bluuebunny/crossref_metadata_2025_split huggingface dataset:
An atypical manifestation of lateral medullary syndrome
Authors: Chakraborty Uddalak , Banik Biswajit , Chandra Atanu , Pal Jyotirmoy 
Published: December 2019

ABSTRACT
Lateral medullary syndrome is a common brainstem stroke associated with a classical triad of Horner’s Syndrome, ipsilateral ataxia and hypalgesia and thermoanasthesia of ipsilateral face. We report a case of a 49-year-old diabetic, non-hypertensive, postmenopausal female who presented with symptoms involving the left dorsal medulla along with right sided hemiparesis and left UMN-type facial palsy. Contralateral hemiparesis was explained by caudal extension of infarct involving the pyramids before decussation at the medulla, known as Babinski–Nageotte Syndrome. UMN-type facial palsy was attributed to involvement of hypothetical supranuclear aberrant corticobulbar fibres of facial nerve which descend down in the contralateral ventromedial medulla, decussate at level of upper medulla and then ascend in the dorsolateral medulla to reach the facial nerve nucleus. Association of these two entities with Wallenberg’s Syndrome have been reported separately in literature, but not together as in this case.
Enhanced Relative Electron Transport Rate Contributes to Increased Photosynthetic Capacity in Autotetraploid Pak Choi
Authors: Zhang Changwei , Wang Huiyu , Xu Yuanyuan , Zhang Shuning , Wang Jianjun , Hu Bing , Hou Xilin , Li Ying , Liu Tongkun 
Published: December 2019

AbstractAutopolyploids often show growth advantages over their diploid progenitors because of their increased photosynthetic activity; however, the underlying molecular basis of such mechanism remains elusive. In this study, we aimed to characterize autotetraploid pak choi (Brassica rapa ssp. chinensis) at the physiological, cellular and molecular levels. Autotetraploid pak choi has thicker leaves than its diploid counterparts, with relatively larger intercellular spaces and cell size and greater grana thylakoid height. Photosynthetic data showed that the relative electron transport rate (rETR) was markedly higher in autotetraploid than in diploid pak choi. Transcriptomic data revealed that the expressions of genes involved in ‘photosynthesis’ biological process and ‘thylakoids’ cellular component were mainly regulated in autotetraploids. Overall, our findings suggested that the increased rETR in the thylakoids contributed to the increased photosynthetic capacity of autotetraploid leaves. Furthermore, we found that the enhanced rETR is associated with increased BrPetC expression, which is likely altered by histone modification. The ectopic expression of BrPetC in Arabidopsis thaliana led to increased rETR and biomass, which were decreased in BrPetC-silenced pak choi. Autotetraploid pak choi also shows altered hormone levels, which was likely responsible for the increased drought resistance and the impaired powdery mildew resistance of this lineage. Our findings further our understanding on how autotetraploidy provides growth advantages to plants.
Is there an indication to utilize intravenous iron in acute trauma patients? Why, how, and when
Authors: Froessler Bernd , Kurmis Andrew , Papendorf David 
Published: December 2019

Purpose of review
Traumatic injury has been described as a growing pandemic which has significant implications for global health. In the trauma setting, anemia is a common occurrence and is frequently inadequately addressed. It is associated with significant morbidity and incurs great cost – both to the patient and to the health system. The cause is multifactorial, and the pathophysiology is incompletely understood. Appropriate care of the trauma patient is a multidisciplinary responsibility and a focused approach to anemia is vital. The recommendation for restrictive transfusion strategies and the potential benefit of intravenous iron (IVI) in the perioperative setting, make the intervention an attractive proposition in the anemic trauma patient.

Recent findings
In an era where the importance of patient blood management is recognized, there is significant attention being given to both the implications and the appropriate management of anemia, in various settings. Advances have been made in the understanding of the mechanisms underlying the anemia associated with traumatic injury and the efficacy of current interventions is being explored. This increased understanding of the pathophysiology behind the condition has also facilitated the postulation of potential therapeutic targets for the future.

