bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient-Specific Explanations for Predictions of Clinical Outcomes
Authors: Tajgardoon Mohammadamin , Samayamuthu Malarkodi J. , Calzoni Luca , Visweswaran Shyam 
Published: November 2019

Abstract
Background Machine learning models that are used for predicting clinical outcomes can be made more useful by augmenting predictions with simple and reliable patient-specific explanations for each prediction.
Objectives This article evaluates the quality of explanations of predictions using physician reviewers. The predictions are obtained from a machine learning model that is developed to predict dire outcomes (severe complications including death) in patients with community acquired pneumonia (CAP).
Methods Using a dataset of patients diagnosed with CAP, we developed a predictive model to predict dire outcomes. On a set of 40 patients, who were predicted to be either at very high risk or at very low risk of developing a dire outcome, we applied an explanation method to generate patient-specific explanations. Three physician reviewers independently evaluated each explanatory feature in the context of the patient's data and were instructed to disagree with a feature if they did not agree with the magnitude of support, the direction of support (supportive versus contradictory), or both.
Results The model used for generating predictions achieved a F1 score of 0.43 and area under the receiver operating characteristic curve (AUROC) of 0.84 (95% confidence interval [CI]: 0.81–0.87). Interreviewer agreement between two reviewers was strong (Cohen's kappa coefficient = 0.87) and fair to moderate between the third reviewer and others (Cohen's kappa coefficient = 0.49 and 0.33). Agreement rates between reviewers and generated explanations—defined as the proportion of explanatory features with which majority of reviewers agreed—were 0.78 for actual explanations and 0.52 for fabricated explanations, and the difference between the two agreement rates was statistically significant (Chi-square = 19.76, p-value < 0.01).
Conclusion There was good agreement among physician reviewers on patient-specific explanations that were generated to augment predictions of clinical outcomes. Such explanations can be useful in interpreting predictions of clinical outcomes.
Potential Benefits of Laparoscopic Repair of Duodenal Atresia: Insights from a Retrospective Comparative Study
Authors: Sidler Martin , Djendov Florin , Curry Joe I. , Blackburn Simon , Giuliani Stefano , Eaton Simon , Mullassery Dhanya , Cross Kate M. , De Coppi Paolo 
Published: November 2019

Abstract
Introduction Congenital duodenal obstruction (CDO) repair can be performed open or laparoscopically. We aimed to determine the potential benefit of laparoscopic repair regarding tolerance of enteral feeding, postoperative pain, hospital stay, and complication rate.
Materials and Methods In a single-center retrospective cohort study, we compared neonates with isolated CDO operated open versus laparoscopically from 2010 to 2019. No transanastomotic tubes were used, and anastomoses were created in a side-to-side fashion in all cases. An early feeding policy is applied for all cases operated at our institution. Statistical comparison was performed using the Mann–Whitney's test or Fisher's exact test where appropriate.
Results Forty-one patients analyzed were similar regarding body weight, gestational age, and proportion of patients with trisomy 21. Median follow-up was 21 months. Four (20%) out of 20 laparoscopic procedures started laparoscopically were converted to open. Comparing the 21 open with the 16 laparoscopically completed patients, median anesthetic duration was shorter by 18% in the open versus laparoscopic completed group (218 vs. 179 minutes, respectively; p = 0.025). Median postoperative time to full enteral feeds was shorter by 4 days in the first group (7 vs. 11 days, respectively; p = 0.028). In accordance, the median duration of parenteral nutrition (PN) was less than half in the laparoscopic completed compared with the open group (5 vs. 11.5 days, respectively; p = 0.031). Postoperative opioids were required for only half the duration in the laparoscopically completed group compared with open (2 vs. 4 days, respectively; p = 0.026). Outcomes such as length of stay, the occurrence of strictures or adhesions requiring reintervention, or line sepsis were similar in both groups.
Conclusion Patients undergoing laparoscopic CDO repair at our institution benefited from shorter time to full enteral feeds, and reduced the need for PN as well as postoperative pain medication.
Asthma Medication Use in Congenital Diaphragmatic Hernia Survivors: A Retrospective Population Level Data Analysis
Authors: Levesque Matthew , Lum Min Suyin A. , Morris Melanie I. , Shawyer Anna C. , Keijzer Richard 
Published: November 2019

