, and both verbal and nonverbal interactions) and the quality of interaction (ie, positive, negative, and neutral). Results: Verbal or both verbal and nonverbal interactions showed significant relationship with positive and negative emotional expressions. Positive interaction was significantly associated with more positive emotional expression, whereas negative interaction was not. Conclusion: Staff–resident interactions are important to promote the psychological well-being of persons with dementia in residential care.
Basic critical care echocardiography: How many studies equate to competence? A pilot study using high fidelity echocardiography simulation
Authors: Bowcock Emma M , Morris Idunn S , Mclean Anthony S , Orde Sam R 
Published: April 2017

Background Assessment of competence in basic critical care echocardiography is complex. Competence relies on not only imaging accuracy but also interpretation and appropriate management decisions. The experience to achieve these skills, real-time, is likely more than required for imaging accuracy alone. We aimed to assess the feasibility of using simulation to assess number of studies required to attain competence in basic critical care echocardiography. Methods This is a prospective pilot study recruiting trainees at various degrees of experience in basic critical care echocardiography using experts as reference standard. We used high fidelity simulation to assess speed and accuracy using total time taken, total position difference and total angle difference across the basic acoustic windows. Interpretation and clinical application skills were assessed using a clinical scenario. ‘Cut-off’ values for number of studies required for competence were estimated. Results Twenty-seven trainees and eight experts were included. The subcostal view was achieved quickest by trainees (median 23 s, IQR 19–37). Eighty-seven percent of trainees did not achieve accuracy across all views; 81% achieved accuracy with the parasternal long axis and the least accurate was the parasternal short axis (44% of trainees). Fewer studies were required to be considered competent with imaging acquisition compared with competence in correct interpretation and integration (15 vs. 40 vs. 50, respectively). Discussion The use of echocardiography simulation to determine competence in basic critical care echocardiography is feasible. Competence in image acquisition appears to be achieved with less experience than correct interpretation and correct management decisions. Further studies are required.
Thrombotic thrombocytopenic purpura
Authors: Joly Bérangère S. , Coppo Paul , Veyradier Agnès 
Published: April 2017

AbstractThrombotic thrombocytopenic purpura (TTP) is a rare and life-threatening thrombotic microangiopathy characterized by microangiopathic hemolytic anemia, severe thrombocytopenia, and organ ischemia linked to disseminated microvascular platelet rich-thrombi. TTP is specifically related to a severe deficiency in ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 repeats, member 13), the specific von Willebrand factor-cleaving protease. ADAMTS13 deficiency is most frequently acquired via ADAMTS13 autoantibodies, but rarely, it is inherited via mutations of the ADAMTS13 gene. The first acute episode of TTP usually occurs during adulthood, with a predominant anti-ADAMTS13 autoimmune etiology. In rare cases, however, TTP begins as soon as childhood, with frequent inherited forms. TTP is ∼2-fold more frequent in women, and its outcome is characterized by a relapsing tendency. Rapid recognition of TTP is crucial to initiate appropriate treatment. The first-line therapy for acute TTP is based on daily therapeutic plasma exchange supplying deficient ADAMTS13, with or without steroids. Additional immune modulators targeting ADAMTS13 autoantibodies are mainly based on steroids and the humanized anti-CD20 monoclonal antibody rituximab. In refractory or unresponsive TTP, more intensive therapies including twice-daily plasma exchange; pulses of cyclophosphamide, vincristine, or cyclosporine A; or salvage splenectomy are considered. New drugs including N-acetylcysteine, bortezomib, recombinant ADAMTS13, and caplacizumab show promise in the management of TTP. Also, long-term follow-up of patients with TTP is crucial to identify the occurrence of other autoimmune diseases, to control relapses, and to evaluate psychophysical sequelae. Further development of both patients’ registries worldwide and innovative drugs is still needed to improve TTP management.
Hematopoietic transcription factor mutations: important players in inherited platelet defects
Authors: Songdej Natthapol , Rao A. Koneti 
Published: April 2017

