bluuebunny/crossref_metadata_2025_split huggingface dataset:
Searching for the optimal positive end-expiratory pressure for lung protective ventilation
Authors: Sahetya Sarina K. 
Published: November 2019

Purpose of review
The optimal strategy for setting positive end-expiratory pressure (PEEP) has not been established. This review examines different approaches for setting PEEP to achieve lung-protective ventilation.

Recent findings
PEEP titration strategies commonly focus either on achieving adequate arterial oxygenation or reducing ventilator-induced lung injury from repetitive alveolar opening and closing, referred to as the open lung approach. Five recent trials of higher versus lower PEEP have not shown benefit with higher PEEP, and one of the five trials showed increased harm for patients treated with the open lung strategy. Evidence suggests that some patients may respond beneficially to higher PEEP by recruiting lung, whereas other patients do not recruit lung and merely overdistend previously open alveoli when higher PEEP is applied. A PEEP titration approach that differentiates PEEP responders from nonresponders and provides higher or lower PEEP accordingly has not been prospectively tested.

Summary
When compared, no method for setting PEEP has been proven superior to another. Based on recent studies, higher compared with lower PEEP has not improved clinical outcomes and worsened mortality in one study. Future research should focus on identifying feasible methods for assessing lung recruitability in response to PEEP to enrich future trials of PEEP strategies.
Emergency Laboratory Evaluations for Patients With Inborn Errors of Metabolism
Authors: Gold Nina B. , Kritzer Amy , Weiner Debra L. , Michelson Kenneth A. 
Published: November 2019

Background
Children with inborn errors of metabolism (IEM) are at risk for metabolic crises triggered by acute illnesses. Crises are identified through laboratory evaluations.

Objectives
Our objective was to determine national adherence to minimum laboratory evaluations for patients with IEM in emergency departments (EDs), as well as factors associated with laboratory evaluation adherence.

Methods
Using the Pediatric Health Information System, we identified visits to 48 EDs from 2012 to 2017 by children with IEM. We analyzed visits for catabolic conditions (dehydration, gastroenteritis, or vomiting) and determined variation in minimum laboratory evaluation adherence. Multivariable models were created to determine predictors of adherence.

Results
Among the visits by children with disorders of the urea cycle, organic acid metabolism, and fatty acid oxidation, 1457 (76.3%) of 1909 adhered to the minimum laboratory evaluation. Median ED-level adherence was 78.2% (interquartile range, 67.4–92.5). Factors associated with adherence were disorder [fatty acid oxidation vs urea cycle disorder; adjusted odds ratio (aOR), 9.35; 95% confidence interval (CI), 4.07–21.47], annual ED volume of patients with IEM (quartile 4 vs 1; aOR, 3.58; 95% CI, 1.51–8.49), and presence of a biochemical genetics fellowship (aOR, 0.29; 95% CI, 0.14–0.62).

Conclusions
Patients with IEM frequently did not receive minimum laboratory evaluations for catabolic conditions. Measures to improve laboratory use in children with IEM should be undertaken.
Recommendations for Enhancing Sports Medicine Fellowship Training
Authors: Jain Nitin B. , Borg-Stein Joanne , Miranda-Comas Gerardo , Micheo William , Visco Christopher , Fredericson Michael 
Published: November 2019

Abstract
Physical medicine and rehabilitation–trained physicians are increasingly interested in caring for patients with musculoskeletal and sports disorders. Sports medicine fellowships are designed to provide competency in sports medicine and musculoskeletal care. The authors, with endorsement from the Association of Academic Physiatrists, provide a framework and tools that Accreditation Council for Graduate Medical Education accredited sports medicine fellowship programs can use to enhance and meet the Accreditation Council for Graduate Medical Education program requirements. Based on the position statement from the American Medical Society for Sports Medicine, we propose recommendations for Accreditation Council for Graduate Medical Education–accredited sports medicine programs to achieve standards of excellence. We also provide recommendations for research requirements during the course of a sports fellowship. With the proposed recommendations, a sports medicine fellowship program can achieve excellence and enhance fellowship training by increasing proficiency in physical medicine and rehabilitation–based skills relevant to sports and musculoskeletal medicine. Given the multidisciplinary nature of musculoskeletal and sports medicine, it is also key that fellowship programs (regardless of the department that they are accredited through) have faculty members that represents these disciplines and accept applicants with residency training in physical medicine and rehabilitation, internal medicine, family medicine, pediatrics, and emergency medicine.
Interactive Relations Across Dimensions of Interpersonal-Level Discrimination and Depressive Symptoms to Carotid Intimal-Medial Thickening in African Americans
Authors: Beatty Moody Danielle L. , Leibel Daniel K. , Pantesco Elizabeth J. , Wendell Carrington R. , Waldstein Shari R. , Evans Michele K. , Zonderman Alan B. 
Published: November 2019

