bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bed utilisation and increased risk ofClostridium difficileinfections in acute hospitals in England in 2013/2014
Authors: Vella Venanzio , Aylin Paul P , Moore Luke , King Alice , Naylor Nichola R , Birgand Gabriel J C , Lishman Hannah , Holmes Alison 
Published: September 2016

BackgroundThe study aimed to identify thresholds for hospital bed utilisation which are independently associated with significantly higher risks forClostridium difficileinfections (CDI) in acute hospitals in England.MethodA retrospective analysis was carried out on reported data from the English National Health Service (NHS) for the financial year 2013/2014. Reported rates of CDI were used as a proxy for hospital infection rates in acute NHS hospital trusts. Multivariate linear regression was used to assess the relationship between bed utilisation values and CDI controlling for confounding factors. Hospitals were finally plotted in a Pabon Lasso graph according to their average bed occupancy rate (BOR) and bed turnover rate (BTR) per year to visualise the relationship between bed utilisation and CDI.ResultsAmong English hospital NHS trusts, increasing BTR and decreasing BOR were associated with a decrease in CDI. However, this effect was not large, and patient mix had a larger impact on CDI rates than bed utilisation.ConclusionsWhile policymakers and managers wishing to target healthcare providers with high CDI rates should look at bed utilisation measures, focusing on these alone is unlikely to have the desired impact. Instead, strategies to combat CDI must take a wider perspective on contributory factors at the institutional level.
P2Y12 hyporesponse (PRU>200) is not associated with increased thromboembolic complications in anterior circulation Pipeline
Authors: Bender Matthew T , Lin Li-Mei , Colby Geoffrey P , Lubelski Daniel , Huang Judy , Tamargo Rafael J , Coon Alexander L 
Published: September 2016

IntroductionRecent reports suggest that thromboembolic complications are associated with Pipeline embolization device (PED) placement cluster in P2Y12 hyporesponders.ObjectiveTo evaluate the role of P2Y12 hyporesponse in PED placement by retrospectively reviewing a single-center series of patients.MethodsWe retrospectively reviewed an institutional review board-approved database of patients with an aneurysm at a single institution and identified all patients with a measured P2Y12 reaction unit (PRU)>200 who had undergone anterior circulation PED placement. Events such as transient ischemic attack, stroke, and hemorrhage were identified as well as demographic and procedural details.ResultsFifty-two patients with a PRU >200 had undergone anterior circulation PED placement. Four patients had prior subarachnoid hemorrhage (SAH) (8%) and 11 aneurysms (21%) had been previously treated. The average aneurysm size was 7.6 mm (±6.2). PED thrombosis occurred intraprocedurally in three patients, none of whom developed neurological deficits after abciximab administration. Treatment of all patients was successful and 48 procedures (92%) had no complications. One patient had a major stroke (2%) with permanent hemiparesis. There were three minor complications (6%): one minor stroke with a visual field cut, one 10 cc intracranial hemorrhage with transient left lower extremity weakness, and one transient neurological deficit not verified by imaging. No deaths or cases of SAH occurred.ConclusionsP2Y12 hyporesponse (PRU>200) is not associated with increased periprocedural complications in a contemporary series of patients undergoing anterior circulation PED placement. Titration of antiplatelet medications to P2Y12 >200 remains unindicated and may increase the risk of hemorrhagic complications.
Total mastectomy in a cow with gangrenous mastitis
Authors: Ortega‐Pacheco Antonio , Aguilar‐Caballero Armando J , Jimenez‐Coello Matilde , Tzab Rene , Gutierrez‐Blanco Eduardo 
Published: September 2016

A three‐year‐old recently calved, dual‐purpose cow (Brown Swiss/zebu) presenting with signs of inappetence was examined. The udder was hot and painful. The left hide teat appeared black in colour and was cold to the touch with a bloody discharge evident on stripping the teat. The other teats had a normal appearance and a few drops of watery milk were coming. A gangrenous mastitis was diagnosed. The histopathology showed the presence of coagulative necrosis and fibrosis. Given the cow's commercial value and udder condition, a total mastectomy was performed. Induction and maintenance of anaesthesia was provided by a constant rate infusion of ketamine‐xylazine and a regional block was performed. Laboratory cultures were positive for Pseudomonas. Ciprofloxacin was provided for 10 days, and topical treatment with a commercial bee honey product was applied covering all the open wounds. After 45 days, the wound granulated; the cow successfully bred and a healthy calf resulted.
Extreme rainfall impacts on soil CO2efflux in an urban forest ecosystem in Beijing, China
Authors: Chen Wenjing , Jia Xin , Li Chunyi , Yu Haiqun , Xie Jing , Wang Ben , Wu Yajuan , Wang Shan 
Published: September 2016