Abstract
Introduction The purpose of this study was to determine if congenital diaphragmatic hernia (CDH) survivors had worse long-term respiratory outcomes compared with age-matched controls, as measured by inhaled bronchodilator use, inhaled steroid use, and asthma-related physician visits.
Materials and Methods We performed a retrospective case-control study of infants with isolated CDH from 1991 to 2013. The primary outcome measures were inhaled bronchodilator prescriptions, inhaled steroid prescriptions, and asthma-related physician visits between 0 and 5 years of age and between 5 and 10 years of age. Subgroup analysis compared the same outcomes for CDH patients grouped by: birth weight, gestational age, side of defect, defect size, liver herniation, hernia sac, and pulmonary hypertension.
Results Fifty-six patients with CDH and 753 age-matched controls met the inclusion criteria for the 0 to 5 years of age analysis. Between 0 and 5 years of age, more CDH survivors were prescribed an inhaled bronchodilator (odds ratio [OR] = 2.47[1.38–4.48], p = 0.001) and inhaled steroid (OR = 2.03[1.07–3.74], p = 0.03), and had an asthma-related physician visit (OR = 1.92[1.00–3.56], p = 0.04). Thirty-eight cases and 491 controls met the inclusion criteria for the 5 to 10 years of age analysis. Between 5 and 10 years of age, CDH survivors were not more likely to be prescribed inhaled bronchodilators, inhaled steroids, or have an asthma-related physician visit. Among the CDH patients, we did not find a clinical characteristic associated with increased inhaled bronchodilator or steroid prescriptions at any age.
Conclusion A history of CDH is associated with higher rates of inhaled bronchodilator prescriptions, inhaled steroid prescriptions, and asthma-related physician visits from 0 to 5 years of age compared with age-matched controls. However, this difference resolves by 5 to 10 years of age.
Pleomorphic xanthoastrocytoma in a case of tuberous sclerosis
Authors: Martin Arvind G. , Singh Mutum Samarendra , Idris Badrisyah , Abdullah Jafri Malin 
Published: November 2019

ABSTRACTTuberous sclerosis is a known phakomatosis and the associated finding of a subependymal giant cell astrocytoma is common with this disorder. A case of tuberous sclerosis with a finding not previously reported, i.e. that of a pleomorphic xanthoastrocytoma, is presented here.
Diagnosis and Management of Pediatric Patients with Intussusception
Authors: Smith Caitlin A. , Maloney Ezekiel 
Published: November 2019

AbstractIntussusception is one of the most common cause of bowel obstruction in infancy. While surgical intervention is sometimes needed, the primary modality for the reduction of intussusception is pneumatic or air enema. This is highly successful in the reduction of ileocolic intussusception with 90% success rate. Here we review the presentation, pathophysiology, appropriate radiographic studies and findings, and fluoroscopic reduction technique.
Tuft Cells: A New Player in Hirschsprung's Disease
Authors: O'Donnell Anne Marie , Nakamura Hiroki , Puri Prem 
Published: November 2019

Abstract
Introduction “Tuft” cells, also known as brush or caveolated cells, are characteristically fusiform shaped, with a distinct apical “tuft” of microvilli extending into the lumen. Double cortin-like kinase 1 (DCLK1) is a microtubule kinase and is a specific marker of intestinal tuft cells. DCLK1-positive tuft cells have been shown to play a key role in gastrointestinal chemosensation, inflammation, and neurotransmission. DCLK1 and Choline acetyltransferase (ChAT), the enzymes responsible for acetylcholine production, are reported to be coexpressed within the gastrointestinal tract. We designed this study to investigate the hypothesis that DCLK1 gene expression is altered in Hirschsprung's disease (HSCR).
Materials and Methods HSCR tissue specimens (n = 6) were collected at the time of pull-through surgery, while control samples were obtained at the time of colostomy closure in patients with imperforate anus (n = 6). Quantitative real-time polymerase chain reaction (qRT-PCR) analysis was undertaken to quantify DCLK1 gene expression, and immunolabeling of DCLK1-positive tuft cells was visualized using confocal microscopy.
Results qRT-PCR analysis revealed significant downregulation of the DCLK1 gene in both aganglionic and ganglionic HSCR specimens compared with controls (p < 0.05). Confocal microscopy revealed DCLK1-positive tuft cell expression within the colonic mucosa, with a reduction in expression in both aganglionic and ganglionic HSCR colon compared with controls.
Conclusion DCLK1 is significantly downregulated in HSCR colon, suggesting a role for tuft cells in cholinergic neurotransmission of the distal colon. The marked decrease in DCLK1 expression within ganglionic specimens highlights the physiologically abnormal nature of this segment in HSCR patients.
Accelerated Intestinal Epithelial Cell Turnover Correlates with Stimulated BMP Signaling Cascade following Intestinal Ischemia–Reperfusion in a Rat
Authors: Ben-Shahar Yoav , Abassi Zaid , Kreizman Shefer Hila , Pollak Yulia , Bhattacharya Udayan , Sukhotnik Igor 
Published: November 2019

