bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deceased donor kidney allocation schemes and international exchange
Authors: Heemann Uwe , Oberbauer Rainer , Sprangers Ben , Gökalp Cenk , Bemelman Frederike 
Published: December 2019

Purpose of review
In this review, we summarize different allocation schemes around the world and identify ways to exchange organs between countries.

Recent findings
The primary goal of transplantation is prolongation of patient survival and an improved quality of life. Most allocation systems try to match the potential survival of the organ with the life expectancy of its recipient. Kidney transplantation enables cost reductions by the avoidance of dialysis for the healthcare system, which is sometimes the driving force for state interventions to enhance donor recruitment
The major benefit from international exchange is the possibility to transplant highly sensitized patients or patients with rare HLA allele.
In a broad international exchange system, there are three possibilities: exchange of surplus organs, exchange of organs to support patients with a potentially excessive waiting time because of HLA antibodies or rare alleles, and exchange of organs to make the best possible match between donor and recipient.

Summary
It is possible to shape a hierarchical allocation scheme, which could be applicable in the majority of populations despite different geographical and socioeconomic conditions: allocation to recipients with special requirements (high-urgency, highly sensitized); identification of a within the region/country; in case no suitable recipient can be identified, offer countrywide or between countries; for every organ transferred to another country, there must be an obligation to give one back.
Relationship of School-Based Physical Therapy Services to Student Goal Achievement
Authors: Chiarello Lisa A. , Effgen Susan K. , Jeffries Lynn M. , McCoy Sarah Westcott , Tezanos Alejandro G. Villasante 
Published: December 2019

Purpose:
To explore the relationships of school-based physical therapy services to student goal achievement.

Methods:
One hundred nine physical therapists and 296 students participated in a practice-based study. Therapists formatted goals using goal attainment scaling and evaluated goal achievement. Using the School-Physical Therapy Interventions for Pediatrics system, therapists documented services weekly for 20 weeks. Group comparisons and logistic regressions were conducted.

Results:
For primary goals, no documented physical therapy services were associated with exceeding goal expectation. For posture/mobility goals, more minutes in self-care activities and services on behalf of the students were associated with exceeding goal expectation; use of cognitive and behavioral training interventions was associated with not exceeding goal expectation (P < .05). For recreation/fitness goals, greater use of functional strength and mobility for playground access and cognitive/behavioral interventions were associated with exceeding goal expectation (P < .05).

Conclusion:
A limited number of physical therapy services was associated with exceeding goal expectation.
Validity of General Movement Assessment Based on Clinical and Home Videos
Authors: Yeh Kuo-Kuang , Liu Wen-Yu , Wong Alice May-Kuen , Lein Reyin 
Published: December 2019

Introduction:The purposes of this study were to develop an instructional leaflet on home video recording for the General Movement Assessment (GMA) and to examine the concurrent and predictive validity of the GMA completed by physical therapists (PTs) and completed by parents.Methods:The GMA and the Alberta Infant Motor Scale (AIMS) were completed by PTs in the clinic. Parents completed the GMA following the instructional leaflet.Results:The content validity of the leaflet was 0.83. The consistency of the GMA results between sources was κ = 0.869. The concurrent validity of the GMA at a corrected age of 3 months was κ = 0.266 (PT) versus 0.525 (parent) using the 10th-percentile cutoffs of the AIMS. The positive likelihood ratio was 26 (PT) versus 25 (parents) at a corrected age of 12 months based on 5th-percentile cutoffs of the AIMS.Conclusions:Home GMA videos are valid for clinical assessment following the instructional leaflet.
An Institutional Approach to the Management of Asymptomatic Chorioamnionitis-Exposed Infants Born ≥35 Weeks Gestation
Authors: Chiruvolu Arpitha , Petrey Barbara , Stanzo Karen C. , Daoud Yahya 
Published: December 2019

Introduction:
Our newborn practice routinely treated asymptomatic chorioamnionitis-exposed infants born at 35 weeks gestation or greater with empiric antibiotics. Starting April 1, 2017, we implemented an algorithm of not treating, unless there was an abnormal clinical and/or laboratory evaluation. The goal of this quality improvement initiative was to reduce the percentage of chorioamnionitis-exposed infants treated with antibiotics (primary outcome measure) to <50%.

