bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining outcomes in cases of elderly patients who fell from ground level at home with normal vital signs at the scene: An analysis of the National Trauma Data Bank
Authors: Ahmed Nasim , Greenberg Patricia 
Published: June 2019

BACKGROUND
The purpose of the study was to evaluate whether the higher level of care significantly affected the outcomes of elderly patients who fell from ground level at home and had a normal physiological examination at the scene.

METHODS
Patients 65 years and older, with normal physiological measures at the scene (Glasgow Coma Scale score = 15, systolic blood pressure > 90 and <160 mm Hg, heart rate (HR) ≥ 60 and ≤100) from the 2012 to 2014 National Trauma Data Bank data sets were included in the study. Patients' characteristics, existing comorbidities, and outcomes were compared between Level I or Level II designated trauma centers (higher level care [group 1]) and Levels III, IV, and unranked/nontrauma centers (lower level care [group 2]). Following initial analyses, propensity score matching was performed, and the rate of in-hospital mortality, median time (days) to death or discharge, and discharge disposition were compared.

RESULTS
Of the 40,800 patients who met inclusion criteria, 18,813 patients were matched from each group on age, sex, race, systolic blood pressure, HR, respiratory rate, Injury Severity Score, and comorbidity statuses. There was no evidence of a significant difference regarding in-hospital mortality (2.5% vs. 2.3%), time to death (median [interquartile range]: 6 [3–11] vs. 6 [3–11]), or time to hospital discharge (median [interquartile range]: 5 [5–5] vs. 5 [5–5]). However, the rate of required postdischarge care (78.9% vs. 81.7%) varied significantly between the groups.

CONCLUSION
Higher levels of care failed to show any significant survival benefits or shorten the time to hospital discharge; however, a significantly higher proportion of patients from lesser-care facilities required follow-up services after discharge.

LEVEL OF EVIDENCE
Therapeutic/Care management, level IV.

STUDY TYPE
Observational case-control.
Optimizing energy expenditure and oxygenation toward ventilator tolerance is associated with lower ventilator and intensive care unit days
Authors: Ang Darwin , Chari Ravi , Garcia Alejandro , Clark Jason , Farrah Jason , Hagan Joshua , Watson Carrie , Richards Winston , Liu Huazhi , Donaldson Dinah , Barde Jason , Alderman Ted 
Published: June 2019

BACKGROUND
We hypothesize that if both energy expenditure and oxygenation are optimized (EEOO) toward ventilator tolerance, this would provide patients with the best condition to be liberated from the ventilator. We defined ventilator tolerance as having a respiratory quotient value between 0.7 and 1.0 while maintaining saturations above 98% with FIO2 70% or less and a normal respiratory rate without causing disturbances to the patient's pH.

METHODS
This is a single-institution prospective cohort study of ventilator dependent patients within a closed trauma intensive care unit (ICU). The study period was over 52 months. A total of 1,090 patients were part of the primary analysis. The test group (EEOO) was compared to a historical cohort, comparing 26 months in each study group. The primary outcome of this study was number of ventilator days. Secondary outcomes included in-hospital mortality, ICU length of stay (LOS), overall hospital length of stay, tracheostomy rates, reintubation rates, and in-hospital complication rates, such as pneumonia and Acute Respiratory Distress Syndrome (ARDS) ARDS. Both descriptive and multivariable regression analyses were performed to compare the effects of the EEOO protocol with our standard protocols alone.

RESULTS
The primary outcome of number of ventilator days was significantly shorter the EEOO cohort by nearly 3 days. This was significant even after adjustment for age, sex, race, comorbidities, nutrition type, and injury severity, (4.3 days vs. 7.2 days, p = 0.0001). The EEOO cohort also had significantly lower ICU days, hospital days, and overall complications rates.

CONCLUSION
Optimizing the patient's nutritional regimen to ventilator tolerance and optimizing oxygenation by means of targeted pulmonary mechanics and inspired FIO2 may be associated with lower ventilator and ICU days, as well as overall complication rates.

LEVEL OF EVIDENCE
Therapeutic, Level IV.
Performance of Creatinine Clearance and Estimated GFR in Assessing Kidney Function in Living Donor Candidates
Authors: Garg Neetika , Snyder Grace , Li Jianbo , Mandelbrot Didier , Poggio Emilio D. 
Published: June 2019

Background.
Glomerular filtration rate (GFR) assessment is a key aspect in the evaluation of living kidney donor candidates; however, data on performance of commonly used methods are limited.