Extreme rainfall events are infrequent disturbances that affect urban environments and soil respiration (Rs). Using data measured in an urban forest ecosystem in Beijing, China, we examined the link between gross primary production (GPP) and soil respiration on a diurnal scale during an extreme rainfall event (i.e., the “21 July 2012 event”), and we examined diel and seasonal environmental controls on Rs. Over the seasonal cycle, Rs increased exponentially with soil temperature (Ts). In addition, Rs was hyperbolically related to soil volumetric water content (VWC), increasing with VWC below a threshold of 0.17 m3m−3, and then decreasing with further increases in VWC. Following the extreme rainfall event (177 mm), Rs showed an abrupt decrease and then maintained a low value of ∼0.3 μmol m−2s−1for about 8 h as soil VWC reached the field capacity (0.34 m3m−3). Rs became decoupled from Ts and increased very slowly, while GPP showed a greater increase. A bivariate Q10-hyperbolical model, which incorporates both Ts and VWC effects, better fits Rs than the Q10model in summer but not for whole year.
Selection Lemmas for Various Geometric Objects
Authors: Ashok Pradeesha , Govindarajan Sathish , Rajgopal Ninad 
Published: September 2016

Selection lemmas are classical results in discrete geometry that have been well studied and have applications in many geometric problems like weak epsilon nets and slimming Delaunay triangulations. Selection lemma type results typically show that there exists a point that is contained in many objects that are induced (spanned) by an underlying point set. In the first selection lemma, we consider the set of all the objects induced by a point set [Formula: see text]. This question has been widely explored for simplices in [Formula: see text], with tight bounds in [Formula: see text]. In our paper, we prove first selection lemma for other classes of geometric objects like boxes and balls in [Formula: see text]. We also consider the strong variant of this problem where we add the constraint that the piercing point comes from [Formula: see text]. We prove an exact result on the strong and the weak variant of the first selection lemma for axis-parallel rectangles and disks (for centrally symmetric point sets). We also show non-trivial bounds on the first selection lemma for axis-parallel boxes and balls in [Formula: see text]. In the second selection lemma, we consider an arbitrary [Formula: see text] sized subset of the set of all objects induced by [Formula: see text]. We study this problem for axis-parallel rectangles and show that there exists a point in the plane that is contained in [Formula: see text] rectangles. This is an improvement over the previous bound by Smorodinsky and Sharir22 when [Formula: see text] is almost quadratic.
Lower Bounds on the Dilation of Plane Spanners
Authors: Dumitrescu Adrian , Ghosh Anirban 
Published: September 2016

(I) We exhibit a set of 23 points in the plane that has dilation at least [Formula: see text], improving the previous best lower bound of [Formula: see text] for the worst-case dilation of plane spanners. (II) For every [Formula: see text], there exists an [Formula: see text]-element point set [Formula: see text] such that the degree [Formula: see text] dilation of [Formula: see text] equals [Formula: see text] in the domain of plane geometric spanners. In the same domain, we show that for every [Formula: see text], there exists a an [Formula: see text]-element point set [Formula: see text] such that the degree [Formula: see text] dilation of [Formula: see text] equals [Formula: see text] The previous best lower bound of [Formula: see text] holds for any degree. (III) For every [Formula: see text], there exists an [Formula: see text]-element point set [Formula: see text] such that the stretch factor of the greedy triangulation of [Formula: see text] is at least [Formula: see text].
Genome-Wide miRNA Analysis Identifies miR-188-3p as a Novel Prognostic Marker and Molecular Factor Involved in Colorectal Carcinogenesis
Authors: Pichler Martin , Stiegelbauer Verena , Vychytilova-Faltejskova Petra , Ivan Cristina , Ling Hui , Winter Elke , Zhang Xinna , Goblirsch Matthew , Wulf-Goldenberg Annika , Ohtsuka Masahisa , Haybaeck Johannes , Svoboda Marek , Okugawa Yoshinaga , Gerger Armin , Hoefler Gerald , Goel Ajay , Slaby Ondrej , Calin George Adrian 
Published: September 2016