Methods:
We compared 123 chorioamnionitis-exposed infants born 1 year before implementation (pre-algorithm group, April 1, 2016, to March 31, 2017) with 111 born 1 year following implementation (post-algorithm group, April 1, 2017, to March 31, 2018). The primary outcome measure was analyzed monthly using a run chart.

Results:
The maternal and neonatal characteristics were similar between both groups. Significantly fewer infants in the post-algorithm group received antibiotics compared with the pre-algorithm group (4.5% versus 96.8%; P < 0.01). There were no differences in median hospital length of stay or incidence of neonatal intensive care unit admissions between both groups. There were no positive blood cultures or readmissions within 7 days for early-onset sepsis in either group.

Conclusion:
An institutional approach of monitoring chorioamnionitis-exposed infants with a clinical and laboratory evaluation decreased antibiotic utilization in the mother-baby unit by 95% without an increase in hospital length of stay, neonatal intensive care unit admissions, or readmissions for early-onset sepsis.
Carbapenem use in critically ill patients
Authors: Patrier Juliette , Timsit Jean-François 
Published: December 2019

Purpose of review
To review available data on carbapenem use in ICU. Carbapenem is a broad spectrum well tolerated antibiotic family that keep an excellent activity to extended spectrum β-lactamases and AmpC hyperproducer and in susceptible Pseudomonas aeruginosa and Acinetobacter baumannii. It becomes a drug of choice for empirical therapy of suspected sepsis in known or presumably known ESBLE carriers.

Recent findings
Carbapenems remained the drug of choice for severe ESBLE infections. In severe critically ill patients, high off-label dose is necessary especially in patients with sepsis and glomerular hyperfiltration. Nevertheless, large spectrum of carbapenems leads to initial overuse. The increase in the overall consumption in the past years with lack of systematic re-evaluation observed is responsible of and carbapenem-selection pressure that contribute to the increase of carbapenem-resistant enterobacteriaceae, A. Baumannii and P. Aeruginosa in ICUs.

Summary
Carbapenems remained a cornerstone of antibiotic therapy of severe infections. Emerging carbapenem resistance is related to the increase of carbapenem consumption. High doses are recommended for early therapy followed by systematic reevaluation on a daily basis with shift to narrow spectrum antimicrobials if possible and early stopping rules.
Poor Outcomes in Kidney Transplant Candidates and Recipients With History of Falls
Authors: Chu Nadia M. , Shi Zhan , Berkowitz Rachel , Haugen Christine E. , Garonzik-Wang Jacqueline , Norman Silas P. , Humbyrd Casey , Segev Dorry L. , McAdams-DeMarco Mara A. 
Published: December 2019

Background.
Falls occur in 28% of hemodialysis patients and increase the risk of physical impairment, morbidity, and mortality. Therefore, it is likely that kidney transplantation (KT) candidates with recurrent falls are less likely to access KT and more likely to experience adverse post-KT outcomes.

Methods.
We used a 2-center cohort study of KT candidates (n = 3666) and recipients (n = 770) (January 2009 to January 2018). Among candidates, we estimated time to listing, waitlist mortality, and transplant rate by recurrent falls (≥2 falls) before evaluation using adjusted regression. Among KT recipients, we estimated risk of mortality, graft loss, and length of stay by recurrent falls before KT using adjusted regression.

Results.
Candidates with recurrent falls (6.5%) had a lower chance of listing (adjusted hazard ratio [aHR] = 0.68, 95% confidence interval [CI], 0.56-0.83) but not transplant rate; waitlist mortality was 31-fold (95% CI, 11.33-85.93) higher in the first year and gradually decreased over time. Recipients with recurrent falls (5.1%) were at increased risk of mortality (aHR = 51.43, 95% CI, 16.00-165.43) and graft loss (aHR = 33.57, 95% CI, 11.25-100.21) in the first year, which declined over time, and a longer length of stay (adjusted relative ratio [aRR] = 1.13, 95% CI, 1.03-1.25). In summary, 6.5% of KT candidates and 5.1% of recipients experienced recurrent falls which were associated with adverse pre- and post-KT outcomes.