ABSTRACT

Objective
This study aimed to examine within-race interactions of multiple dimensions of self-reported discrimination with depressive symptoms in relation to carotid intimal-medial thickness (IMT), a subclinical marker of atherosclerosis prospectively implicated in stroke incidence, in middle-aged to older African American and white adults.

Methods
Participants were a socioeconomically diverse group of 1941 African Americans (56.5%) and whites from the Healthy Aging in Neighborhoods of Diversity across the Life Span study (30–64 years old, 47% men, 45.2% with household income <125% federal poverty threshold) who underwent carotid IMT measurement. Discrimination was assessed across four dimensions (everyday, frequency across various social statuses, racial, and lifetime burden). The Center for Epidemiologic Studies Depression scale was used to assess depressive symptoms.

Results
In cross-sectional hierarchical regression analyses, two interactions were observed in African Americans: more frequent discrimination across various social statuses (b < 0.001, p = .006) and a higher lifetime discrimination burden (b < 0.001, p = .02) were each related to thicker carotid IMT in those with greater depressive symptoms. No significant findings were observed within whites.

Conclusions
Among African Americans, those reporting high levels of discrimination and depressive symptoms have increased carotid atherosclerosis and may be at greater risk for clinical end points compared with those reporting one or neither of these risk factors. Findings suggest that assessment of interactive relationships among social and psychological factors may elucidate novel pathways for cardiovascular disease, including stroke, among African Americans.
Psychosocial Factors Affecting Parental Report of Symptoms in Children: A Systematic Review
Authors: Smith Louise E. , Weinman John , Yiend Jenny , Rubin James 
Published: November 2019

ABSTRACT

Objective
Parents make important treatment decisions for their children based on symptoms they perceive their child to be experiencing. Multiple psychological factors are associated with subjective symptom perception, but factors affecting perception of symptoms in others have been explored less. We systematically reviewed the literature to identify parent and child psychological factors associated with parental report of physical symptoms in their child.

Methods
We searched Embase, Ovid, PsycINFO, and Scopus for studies that investigated associations between psychological factors and parental report of symptoms in their child.

Results
Thirty-six citations reporting on 34 studies that assessed the association between parent or child psychological factors and parental report of physical symptoms in the child were included in the review. Three main factors were identified as being associated with parental symptom report. First, there was evidence for an association between parental symptom report and affect, in particular parent and child anxiety. Second, child behavioral and conduct problems, and temperament-related challenges (problems with feeding and sleeping) were associated with parental symptom report. Third, parental expectations and beliefs that symptoms would occur were associated with parental symptom report, although few studies investigated these associations.

Conclusions
Parent and child affect, and parental expectations and beliefs may influence parents’ cognition, causing them to pay more attention to their child, interpret their child’s behavior as symptomatic, and recall symptoms in the child. Given the importance of parental perception of symptoms in driving decisions around care, additional research in this field is needed.
Exploring the cerebral substrate of voice perception in primate brains
Authors: Bodin Clémentine , Belin Pascal 
Published: November 2019