AbstractTranscription factors (TFs) are proteins that bind to specific DNA sequences and regulate expression of genes. The molecular and genetic mechanisms in most patients with inherited platelet defects are unknown. There is now increasing evidence that mutations in hematopoietic TFs are an important underlying cause for defects in platelet production, morphology, and function. The hematopoietic TFs implicated in patients with impaired platelet function and number include runt-related transcription factor 1, Fli-1 proto-oncogene, E-twenty-six (ETS) transcription factor (friend leukemia integration 1), GATA-binding protein 1, growth factor independent 1B transcriptional repressor, ETS variant 6, ecotropic viral integration site 1, and homeobox A11. These TFs act in a combinatorial manner to bind sequence-specific DNA within promoter regions to regulate lineage-specific gene expression, either as activators or repressors. TF mutations induce rippling downstream effects by simultaneously altering the expression of multiple genes. Mutations involving these TFs affect diverse aspects of megakaryocyte biology, and platelet production and function, culminating in thrombocytopenia and platelet dysfunction. Some are associated with predisposition to hematologic malignancies. These TF variants may occur more frequently in patients with inherited platelet defects than generally appreciated. This review focuses on alterations in hematopoietic TFs in the pathobiology of inherited platelet defects.
Invariant natural killer T cells ameliorate murine chronic GVHD by expanding donor regulatory T cells
Authors: Du Jing , Paz Katelyn , Thangavelu Govindarajan , Schneidawind Dominik , Baker Jeanette , Flynn Ryan , Duramad Omar , Feser Colby , Panoskaltsis-Mortari Angela , Negrin Robert S. , Blazar Bruce R. 
Published: April 2017

Key Points
Low doses of donor iNKT infusion prevent and reverse murine cGVHD. iNKT efficacy in treating established cGVHD is dependent on donor Treg expansion.
Prevalence of Complementary Medicine Use in Patients With Cancer: A Turkish Comprehensive Cancer Center Experience
Authors: Yalcin Suayib , Hurmuz Pervin , McQuinn Lacey , Naing Aung 
Published: April 2017

Purpose Complementary and alternative medicine (CAM) has been popular among patients with cancer for several decades. The objectives of this study were to evaluate the prevalence of CAM use and to identify the factors affecting CAM use in a large patient cohort seen at a comprehensive cancer center in Turkey. Patients and Methods An investigator-designed survey was completed by volunteer patients who visited the outpatient clinic in the medical oncology department. CAM use encompassed pharmacologic agents including vitamins, dietary supplements, and herbal products or nonpharmacologic methods like prayer, meditation, hypnosis, massage, or acupuncture. Results Of 1,499 patients who answered the survey, 1,433 (96%) used nonpharmacologic CAM and 60 (4%) used pharmacologic CAM (pCAM). The most frequent types of CAM used were prayer (n = 1,433) followed by herbal products (n = 42). pCAM use was not significantly associated with age ( P = .63), sex ( P = .15), diagnosis ( P = .15), or income level ( P = .09). However, it was significantly associated with the level of education ( P = .0067) and employment status ( P < .001). Patients with higher education levels used more pCAM products ( P = .025). Among 60 pCAM users, six patients (10%) used pCAM for more than 2 years and 22 (36%) did not consult their physicians about their pCAM use. Only nine patients (15%) reported unpleasant adverse effects related to pCAM. Conclusion Although CAM use was high among our patients, prevalence of pCAM use was lower than expected. Patients with higher education levels tended to use more pCAM.
Treatment of Pediatric Obesity: An Umbrella Systematic Review
Authors: Rajjo Tamim , Mohammed Khaled , Alsawas Mouaz , Ahmed Ahmed T. , Farah Wigdan , Asi Noor , Almasri Jehad , Prokop Larry J. , Murad Mohammad Hassan 
Published: April 2017

Abstract

Objective:
Multiple interventions are available to reduce excess body weight in children. We appraised the quality of evidence supporting each intervention and assessed the effectiveness on different obesity-related outcomes.

Methods:
We conducted a systematic search for systematic reviews of randomized controlled trials evaluating pediatric obesity interventions applied for ≥6 months. We assessed the quality of evidence for each intervention using GRADE (Grading of Recommendation, Assessment, Development, and Evaluation) approach.