Conclusions.
While recurrent falls were relatively rare in KT candidates and recipients, they were associated with adverse outcomes. Transplant centers should consider employing fall prevention strategies for high-risk candidates as part of comprehensive prehabilitation.
Outcomes After Declining a Steatotic Donor Liver for Liver Transplant Candidates in the United States
Authors: Jackson Kyle R. , Bowring Mary G. , Holscher Courtenay , Haugen Christine E. , Long Jane J. , Liyanage Luckmini , Massie Allan B. , Ottmann Shane , Philosophe Benjamin , Cameron Andrew M. , Segev Dorry L. , Garonzik-Wang Jacqueline 
Published: December 2019

Background.Steatotic donor livers (SDLs, ≥30% macrosteatosis on biopsy) are often declined, as they are associated with a higher risk of graft loss, even though candidates may wait an indefinite time for a subsequent organ offer. We sought to quantify outcomes for transplant candidates who declined or accepted an SDL offer.Methods.We used Scientific Registry of Transplant Recipients offer data from 2009 to 2015 to compare outcomes of 759 candidates who accepted an SDL to 13 362 matched controls who declined and followed candidates from the date of decision (decline or accept) until death or end of study period. We used a competing risk framework to understand the natural history of candidates who declined and Cox regression to compare postdecision survival after declining versus accepting (ie, what could have happened if candidates who declined had instead accepted).Results.Among those who declined an SDL, only 53.1% of candidates were subsequently transplanted, 23.8% died, and 19.4% were removed from the waitlist. Candidates who accepted had a brief perioperative risk period within the first month posttransplant (adjusted hazard ratio [aHR]:2.493.494.89,P< 0.001), but a 62% lower mortality risk (aHR:0.310.380.46,P< 0.001) beyond this. Although the long-term survival benefit of acceptance did not vary by candidate model for end-stage liver disease (MELD), the short-term risk period did. MELD 6–21 candidates who accepted an SDL had a 7.88-fold higher mortality risk (aHR:4.807.8812.93,P< 0.001) in the first month posttransplant, whereas MELD 35–40 candidates had a 68% lower mortality risk (aHR:0.110.320.90,P= 0.03).Conclusions.Appropriately selected SDLs can decrease wait time and provide substantial long-term survival benefit for liver transplant candidates.
Reverse-Engineering the Cortical Architecture for Controlled Semantic Cognition
Authors: Jackson Rebecca L. , Rogers Timothy T. , Lambon Ralph Matthew A. 
Published: December 2019

AbstractWe present a ‘reverse engineering’ approach to deconstruct cognition into neurocomputational mechanisms and their underlying cortical architecture, using controlled semantic cognition as a test case. By systematically varying the structure of a computational model and assessing the functional consequences, we identified architectural properties necessary for generating the core functions of the semantic system. Semantic cognition presents a challenging test case as the brain must achieve two seemingly contradictory functions: abstracting context-invariant conceptual representations across time and modalities, whilst producing specific context-sensitive behaviours appropriate for the immediate task. These functions were best achieved in models possessing a single, deep multimodal hub with sparse connections from modality-specific inputs, and control systems acting on peripheral rather than deep network layers. These architectural features correspond well with those suggested by neural data, strongly supporting the efficacy of the reverse engineering approach, and further generating novel hypotheses about the neuroanatomy of controlled semantic cognition.
Prostate Specific Membrane Antigen expression in the vasculature of primary lung carcinomas associates with faster metastatic dissemination to brain
Authors: Ramanathan Jayendrakishore Tanjore , Lehtipuro Suvi , Sihto Harri , Tóvári József , Reiniger Lilla , Téglási Vanda , Moldvay Judit , Nykter Matti , Haapasalo Hannu , Joncour Vadim Le , Laakkonen Pirjo 
Published: December 2019