Abstract
Introduction Bone morphogenetic proteins (BMPs) are a family of proteins that regulate proliferation and differentiation of intestinal epithelial cells. The purpose of this study was to evaluate the role of BMP signaling following intestinal ischemia–reperfusion (IR) in a rat model.
Materials and Methods Male Sprague-Dawley rats were divided into four experimental groups: Sham-24 and Sham-48 rats underwent laparotomy and were sacrificed 24 or 48 hours later, respectively; IR-24 and IR-48 rats underwent occlusion of superior mesenteric artery and portal vein for 30 minutes followed by 24 or 48 hours of reperfusion, respectively. Enterocyte proliferation and apoptosis were determined at sacrifice. BMP-related genes and protein expression were determined using real-time polymerase chain reaction, Western blot, and immunohistochemistry for 48 hours followed by IR.
Results IR rats demonstrated a significant increase in BMP2 (twofold increase, p < 0.05), BMP4 (sevenfold increase), STAT3 (70% increase), BMPR1 (70% increase) messenger ribonucleic acid levels in jejunum and was accompanied by a significant increase in BMP2 and BMP4 protein levels in jejunum (sixfold increase) (Western blot) and upward increase in the number of BMP-positive cells (by immunohistochemistry) in jejunal (48% increase) and ileal (56% increase) villi compared with Sham-48 animals. Elevation in BMP2 and BMP4 levels was associated with increased rates of cell proliferation and increased cell apoptosis.
Conclusion Forty-eight hours following intestinal IR in rats, BMP signaling pathway was stimulated. The increase in BMP signaling pathway activity correlates with accelerated cell turnover.
Efficacy of PARP Inhibitors in the Treatment of Ovarian Cancer: A Literature-Based Review
Authors: Goswami Vikas , Koyyala Venkata Pradeep Babu , Goyal Sumit , Sharma Manish , Goel Varun , Dhamne Nilesh , Maheshwari Udip , Sharma Atul 
Published: November 2019

AbstractPoly (ADP-ribose) polymerase (PARP) inhibitors are a unique class of therapeutic agents that focus on tumors with deficiencies in the homologous recombination DNA repair mechanism. Genomic instability outlines high-grade serous ovarian cancer, with 50% of all tumors displaying defects in the important DNA repair mechanism of homologous recombination. Earlier research studies have demonstrated considerable efficiency for PARP inhibitors in patients with germ line breast-related cancer antigens 1 and 2 (BRCA-1/BRCA-2) mutations. It has also been observed that BRCA wild-type patients with other defects in the homologous recombination repair mechanism get benefited from this therapy. Companion homologous recombination deficiency (HRD) scores are being developed to guide the selection of patients that are most likely to benefit from PARP inhibition. The selection of PARP inhibitor is mainly dependent upon the number of prior therapies and the presence of a BRCA mutation or HRD. The identification of cases which are most likely to get benefited from PARP inhibitor therapy in view of HRD and other biomarker assessments is still challenging. The purpose of this review is to focus and describe the current evidences for PARP inhibitors in ovarian malignancy, their mechanism of action, and the outstanding issues, including the rate of long-term toxicities and the evolving resistance.
Natural capital accounting perspectives: a pragmatic way forward
Authors: Turner Kerry , Badura Tomas , Ferrini Silvia 
Published: November 2019