Summary
Suboptimally managed anemia impacts on clinical outcome and contributes to the burden of costs associated with trauma. The cause of the anemia associated with trauma is multifactorial and should be addressed at several levels. The role of IVI in this setting is yet to be clearly defined.
Correlation Between Heart Rate Characteristic Index Score and Severity of Brain Injury in Neonates With Hypoxic-Ischemic Encephalopathy
Authors: Kayton Allyson , DeGrazia Michele , Sharpe Elizabeth , Smith Denise , Perez Jose A. , Weiss Michael D. 
Published: December 2019

Background:
Hypoxic-ischemic encephalopathy (HIE) remains devastating for neonates despite widespread treatment with therapeutic hypothermia (TH). The heart rate characteristic (HRC) index score, a measure of heart rate variability, could prove useful in the management of neonates with HIE as new therapies emerge or when withdrawal-of-support decisions are being considered.

Purpose:
The main purpose was to describe correlation between HRC index scores and brain magnetic resonance imaging (MRI) severity of injury for neonates with HIE.

Methods/Analysis:
Low/high HRC index scores retrieved at initiation of TH (baseline), 24, 48, 72, and 96 hours, brain MRI severity of injury, and National Institute of Child Health and Human Development Death/Disability and Death scores were collected and analyzed retrospectively. Independent t tests and linear regression were used to examine relationships for each outcome measure.

Results:
Twenty-seven neonates were stratified into 2 groups: noninjury (n = 11) and injury (n = 16). Statistically significant relationships were observed. Strikingly, mean low HRC index score for the noninjury group ranged between 0.37 and 0.65 and was between 0.61 and 0.86 for the injury group. Mean high HRC index score for the noninjury group ranged between 0.66 and 1.02 and was between 1.04 and 1.41 for the injury group.

Implications for Practice:
HRC index score may be a useful guide in the future management of neonates with HIE.

Implications for Research:
This study established correlations between HRC index and MRI injury scores in neonates treated with TH. Further research is warranted to establish important relationships between brain injury and HRC index scores before this tool can be used clinically for this purpose.
Patient-Centered Care: Total Hip Arthroplasty for Displaced Femoral Neck Fracture Does Not Increase Infection Risk
Authors: Campbell Abigail , Lott Ariana , Gonzalez Leah , Kester Benjamin , Egol Kenneth A. 
Published: December 2019

ABSTRACT

Introduction:
Total hip arthroplasty (THA) is often used for displaced femoral neck fracture. In this study, institutional hip arthroplasty data were compared with the National American College of Surgeons National Surgical Quality Improvement Program (NSQIP) data for any differences in outcomes between our hospital, with an integrated hip fracture care pathway, and those of the country as a whole.

Methods:
Elective THA was compared with arthroplasty performed for acute fracture. Outcomes for both groups included thromboembolic event (VTE), death, and deep prosthetic infection.

Results:
Institutional data revealed no increased rate of infection after THA for fracture compared with elective. National Surgical Quality Improvement Program analysis revealed higher infection rates in fracture arthroplasty. There was an increased VTE rate in fracture performed for arthroplasty compared with elective in both institutional and NSQIP data.

Conclusions:
When performed at an academic medical center with an integrated care program, THA for fracture can have similar infection rates to elective THA. By contrast, national data showed significantly higher rates of infection and VTE for arthroplasty for fracture compared with elective. The contrast in complication rates may be related to well-functioning comprehensive interdisciplinary pathways. Patient-centered care pathways may be optimal for hip fracture patients.
Noninvasive positive pressure ventilation in stable patients with COPD
Authors: Wiles Samuel P. , Aboussouan Loutfi S. , Mireles-Cabodevila Eduardo 
Published: December 2019

Purpose of review
Long-term noninvasive positive pressure ventilation (NIV) used to be a controversial form of therapy for patients with stable hypercapnic chronic obstructive pulmonary disease (SH-COPD). New evidence described in this review defines the optimal settings, timing and target population for NIV utilization in SH-COPD necessary to maximize its benefit.

