bluuebunny/crossref_metadata_2025_split huggingface dataset:
Schilddrüsenkarzinom – ist weniger (Therapie) mehr?
Authors: Todica Andrei , Ladurner Roland , Spitzweg Christine 
Published: April 2018

Was ist neu?
„Active Surveillance“ beim papillären Mikrokarzinom (PTMC) Entgegen früherer Empfehlungen wird in aktuellen Leitlinien eine weitere Abklärung von Schilddrüsenknoten mittels Feinnadelpunktion nicht mehr bei Knoten < 1 cm empfohlen, um eine Überdiagnostik der häufigen und sich meist indolent verhaltenden PTMC zu vermeiden. Daten aus prospektiven Untersuchungen aus Japan und den USA belegen außerdem, dass bei sorgfältig selektierten Patienten mit PTMC ein „Active Surveillance“-Ansatz in Erwägung gezogen werden kann, bei dem die chirurgische Therapie mit kurativem Ansatz erst dann erfolgt, wenn sich ein signifikanter Progress zeigt.
Anpassung der Therapie mit individualisierter Risikostratifizierung Unter Verwendung verschiedener von internationalen Fachgesellschaften vorgeschlagener Risikostratifizierungssysteme werden international eingeschränkt radikale chirurgische Therapieverfahren und ein restriktiverer Einsatz der Radiojodtherapie bei Patienten mit Niedrig-Risiko-DTC empfohlen sowie eine risikoadaptierte Individualisierung der Schilddrüsenhormonsubstitutionsdosis. Ein weiteres international mittlerweile breit akzeptiertes Werkzeug zur Risikostratifizierung der Therapie beim DTC ist die dynamische Risikoanpassung nach R. Michael Tuttle, die eine Neueinschätzung des Risikos im Verlauf auf dem Boden des therapeutischen Ansprechens erlaubt. Unter Berücksichtigung der internationalen Leitlinien werden auch in Deutschland derzeit aktuelle interdisziplinäre evidenzbasierte Leitlinien für die Diagnostik und Therapie von DTC erstellt.
Systemische Therapie beim Radiojod-refraktären DTC Angesichts der Nebenwirkungsprofile der molekular gezielten Therapien wird auch nach der Zulassung von Sorafenib und Lenvatinib bei begrenzter Tumorlast, asymptomatischer Erkrankung und stabilem Krankheitsverlauf neben der Ausschöpfung anderer nebenwirkungsärmerer palliativer Therapieverfahren primär eine „Watch-and-Wait“-Strategie empfohlen. Molekular gezielte Therapien werden erst dann in Erwägung gezogen, wenn ein signifikanter Progress bei hoher Tumorlast vorliegt und eine Watch-and-Wait-Strategie nicht mehr sinnvoll ist.
Moral narratives and mental health: rethinking understandings of distress and healthcare support in contexts of austerity and welfare reform
Authors: Thomas Felicity , Hansford Lorraine , Ford Joseph , Wyatt Katrina , McCabe Rosemarie , Byng Richard 
Published: April 2018

AbstractAssociations between mental health and poverty are increasingly well established. Yet in neoliberally oriented contexts in which distress engendered through the everyday hardships of poverty is increasingly pathologised and medicalised, important questions are raised over the assumptions inherent within mental health policy and its implementation. Using the UK as a focus, this paper reviews and maps out key questions that require investigation in order to better understand the complex inter-relations between poverty and distress; explores how current paradigms might influence notions of individual responsibility and agency as well as health seeking behaviours; and examines the role of, and cultural and systemic expectations and constraints placed upon GPs as they respond to distress amongst patients from low-income communities. In so doing, we argue for recognition of the moral narratives that underpin both mental health care and processes of welfare reform, and call for an expansion of conventional notions of evidence-based healthcare to incorporate the understandings, experiences and priorities of people from low-income groups. We call for more detailed questioning and analysis of the interactions that lead to mental health diagnosis and treatment and better understanding of the relevance and effectiveness of current treatment options. As a central tenet of this, we argue for more flexible and nuanced healthcare responses that better reflect the dynamic and multi-faceted nature of poverty-related distress.
Biomechanical characterization of the Junzuki karate punch: indexes of performance
Authors: Rinaldi Martina , Nasr Yasmen , Atef Ghada , Bini Fabiano , Varrecchia Tiwana , Conte Carmela , Chini Giorgia , Ranavolo Alberto , Draicchio Francesco , Pierelli Francesco , Amin Mokhtar , Marinozzi Franco , Serrao Mariano 
Published: April 2018