Abstract
Purpose: Characterization of colorectal cancer transcriptome by high-throughput techniques has enabled the discovery of several differentially expressed genes involving previously unreported miRNA abnormalities. Here, we followed a systematic approach on a global scale to identify miRNAs as clinical outcome predictors and further validated them in the clinical and experimental setting.
Experimental Design: Genome-wide miRNA sequencing data of 228 colorectal cancer patients from The Cancer Genome Atlas dataset were analyzed as a screening cohort to identify miRNAs significantly associated with survival according to stringent prespecified criteria. A panel of six miRNAs was further validated for their prognostic utility in a large independent validation cohort (n = 332). In situ hybridization and functional experiments in a panel of colorectal cancer cell lines and xenografts further clarified the role of clinical relevant miRNAs.
Results: Six miRNAs (miR-92b-3p, miR-188-3p, miR-221-5p, miR-331-3p, miR-425-3p, and miR-497-5p) were identified as strong predictors of survival in the screening cohort. High miR-188-3p expression proves to be an independent prognostic factor [screening cohort: HR = 4.137; 95% confidence interval (CI), 1.568–10.917; P = 0.004; validation cohort: HR = 1.538; 95% CI, 1.107–2.137; P = 0.010, respectively]. Forced miR-188-3p expression increased migratory behavior of colorectal cancer cells in vitro and metastases formation in vivo (P &lt; 0.05). The promigratory role of miR-188-3p is mediated by direct interaction with MLLT4, a novel identified player involved in colorectal cancer cell migration.
Conclusions: miR-188-3p is a novel independent prognostic factor in colorectal cancer patients, which can be partly explained by its effect on MLLT4 expression and migration of cancer cells. Clin Cancer Res; 23(5); 1323–33. ©2016 AACR.
Intratumor Heterogeneity of Homologous Recombination Deficiency in Primary Breast Cancer
Authors: von Wahlde Marie-Kristin , Timms Kirsten M. , Chagpar Anees , Wali Vikram B. , Jiang Tingting , Bossuyt Veerle , Saglam Ozlen , Reid Julia , Gutin Alexander , Neff Chris , Lanchbury Jerry S. , Hatzis Christos , Hofstatter Erin , Pusztai Lajos 
Published: September 2016

Abstract
Purpose: The 3-biomarker homologous recombination deficiency (HRD) assay measures the number of telomeric allelic imbalances, loss of heterozygosity, and large-scale state transitions in tumor DNA and combines these metrics into a single score that reflects DNA repair deficiency. The goal of this study is to assess the consistency of these HRD measures in different biopsies from distinct areas of the same cancer.
Experimental Design: HRD scores, BRCA mutation status, and BRCA1 promoter methylation were assessed in 99 samples from 33 surgically resected, stage I–III breast cancers; each cancer was biopsied in three distinct areas. Homologous recombination repair (HR) deficiency was defined as either high HRD score (≥42) or tumor BRCA mutation.
Results: Eighty-one biopsies from 32 cancers were analyzed. Tumor BRCA status was available for all samples, HRD scores for 70, and BRCA1 methylation values for 76 samples. The BRCA1/2 mutation and promoter methylation status and HR category showed perfect concordance across all biopsies from the same cancer. All tumors with BRCA1/2 mutations or promoter methylation had high HRD scores, as did 17% (4/24) of the BRCA1/2 wild-type and nonmethylated tumors. The HRD scores were also highly consistent between different biopsies from the same tumor with an intraclass correlation coefficient of 0.977, indicating that only 2.3% of the variance is attributed to within-tumor biopsy-to-biopsy variation.
Conclusions: These results indicate that within-tumor spatial heterogeneity for HRD metrics and the technical noise in the assay are small and do not influence HRD scores and HR status. Clin Cancer Res; 23(5); 1193–9. ©2016 AACR.
Whole Genomic Copy Number Alterations in Circulating Tumor Cells from Men with Abiraterone or Enzalutamide-Resistant Metastatic Castration-Resistant Prostate Cancer
Authors: Gupta Santosh , Li Jing , Kemeny Gabor , Bitting Rhonda L. , Beaver Joshua , Somarelli Jason A. , Ware Kathryn E. , Gregory Simon , Armstrong Andrew J. 
Published: September 2016