ABSTRACT

Introduction
: Recent debates surrounding the application of natural capital accounting (NCA) have produced several approaches to further develop this system, as well as highlighted a number of conceptual and methodological issues that need to be resolved before mainstreaming NCA into policy and decision making. We argue that prolonged debate over the value concepts (i.e., exchange versus other values) underpinning different modifications to NCA has slowed progress in experimentation and uptake by policymakers.
Outcomes
: Consequently we propose three broad approaches which can be progressed in parallel to reinvigorate experimentation with the NCA principles and practice, while at the same time generating policy relevant tools and evidence bases for decision support. The three approaches are; extended SNA accounting anchored to the use of exchange values; a complementary accounts network (CAN) that utilizes plural values as supplementary accounts to the SNA system; and wealth accounting that focuses on measures of welfare and wellbeing. The three approaches are complementary and data developed in any one can inform the other two.
Conclusions
: We contend that CAN offers the most flexibility and opportunities to progress short term support for decision making on environmental issues which are now becoming urgent.
How Do ImPACT Quick Test Scores Compare with ImPACT Online Scores in Non-Concussed Adolescent Athletes?
Authors: Elbin R J , D’Amico Nathan R , McCarthy Matthew , Womble Melissa N , O’Connor Sydne , Schatz Philip 
Published: November 2019

Abstract

Objective
To compare neurocognitive scores between the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) Quick Test (QT) and Online Versions in non-concussed high school athletes.

Methods
A sample of 47 high school athletes completed the ImPACT Online Version pre-season and the ImPACT QT approximately 3 months later. Paired sample t-tests and Pearson’s correlations examined differences and relationships between the ImPACT batteries.

Results
The ImPACT QT scores were significantly higher for performance on the Three Letters: Average Counted (p &lt; .001, d = .88), Three Letters: Average Counted Correctly (p &lt; .001, d = .80), and Symbol Match: Correct RT Visible (p &lt; .001, d = .72), and Symbol Match: Correct RT Hidden (p = .002, d = .50) subtests. There were significant relationships for Three Letters: Average Counted (r = .85, p &lt; .001), Three Letters: Average Counted Correctly (r = .82, p &lt; .001), and Symbol Match: Total Correct Hidden (r = .40, p = .006) subtests.

Conclusions
Post-injury evaluation data using ImPACT QT should be compared to normative referenced data, and not to pre-season data from the ImPACT Online Version.
Value Profiles and Perceived Job Performance of Social Workers in Israel
Authors: Levin Lia , Benish-Weisman Maya , Savaya Riki 
Published: November 2019

AbstractValues play a crucial role in the credo of social work. Recent definitions of the profession delineate the values that should guide social work worldwide. At the same time, social workers’ employment patterns and changes in the traditional welfare state have resulted in fragmentations in the profession, highlighting the importance of shared professional values. This study is the first to examine value profiles endorsed by social workers, as well as the association between such profiles and social workers’ perceived job performance. Participants in the study were 519 social workers, working in various organizations and with diverse populations in Israel. Its findings delineate three value profiles identified among our sample—growth-focused, social-focused and growth-self-focused. Differences between social workers endorsing each profile were found in terms of workers’ perceived job performance and perceived job-related abilities. These findings are discussed with relation to their unique contribution to what is known about values supported by social workers, as well as concerning the relationship between these values and social workers’ job-related functioning in the context of the social work profession and social services in Israel.
Strong genetic differentiation among populations of Fosterella rusbyi (Bromeliaceae) in Bolivia
Authors: Wöhrmann Tina , Michalak Ingo , Zizka Georg , Weising Kurt 
Published: November 2019

AbstractThe terrestrial bromeliad Fosterella rusbyi is endemic to the Bolivian Andes, where it mainly grows on steep, exposed slopes along roadsides and riverbeds in the seasonally dry tropical forest (SDTF) and the mesic montane forest (Yungas) biomes. We hypothesize that allopatric speciation may have been a main driver of diversification in Fosterella since the Miocene and that the scattered distribution of suitable habitats fostered the evolution of the high degree of endemism observed today. To provide further information relating to this hypothesis, we analysed the partition of genetic diversity and the extent of gene flow among natural populations of F. rusbyi using plastid and nuclear microsatellite markers. Nineteen plastid haplotypes were found, but the mean haplotype diversity per population was low. Nuclear microsatellite markers revealed 177 different multilocus genotypes (MLGs), of which 31 occurred in more than one plant. Recurrent MLGs were found in 76 plants that were therefore identified as clones. A considerable deficit of heterozygotes was detected at all nuclear loci. Geographical and genetic distances between populations were only weakly correlated with each other. Genetic divergence between populations was extremely high for both marker classes, suggesting that seed and pollen flow are low, even over short distances. The observed patterns are consistent with our hypothesis that newly available sites are sporadically colonized by one or a few founders, followed by in situ population expansion via vegetative propagation, self-pollination and/or biparental inbreeding, genetic differentiation among persistent populations and, ultimately, allopatric speciation.
Transformation of Event Representations along Middle Temporal Gyrus
Authors: Leshinskaya Anna , Thompson-Schill Sharon L 
Published: November 2019