Methods.
We examined 769 living kidney donor candidates with 24-hour urine collections assessed as accurate by comparing measured creatinine excretion rate (CER) to CER estimated using a 4-variable equation previously developed and validated using robust methodology.

Results.
Of all collections, 42.6% would have been deemed inaccurate, mostly under-collections, using the conventional weight- and gender-based CER estimation. Creatinine clearance (CrCl) overestimated 125I-iothalamate GFR (iGFR), estimated GFR (eGFR), underestimated iGFR, and their average [Avg (CrCl and eGFR)] essentially eliminated the GFR bias (median bias = +2.2, −5.4, and −1.0 mL/min/1.73 m,2 respectively; P < 0.001). This held true for all subgroups except blacks, where all 3 measures overestimated iGFR. Avg (CrCl and eGFR) also offered modestly improved accuracy compared with CrCl alone, as measured by the proportion of values falling within 10% (50.7% versus 45.3%; P = 0.009) and 30% of iGFR (94.5% versus 89.3%; P < 0.001).

Conclusions.
When measured GFR is unavailable, the Avg (CrCl and eGFR) provides a better estimate of kidney function in kidney donor candidates than either measure alone, although in blacks the estimates are neither better nor worse.
Long-term Effects of Hypothermic Ex Situ Perfusion on Skeletal Muscle Metabolism, Structure, and Force Generation After Transplantation
Authors: Gok Emre , Kubiak Carrie A. , Guy Erin , Ponder Mathew , Hoenerhoff Mark J. , Rojas-Pena Alvaro , Kemp Stephen W.P. , Bartlett Robert H. , Ozer Kagan 
Published: June 2019

Background.
Hypothermic ex situ perfusion (HESP) systems are used to prolong allograft survival in solid organ transplantations and have been shown to be superior to static cold storage (SCS) methods. However, the effect of this preservation method on limb allograft survival and long-term function has not yet been tested. In this study, we investigated the long-term effects of the HESP on skeletal muscle metabolism, structure, and force generation and compared it with the current standard of preservation.

Methods.
Forty male Lewis rats (250 ± 25 g) were divided into 5 groups, including naive control, sciatic nerve transection or repair, immediate transplantation, SCS, and HESP. For the SCS group, limbs were preserved at 4°C for 6 hours. In the HESP group, limbs were continuously perfused with oxygenated histidine-tryptophan-ketoglutarate (HTK) solution at 10–15°C for 6 hours. Hemodynamic and biochemical parameters of perfusion were recorded throughout the experiment. At 12 weeks, electromyography and muscle force measurements (maximum twitch and tetanic forces) were obtained along with muscle samples for histology and metabolomics analysis.

Results.
Histology demonstrated 48% myocyte injury in the HESP group compared with 49% in immediate transplantation (P = 0.96) and 74% in the SCS groups (P < 0.05). The maximum twitch force measurement revealed a significantly higher force in the HESP group compared with the SCS group (P = 0.029). Essential amino acid levels of the gastrocnemius muscle did not reach significance, with the exception of higher proline levels in the HESP group.

Conclusions.
HESP using HTK protects viability of the limb but fails to restore muscle force in the long term.
Amyloidosis Diagnosed in Solid Organ Transplant Recipients
Authors: Sharpley Faye A. , Fontana Marianna , Gilbertson Janet A. , Gillmore Julian D. , Hawkins Philip N. , Mahmood Shameem , Manwani Richa , Martinez-Naharro Ana , Quarta Cristina , Rezk Tamer M. , Rowczenio Dorota , Sachchithanantham Sajitha , Whelan Carol J. , Wechalekar Ashutosh D. , Lachmann Helen J. 
Published: June 2019

Background.
Development of amyloidosis post solid-organ transplantation has not been reported, although plasma cell neoplasms are a rare form of posttransplant lymphoproliferative disorder, which could be complicated by light chain amyloidosis (AL) amyloidosis.

Methods.
We searched our database of 5112 patients seen between 1994 and 2018 with a diagnosis of amyloidosis post solid-organ transplant. Patients were excluded if the amyloid diagnosis preceded the transplant date. The indication and type of organ transplant were recorded in addition to the amyloidosis type, organs involved, treatment given, and survival.