AbstractThe aims of this study were: (i) to determine kinematic, kinetic, and electromyographic characteristics of Junzuki karate punch in professional karate athletes; (ii) to identify biomechanical parameters that correlate with punch force and lead to a higher punching performance; (iii) to verify the presence of muscle co‐activation in the upper limb, trunk, and lower limb muscles. Data were collected from nine experienced karatekas from the Accademia Italiana Karate e Arti Marziali during the execution of the specific punch. Mean punch forces (181.2 N) delivered to the target, the range of motion of both right and left knees (1.13 and 0.82 rad) and right elbow (1.49 rad) joints, and the angles at impact (knee: 0.81 and 0.91 rad; elbow: 1.19 rad) in the sagittal plane were computed. Furthermore, the trunk rotational angular acceleration (63.1 rad s−2), force related to the lower limbs (550.2 and 425.1 N), and co‐activation index for the upper limb (36.1% and 34.7%), trunk (24.5% and 16%), and lower limbs (16.0% and 16.1%) muscles were evaluated bilaterally. Significant positive correlations were found between the punch force and both right and left knee flexion at the instant of impact and right and left leg force. Significant negative correlation was found between the punch force and maximum trunk angular acceleration. Significant differences (p = .03) in the co‐activation index among the upper limb, trunk, and lower limbs muscles highlighted a rostro‐caudal gradient on both body sides. This research could be of use to performers and coaches when considering training preparations.
G-Anchor: a novel approach for whole-genome comparative mapping utilizing evolutionary conserved DNA sequences
Authors: Lenis Vasileios Panagiotis E , Swain Martin , Larkin Denis M 
Published: April 2018

Abstract

Background
Cross-species whole-genome sequence alignment is a critical first step for genome comparative analyses, ranging from the detection of sequence variants to studies of chromosome evolution. Animal genomes are large and complex, and whole-genome alignment is a computationally intense process, requiring expensive high-performance computing systems due to the need to explore extensive local alignments. With hundreds of sequenced animal genomes available from multiple projects, there is an increasing demand for genome comparative analyses.

Results
Here, we introduce G-Anchor, a new, fast, and efficient pipeline that uses a strictly limited but highly effective set of local sequence alignments to anchor (or map) an animal genome to another species' reference genome. G-Anchor makes novel use of a databank of highly conserved DNA sequence elements. We demonstrate how these elements may be aligned to a pair of genomes, creating anchors. These anchors enable the rapid mapping of scaffolds from a de novo assembled genome to chromosome assemblies of a reference species. Our results demonstrate that G-Anchor can successfully anchor a vertebrate genome onto a phylogenetically related reference species genome using a desktop or laptop computer within a few hours and with comparable accuracy to that achieved by a highly accurate whole-genome alignment tool such as LASTZ. G-Anchor thus makes whole-genome comparisons accessible to researchers with limited computational resources.

Conclusions
G-Anchor is a ready-to-use tool for anchoring a pair of vertebrate genomes. It may be used with large genomes that contain a significant fraction of evolutionally conserved DNA sequences and that are not highly repetitive, polypoid, or excessively fragmented. G-Anchor is not a substitute for whole-genome aligning software but can be used for fast and accurate initial genome comparisons.
G-Anchor is freely available and a ready-to-use tool for the pairwise comparison of two genomes.
Repeal of Comprehensive Background Check Policies and Firearm Homicide and Suicide
Authors: Kagawa Rose M.C. , Castillo-Carniglia Alvaro , Vernick Jon S. , Webster Daniel , Crifasi Cassandra , Rudolph Kara E. , Cerdá Magdalena , Shev Aaron , Wintemute Garen J. 
Published: April 2018

Background:
In 2016, firearms killed 38,658 people in the United States. Federal law requires licensed gun dealers, but not private parties, to conduct background checks on prospective firearm purchasers with the goal of preventing prohibited persons from obtaining firearms. Our objective was to estimate the effect of the repeal of comprehensive background check laws—requiring a background check for all handgun sales, not just sales by licensed dealers—on firearm homicide and suicide rates in Indiana and Tennessee.

Methods:
We compared age-adjusted firearm homicide and suicide rates, measured annually from 1981 to 2008 and 1994 to 2008 in Indiana and Tennessee, respectively, to rates in control groups constructed using the synthetic control method.

Results:
The average rates of firearm homicide and suicide in Indiana and Tennessee following repeal were within the range of what could be expected, given natural variation (differences = 0.7 firearm homicides and 0.5 firearm suicides per 100,000 residents in Indiana and 0.4 firearm homicides and 0.3 firearm suicides per 100,000 residents in Tennessee). Sensitivity analyses resulted in similar findings.

