bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fine crackles on chest auscultation in the early diagnosis of idiopathic pulmonary fibrosis: a prospective cohort study
Authors: Moran-Mendoza Onofre , Ritchie Thomas , Aldhaheri Sharina 
Published: July 2021

IntroductionIdiopathic pulmonary fibrosis (IPF) is an interstitial lung disease (ILD) with a poor prognosis. Early diagnosis and treatment of IPF may increase lifespan and preserve quality of life. Chest CT is the best test to diagnose IPF, but it is expensive and impractical as a screening test. Fine crackles on chest auscultation may be the only best to screen for IPF.MethodsWe prospectively assessed the presence and type of crackles on chest auscultation in all patients referred to the ILD Clinic at the Kingston Health Sciences Center in Ontario, Canada. Clinicians with varying levels of experience recorded the presence of fine crackles, coarse crackles or both independently and unaware of the final diagnosis. We applied multinomial logistic regression to adjust for ILD severity and factors that could affect the identification of crackles.ResultsWe evaluated 290 patients referred to the ILD Clinic. On initial presentation, 93% of patients with IPF and 73% of patients with non-IPF ILD had fine crackles on auscultation. In patients with IPF, fine crackles were more common than cough (86%), dyspnoea (80%), low diffusing capacity (87%), total lung capacity (57%) and forced vital capacity (50%). There was 90% observer agreement in identifying fine crackles at a subsequent visit. In multiple regression analysis, the identification of fine crackles was unaffected by lung function, symptoms, emphysema, chronic obstructive pulmonary disease, obesity or clinician experience (p>0.05).ConclusionsFine crackles on chest auscultation are a sensitive and robust screening tool that can lead to early diagnosis and treatment of patients with IPF.
Childhood reading problems and cognitive ageing across mid to later life
Authors: John Amber , Stott Josh , Richards Marcus 
Published: July 2021

BackgroundLittle research has investigated long-term associations of childhood reading with cognitive ageing. The aim of this study was to test longitudinal associations between childhood reading problems and cognitive function from mid-adulthood (age 43) to early old age (age 69), and whether associations were mediated by education.MethodsData were from the MRC National Survey of Health and Development, a prospective population-based birth cohort. Reading problems were measured at age 11 using a reading test. Verbal memory and processing speed were measured at ages 43, 53, 60–64 and 69 and Addenbrooke’s Cognitive Examination (ACE) was administered at age 69. Linear mixed models and path analyses were used to test: (1) associations between reading problems and verbal memory and processing speed trajectories; (2) associations between reading problems and ACE-III scores; (3) whether associations were mediated by education.ResultsReading problems were associated with poorer verbal memory at intercept but not rate of decline (N=1726), and were not associated with processing speed intercept or decline (N=1730). There were higher rates of scores below ACE-III clinical thresholds (<82 and <88) in people with reading problems compared with those without. Reading problems were associated with poorer total ACE-III scores and all domain scores at age 69 (N=1699). Associations were partly mediated by education.ConclusionReading problems in childhood were associated with poorer cognitive function in early old age, and associations were partly mediated by education.
Long-term trajectories of decline in cognition and daily functioning before and after stroke
Authors: Heshmatollah Alis , Dommershuijsen Lisanne J. , Fani Lana , Koudstaal Peter J. , Ikram M. Arfan , Ikram M. Kamran 
Published: July 2021