One can consider human language to be the Swiss army knife of the vast domain of animal communication. There is now growing evidence suggesting that this technology may have emerged from already operational material instead of being a sudden innovation. Sharing ideas and thoughts with conspecifics via language constitutes an amazing ability, but what value would it hold if our conspecifics were not first detected and recognized? Conspecific voice (CV) perception is fundamental to communication and widely shared across the animal kingdom. Two questions that arise then are: is this apparently shared ability reflected in common cerebral substrate? And, how has this substrate evolved? The paper addresses these questions by examining studies on the cerebral basis of CV perception in humans' closest relatives, non-human primates. Neuroimaging studies, in particular, suggest the existence of a ‘voice patch system’, a network of interconnected cortical areas that can provide a common template for the cerebral processing of CV in primates.This article is part of the theme issue ‘What can animal communication teach us about human language?’
Animal cognition and the evolution of human language: why we cannot focus solely on communication
Authors: Fitch W. Tecumseh 
Published: November 2019

Studies of animal communication are often assumed to provide the ‘royal road’ to understanding the evolution of human language. After all, language is the pre-eminent system of human communication: doesn't it make sense to search for its precursors in animal communication systems? From this viewpoint, if some characteristic feature of human language is lacking in systems of animal communication, it represents a crucial gap in evolution, and evidence for an evolutionary discontinuity. Here I argue that we should reverse this logic: because a defining feature of human language is its ability to flexibly represent and recombine concepts, precursors for many important components of language should be sought in animalcognitionrather than animal communication. Animal communication systems typically only permit expression of a small subset of the concepts that can be represented and manipulated by that species. Thus, if a particular concept is not expressed in a species' communication system this is not evidence that it lacks that concept. I conclude that if we focus exclusively on communicative signals, we sell the comparative analysis of language evolution short. Therefore, animal cognition provides a crucial (and often neglected) source of evidence regarding the biology and evolution of human language.This article is part of the theme issue ‘What can animal communication teach us about human language?’
Factors associated with risk of developmental delay in preschool children in a setting with high rates of malnutrition: a cross-sectional analysis of data from the IHOPE study, Madagascar
Authors: Miller Ann C. , Garchitorena Andres , Rabemananjara Faramalala , Cordier Laura , Randriamanambintsoa Marius , Rabeza Victor , Razanadrakoto Hery-Tiana Rahaniraka , Ramakasoa Ranaivozafindary Rakoto , RamahefarisonTiana Olivier , Ratsimbazafy Baolova Nathaline , Ouenzar Mohammed Ali , Bonds Matthew H. , Ratsifandrihamanana Lisy 
Published: November 2019

BackgroundNearly two hundred eighty million children in low and middle income countries are at risk for not achieving their full developmental potential(1). Poor development can lead to reduced scholastic ability(2) or opportunity (promoting and entrenching inequity), and has been associated with lower adult earning potential(3), and poorer health(4), thus potentially contributing to intergenerational poverty traps.While the entire period of childhood is important for development, the first 1000 days (conception to age 2) are critically important for brain development; with the most rapid and prolific development of neural pathways, first in sensory development, then language skills and then higher cognitive functioning(5). Experiences during this period – positive or negative – can substantially impact the architecture of the developing brain. Adverse events such as exposure to familial or societal violence, toxins such as lead or arsenic, illness (anemia, diarrhea, HIV, chronic malnutrition, maternal depression), or lack of a developmentally stimulating and nurturing environment can all act as toxic stressors on young children that negatively impact cognitive development throughout the life-course(6). Infants and young children in settings of poverty are often faced with many of these stressors(7).
Methylenetetrahydrofolate reductase (MTHFR) A1298C polymorphism and risk of lung cancer
Authors: Rai Vandana 
Published: November 2019