Results:
From 16 systematic reviews, we identified 133 eligible randomized controlled trials. Physical activity interventions reduced systolic blood pressure and fasting glucose (low to moderate quality of evidence). Dietary interventions with low-carbohydrate diets had a similar effect to low-fat diets in terms of body mass index (BMI) reduction (moderate quality of evidence). Educational interventions reduced waist circumference, BMI, and diastolic blood pressure (low quality of evidence). Pharmacological interventions reduced BMI (metformin, sibutramine, orlistat) and waist circumference (sibutramine, orlistat) and increased high-density lipoprotein cholesterol (sibutramine) but also raised systolic and diastolic blood pressure (sibutramine). Surgical interventions (laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass, sleeve gastrectomy) resulted in the largest BMI reduction (moderate quality of evidence). Combined interventions consisting of dietary modification, physical activity, behavioral therapy, and education significantly reduced systolic and diastolic blood pressure, BMI, and triglycerides. Combined parent–child interventions and parent-only interventions had similar effects on BMI (low quality of evidence).

Conclusions:
Several childhood obesity interventions are effective in improving metabolic and anthropometric measures. A comprehensive multicomponent intervention, however, appears to have the best overall outcomes.
Radiotherapy, Especially at Young Age, Increases the Risk for De Novo Brain Tumors in Patients Treated for Pituitary/Sellar Lesions
Authors: Burman Pia , van Beek André P. , Biller Beverly M. K. , Camacho-Hübner Cecilia , Mattsson Anders F. 
Published: April 2017

Abstract

Context:
De novo brain tumors developing after treatment of pituitary/sellar lesions have been reported, but it is unknown whether this is linked to any of the treatment modalities.

Objective:
To study the occurrence of malignant brain tumors and meningiomas in a large cohort of patients treated for pituitary/sellar lesions, with special emphasis on the role of radiotherapy (RT).

Patients and Methods:
Patients (n = 8917) who were hypopituitary due to pituitary adenomas, craniopharyngiomas, and other sellar tumors followed in KIMS (Pfizer International Metabolic Database) from 1994 to 2012 were included. Treatment consisted of surgery and/or medical therapy in 4927 patients, RT alone, or with surgery in 3236 patients; data were missing in 754. Incidence rate ratios (RRs) were analyzed through Poisson regression methods with internal comparisons.

Results:
During 53,786 patient-years, 17 cases of malignant brain tumors (13 exposed to RT) and 27 meningiomas (22 exposed to RT) were reported. RR for RT vs no RT was 3.34 [95% confidence interval (CI), 1.06 to 10.6] for malignant brain tumors, and 4.06 (95% CI, 1.51 to 10.9) for meningiomas. The risk of developing a malignant brain tumor increased by 2.4-fold (P = 0.005) and meningioma by 1.6-fold with every 10 years of younger age at RT (P = 0.05). Incidence rates were similar in patients treated with conventional RT compared with stereotactic RT.

Conclusion:
RT of pituitary tumors is associated with increased risk of developing malignant brain tumors and meningiomas, especially when given at younger ages. In balancing risks and benefits of RT, our findings emphasize that special consideration should be given to the age of the patient.
The Logical Burdens of Proof. Assertion and Hypothesis
Authors: Chiffi Daniele , Schang Fabien 
Published: April 2017

The paper proposes two logical analyses of (the norms of) justification. In a first, realist-minded case, truth is logically independent from justification and leads to a pragmatic logic LP including two epistemic and pragmatic operators, namely, assertion and hypothesis. In a second, antirealist-minded case, truth is not logically independent from justification and results in two logical systems of information and justification: AR4 and AR4¢, respectively, provided with a question-answer semantics. The latter proposes many more epistemic agents, each corresponding to a wide variety of epistemic norms. After comparing the different norms of justification involved in these logical systems, two hexagons expressing Aristotelian relations of opposition will be gathered in order to clarify how (a fragment of) pragmatic formulas can be interpreted in a fuzzy-based question-answer semantics.
Notions of Maximality for Integral Lattice-Free Polyhedra: The Case of Dimension Three
Authors: Averkov Gennadiy , Krümpelmann Jan , Weltge Stefan 
Published: April 2017