ObjectiveAlthough knowledge on poststroke cognitive and functional decline is increasing, little is known about the possible decline of these functions before stroke. We determined the long-term trajectories of cognition and daily functioning before and after stroke.MethodsBetween 1990 and 2016, we repeatedly assessed cognition (Mini-Mental State Examination (MMSE), 15-Word Learning, Letter–Digit Substitution, Stroop, Verbal Fluency, Purdue Pegboard) and basic and instrumental activities of daily living (BADL and IADL) in 14 712 participants within the population-based Rotterdam Study. Incident stroke was assessed through continuous monitoring of medical records until 2018. We matched participants with incident stroke to stroke-free participants (1:3) based on sex and birth year. Trajectories of cognition and daily functioning of patients who had a stroke 10 years before and 10 years after stroke and the corresponding trajectories of stroke-free individuals were constructed using adjusted linear mixed effects models.ResultsDuring a mean follow-up of 12.5±6.8 years, a total of 1662 participants suffered a first-ever stroke. Patients who had a stroke deviated from stroke-free controls up to 10 years before stroke diagnosis in cognition and daily functioning. Significant deviations before stroke were seen in scores of MMSE (6.4 years), Stroop (5.7 years), Purdue Pegboard (3.8 years) and BADL and IADL (2.2 and 3.0 years, respectively).ConclusionPatients who had a stroke have steeper declines in cognition and daily functioning up to 10 years before their first-ever stroke compared with stroke-free individuals. Our findings suggest that accumulating intracerebral pathology already has a clinical impact before stroke.
Are conscientious objectors morally obligated to refer?
Authors: Reis-Dennis Samuel , Brummett Abram L 
Published: July 2021

AbstractIn this paper, we argue that providers who conscientiously refuse to provide legal and professionally accepted medical care are not always morally required to refer their patients to willing providers. Indeed, we will argue that refusing to refer is morally admirable in certain instances. In making the case, we show that belief in a sweeping moral duty to refer depends on an implicit assumption that the procedures sanctioned by legal and professional norms are ethically permissible. Focusing on examples of female genital cutting, clitoridectomy and ‘normalizing’ surgery for children with intersex traits, we argue that this assumption is untenable and that providers are not morally required to refer when refusing to perform genuinely unethical procedures. The fact that acceptance of our thesis would force us to face the challenge of distinguishing between ethical and unethical medical practices is a virtue. This is the central task of medical ethics, and we must confront it rather than evade it.
Disaster preparedness should represent an augmentation of the everyday trauma system, but are we prepared?
Authors: Jørgensen Jørgen Joakim , Monrad-Hansen Peter Wiel , Gaarder Christine , Næss Paal Aksel 
Published: July 2021

BackgroundThe increased frequency, geographical spread and the heterogenicity in mass casualty incidents (MCIs) challenge healthcare systems worldwide. Trauma systems constitute the base for disaster preparedness. Norway is sparsely populated, with four regional trauma centers (TCs) and 35 hospitals treating trauma (non-trauma centers (NTCs)). We wanted to assess whether hospitals fill the national trauma system requirements for competence and the degree of awareness of MCI plans.MethodsWe conducted a cross-sectional survey of on-call trauma teams in all 39 hospitals during two time periods: July–August (holiday season (HS)) and September–June (non-holiday season (NHS)). A standardized questionnaire was used to evaluate the MCI preparedness.ResultsA total of 347 trauma team members participated (HS: 173 and NHS: 174). Over 95% of the team members were aware of the MCI plan; half had read the plan during the last 6 months, whereas 63% at the TCs and 74% at NTCs were confident with their MCI role. Trauma team exercises were conducted regularly and 86% had ever participated. Only 63% at the TCs and 53% at the NTCs had participated in an MCI exercise. The proportion of resident surgeons and anesthetists with >4 years’ clinical experience was significantly higher in TCs (88% and 63%) than in NTCs (27% and 17%). All the on-call consultant surgeons were at home, leaving interns in charge at several of the hospitals. All resident surgeons at the TCs were ATLS providers compared with 64% at the NTCs, and almost 90% of the consultant surgeons had participated in advanced trauma surgical courses.DiscussionDespite increased national focus on disaster preparedness, we identified limited compliance with trauma system requirements concerning competency and training. Strict guidelines to secure immediate notification and early presence of consultants whenever a situation that might turn into an MCI occurs should be a prerequisite.Level of evidenceLevel IV. Study type: cross- sectional.
Where the infection is isolated rather than the specific species correlates with adherence strength, whereas biofilm density remains static in clinically isolated Candida and arthroconidial yeasts
Authors: ElGindi Mei , Al-Baghdadi Rula , Jackman Alex B. , Antonyan Angelina S. , McMahon Diana L. , Taj-Aldeen Saad J. , Finkel Jonathan S. 
Published: July 2021