Conclusion:
We found no evidence of an association between the repeal of comprehensive background check policies and firearm homicide and suicide rates in Indiana and Tennessee. In order to understand whether comprehensive background check policies reduce firearm deaths in the United States generally, more evidence on the impact of such policies from other states is needed. See video abstract at, http://links.lww.com/EDE/B353.
Transient Tachypnea of the Newborn Is Associated With an Increased Risk of Hospitalization Due to Respiratory Syncytial Virus Bronchiolitis
Authors: Heinonen Santtu , Süvari Liina , Gissler Mika , Pitkänen Olli , Andersson Sture , Helve Otto 
Published: April 2018

Background:
Transient tachypnea of the newborn (TTN) is a self-limiting respiratory disorder, resulting from a failure to clear the lungs of perinatal fluid. As similar pathophysiologic features are present in children with respiratory syncytial virus (RSV) bronchiolitis, we hypothesized that these two conditions may be connected.

Methods:
This was a population-based cohort study that included all children born in term (≥37 weeks of gestation) without congenital malformations in Finland between 1996 and 2015. Children diagnosed with TTN (International Statistical Classification of Diseases and Related Health Problems, 10th Revision [ICD-10] code P22.1) after birth and children hospitalized because of RSV bronchiolitis (ICD-10 code J21.0) during first year of life were identified from the Medical Birth Register and National Hospital Discharge Register, respectively, and the data were linked. Logistic regression was used to analyze the association between these two conditions.

Results:
Of the 1,042,045 children included in the study cohort, 16,327 (1.57%) were diagnosed with TTN at birth and 12,345 (1.18%) were hospitalized because of RSV bronchiolitis during the first year of life. The rate of RSV hospitalization was higher in children with a history of TTN compared with children without TTN diagnosis [260/16,327 (1.59%) vs. 12,085/1,025,718 (1.18%), respectively; P value <0.0001]. After adjusting for gestational age at birth, mode of delivery, gender, birth weight, multiple births, older siblings and maternal smoking, TTN was associated with increased risk for RSV hospitalization (odds ratio: 1.31, 95% confidence interval: 1.16–1.48).

Conclusions:
TTN diagnosis after birth was associated with increased risk for RSV hospitalization during the first year of life.
How Well Does Dual-Energy Computed Tomography With Metal Artifact Reduction Software Improve Image Quality and Quantify Computed Tomography Number and Iodine Concentration?
Authors: Ohira Shingo , Kanayama Naoyuki , Wada Kentaro , Karino Tsukasa , Nitta Yuya , Ueda Yoshihiro , Miyazaki Masayoshi , Koizumi Masahiko , Teshima Teruki 
Published: April 2018

Objective
The objective of this study was to assess the accuracy of the quantitative measurements obtained using dual-energy computed tomography with metal artifact reduction software (MARS).

Methods
Dual-energy computed tomography scans (fast kV-switching) are performed on a phantom, by varying the number of metal rods (Ti and Pb) and reference iodine materials. Objective and subjective image analyses are performed on retroreconstructed virtual monochromatic images (VMIs) (VMI at 70 keV).

Results
The maximum artifact indices for VMI-Ti and VMI-Pb (5 metal rods) with MARS (without MARS) were 17.4 (166.7) and 34.6 (810.6), respectively; MARS significantly improved the mean subjective 5-point score (P < 0.05). The maximum differences between the measured Hounsfield unit and theoretical values for 5 mg/mL iodine and 2-mm core rods were −42.2% and −68.5%, for VMI-Ti and VMI-Pb (5 metal rods), respectively, and the corresponding differences in the iodine concentration were −64.7% and −73.0%, respectively.

Conclusions
Metal artifact reduction software improved the objective and subjective image quality; however, the quantitative values were underestimated.
Evaluation of Modified Look-Locker Inversion Recovery and Arrhythmia-Insensitive Rapid Cardiac T1 Mapping Pulse Sequences in Cardiomyopathy Patients
Authors: Robison Sean , Hong KyungPyo , Kim Daniel , Lloyd Rachel , Ramchand Jay , Hornsey Emma , Srivastava Piyush , Smith Gerard , Kearney Leighton , Lim Ruth 
Published: April 2018

Objective
The aim of this study was to compare the performance of arrhythmia-insensitive rapid (AIR) and modified Look-Locker inversion recovery (MOLLI) T1 mapping in patients with cardiomyopathies.