Recent findings
NIV, when titrated appropriately, leads to improved clinical outcomes. High inspiratory positive airway pressures aimed at decreasing CO2 levels can ensure NIV success in SH-COPD. NIV initiated when patients remain hypercapnic whereas in a clinical stable state following an acute exacerbation can prolong the time to a readmission. Technological advances in NIV algorithms and remote monitoring have the potential to improve use and titration. NIV and portable NIV improve exercise tolerance and may accentuate the benefits derived from pulmonary rehabilitation alone.

Summary
Use of high-intensity NIV in SH-COPD is beneficial yet appropriate patient selection and implementation is paramount.
Racial Disparities in Resection of Early Stage Non–Small Cell Lung Cancer
Authors: Ezer Nicole , Mhango Grace , Bagiella Emilia , Goodman Emily , Flores Raja , Wisnivesky Juan P. 
Published: December 2019

Background:
Racial disparities in resection of non–small cell lung cancer (NSCLC) are well documented. Patient-level and system-level factors only partially explain these findings. Although physician-related factors have been suggested as mediators, empirical evidence for their contribution is limited.

Objective:
To determine if racial disparities in receipt of thoracic surgery persisted after patients had a surgical consultation and whether there was a physician contribution to disparities in care.

Methods:
The authors identified 19,624 patients with stage I-II NSCLC above 65 years of age from the Surveillance-Epidemiology and End-Results-Medicare database. They studied black and white patients evaluated by a surgeon within 6 months of diagnosis. They assessed for racial differences in resection rates among surgeons using hierarchical linear modeling. Our main outcome was receipt of NSCLC resection. A random intercept was included to test for variability in resection rates across surgeons. Interaction between patient race and the random surgeon intercept was used to evaluate for heterogeneity between surgeons in resection rates for black versus white patients.

Results:
After surgical consultation, black patients were less likely to undergo resection (adjusted odds ratio, 0.57; 95% confidence interval, 0.47–0.69). Resection rates varied significantly between surgeons (P<0.001). A significant interaction between the surgeon intercept and race (P<0.05) showed variability beyond chance across surgeons in resection rates of black versus white patients. When the model included thoracic surgery specifalization the physician contribution to disparities in care was decreased.

Conclusions:
Racial disparities in resection of NSCLC exist even among patients who had access to a surgeon. Heterogeneity between surgeons in resection rates between black and white patients suggests a physician’s contribution to observed racial disparities. Specialization in thoracic surgery attenuated this contribution.
The Significance of a Knee Injury in the Investigation of an Unsuspected Motor Vehicle-Pedestrian Collision
Authors: Halari Moheem Masumali , Shkrum Michael James 
Published: December 2019

Abstract
Characteristic injury patterns have been described in pedestrians struck by motor vehicles. The common injury pattern seen in upright pedestrians consists of a triad of head, pelvis, and lower extremity trauma. There are several factors such as vehicular type, design, mass and speed, and impact surfaces that influence the type and distribution of these injuries. We report a case that illustrates the importance of examination of the knee at autopsy when the typical lower extremity diaphyseal fractures that are usually seen in a motor vehicle-pedestrian collision are absent.
Sources of Variability in Pediatric Head Computed Tomography Use Among Emergency Departments in New Jersey
Authors: Holmes Aline M. , Sacchetti Alfred , Bukata W. Richard , Sheth Soniya 
Published: December 2019

Objective
Published guidelines have been developed to limit ionizing radiation exposure in children related to diagnostic computed tomography (CT). This study examines the sources of variability in head CT use in children in emergency departments (EDs) in New Jersey despite the presence of such consensus recommendations.

Methods
The New Jersey Hospital Association (NJHA) Clinical Repository was queried for study data on all patients younger than 18 years discharged from the ED over a 1-year period. Patient information collected included: treating hospital, patient age, discharge diagnosis, use of head CT, children's hospital (CH) certification, presence of licensed in-patient pediatric beds, association with a hospital system and hospital annual pediatric ED volume. A potential diagnosis requiring a head CT (PDRCT) was defined as one of the following discharge diagnoses: Head Injury, Seizure, Syncope or Headache. Analysis of CT use per 10,000 ED visits was performed through ANOVA, analysis of means for variances, and χ2.