To colonize and infect the host, arthroconidial yeasts must avoid being killed by the host’s defenses. The formation of biofilms on implanted devices allows fungi to avoid host responses and to disseminate into the host. To better study the mechanisms of infection by arthroconidial yeasts, adherence and biofilm formation were assayed using patient samples collected over 10 years. In clinical samples, adherence varies within species, but the relative adherence is constant for those samples isolated from the same infection site. Herein we document, for the first time, in-vitro biofilm formation by Trichosporon dohaense, T. ovoides, T. japonicum, T. coremiiforme, Cutaneotrichosporon mucoides, Cutaneotrichosporon cutaneum, Galactomyces candidus, and Magnusiomyces capitatus on clinically relevant catheter material. Analysis of biofilm biomass assays indicated that biofilm mass changes less than 2-fold, regardless of the species. Our results support the hypothesis that most pathogenic fungi can form biofilms, and that biofilm formation is a source of systemic infections.
Dark matter in the fully flipped 3-3-1-1 model
Authors: Van Loi Duong , Nam Cao H. , Van Dong Phung 
Published: July 2021

AbstractWe present the features of the fully flipped 3-3-1-1 model and show that this model leads to dark matter candidates naturally. We study two dark matter scenarios corresponding to the triplet fermion and singlet scalar candidates, and we determine the viable parameter regimes constrained from the observed relic density and direct detection experiments.
Efficient Retrieval of Human Motion Episodes Based on Indexed Motion-Word Representations
Authors: Budikova Petra , Sedmidubsky Jan , Horvath Jan , Zezula Pavel 
Published: July 2021

With the increasing availability of human motion data captured in the form of 2D or 3D skeleton sequences, more complex motion recordings need to be processed. In this paper, we focus on similarity-based indexing and efficient retrieval of motion episodes — medium-sized skeleton sequences that consist of multiple semantic actions and correspond to some logical motion unit (e.g. a figure skating performance). As a first step toward efficient retrieval, we apply the motion-word technique to transform spatio-temporal skeleton sequences into compact text-like documents. Based on these documents, we introduce a two-phase retrieval scheme that first finds a set of candidate query results and then re-ranks these candidates with more expensive application-specific methods. We further index the motion-word documents using inverted files, which allows us to retrieve the candidate documents in an efficient and scalable manner. We also propose additional query-reduction techniques that accelerate both the retrieval phases by removing semantically irrelevant parts of the motion query. Experimental evaluation is used to analyze the effects of the individual proposed techniques on the retrieval efficiency and effectiveness.
Metabolic Enzyme DLST Promotes Tumor Aggression and Reveals a Vulnerability to OXPHOS Inhibition in High-Risk Neuroblastoma
Authors: Anderson Nicole M. , Qin Xiaodan , Finan Jennifer M. , Lam Andrew , Athoe Jacob , Missiaen Rindert , Skuli Nicolas , Kennedy Annie , Saini Amandeep S. , Tao Ting , Zhu Shizhen , Nissim Itzhak , Look A. Thomas , Qing Guoliang , Simon M. Celeste , Feng Hui 
Published: July 2021

Abstract

High-risk neuroblastoma remains therapeutically challenging to treat, and the mechanisms promoting disease aggression are poorly understood. Here, we show that elevated expression of dihydrolipoamide S-succinyltransferase (DLST) predicts poor treatment outcome and aggressive disease in patients with neuroblastoma. DLST is an E2 component of the α-ketoglutarate (αKG) dehydrogenase complex, which governs the entry of glutamine into the tricarboxylic acid cycle (TCA) for oxidative decarboxylation. During this irreversible step, αKG is converted into succinyl-CoA, producing NADH for oxidative phosphorylation (OXPHOS). Utilizing a zebrafish model of MYCN-driven neuroblastoma, we demonstrate that even modest increases in DLST expression promote tumor aggression, while monoallelic dlst loss impedes disease initiation and progression. DLST depletion in human MYCN-amplified neuroblastoma cells minimally affected glutamine anaplerosis and did not alter TCA cycle metabolites other than αKG. However, DLST loss significantly suppressed NADH production and impaired OXPHOS, leading to growth arrest and apoptosis of neuroblastoma cells. In addition, multiple inhibitors targeting the electron transport chain, including the potent IACS-010759 that is currently in clinical testing for other cancers, efficiently reduced neuroblastoma proliferation in vitro. IACS-010759 also suppressed tumor growth in zebrafish and mouse xenograft models of high-risk neuroblastoma. Together, these results demonstrate that DLST promotes neuroblastoma aggression and unveils OXPHOS as an essential contributor to high-risk neuroblastoma.