Methods
In 58 patients referred for clinical cardiac magnetic resonance imaging at 1.5 T, we compared MOLLI and AIR native and postcontrast T1 measurements. Two readers independently analyzed myocardial and blood T1 values. Agreement between techniques, interreader agreement per technique, and intrascan agreement per technique were evaluated.

Results
The MOLLI and AIR T1 values were strongly correlated (r
2 = 0.98); however, statistically significantly different T1 values were derived (bias 80 milliseconds, pooled data, P < 0.01). Both techniques demonstrated high repeatability (MOLLI, r
2 = 1.00 and coefficient of repeatability [CR] = 72 milliseconds; AIR, r
2 = 0.99 and CR = 184.2 milliseconds) and produced high interreader agreement (MOLLI, r
2 = 1.00 and CR = 51.7 milliseconds; AIR, r
2 = 0.99 and CR = 183.5 milliseconds).

Conclusions
Arrhythmia-insensitive rapid and MOLLI sequences produced significantly different T1 values in a diverse patient cohort.
Killing Me Sovereignly: The Quiet Demise of the Americans With Disabilities Act
Authors: Miller Michelle , Neal-Boylan Leslie 
Published: April 2018

Abstract

Purpose
The aim of the study was to make rehabilitation nurses aware that the Supreme Court has limited some of the protections afforded by the Americans With Disabilities Act (1990) on the basis of “sovereign immunity.”

Methods
The authors use the case review method to analyze Supreme Court cases and alternatives for people with disabilities discriminated against because of the state in which they live.

Findings
Sovereign immunity makes it more difficult for a disabled person to bring a lawsuit against a state government (as an employer or provider of a public service) under the Americans With Disabilities Act.

Conclusion
The extent to which disabled Americans can fully participate in their communities should not depend on where in the country they live.

Clinical Relevance
As patient advocates, rehabilitation nurses are in an ideal position to educate patients and families and have a duty to make their voices heard to persuade lawmakers to strengthen legal protections for disabled Americans.
Reduced deoxyribonuclease enzyme activity in response to high postinjury mitochondrial DNA concentration provides a therapeutic target for Systemic Inflammatory Response Syndrome
Authors: McIlroy Daniel J. , Minahan Kyra , Keely Simon , Lott Natalie , Hansbro Philip , Smith Doug W. , Balogh Zsolt J. 
Published: April 2018

BACKGROUND
Cell-free mitochondrial DNA (mtDNA) is proinflammatory and has been detected in high concentrations in trauma patients’ plasma. Deoxyribonuclease (DNAse) is the free plasma enzyme responsible for the digestion of extracellular DNA. The relationship between mtDNA and DNAse after major trauma is unknown. We hypothesized that DNAse activity would be elevated after injury and trauma surgery and would be associated with high concentrations of extracellular DNA.

METHODS
Two-year prospective study was performed on 103 consecutive trauma patients (male, 81%; age, 38 years [interquartile range, 30–59 years]; injury severity score, 18 [interquartile range, 12–26 years]) who underwent standardized major orthopedic trauma surgical interventions. Blood was collected at five perioperative time points (preoperative, postoperative, 7 hours, 24 hours, and 3 days postoperatively). Healthy control subjects (n = 20) were also sampled. Cell-free mtDNA and nuclear DNA (nDNA) were measured using quantitative polymerase chain reaction. Deoxyribonuclease was also assayed in the same plasma samples.

RESULTS
Increased levels of mtDNA (from preoperative 163 ± 86 ng/mL to 3 days 282 ± 201 ng/mL, p < 0.0001) and nDNA (from preoperative 28 ± 20 ng/mL to 3 days 37 ± 27 ng/mL, p < 0.05) were present in trauma patients at all perioperative time points compared with healthy controls (mtDNA: 4 ± 2 ng/mL; nDNA: 10 ± 5 ng/mL). Deoxyribonuclease activity was lower in the trauma cohort (from preoperative 0.06 ± 0.04U/mL to 3 days 0.08 ± 0.04U/mL, p < 0.0001) compared with healthy controls (DNAse: 0.17 ± 0.03U/mL). There was no correlation between DNAse and perioperative DNA concentrations. Elevated mtDNA (but not nDNA) correlated with the development of systemic inflammatory response syndrome (SIRS) (p = 0.026) but not multiple organ failure.

CONCLUSIONS
The significant perioperative elevation in plasma-free mtDNA concentration is associated with the development of SIRS. The fact that increased cell-free DNA concentrations present with significantly lower than healthy control DNAse activity suggests a potential therapeutic opportunity with DNAse administration to modulate postinjury severe SIRS.