Results.
Thirty patients were identified. The median age at diagnosis with amyloidosis was 52 years (range 33–77). The median time from transplantation to diagnosis was 10.5 years (0.58–36). The grafts were kidney (N = 25, 83.3%), liver (N = 2, 6.7%), heart (N = 2, 6.7%), and combined heart, lung, and kidney (N = 1, 3.3%). The type of amyloidosis was systemic AL (N = 14, 47%), serum amyloid A amyloidosis (AA) (N = 11, 37%), localized AL (N = 3, 10%), wild-type transthyretin amyloidosis (ATTR) (N = 1, 3.3%), and amyloid of uncertain type (N = 1, 3.3%). Renal graft dysfunction was seen in 11 of 25 (44%) cases. Median graft survival was 185 months (96–269), and median survival from diagnosis with amyloidosis was 45 months (2–89); median survival by amyloidosis type was localized AL: 64 months (20–67), systemic AL: 23.5 months (0–95), ATTR amyloidosis: 17 months, and AA, 15 months (0–77).

Conclusions.
This series is the first description of amyloidosis post solid-organ transplant; 30 cases among 5112 amyloid patients >24 years suggests that amyloidosis may occur post solid-organ transplantation with an overall poor survival.
Geographic Differences in Population Health and Expected Organ Supply in the Gulf Coast Region of the United States Compared to Non-Gulf States
Authors: Reed Rhiannon D. , Shelton Brittany A. , Mustian Margaux N. , MacLennan Paul A. , Sawinski Deirdre , Locke Jayme E. 
Published: June 2019

Background.
The Final Rule aimed to reduce geographic disparities in access to transplantation by prioritizing the need for transplant over donor proximity. However, disparities in waiting times persist for deceased donor kidney transplantation. The kidney allocation system implemented in 2014 does not account for potential local supply based on population health characteristics within a donation service area (DSA). We hypothesized that regions with traditionally high rates of comorbid disease, such as the states located along the Gulf of Mexico (Gulf States), may be disadvantaged by limited local supply secondary to poor population health.

Methods.
Using data from the Robert Wood Johnson Foundation County Health Rankings, the United States Renal Data System, and the Scientific Registry of Transplant Recipients, we compared population-level characteristics and expected kidney donation rates by Gulf States location.

Results.
Prevalence of African American ethnicity, end-stage renal disease, diabetes, fair/poor self-rated health, physical inactivity, food insecurity, and uninsurance were higher among Gulf State DSAs. On unadjusted analyses, Gulf State DSAs were associated with 3.52 fewer expected kidney donors per 100 eligible deaths than non-Gulf States. After adjustment, there was no longer a statistically significant difference in expected kidney donation rate.

Conclusions.
Although Gulf State DSAs have lower expected donation rates, these differences appear to be driven by the prevalence of health factors negatively associated with donation rate. These data suggest the need to discuss population health characteristics when examining kidney allocation policy, to account for potential lower supply of donors and to further address geographic disparities in access to kidney transplantation.
Effects of Left Versus Right Dorsolateral Prefrontal Cortex Repetitive Transcranial Magnetic Stimulation on Affective Flexibility in Healthy Women: A Pilot Study
Authors: Lantrip Crystal , Delaloye Sibylle , Baird Lauren , Dreyer-Oren Sarah , Brady Robert E. , Roth Robert M. , Gunning Faith , Holtzheimer Paul 
Published: June 2019

Objective:
To determine the antidepressant mechanism of action for repetitive transcranial magnetic stimulation (rTMS) to the left dorsolateral prefrontal cortex (DLPFC) in healthy women. Our primary hypothesis was that a single session of left DLPFC rTMS, compared with a session of right DLPFC rTMS, would result in better (reduced) negative nonaffective switch costs in healthy women.

Background:
The antidepressant mechanism of action for rTMS is not clear. It is possible that rTMS to the DLPFC improves emotion regulation, which could be a part of its antidepressant mechanism.

Methods:
Twenty-five healthy women were randomized to receive left high-frequency (HF) rTMS versus right HF rTMS in one session and then contralateral stimulation during a second session. Emotion regulation was assessed via switch costs for reappraisal of negatively valenced information on an affective flexibility task.

Results:
For negative nonaffective switch costs, the interaction effect in the two-way ANOVA was not significant (F
1,19=3.053, P=0.097). Given that left HF rTMS is the approved treatment for depression, post hoc t tests were completed with particular interest in the left-side findings. These tests confirmed that negative nonaffective switch costs significantly improved immediately after left rTMS (t
1,19=2.664, P=0.015) but not right rTMS.