Significance:
These findings demonstrate a novel role for DLST in neuroblastoma aggression and identify the OXPHOS inhibitor IACS-010759 as a potential therapeutic strategy for this deadly disease.
The Prognostic Role of MYC Structural Variants Identified by NGS and FISH in Multiple Myeloma
Authors: Sharma Neeraj , Smadbeck James B. , Abdallah Nadine , Zepeda-Mendoza Cinthya , Binder Moritz , Pearce Kathryn E. , Asmann Yan W. , Peterson Jess F. , Ketterling Rhett P. , Greipp Patricia T. , Bergsagel P. Leif , Rajkumar S. Vincent , Kumar Shaji K. , Baughn Linda B. 
Published: July 2021

Abstract

Purpose:
Structural variants (SV) of the MYC gene region are common in multiple myeloma and influence disease progression. However, the prognostic significance of different MYC SVs in multiple myeloma has not been clearly established.

Experimental Design:
We conducted a retrospective study of multiple myeloma comparing MYC SV subtypes identified by next-generation sequencing (NGS) and FISH to MYC expression and disease survival using 140 cases from Mayo Clinic and 658 cases from the MMRF CoMMpass study.

Results:
MYC SVs were found in 41% of cases and were classified into nine subtypes. A correlation between the presence of a MYC SV and increased MYC expression was identified. Among the nine MYC subtypes, the non-immunoglobulin (non-Ig) insertion subtype was independently associated with improved outcomes, while the Ig insertion subtype, specifically involving the IgL gene partner, was independently associated with poorer outcomes compared with other MYC SV subtypes. Although the FISH methodology failed to detect approximately 70% of all MYC SVs, those detected by FISH were associated with elevated MYC gene expression and poor outcomes suggesting a different pathogenic role for FISH-detected MYC subtypes compared with other MYC subtypes.

Conclusions:
Understanding the impact of different MYC SVs on disease outcome is necessary for the reliable interpretation of MYC SVs in multiple myeloma. NGS approaches should be considered as a replacement technique for a more comprehensive evaluation of the multiple myeloma clone.
The Three Choruses of Plato’s Laws and their Function in the Dialogue
Authors: Pfefferkorn Julia 
Published: July 2021

Abstract
This article questions a longtime credo concerning Plato’s Laws, namely that the three choruses introduced in Book 2 are institutions of the dialogue’s political project. A detailed analysis of relevant passages shows that the evidence is insufficent. Rather, it is argued, this part of Book 2 is essentially plurivalent: on three separate semantic layers, the choruses illustrate political, moral-psychological and key educational issues of the Laws. Apart from explaining the disappearance of the choruses after Book 2, the proposed reading aims to bring to light an impressively artful philosophical and literary strategy of Plato’s.
Banned and Branded: The Mesopotamian Background of Šamata
Authors: Paz Yakir 
Published: July 2021

Abstract
The verb √šmt and noun šamata, attested in the dialects of Eastern Aramaic in the Sasanian period, would seem at first to be synonymous with the Palestinian term nidui, ‘excommunication’. However, a closer examination reveals that šamata has a different semantic value. It is not simply conceived as a social sanction of excommunication but is understood as a curse involving divine violence; is closely associated with binding; and is often perceived as the property of powerful agents. In this article I argue that √šmt is derived from the Akkadian šamātu, ‘to mark’, ‘to brand’, especially in its more restricted sense ‘to brand temple slaves’ and ‘to dedicate a person to a deity’. Understanding the Mesopotamian roots of šamata might help us better explain its unique regional features, shared by the Aramaic speaking groups in the Sasanian Empire.
The Status and Future of Small Uncrewed Aircraft Systems (UAS) in Operational Meteorology
Authors: Pinto James O. , O’Sullivan Debbie , Taylor Stewart , Elston Jack , Baker C. B. , Hotz David , Marshall Curtis , Jacob Jamey , Barfuss Konrad , Piguet Bruno , Roberts Greg , Omanovic Nadja , Fengler Martin , Jensen Anders A. , Steiner Matthias , Houston Adam L. 
Published: July 2021