Results
A total of 735,866 ED visits were examined with 16,942 (2.3%) undergoing head CTs. Mean Pediatric Head CT use per 10,000 ED visits for the state was 275 (±16; range, 27–640). During the study period 47,169 (6.4%) ED visits met the PDRCT criteria, 11,495 (27%) of which underwent head CTs. Mean Pediatric Head CT use in this group per 10,000 PDRCT visits was 2948 (±152; range, 728–5806). Characteristics associated with lowest use of head CTs in the PDRCT group included: ED census greater than 10,000 visits per year, CH designation, and younger patient. The presence of in-patient pediatric beds and association with a hospital system with or without an in system CH were not associated with lower head CT use.

Conclusions
Despite existing recommendation regarding head CTs in children, there exists a large degree of variability in use of this diagnostic study in EDs in New Jersey.
Respiratory Motion Detection and Correction for MR Using the Pilot Tone
Authors: Vahle Thomas , Bacher Mario , Rigie David , Fenchel Matthias , Speier Peter , Bollenbeck Jan , Schäfers Klaus P. , Kiefer Berthold , Boada Fernando E. 
Published: December 2019

Objectives
The aim of this study was to develop a method for tracking respiratory motion throughout full MR or PET/MR studies that requires only minimal additional hardware and no modifications to the sequences.

Materials and Methods
Patient motion that is caused by respiration affects the quality of the signal of the individual radiofrequency receive coil elements. This effect can be detected as a modulation of a monofrequent signal that is emitted by a small portable transmitter placed inside the bore (Pilot Tone). The frequency is selected such that it is located outside of the frequency band of the actual MR readout experiment but well within the bandwidth of the radiofrequency receiver, that is, the oversampling area. Temporal variations of the detected signal indicate motion. After extraction of the signal from the raw data, principal component analysis was used to identify respiratory motion. The approach and potential applications during MR and PET/MR examinations that rely on a continuous respiratory signal were validated with an anthropomorphic, PET/MR-compatible motion phantom as well as in a volunteer study.

Results
Respiratory motion detection and correction were presented for MR and PET data in phantom and volunteer studies. The Pilot Tone successfully recovered the ground-truth respiratory signal provided by the phantom.

Conclusions
The presented method provides reliable respiratory motion tracking during arbitrary imaging sequences throughout a full PET/MR study. All results can directly be transferred to MR-only applications as well.
Effects of Multidrug-resistant Bacteria in Donor Lower Respiratory Tract on Early Posttransplant Pneumonia in Lung Transplant Recipients Without Pretransplant Infection
Authors: Lee Kyoung Hwa , Jeong Su Jin , Kim Song Yee , Han Sang Hoon , Park Moo Suk , Lee Jin Gu , Yoo Seul Gi , La Yeonju , Kwon Da Eun , Lee Chang Young , Song Yong Goo , Paik Hyo Chae 
Published: December 2019

Background.
Multidrug-resistant (MDR) bacteria in the lower respiratory tracts of allografts may be risk factors for early posttransplant pneumonia (PTP) that causes detrimental outcomes in lung transplant recipients (LTRs). We evaluated the effects of immediate changes in MDR bacteria in allografts on early PTP and mortality rates in LTRs.

Methods.
We reviewed 90 adult bilateral LTRs without pretransplant infections who underwent lung transplantation between October 2012 and May 2018. Quantitative cultures were performed with the bronchoalveolar lavage fluids of the allografts preanastomosis and within 3 days posttransplant. The International Society for Heart and Lung Transplantation consensus defines early PTP as pneumonia acquired within 30 days posttransplant and not associated with acute rejection.

Results.
MDR Acinetobacter baumannii (11/34, 32.4%) and Staphylococcus aureus (9/34, 26.5%) were identified in 24.4% (22/90) of the preanastomosis allografts. Four LTRs had the same MDR bacteria in allografts preanastomosis and posttransplant. Allograft MDR bacteria disappeared in 50% of the LTRs within 3 days posttransplant. Early PTP and all-cause in-hospital mortality rates were not different between LTRs with and without preanastomosis MDR bacteria (P = 0.75 and 0.93, respectively). MDR bacteria ≥104 CFU/mL in the lungs within 3 days posttransplant was associated with early PTP (odds ratio, 5.8; 95% confidence interval, 1.3-27.0; P = 0.03).