Abstract
Purpose: Beyond enumeration, circulating tumor cells (CTCs) can provide genetic information from metastatic cancer that may facilitate a greater understanding of tumor biology and enable a precision medicine approach.
Experimental Design: CTCs and paired leukocytes from men with metastatic castration-resistant prostate cancer (mCRPC) were isolated from blood through red cell lysis, CD45 depletion, and flow sorting based on EpCAM/CD45 expression. We next performed whole genomic copy number analysis of CTCs and matched patient leukocytes (germline) using array-based comparative genomic hybridization (aCGH) from 16 men with mCRPC, including longitudinal and sequential aCGH analyses of CTCs in the context of enzalutamide therapy.
Results: All patients had mCRPC and primary or acquired resistance to abiraterone acetate or enzalutamide. We compiled copy gains and losses, with a particular focus on those genes highly implicated in mCRPC progression and previously validated as being aberrant in metastatic tissue samples and genomic studies of reference mCRPC datasets. Genomic gains in &gt;25% of CTCs were observed in AR, FOXA1, ABL1, MET, ERG, CDK12, BRD4, and ZFHX3, while common genomic losses involved PTEN, ZFHX3, PDE4DIP, RAF1, and GATA2. Analysis of aCGH in a sample with sequential enzalutamide-resistant visceral progression showed acquired loss of AR amplification concurrent with gain of MYCN, consistent with evolution toward a neuroendocrine-like, AR-independent clone.
Conclusions: Genomic analysis of pooled CTCs in men with mCRPC suggests a reproducible, but highly complex molecular profile that includes common aberrations in AR, ERG, c-MET, and PI3K signaling during mCRPC progression, which may be useful for predictive biomarker development. Clin Cancer Res; 23(5); 1346–57. ©2016 AACR.
c-Jun N-Terminal Kinase Inactivation by Mitogen-Activated Protein Kinase Phosphatase 1 Determines Resistance to Taxanes and Anthracyclines in Breast Cancer
Authors: Rincón Raúl , Zazo Sandra , Chamizo Cristina , Manso Rebeca , González-Alonso Paula , Martín-Aparicio Ester , Cristóbal Ion , Cañadas Carmen , Perona Rosario , Lluch Ana , Eroles Pilar , García-Foncillas Jesús , Albanell Joan , Rovira Ana , Madoz-Gúrpide Juan , Rojo Federico 
Published: September 2016

Abstract
MAPK phosphatase-1 (MKP-1) is overexpressed during malignant transformation of the breast in many patients, and it is usually associated with chemoresistance through interference with JNK-driven apoptotic pathways. Although the molecular settings of the mechanism have been documented, details about the contribution of MKP-1 to the failure of chemotherapeutic interventions are unclear. Transient overexpression of MKP-1 and treatment with JNK-modulating agents in breast carcinoma cells confirmed the mediation of MKP-1 in the resistance to taxanes and anthracyclines in breast cancer, through the inactivation of JNK1/2. We next assessed MKP-1 expression and JNK1/2 phosphorylation status in a large cohort of samples from 350 early breast cancer patients treated with adjuvant anthracycline–based chemotherapy. We detected that MKP-1 overexpression is a recurrent event predominantly linked to dephosphorylation of JNK1/2 with an adverse impact on relapse of the tumor and overall and disease-free survival. Moreover, MKP-1 and p-JNK1/2 determinations in 64 locally advanced breast cancer patients treated with neoadjuvant taxane–based chemotherapy showed an inverse correlation between MKP-1 overexpression (together with JNK1/2 inhibition) and the pathologic response of the tumors. Our results emphasize the importance of MKP-1 as a potential predictive biomarker for a subset of breast cancer patients with worse outcome and less susceptibility to treatment. Mol Cancer Ther; 15(11); 2780–90. ©2016 AACR.
Cardiovascular Magnetic Resonance Findings Late After the Arterial Switch Operation
Authors: Shepard Charles W. , Germanakis Ioannis , White Matthew T. , Powell Andrew J. , Co-Vu Jennifer , Geva Tal 
Published: September 2016

Background—
Despite its robust diagnostic capabilities in adolescents and adult patients after the arterial switch operation, little information is available on the cardiovascular magnetic resonance findings in this population.

Methods and Results—

The cardiovascular magnetic resonance findings of 220 consecutive patients evaluated in our center were retrospectively reviewed (median age at cardiovascular magnetic resonance, 15.4 years; 66.8% male sex). Compared with published normal values, left and right ventricular end-diastolic volume
z
scores were mildly enlarged (0.48±1.76 and 0.33±1.5;
P
=0.0003 and 0.0038, respectively), with 26% of patients having left ventricular dilatation and 20% having right ventricular dilatation. Left ventricular dysfunction was present in 21.5% of patients (mild in most), and only 5.1% of patients had mild right ventricular dysfunction. Myocardial scar was found in 1.8% of patients. Dilatation of the neoaortic root was common (76%), and root
z
score increased at an average rate of 0.03 points per year. By multivariable analysis, neoaortic root dilatation was associated with worse neoaortic valve regurgitation (OR, 5.29;
P
=0.0016). The diameters of the thoracic aorta distal to the root were near-normal in most patients, whereas the neomain pulmonary artery was typically oval shaped with decreased anteroposterior and normal lateral diameters.

