bluuebunny/crossref_metadata_2025_split huggingface dataset:
Starvation reduces hyaluronan synthesis by suppressing TGF-β1/IGF-I signaling in rat skin
Authors: Yamane Takumi , Kawasaki Rui , Konno Ryosuke , Iwatsuki Ken , Oishi Yuichi 
Published: November 2018

ABSTRACT
Although starvation has been reported to influence the functions of various tissues, its effects on the skin are not well understood. In this study, we investigated the effect of starvation on hyaluronan synthesis in rat skin. Starvation reduced hyaluronan synthesis in the skin. Starvation also decreased the skin mRNA expression of transforming growth factor (TGF)-β1, which enhances the gene expression of rhas2 and rhas3. The serum levels of insulin-like growth factor (IGF)-I, which enhances rhas2, rhas3, and TGF-β1 mRNA expression, in the starvation group were considerably lower than those in the control (CO) group. IGF-IR phosphorylation was substantially lower in the starvation group compared with the CO group. These findings suggest that starvation reduces hyaluronan synthesis in the skin by suppressing TGF-β1/IGF-I signaling.
Abbreviations: HAS: hyaluronan synthase; IGF-I: insulin-like growth factor-I; IGFBP-1: insulin-like growth factor binding protein-1; TGF-β1: transforming growth factor-β1; TBST: tris buffered saline containing 0.5% (v/v) Tween 20; HABP: hyaluronic acid binding protein; GAPDH: glyceraldehyde-3-phosphate dehydrogenase
Efficient and accurate detection of splice junctions from RNA-seq with Portcullis
Authors: Mapleson Daniel , Venturini Luca , Kaithakottil Gemy , Swarbreck David 
Published: November 2018

Abstract
Next-generation sequencing technologies enable rapid and cheap genome-wide transcriptome analysis, providing vital information about gene structure, transcript expression, and alternative splicing. Key to this is the accurate identification of exon-exon junctions from RNA sequenced (RNA-seq) reads. A number of RNA-seq aligners capable of splitting reads across these splice junctions (SJs) have been developed; however, it has been shown that while they correctly identify most genuine SJs available in a given sample, they also often produce large numbers of incorrect SJs. Here, we describe the extent of this problem using popular RNA-seq mapping tools and present a new method, called Portcullis, to rapidly filter false SJs derived from spliced alignments. We show that Portcullis distinguishes between genuine and false-positive junctions to a high degree of accuracy across different species, samples, expression levels, error profiles, and read lengths. Portcullis is portable, efficient, and, to our knowledge, currently the only SJ prediction tool that reliably scales for use with large RNA-seq datasets and large, highly fragmented genomes, while delivering accurate SJs.
Generation, implementation, and appraisal of an N-gram-based stemming algorithm
Authors: Pande Bhagwati P , Tamta Pawan , Dhami Hoshiyar S 
Published: November 2018

Abstract
A language-independent stemmer has always been looked for. Single N-gram tokenization technique works well; however, it often generates stems that start with intermediate characters, rather than initial ones. We present a novel technique that takes the concept of N-gram stemming one step ahead and compare our method with an established algorithm in the field, say, Porter’s stemmer for English, Spanish, and Portuguese languages. Results indicate that our N-gram stemmer is comparable with the Porter’s linguistic stemmer.
What is a Case-Control Study?
Authors: Dupépé Esther B , Kicielinski Kimberly P , Gordon Amber S , Walters Beverly C 
Published: November 2018

Abstract
Case-control (case-control, case-controlled) studies are beginning to appear more frequently in the neurosurgical literature. They can be more robust, if well designed, than the typical case series or even cohort study to determine or refine treatment algorithms. The purpose of this review is to define and explore the differences between case-control studies and other so-called nonexperimental, quasiexperimental, or observational studies in determining preferred treatments for neurosurgical patients.
Blockchain technology: development and prospects
Authors: Zhao Weijie 
Published: November 2018