AbstractGlioblastomas and brain metastases (BM) of solid tumors are the most common central nervous system neoplasms associated with very unfavorable prognosis. In this study, we report the association of Prostate Specific Membrane Antigen with various clinical parameters in a large cohort of primary and secondary brain tumors. A tissue micro array containing 371 cases of ascending grade gliomas pertaining to astrocytic origin, samples of 52 cases of primary lung carcinomas with matching brain metastases with follow-up time accounting to 10.4 years was evaluated for PSMA expression using immunohistochemistry. In addition, PSMA expression was studied in brain metastases arising from melanomas and breast carcinomas. Neovascular expression of PSMA was evident alongside with high expression in the proliferating microvasculature of glioblastomas when compared to the tumor cell expression. This result corroborated with the results obtained from thein silico(cancer genome databases) analyses. In the matched primary lung cancers and their brain metastases (n = 52), vascular PSMA expression in primary tumors led to significantly accelerated metastatic dissemination to the brain with a tendency towards poor overall survival. Taken together, we report the vascular expression of PSMA in the primary and secondary brain tumors that globally associates with the malignant progression and poor outcome of the patients.
Elucidation of the determinant for orchestration of solo unisexual cycle in an important human fungal pathogen
Authors: Hu Pengjie , Liu Huimin , Chen Lei , He Guang-Jun , Tian Xiuyun , Yao Xiaoxia , Zhao Tong , Li Chunli , Tao Changyu , Yang Ence , Wang Linqi 
Published: December 2019

AbstractIn fungi, the sex-determination program universally directs sexual development and syngamy (the fusion of gametes) that underlies pre-meiotic diploidization. However, the contribution of sex-determination to syngamy-independent sexual cycle, which requires autopolyploidization as an alternative approach to elevate ploidy before meiosis, remains unclear in fungi and other eukaryotes. The human fungal pathogenCryptococcus neoformans, as a model organism for studying fungal sexual reproduction, can undergo syngamy-dependent bisexual and syngamy-independent solo unisexual reproduction, in which endoreplication is considered to enable pre-meiotic self-diploidization. Here, by characterizing a mutant lacking all the core sex-determination factors, we show that sex-determination plays a central role in bisexual syngamy but is not strictly required for unisexual development and self-diploidization. This implies an unknown circuit, rather than the sex-determination program, for specifically coordinatingCryptococcusunisexual cycle. We reveal that syngamy and self-diploidization are both governed by the Qsp1-directed paracrine system via two regulatory branches, Vea2 and Cqs2. Vea2 directs bisexual syngamy through the sex-determination program; conversely, Cqs2 is dispensable for bisexual syngamy but activates unisexual endoreplication. Through functional profiling of 41 transcription factors documented to regulateCryptococcussexual development, we reveal that only Cqs2 can drive and integrate all unisexual phases and ensure the production of meiospore progenies. Furthermore, ChIP-seq analysis together with genetic evaluation indicate that Cqs2 induces unisexual self-diploidization through its direct control ofPUM1, whose expression is sufficient to drive autopolyploidization. Therefore, Cqs2 serves as the critical determinant that orchestratesCryptococcusmultistage unisexual cycle that does not strictly require the sexual-determination program.
Chances and challenges of machine learning based disease classification in genetic association studies illustrated on age-related macular degeneration
Authors: Günther Felix , Brandl Caroline , Winkler Thomas W. , Wanner Veronika , Stark Klaus , Küchenhoff Helmut , Heid Iris M. 
Published: December 2019

AbstractImaging technology and machine learning algorithms for disease classification set the stage for high-throughput phenotyping and promising new avenues for genome-wide association studies (GWAS). Despite emerging algorithms, there has been no successful application in GWAS so far. We established machine learning based disease classification in genetic association analysis as a misclassification problem. To evaluate chances and challenges, we performed a GWAS based on automated classification of age-related macular degeneration (AMD) in UK Biobank (images from 135,500 eyes; 68,400 persons). We quantified misclassification of automatically derived AMD in internal validation data (images from 4,001 eyes; 2,013 persons) and developed a maximum likelihood approach (MLA) to account for it when estimating genetic association. We demonstrate that our MLA guards against bias and artefacts in simulation studies. By combining a GWAS on automatically derived AMD classification and our MLA in UK Biobank data, we were able to dissect true association (ARMS2/HTRA1, CFH) from artefacts (nearHERC2) and to identify eye color as relevant source of misclassification. On this example of AMD, we are able to provide a proof-of-concept that a GWAS using machine learning derived disease classification yields relevant results and that misclassification needs to be considered in the analysis. These findings generalize to other phenotypes and also emphasize the utility of genetic data for understanding misclassification structure of machine learning algorithms.
Worldwide recombination in emergent white-nose syndrome pathogenPseudogymnoascus destructans
Authors: Sharma Lav , Sousa Márcia , Faria Ana S. , Nunes-Pereira Margarida , Cabral João A. , Phillips Alan J. L. , Marques Guilhermina , Paiva-Cardoso Maria das Neves 
Published: December 2019