Conclusions—
Although the majority of arterial switch operation patients have normal ventricular size and function and myocardial scar is rare, an important minority exhibits ventricular enlargement or dysfunction. Neoaortic root dilatation, which is present in most patients and progresses over time, is strongly associated with significant neoaortic valve regurgitation. The findings of this study provide reference values against which arterial switch operation patients can be compared with their peers.
Do Acute Myocardial Infarction and Heart Failure Readmissions Flagged as Potentially Preventable by the 3M Potentially Preventable Readmissions Software Have More Process-of-Care Problems?
Authors: Borzecki Ann M. , Chen Qi , Mull Hillary J. , Shwartz Michael , Bhatt Deepak L. , Hanchate Amresh , Rosen Amy K. 
Published: September 2016

Background—
The 3M Potentially Preventable Readmissions (3M-PPR) software matches clinically related index admission and readmission diagnoses that may signify in-hospital or postdischarge quality problems. To assess whether the PPR algorithm identifies preventable readmissions, we compared processes of care between PPR software-flagged and nonflagged cases.

Methods and Results—

Using 2006 to 2010 national VA administrative data, we identified acute myocardial infarction and heart failure discharges associated with 30-day all-cause readmissions, then flagged cases (PPR-Yes/PPR-No) using the 3M-PPR software. To assess care quality, we abstracted medical records of 100 readmissions per condition using tools containing explicit processes organized into admission work-up, in-hospital evaluation/treatment, discharge readiness, postdischarge period. We derived quality scores, scaled to a maximum of 25 per section (maximum total score=100) and compared cases on total and section-specific mean scores. For acute myocardial infarction, 77 of 100 cases were flagged as PPR-Yes. Section quality scores were highest for in-hospital evaluation/treatment (20.5±2.8) and lowest for postdischarge care (6.8±9.1). Total and section-related mean scores did not differ by PPR status; respective PPR-Yes versus PPR-No total scores were 61.6±11.1 and 60.4±9.4;
P
=0.98. For heart failure, 86 of 100 cases were flagged as PPR-Yes. Section scores were highest for discharge readiness (18.8±2.4) and lowest for postdischarge care (7.3±8.1). Like acute myocardial infarction, total and section-related mean scores did not differ by PPR status; PPR-Yes versus PPR-No total scores were 61.2±10.8 and 63.4±7.0, respectively;
P
=0.47.

Conclusions—
Among VA acute myocardial infarction and heart failure readmissions, the 3M-PPR software does not distinguish differences in case-level quality of care. Whether 3M-PPR software better identifies preventable readmissions by using other methods to capture poorly documented processes or performing different comparisons requires further study.
Prediction of Stroke Onset Is Improved by Relative Fluid-Attenuated Inversion Recovery and Perfusion Imaging Compared to the Visual Diffusion-Weighted Imaging/Fluid-Attenuated Inversion Recovery Mismatch
Authors: Wouters Anke , Dupont Patrick , Norrving Bo , Laage Rico , Thomalla Götz , Albers Gregory W. , Thijs Vincent , Lemmens Robin 
Published: September 2016

Background and Purpose—
Acute stroke patients with unknown time of symptom onset are ineligible for thrombolysis. The diffusion-weighted imaging and fluid-attenuated inversion recovery (FLAIR) mismatch is a reasonable predictor of stroke within 4.5 hours of symptom onset, and its clinical usefulness in selecting patients for thrombolysis is currently being investigated. The accuracy of the visual mismatch rating is moderate, and we hypothesized that the predictive value of stroke onset within 4.5 hours could be improved by including various clinical and imaging parameters.

Methods—

In this study, 141 patients in whom magnetic resonance imaging was obtained within 9 hours after symptom onset were included. Relative FLAIR signal intensity was calculated in the region of nonreperfused core. Mean
T
max
was calculated in the total region with
T
max
>6 s. Mean relative FLAIR, mean
T
max
, lesion volume with
T
max
>6 s, age, site of arterial stenosis, core volume, and location of infarct were analyzed by logistic regression to predict stroke onset time before or after 4.5 hours.

Results—

Receiver-operating characteristic curve analysis revealed an area under the curve of 0.68 (95% confidence interval 0.59–0.78) for the visual diffusion-weighted imaging/FLAIR mismatch, thereby correctly classifying 69% of patients with an onset time before or after 4.5 hours. Age, relative FLAIR, and
T
max
increased the accuracy significantly (
P
<0.01) to an area under the curve of 0.82 (95% confidence interval 0.74–0.89). This new predictive model correctly categorized 77% of patients according to stroke onset before versus after 4.5 hours.

Conclusions—
In patients with unknown stroke onset, the accuracy of predicting time from symptom onset within 4.5 hours is improved by obtaining relative FLAIR and perfusion imaging.