Conclusions:
These findings suggest that left DLPFC HF rTMS may lead to antidepressant effects by improving the regulation of emotion.
Circulating concentrations of micro-nutrients and risk of breast cancer: A Mendelian randomization study
Authors: Papadimitriou N. , Dimou N. , Gill D. , Tzoulaki I. , Murphy N. , Riboli E. , Lewis S. J. , Martin R. M. , Gunter M. J. , Tsilidis K. K. 
Published: June 2019

AbstractBackgroundThe epidemiological literature reports inconsistent associations between consumption or circulating concentrations of micro-nutrients and breast cancer risk. We investigated associations between genetically determined concentrations of 11 micro-nutrients (beta-carotene, calcium, copper, folate, iron, magnesium, phosphorus, selenium, vitamin B6, vitamin B12 and zinc) and breast cancer risk using Mendelian randomization (MR).Materials and methodsA two-sample MR study was conducted using 122,977 women with breast cancer, of whom 69,501 were estrogen receptor positive (ER+ve) and 21,468 were ER−ve, and 105,974 controls from the Breast Cancer Association Consortium. MR analyses were conducted using the inverse variance weighted approach, and sensitivity analyses were conducted to assess the impact of potential violations of MR assumptions.ResultsOne standard deviation (SD: 0.08 mmol/L) higher genetically determined concentration of magnesium was associated with a 17% (odds ratio [OR]: 1.17, 95% confidence interval [CI]: 1.10 to 1.25, P=9.1 × 10−7) and 20% (OR: 1.20, 95% CI: 1.11 to 1.30, P=3.17 × 10−6) higher risk of overall and ER+ve breast cancer, respectively. An inverse association was observed for a SD (0.5 mg/dL) higher genetically determined phosphorus concentration and ER−ve breast cancer (OR: 0.84, 95% CI: 0.72 to 0.98, P=0.03). A suggestive inverse association was observed for a SD (0.48 mg/dL) higher genetically determined calcium concentration with overall breast cancer (OR: 0.91, 95% CI: 0.83 to 1.00, P=0.06). There was little evidence that any of the other nutrients were associated with breast cancer. The results for magnesium were robust under all sensitivity analyses.ConclusionsHigher circulating concentrations of magnesium, phosphorus and calcium may affect breast cancer risk. Further work is required to replicate these findings and investigate underlying mechanisms.key messageWe conducted a Mendelian randomization study to investigate whether concentrations of 11 micro-nutrients are associated with risk of breast cancer. An increased risk of overall and oestrogen-receptor positive disease was observed for genetically higher concentrations of magnesium and inverse associations were observed for phosphorus and calcium concentrationsWhere authors are identified as personnel of the International Agency for Research on Cancer / World Health Organization, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy or views of the International Agency for Research on Cancer / World Health Organization.
Kv4.1, a key ion channel for low frequency firing of dentate granule cells, is crucial for pattern separation
Authors: Kim Kyung-Ran , Lee Seung Yeon , Kim Yoonsub , Kwon Min Jeong , Jeong Hyeon-Ju , Lee Sanghyeon , Suh Young Ho , Kang Jong-Sun , Cho Hana , Lee Suk-Ho , Kim Myoung-Hwan , Ho Won-Kyung 
Published: June 2019

AbstractThe dentate gyrus (DG) in the hippocampus may play key roles in remembering distinct episodes through pattern separation, which may be subserved by the sparse firing properties of granule cells (GCs) in the DG. Low intrinsic excitability is characteristic of mature GCs, but ion channel mechanisms are not fully understood. Here, we investigated ionic channel mechanisms for firing frequency regulation in GCs of the rat hippocampus, and identified Kv4.1 as a key player. Immunofluorescence analysis showed that Kv4.1 was preferentially expressed in the DG, and its expression level was higher at 8-week than 3-week-old mice, suggesting a developmental regulation of Kv4.1 expression. With respect to firing frequency, GCs are categorized into two distinctive groups: low frequency (LF) and high frequency (HF) firing GCs. Input resistance (Rin) of most LF-GCs is lower than 200 MΩ, suggesting that LF-GCs are fully mature GCs. Kv4.1 channel inhibition by intracellular perfusion of Kv4.1 antibody increased firing rates and gain of the input-output relationship selectively in LF-GCs with no significant effect on resting membrane potential and Rin, but had no effect in HF-GCs. Importantly, mature GCs from mice depleted of Kv4.1 transcripts in the DG showed increased firing frequency, and these mice showed an impairment in contextual discrimination task. Our findings suggest that Kv4.1 expression occurring at late stage of GC maturation is essential for low excitability of DG networks and thereby contributes to pattern separation.
Opioid mortality following implementation of medical marijuana programs (1999-2017) in the United States
Authors: Kaufman Daniel E. , Nihal Asawer M. , Leppo Janan D. , Staples Kelly M. , McCall Kenneth L. , Piper Brian J. 
Published: June 2019