AbstractRecent epidemiological studies have reported association between methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms and lung cancer. The aim of the present study to perform a meta-analysis of published studies to validate the association between MTHFR A1298C polymorphism and risk of lung cancer.PubMed, Springer Link, Science Direct and Google Scholar databases were searched for eligible studies. Of the 78 initially identified studies, 11 case–control studies with 5,996 patients and 7,404 healthy controls were finally included in the present meta-analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated to assess the association, and all statistical analyses were performed using MIX software (version 1.7).No statistically significant associations were found between the MTHFR A1298C polymorphism and lung cancer risk in the additive/ allele contrast, co-dominant/heterozygote, homozygote, dominant and recessive genetic models (C vs. A: OR= 0.95, 95% CI= 0.83-1.08; CC vs. AA: OR= 1.13, 95% CI= 0.83-1.5; AC vs. AA: OR= 0.86, 95% CI= 0.70-1.02; AC+CC vs. AA: OR= 0.89, 95% CI= 0.75-1.05; CC vs. AA+AC: OR= 1.20, 95% CI= 0.89-1.40). Significant heterogeneity between individual studies was evident in all five models. In conclusion, present meta-analysis results indicated that there is no significant association between MTHFR A1298C polymorphism and risk of lung cancer.
IE-Map: A novel in-vivo atlas template of the human inner ear
Authors: Ahmadi Seyed-Ahmad , Raiser Theresa , Rühl Ria Maxine , Flanagin Virginia L. , Eulenburg Peter zu 
Published: November 2019

AbstractBrain atlases and templates are core tools in scientific research with increasing importance also in clinical applications. Advances in neuroimaging now allowed us to expand the atlas domain to the vestibular and auditory organ, the inner ear. In this study, we present IE-Map, an in-vivo template and atlas of all known substructures of the human labyrinth derived from multi-modal high-resolution magnetic resonance imaging data in a non-invasive manner (no contrast agent or radiation). We reconstructed a common template from 126 inner ears (63 normal subjects) and annotated it with 94 established landmarks and semi-automatic segmentations. Quantitative substructure analysis revealed a correlation of labyrinth parameters with total intracranial volume. No effects of gender or laterality were found. We provide the validated templates, atlas segmentations, surface meshes and landmark annotations as open-access material, to provide neuroscience researchers and clinicians in neurology, neurosurgery, and otorhinolaryngology with a widely applicable tool for computational neurootology.
Mutation prevalence tables for hereditary cancer derived from multi-gene panel testing
Authors: Hart Steven N. , Polley Eric C. , Yussuf Amal , Yadav Siddhartha , Goldgar David E. , Hu Chunling , LaDuca Holly , Smith Laura P. , Fujimoto June , Li Shuwei , Couch Fergus J. , Dolinsky Jill S. 
Published: November 2019

AbstractPurposeMulti-gene panel testing for cancer predisposition mutations is becoming routine in clinical care. However, the gene content of panels offered by testing laboratories vary significantly, and data on mutation detection rates by gene and by panel is limited, causing confusion among clinicians on which test would be the most appropriate to order. Moreover, screening guidelines are not described in sufficient granularity to explain how differences in family, personal history, age, and other factors would affect the prevalence of finding a mutation in similar populations. The tool herein quantifies prevalence of mutations in hereditary cancer genes based on personalized clinical and demographic characteristics.MethodsUsing results from approximately 150,000 multi-gene panel tests conducted at Ambry Genetics, we built an interactive prevalence tool to explore how differences in ethnicity, age of onset, and personal and family history of different cancers affect the prevalence of pathogenic mutations in 31 cancer predisposition genes, across various clinically available hereditary cancer gene panels.ResultsOver 13,000 mutation carriers were identified in this high-risk population. Most of the cases were Non-Hispanic White (74%, n=109,537), but also provide an appreciable dataset for those identifying as Black (n=10,875), Ashkenazi Jewish (n=10,464), Hispanic (n=10,028), and Asian (n=7,090). The most prevalent cancer types were breast (50%), ovarian (6.6%), and colorectal (4.7%), which is expected based on genetic testing guidelines and clinician referral for testing.ConclusionThe Hereditary Cancer Multi-Gene Panel Prevalence Tool presented here can be used to provide insight into the prevalence of mutations on a per-gene and per-multigene panel basis, while conditioning on multiple custom phenotypic variables to include race and cancer type. The tool can be found at https://www.ambrygen.com/prevalence-tool.
The efficacy of DNA MMR enzyme immunohistochemistry as a screening test for hypermutated gliomas
Authors: McCord Matthew , Steffens Alicia , Javier Rodrigo , Kam Kwok-Ling , McCortney Kathleen , Horbinski Craig 
Published: November 2019