AbstractPseudogymnoascus destructans(Pd), the emergent fungus causing bat “White-Nose Syndrome”, responsible for ∼6 million mortalities in the United States (US), is thought to expand clonally in North America and Europe. Presence of distinct mating-types in Europe led to numerous research attempts searching for population sexuality worldwide. This study not only presents the first evidence of genetic recombination in Pd but also detects recombination in Pd genotype data generated by previous studies in Europe and North America, through clone-corrected linkage disequilibrium analysis. Portuguese and other European populations are apparently reproducing through sex between two mating-types. Seeming parasexual recombination in the invasive single mating-type US population rings alarms for the North American bat populations and deserves urgent attention. This study emphasizes on clone-correction in linkage disequilibrium analysis.One Sentence SummaryClone-correction yielded signs of elusive recombination in the global “clonal” populations of white-nose syndrome pathogen.
An implicit memory of errors limits human sensorimotor adaptation
Authors: Albert Scott T. , Jang Jihoon , Sheahan Hannah , Teunissen Lonneke , Vandevoorde Koenraad , Shadmehr Reza 
Published: December 2019

AbstractAfter extended practice, motor adaptation reaches a limit in which learning appears to stop, despite the fact that residual errors persist. What prevents the brain from eliminating the residual errors? Here we found that the adaptation limit was causally dependent on the second order statistics of the perturbation; when variance was high, learning was impaired and large residual errors persisted. However, when learning relied solely on explicit strategy, both the adaptation limit and its dependence on perturbation variability disappeared. In contrast, when learning depended entirely, or in part on implicit learning, residual errors developed. Residual errors in implicit performance were caused by variance-dependent modifications to error sensitivity, not forgetting. These observations are consisted with a model of learning in which the implicit system becomes more sensitive to error when errors are consistent, but forgets this memory of errors over time. Thus, residual errors in motor adaptation are a signature of the implicit learning system, caused by an error sensitivity that depends on the history of past errors.
The connectome of theCaenorhabditis eleganspharynx
Authors: Cook Steven J. , Crouse Charles M. , Yemini Eviatar , Hall David H. , Emmons Scott W. , Hobert Oliver 
Published: December 2019

AbstractDetailed anatomical maps of individual organs and entire animals have served as invaluable entry points for ensuing dissection of their evolution, development, and function. The pharynx of the nematodeCaenorhabditis elegansis a simple neuromuscular organ with a self-contained, autonomously acting nervous system, composed of 20 neurons that fall into 14 anatomically distinct types. Using serial EM reconstruction, we re-evaluate here the connectome of the pharyngeal nervous system, providing a novel and more detailed view of its structure and predicted function. Contrasting the previous classification of pharyngeal neurons into distinct inter- and motorneuron classes, we provide evidence that most pharyngeal neurons are also likely sensory neurons and most, if not all, pharyngeal neurons also classify as motorneurons. Together with the extensive cross-connectivity among pharyngeal neurons, which is more widespread than previously realized, the sensory-motor characteristics of most neurons define a shallow network architecture of the pharyngeal connectome. Network analysis reveals that the patterns of neuronal connections are organized into putative computational modules that reflect the known functional domains of the pharynx. Compared to the somatic nervous system, pharyngeal neurons both physically associate with a larger fraction of their neighbors and create synapses with a greater proportion of their neighbors. We speculate that the overall architecture of the pharyngeal nervous system may be reminiscent of the architecture of ancestral, primitive nervous systems.