Abstract
It has been more than 10 years since Satoshi Nakamoto published his famous paper entitled ‘Bitcoin: a peer-to-peer electronic cash system’, which set the foundation of blockchain technology. Accompanied by the price volatility of bitcoins from 2017 to 2018, blockchain has been a hot word on the internet, and particularly hot in China. Blockchain offers a distributed and secure system for data storage and value transactions. Its applications are springing up in multiple fields.
The Chinese government is considering these trends with great caution. Initial coin offering has been banned in China since September 2017. By contrast, an official white paper on China's blockchain technology, which was released in May 2018, said that blockchain technology will be widely applied in the real economy of China within 3 years. In a recent panel discussion held by National Science Review, experts talked about related topics. Their opinions may provide a quick view of the future development of blockchain in China and abroad.

Jing Chen
Assistant Professor of Computer Science Department, Stony Brook University and Chief Scientist at Algorand LLC, USA

Xiaotie Deng
Professor of School of Electronics Engineering and Computer Science, Peking University, China

Guohua Gan
Vice President of Beijing Tai Cloud Technology Corp., China

Xiaoyun Wang
Professor of Institute of Advanced Study, Tsinghua University, China

Zhiming Zheng
Professor of School of Mathematics and Systems Science, Beihang University, China

Lei Guo (Chair)
Professor of Academy of Mathematics and Systems Science, Chinese Academy of Sciences, China
Diverting dementia
Authors: Ritsema Tamara S. 
Published: November 2018

ABSTRACT
As the population ages, more adults in the United States are living with dementia. Younger family members often are concerned that they too may develop dementia, but the general public is largely unaware that strategies exist to slow or delay onset of dementia. In fact, by implementing a number of healthful strategies throughout their lifespans, patients may be able to reduce the likelihood of developing dementia or at least delay its onset. These strategies include eating a high-quality diet; keeping physically, socially, and intellectually active; preventing or treating hearing loss; avoiding obesity, hypertension, and diabetes; and avoiding or stopping tobacco smoking. This article reviews the recent scientific literature for dementia risk-reduction strategies and offers suggestions to healthcare professionals who wish to help their patients stave off cognitive loss.
Orthopaedic surgery resident consultations at a level I trauma center
Authors: Snoap Tyler , Walbridge Joseph , Albright Patrick , Weistroffer Joseph , Kenter Keith 
Published: November 2018

Background:
The responsibilities of an on-call orthopaedic surgery resident has been minimally described in the literature. The most common diagnoses, procedures, and surgical cases that occur during an on-call shift would be of interest to an incoming resident. This study was designed to provide insight as to the knowledge and skills necessary to be a competent orthopaedic surgery resident on call.

Methods:
An electronic databank was created for the on-call residents to prospectively log inpatient and emergency department consultations at a level I trauma center over a 3-month period. Pertinent information was gathered about each consultation such as the diagnosis, treatment required in the emergency department or formal operative suite, type of anesthetic used to complete a reduction or procedure if necessary, duration of consultation, and more.

Results:
Over 500 consults were recorded during the collection period. The top three most common diagnoses included distal radial and/or distal ulnar fracture (8.2%), hand laceration (8.0%), and compression, burst, transverse process, or fracture dislocation of the spine (5.7%). The top three most common procedures or reductions performed in the emergency department included closed reduction of a fracture (38.9%), irrigation and debridement (24.0%), and closed reduction of a fracture dislocation or isolated dislocation (15.7%).

Conclusions:
This is the first study to evaluate the most common diagnoses and procedures encountered by orthopaedic residents on call at a level I trauma center. The results of the study can be utilized by orthopaedic program directors and department chairs, residents in training, and medical students.
Facilitators and Barriers to Reducing Emergency Department Admissions for Chest Pain: A Qualitative Study
Authors: Lin Michelle P. , Natsui Shaw , Sinnette Corine , Ball Alexis , Weissman Joel S. , Schuur Jeremiah D. 
Published: November 2018

Background:
Chest pain of possible cardiac etiology is a leading reason for emergency department (ED) visits and hospitalizations nationwide. Evidence suggests outpatient management is safe and effective for low-risk patients; however, ED admission rates for chest pain vary widely. To identify barriers and facilitators to outpatient management after ED visits, we performed a multicenter qualitative study of key stakeholders.