ABSTRACTA subset of gliomas has DNA repair defects that lead to hypermutated genomes. While such tumors are resistant to alkylating chemotherapies, they may also express more mutant neoantigens on their cell surfaces, and thus be more responsive to immunotherapies. A fast, inexpensive method of screening for hypermutated gliomas would therefore be of great clinical value. Since immunohistochemistry (IHC) for the DNA mismatch repair (MMR) proteins Msh2, Msh6, Mlh1, and Pms2 is already used to screen for hypermutated colorectal cancers, we sought to determine whether that panel might have similar utility in gliomas. MMR IHC was scored in 100 WHO grade I-IV gliomas with known tumor mutation burdens (TMB), while blinded to TMB data. Eight of 100 cases showed loss of one or more MMR proteins by IHC, and all 8 were hypermutated. Among the remaining 94 gliomas with intact MMR IHC, only one was hypermutated; that tumor had an inactivating mutation in another DNA repair gene, ATM. Overall accuracy, sensitivity, and specificity were 99%, 89%, and 100%, respectively. The strongest correlates with hypermutation were prior TMZ treatment, MGMT promoter methylation, and IDH1 mutation. Among MMR-deficient hypermutated gliomas, 50% contained both MMR-lost and MMR-retained tumor cells. Together, these data suggest that MMR IHC could be a viable front-line screening test for gliomas in which immunotherapy is being considered. They also suggest that not all cells in a hypermutated glioma may actually be MMR-deficient, a finding that might need to be considered when treating such tumors with immunotherapies.
Pre-season screening currently has no value for injury prediction: The development and internal validation of a multivariable prognostic model to predict indirect muscle injury risk in elite football (soccer) players
Authors: Hughes Tom , Riley Richard D. , Callaghan Michael J. , Sergeant Jamie C. 
Published: November 2019

ABSTRACTBackgroundIn elite football (soccer), periodic health examination (PHE) could provide prognostic factors to predict injury risk.ObjectiveTo develop and internally validate a prognostic model to predict individual indirect (non-contact) muscle injury (IMI) risk during a season in elite footballers, only using PHE-derived candidate prognostic factors.MethodsRoutinely collected preseason PHE and injury data were used from 119 players over 5 seasons (1stJuly 2013 to 19thMay 2018). Ten candidate prognostic factors (12 parameters) were included in model development. Multiple imputation was used to handle missing values. The outcome was any time-loss, index indirect muscle injury (I-IMI) affecting the lower extremity. A full logistic regression model was fitted, and a parsimonious model developed using backward-selection to remove non-significant factors. Predictive performance was assessed through calibration, discrimination and decision-curve analysis, averaged across all imputed datasets. The model was internally validated using bootstrapping and adjusted for overfitting.ResultsDuring 317 participant-seasons, 138 I-IMIs were recorded. The parsimonious model included only age and frequency of previous IMIs; apparent calibration was perfect but discrimination was modest (C-index = 0.641, 95% confidence interval (CI): 0.580 to 0.703), with clinical utility evident between risk thresholds of 37-71%. After validation and overfitting adjustment, performance deteriorated (C-index = 0.580; calibration-in-the-large =-0.031, calibration slope =0.663).ConclusionThe selected PHE data were insufficient prognostic factors from which to develop a useful model for predicting IMI risk in elite footballers. Further research should prioritise identifying novel prognostic factors to improve future risk prediction models in this field.Trial registration numberNCT03782389KEY POINTSFactors measured through preseason screening generally have weak prognostic strength for future indirect muscle injuries and further research is needed to identify novel, robust prognostic factors.Because of sample size restrictions, and until the evidence base improves, it is likely that any further attempts at creating a prognostic model at individual club level would also suffer from poor performance.The value of using preseason screening data to make injury predictions or to select bespoke injury prevention strategies remains to be demonstrated, so screening should only be considered as useful for detection of salient pathology or for rehabilitation/ performance monitoring purposes at this time.