AbstractThe United States is in the midst of an opioid overdose epidemic. A prior report using the Center for Disease Control’s Wide-ranging Online Data for Epidemiologic Research (WONDER) database discovered that opioid overdoses decreased by 24.8% from 1999 to 2010 in states with medical cannabis (MC+) relative to those without (MC−). The present study evaluated any differences following MC legislation on WONDER reported opioid overdoses, corrected for population, from 1999 to 2017 using an interrupted time series. Overdoses were significantly higher in MC+ states from 2012-2017. The slope of opioid overdose deaths over time increased significantly post-implementation in states without MC (3-years Pre = 0.1 ± 0.1, 3-years Post = 0.7 ± 0.2, t(16) = 2.88, p ≤ .011). Overdose deaths showed a non-significant elevation in states with MC (Pre = 1.3 ± 0.3, Post = 2.8 ± 0.8, t(11) = 2.01, p = .069). Post-legalization slopes were significantly higher in MC+ than MC− (t(11.95) = 2.70, p < .05). Overall, any impact of medical cannabis laws on opioid overdoses appears modest. There are other confounds (e.g. death determination reporting quality) which differ non-randomly among states and are non-trivial to account for in ecological investigations of cannabis policy. Alternatively, the potency of fentanyl analogues may obscure any protective effects of MC against illicit opioid harms.
Evidence for transposable element control by Argonautes in a parasitic flatworm lacking the piRNA pathway
Authors: Protasio Anna V. , Rawlinson Kate A. , Miska Eric A. , Berriman Matt , Rinaldi Gabriel 
Published: June 2019

AbstractTransposable elements (TEs) are mobile parts of the genome that can jump or self-replicate, posing a threat to the stability and integrity of the host genome. TEs are prevented from causing damage to the host genome by defense mechanisms such as nuclear silencing, where TE transcripts are targeted for degradation in an RNAi-like fashion. These pathways are well characterised in model organisms but very little is known about them in other species. Parasitic flatworms present an opportunity to investigate evolutionary novelties in TE control because they lack canonical pathways identified in model organisms (such as the piRNA pathways) but have conserved central players such as Dicer and Ago (argonaute) enzymes. Notably, parasitic flatworm Ago proteins are phylogenetically distinct from classical Ago, raising the question of whether they play special roles in these organisms. In this report, we investigate the role of Ago proteins in the parasitic flatworm Schistosoma mansoni. We show that transcript abundance of two retrotransposable elements increases upon silencing of S. mansoni Ago genes. We further demonstrate that SmAgo2 protein is primarily localised in the germ line of adult worms and its sub-cellular localisation is both nuclear and cytoplasmic. These findings provide further evidence of active TE control under a yet not fully unveiled pathway.
Chromosome level draft genomes of the fall armyworm, Spodoptera frugiperda (Lepidoptera: Noctuidae), an alien invasive pest in China
Authors: Liu Huan , Lan Tianming , Fang Dongming , Gui Furong , Wang Hongli , Guo Wei , Cheng Xiaofang , Chang Yue , He Shuqi , Lyu Lihua , Sahu Sunil Kumar , Cheng Le , Li Haimeng , Liu Ping , Fan Guangyi , Liu Tongxian , Hao Ruoshi , Lu Haorong , Chen Bin , Zhu Shusheng , Lu Zhihui , Huang Fangneng , Dong Wei , Dong Yang , Kang Le , Yang Huanming , Sheng Jun , Zhu Youyong , Liu Xin 
Published: June 2019

AbstractThe fall armyworm (FAW), Spodoptera frugiperda (J.E. Smith) is a severely destructive pest native to the Americas, but has now become an alien invasive pest in China, and causes significant economic loss. Therefore, in order to make effective management strategies, it is highly essential to understand genomic architecture and its genetic background. In this study, we assembled two chromosome scale genomes of the fall armyworm, representing one male and one female individual procured from Yunnan province of China. The genome sizes were identified as 542.42 Mb with N50 of 14.16 Mb, and 530.77 Mb with N50 of 14.89 Mb for the male and female FAW, respectively. We predicted about 22,201 genes in the male genome. We found the expansion of cytochrome P450 and glutathione s-transferase gene families, which are functionally related to the intensified detoxification and pesticides tolerance. Further population analyses of corn strain (C strain) and rice strain (R strain) revealed that the Chinese fall armyworm was most likely invaded from Africa. These strain information, genome features and possible invasion source described in this study will be extremely important for making effective strategies to manage the fall armyworms.