AbstractWhen learning about events through visual experience, one must not only identify which events are visually similar but also retrieve those events’ associates—which may be visually dissimilar—and recognize when different events have similar predictive relations. How are these demands balanced? To address this question, we taught participants the predictive structures among four events, which appeared in four different sequences, each cued by a distinct object. In each, one event (“cause”) was predictably followed by another (“effect”). Sequences in the same relational category had similar predictive structure, while across categories, the effect and cause events were reversed. Using functional magnetic resonance imaging data, we measured “associative coding,” indicated by correlated responses between effect and cause events; “perceptual coding,” indicated by correlated responses to visually similar events; and “relational category coding,” indicated by correlated responses to sequences in the same relational category. All three models characterized responses within the right middle temporal gyrus (MTG), but in different ways: Perceptual and associative coding diverged along the posterior to anterior axis, while relational categories emerged anteriorly in tandem with associative coding. Thus, along the posterior–anterior axis of MTG, the representation of the visual attributes of events is transformed to a representation of both specific and generalizable relational attributes.
Concurrent Extraction and Purification of Gentiopicroside from Gentiana scabra Bunge Using Microwave-Assisted Ethanol-Salt Aqueous Two-Phase Systems
Authors: Cheng Zhenyu , Song Haiyan , Zhang Yuewei , Han Dandan , Yu Xue , Shen Qihui , Zhong Fangli 
Published: November 2019

AbstractA potential method called microwave-assisted aqueous two-phase extraction (MA-ATPE) was developed for concurrent extraction and purification of gentiopicroside from Gentiana scabra Bunge. Formation characteristics of aqueous two-phase system (ATPS) composed of ethanol and 25 kinds of salts were investigated; K2HPO4 (w/w, 21.71%) and ethanol (w/w, 40.72%) were determined to be the optimal compositions of ATPS. Response surface methodology based on Box–Behnken design was used to investigate the extraction conditions, the optimal parameters were summarized as follows: 80°C of extraction temperature, 31 s of extraction time, 11:1 (mL/g) of liquid-to-solid ratio, 100 meshes of particle size and 806 W of microwave power. Under these conditions, the extraction yield of gentiopicroside was 65.32 ± 0.24 mg/g with a recovery of 96.51%. Compared with other four methods, the purity of gentiopicroside in the crude extracts reached 17.16 ± 0.25%, which was significantly higher than that of smashing tissue extraction, microwave assisted-extraction, ultrasonic-assisted extraction and heat reflux extraction, respectively. In addition, the phase-forming salt can be recyclable. Therefore, MA-ATPE was an excellent and alternative technique to the conventional extraction approaches of gentiopicroside.
Overexpression of the peroxin Pex34p suppresses impaired acetate utilization in yeast lacking the mitochondrial aspartate/glutamate carrier Agc1p
Authors: Chalermwat Chalongchai , Thosapornvichai Thitipa , Wongkittichote Parith , Phillips John D , Cox James E , Jensen Amornrat N , Wattanasirichaigoon Duangrurdee , Jensen Laran T 
Published: November 2019

ABSTRACT
PEX34, encoding a peroxisomal protein implicated in regulating peroxisome numbers, was identified as a high copy suppressor, capable of bypassing impaired acetate utilization of agc1∆ yeast. However, improved growth of agc1∆ yeast on acetate is not mediated through peroxisome proliferation. Instead, stress to the endoplasmic reticulum and mitochondria from PEX34 overexpression appears to contribute to enhanced acetate utilization of agc1∆ yeast. The citrate/2-oxoglutarate carrier Yhm2p is required for PEX34 stimulated growth of agc1∆ yeast on acetate medium, suggesting that the suppressor effect is mediated through increased activity of a redox shuttle involving mitochondrial citrate export. Metabolomic analysis also revealed redirection of acetyl-coenzyme A (CoA) from synthetic reactions for amino acids in PEX34 overexpressing yeast. We propose a model in which increased formation of products from the glyoxylate shunt, together with enhanced utilization of acetyl-CoA, promotes the activity of an alternative mitochondrial redox shuttle, partially substituting for loss of yeast AGC1.