Conclusions.
High levels of preexisting MDR bacteria in allografts did not increase early PTP and mortality rates in LTRs. Despite the small and highly selective study population, lung allografts with MDR bacteria may be safely transplanted with appropriate posttransplant antibiotic therapy.
Effectiveness of interpretive front-of-pack nutritional labelling schemes on the promotion of healthier food choices: a systematic review
Authors: Feteira-Santos Rodrigo , Fernandes João , Virgolino Ana , Alarcão Violeta , Sena Catarina , Vieira Carlota P. , Gregório Maria João , Nogueira Paulo , Costa Andreia , Graça Pedro , Santos Osvaldo 
Published: December 2019

ABSTRACT

Aims:
Interpretive front-of-package nutrition labelling can contribute to healthier food habits. This systematic review aimed to examine the effectiveness of interpretive front-of-package nutrition labelling schemes on consumers’ food choices, namely at the moment of food purchase, and to analyse if this potential front-of-package nutrition labelling's effect varies according to different socioeconomic groups.

Methods:
Electronic databases (Cochrane Library, PubMed, Scopus, and Web of Science) search was performed to identify peer-reviewed articles describing longitudinal studies evaluating the effect of front-of-package nutrition labelling schemes on consumers’ food choices, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-Equity 2012 Extension guidelines. No publication-period or language restrictions were applied. PROGRESS-Plus framework was used to report if and how socioeconomic factors were considered in analyses of front-of-package nutrition labelling-related interventions’ effect.

Results:
Nine studies were selected for narrative synthesis (seven randomized controlled trials and two cross-over trials). When compared with no-interpretive-label conditions, front-of-package nutrition labelling showed a positive impact for nutritional content understanding, healthiness perception of products, selection of products with better nutritional quality, and purchase intention. However, there is no robust evidence of superiority of a specific front-of-package nutrition labelling scheme's effect, neither on consumers’ understanding of nutritional content nor on food choices. An evaluation of the studies following the PROGRESS-Plus framework revealed that socioecononomic status and education were the most frequently used dimensions, when assessing the effect of interpretative front-of-pack nutrition labels. More evidence is necessary to determine the role of front-of-pack nutrition labels in decreasing inequalities between different population subgroups, namely among the most vulnerable subgroups, on the promotion of healthy food choices.

Conclusion:
Well controlled longitudinal studies, following a real-world evidence approach, are needed to clarify front-of-package nutrition labelling's impact on consumers’ food choices, namely at purchase points, taking into account the most vulnerable population subgroups, such as those with lower literacy and/or financial resources.
Mentor–mentee relationships as anchors for pre service teachers’ coping on professional placement
Authors: Wilson Anat , Huynh Minh 
Published: December 2019

PurposeMentor–mentee relationships are important for individual wellbeing, mental health, professional agency and confidence. In the context of an initial teacher education (ITE) programme, these relationships become a key factor. Pre-service teachers’ capacity to cope on a professional placement is closely linked to the quality of the mentoring relationship. The purpose of this paper is to identify the negative coping strategies used by pre-service teachers who struggle to cope in a school placement in Melbourne, Australia, highlighting the importance of providing quality mentorship.Design/methodology/approachA mixed-methods approach was used for the analysis of pre-service teachers’ coping on a teaching practicum and to identify common related beliefs. A total of 177 pre-service teachers, who have completed at least one supervised practicum participated in this study. The Coping Scale for Adults second edition (CSA-2) was administered alongside an open-ended questionnaire to identify frequently used coping styles and associated thoughts and beliefs.FindingsThe results show that pre-service teachers who favour non-productive coping strategies were more likely to express feelings of loneliness, pointed at poor communication with their mentor and described thoughts about leaving the teaching profession.Originality/valueUsing the Coping Scale for Adults in the context of practicum provides an insight into individual experiences. The implications of mentor–mentee relationships for individuals’ coping are highlighted. initial teacher education programs and schools have significant roles in supporting mentor–mentee relationships and practical supportive interventions are offered.