Lattice-free sets and their applications for cutting-plane methods in mixed-integer optimization have been studied in recent literature. The family of all integral lattice-free polyhedra that are not properly contained in another integral lattice-free polyhedron has been of particular interest. We call these polyhedra ℤd-maximal. For fixed d, the family of ℤd-maximal integral lattice-free polyhedra is finite up to unimodular equivalence. In view of possible applications in cutting-plane theory, one would like to have a classification of this family. This is a challenging task already for small dimensions. In contrast, the subfamily of all integral lattice-free polyhedra that are not properly contained in any other lattice-free set, which we call ℝd-maximal lattice-free polyhedra, allow a rather simple geometric characterization. Hence, the question was raised for which dimensions the notions of ℤd-maximality and ℝd-maximality are equivalent. This was known to be the case for dimensions one and two. On the other hand, for d ≥ 4 there exist integral lattice-free polyhedra that are ℤd-maximal but not ℝd-maximal. We consider the remaining case d = 3 and prove that for integral lattice-free polyhedra the notions of ℝ3-maximality and ℤ3-maximality are equivalent. This allows to complete the classification of all ℤ3-maximal integral lattice-free polyhedra.
A History of Everyday Things in England: Illustrators of mid-twentieth-century social history books
Authors: McCannon Desdemona 
Published: April 2017

Abstract
The illustrated books considered in this article present histories of everyday life and align with the genre of history writing that had existed at least since the nineteenth century, of women documenting the domestic sphere, challenging the hegemonic and dominant narratives of history and presenting ‘Englishness’ instead within the practices and objects of the everyday. The use of illustrations to evoke empathy, describe the detail of ordinary lives and offer graphic interpretations of data shows an engagement with the pedagogical possibilities of visual literacy in schoolbooks, allied to developments in the state school system at the time. The books demonstrate a variety of approaches towards the function of illustration in textbooks for children. These approaches include presenting ‘picturesque’ narratives, promoting imaginative empathy through the use of contempareneous visual source material, and encouraging critical thinking through pattern recognition in the assessment of information graphics. The article considers the visual mode in each book and maps its production onto social, political and ideological contexts of mid-twentieth-century England, offering feminist perspectives on the notion of history writing, scholarship and pedagogy.
Loss of α-Synuclein Does Not Affect Mitochondrial Bioenergetics in Rodent Neurons
Authors: Pathak Divya , Berthet Amandine , Bendor Jacob T. , Yu Katharine , Sellnow Rhyomi C. , Orr Adam L. , Nguyen Mai K , Edwards Robert H. , Manfredsson Fredric P. , Nakamura Ken 
Published: April 2017

AbstractIncreased α-synuclein (αsyn) and mitochondrial dysfunction play central roles in the pathogenesis of Parkinson’s disease (PD), and lowering αsyn is under intensive investigation as a therapeutic strategy for PD. Increased αsyn levels disrupt mitochondria and impair respiration, while reduced αsyn protects against mitochondrial toxins, suggesting that interactions between αsyn and mitochondria influences the pathologic and physiologic functions of αsyn. However, we do not know if αsyn affects normal mitochondrial function or if lowering αsyn levels impacts bioenergetic function, especially at the nerve terminal where αsyn is enriched. To determine if αsyn is required for normal mitochondrial function in neurons, we comprehensively evaluated how lowering αsyn affects mitochondrial function. We found that αsyn knockout (KO) does not affect the respiration of cultured hippocampal neurons or cortical and dopaminergic synaptosomes, and that neither loss of αsyn nor all three (α, β and γ) syn isoforms decreased mitochondria-derived ATP levels at the synapse. Similarly, neither αsyn KO nor knockdown altered the capacity of synaptic mitochondria to meet the energy requirements of synaptic vesicle cycling or influenced the localization of mitochondria to dopamine (DA) synapsesin vivo. Finally, αsyn KO did not affect overall energy metabolism in mice assessed with a Comprehensive Lab Animal Monitoring System. These studies suggest either that αsyn has little or no significant physiological effect on mitochondrial bioenergetic function, or that any such functions are fully compensated for when lost. These results implicate that αsyn levels can be reduced in neurons without impairing (or improving) mitochondrial bioenergetics or distribution.