AbstractThe boundary layer plays a critical role in regulating energy and moisture exchange between the surface and the free atmosphere. However, the boundary layer and lower atmosphere (including shallow flow features and horizontal gradients that influence local weather) are not sampled at time and space scales needed to improve mesoscale analyses that are used to drive short-term model predictions of impactful weather. These data gaps are exasperated in remote and less developed parts of the world where relatively cheap observational capabilities could help immensely. The continued development of small, weather-sensing uncrewed aircraft systems (UAS), coupled with the emergence of an entirely new commercial sector focused on UAS applications, has created novel opportunities for partially filling this observational gap. This article provides an overview of the current level of readiness of small UAS for routinely sensing the lower atmosphere in support of national meteorological and hydrological services (NMHS) around the world. The potential benefits of UAS observations in operational weather forecasting and numerical weather prediction are discussed, as are key considerations that will need to be addressed before their widespread adoption. Finally, potential pathways for implementation of weather-sensing UAS into operations, which hinge on their successful demonstration within collaborative, multi-agency-sponsored testbeds, are suggested.
Effect of suicide prevention law and media guidelines on copycat suicide of general population following celebrity suicides in South Korea, 2005–2017
Authors: Jang Jihoon , Myung Woojae , Kim Seongcheol , Han Minhee , Yook Vidal , Kim Eun Ji , Jeon Hong Jin 
Published: July 2021

Objective: To prevent copycat suicides following media reporting of celebrity suicides, the South Korean government enacted a ‘suicide prevention law’ in 2012 and revised the media guidelines for suicide reporting in 2013. This study examined how these two regulatory measures affected suicide trends among the general population in South Korea. Methods: We analyzed the individual effect estimates for the general population within 30 days following the media report of 24 celebrity suicides using multivariate negative binomial regression. We performed a meta-analysis to compute the pooled rate ratios of the two regulations. We examined the trends in daily suicides by month during three time intervals before and after enactment using an autoregressive model and tested their significance using a piecewise linear regression. Results: Total suicides increased by 6.27 daily during the 30-day period after celebrity suicides. Compared with the 30 days prior to the reports on the suicide of 24 celebrities, the number of suicidal deaths in the general population increased by 13% during the 30 days after the reports were announced (pooled rate ratio 1.13, 95% confidence interval: 0.06–0.18; p < 0.001). There was a significant downward trend in the average daily suicide deaths, and no significant increase in suicide rates, after the enactment of the suicide prevention law ( p < 0.001) and revision of the media guidelines ( p = 0.014). Conclusions: Suicide prevention and media guidelines were effective in reducing the effect of celebrity suicides. In addition to regulating media reporting of celebrity suicide, measures are needed to address viral republication on social media and to prevent suicide among entertainers.
Intraoperative completion cone-beam computed tomography for the assessment of residual lesions after primary treatment of proximal venous outflow obstructions
Authors: Baccellieri Domenico , Apruzzi Luca , Ardita Vincenzo , Bilman Victor , De Cobelli Francesco , Melissano Germano , Chiesa Roberto 
Published: July 2021

Objective Report the usefulness of completion cone-beam computed tomography (CBCT) as an adjunct tool during femoro-ilio-caval recanalization post stent placement. Methods Data from patients who underwent complex endovenous recanalization for chronic proximal outflow obstruction from January 2018 to May 2020 were analyzed. Two groups of patients were obtained based on the execution or not of completion CBCT. Outcomes, radiation, and contrast doses in the two groups were compared. Results Fifteen patients (9 female, mean age 46.9 ± 13.3) in the control group and ten patients (7 female, 58.3 ± 14) in the CBCT group were included. In the CBCT group, one patient underwent an intraprocedural revision due to a residual lesion. The median total kerma area product (KAPtotal) and the total volume of contrast injected were not statistically different in the two groups. Conclusions Completion CBCT after endovenous procedures might identify residual stenosis or stent malposition without a significant increase of total contrast injected and KAPtotal.