LEVEL OF EVIDENCE
Prognostic/Epidemiological, level II.
On the complexity of shark bite wounds: From associated bacteria to trauma management and wound repair
Authors: Isci Evren Tevfik , Ritter Erich 
Published: April 2018

ABSTRACT
The mouth of a shark is a breeding ground for a large variety of bacteria which can easily get transferred onto a human body in the event of a shark bite. Here, we review infections originating from shark oral bacterial flora, which originate from the microbiome of its prey, as well as from the surroundings where an incident takes place. We use the example of an incident which occurred in an aquarium involving a sandtiger shark, Carcharias taurus. In addition to a succinct analysis and interpretation of the wound and recovery process, an overview of currently known bacteria associated with shark bite wounds is given, as well as a summary of the effects of various previously tested antibiotics on bacteria derived from blacktip sharks, Carcharhinus limbatus, bull sharks, C. leucas, and tiger sharks, Galeocerdo cuvier.

LEVEL OF EVIDENCE
Therapeutic study, level V.
Accuracy of genomic selection for growth and wood quality traits in two control-pollinated progeny trials using exome capture as genotyping platform in Norway spruce
Authors: Chen Zhi-Qiang , Baison John , Pan Jin , Karlsson Bo , Gull Bengt Andersson , Westin Johan , García Gil María Rosario , Wu Harry X. 
Published: April 2018

AbstractBackgroundGenomic selection (GS) can increase genetic gain by reducing the length of breeding cycle in forest trees. Here we genotyped 1370 control-pollinated progeny trees from 128 full-sib families in Norway spruce (Picea abies (L.) Karst.), using exome capture as a genotyping platform. We used 116,765 high quality SNPs to develop genomic prediction models for tree height and wood quality traits. We assessed the impact of different genomic prediction methods, genotype-by-environment interaction (G×E), genetic composition, size of the training and validation set, relatedness, and the number of SNPs on the accuracy and predictive ability (PA) of GS.ResultsUsing G matrix slightly altered heritability estimates relative to pedigree-based method. GS accuracies were about 11–14% lower than those based on pedigree-based selection. The efficiency of GS per year varied from 1.71 to 1.78, compared to that of the pedigree-based model if breeding cycle length was halved using GS. Height GS accuracy decreased more than 30% using one site as training for GS prediction to the second site, indicating that G×E for tree height should be accommodated in model fitting. Using half-sib family structure instead of full-sib led a significant reduction in GS accuracy and PA. The full-sib family structure only needed 750 makers to reach similar accuracy and PA as 100,000 markers required for half-sib family, indicating that maintaining the high relatedness in the model improves accuracy and PA. Using 4000–8000 markers in full-sib family structure was sufficient to obtain GS model accuracy and PA for tree height and wood quality traits, almost equivalent to that obtained with all makers.ConclusionsThe study indicates GS would be efficient in reducing generation time of a breeding cycle in conifer tree breeding program that requires a long-term progeny testing. Sufficient number of trees within-family (16 for growth and 12 for wood quality traits) and number of SNPs (8000) are required for GS with full-sib family relationship. GS methods had little impact on GS efficiency for growth and wood quality traits. GS model should incorporate G × E effect when a strong G×E is detected.
Cell cycle-controlled clearance of the CcrM DNA methyltransferase by Lon is dependent on DNA-facilitated proteolysis and substrate polar sequestration
Authors: Zhou Xiaofeng , Shapiro Lucy 
Published: April 2018

AbstractN6-adenine methylation catalyzed by the DNA methyltransferase CcrM is an essential epigenetic event of theCaulobactercell cycle. Limiting CcrM to a specific time period during the cell cycle relies on temporal control ofccrMtranscription and CcrM proteolysis. We investigated how Lon, a protease from AAA+ superfamily conserved from bacteria to humans, temporally degrades CcrM to maintain differential chromosomal methylation state, thereby regulating transcription factor synthesis and enabling cell cycle progression. We demonstrate that CcrM degradation by Lon requires DNA as an adaptor for robust proteolysis. Lon, a DNA-bound protein, is constitutively active throughout the cell cycle, but allows CcrM mediated DNA methylation only when CcrM is transcribed and translated upon completion of DNA replication. An additional mechanism to limit CcrM activity to a narrow window of the cell cycle is its sequestration to the pole of the progeny stalked cell, which prevents physical contact with DNA-bound Lon. Thus, we have provided evidence for a novel mechanism for substrate selection by the Lon protease, providing robust cell cycle control mediated by DNA methylation.