Methods and Results:
We identified Massachusetts hospitals with below-average admission rates for adult ED chest pain visits from 2010 to 2011. We performed a qualitative case study of 27 stakeholders across 4 hospitals to identify barriers and facilitators to outpatient management. Clinicians cited ability to coordinate follow-up care, including stress testing and cardiology consultation, as key facilitators of ED discharge. When these services are unavailable, or inconsistently available, they present a barrier to outpatient management. Clinicians identified pressure to maintain throughput and the lack of observation units as barriers to ED discharge. At 3 of 4 hospitals without observation units, clinicians did not use clinical protocols to guide the admission decision. At the site with a dedicated ED observation unit, low ED admission rates were attributed to clinician adherence to clinical protocols.

Conclusions:
In conclusion, most participants have not adopted protocols focused on reducing variation in ED chest pain admissions. Robust systems to ensure follow-up care after ED visits may reduce admission rates by mitigating the perceived risk of discharging ED patients with chest pain. Greater use of observation protocols may promote adoption of clinical guidelines and reduce admission rates.
OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY CHANGES AFTER SUBTHRESHOLD MICROPULSE YELLOW LASER IN DIABETIC MACULAR EDEMA
Authors: Vujosevic Stela , Gatti Valentina , Muraca Andrea , Brambilla Marco , Villani Edoardo , Nucci Paolo , Rossetti Luca , De Cilla' Stefano 
Published: November 2018

Purpose:
To assess changes on optical coherence tomography (OCT) angiography in diabetic macular edema (DME) treated with subthreshold micropulse yellow laser (SMPL) over a period of 6 months.

Methods:
Thirty-five eyes (35 consecutive patients) with treatment-naive DME prospectively underwent (at baseline, 3 and 6 months) best-corrected visual acuity, swept-source OCT angiography/OCT, and fundus autofluorescence. Following parameters were evaluated on OCT angiography in the superficial capillary plexus (SCP) and deep capillary plexus (DCP): the area of foveal avascular zone, number of microaneurysms (MA), area of cysts, and presence of capillary network alterations. Microaneurysm change was also evaluated in 15 fellow eyes, not needing treatment over 6 months. Vessel and perfusion densities were evaluated in the SCP, DCP, and choriocapillaris, with image J. Retina thickness, number of hyperreflective retinal spots, and external limiting membrane integrity were evaluated on OCT. All measurements were performed by two masked graders, independently.

Results:
All patients had diabetes mellitus Type 2 (mean age, 69.4 ± 10.9 years; duration of diabetes mellitus, 15.7 ± 8.7 years; and HbA1c 7.7 ± 1.2%). Mean best-corrected visual acuity at baseline was 69.7 ± 12.0 letters ETDRS, 72.7 ± 10.7 at 3 months (gain 3.1 ± 4.3, P = 0.0049) and 74.3 ± 9.5 at 6 months (gain 4.6 ± 7.2, P < 0.0001). Foveal avascular zone area decreased in the DCP at 6 months (P = 0.01). Area of cysts decreased in the SCP at 3 months and 6 months (P = 0.038; P = 0.049), and in the DCP at 6 months (P = 0.0071). Number of MA decreased at 6 months in the SCP (P = 0.0007) and at 3 months and 6 months in the DCP (P = 0.048; P < 0.0001) in treated eyes. No significant change in number of MA was found in nontreated eyes. There was no statistically significant change in any other OCT angiography/OCT parameter.

Conclusion:
Subthreshold micropulse yellow laser induces more pronounced changes in the DCP than in the SCP in DME. These changes occurred as early as 3 months after treatment. The evaluation of specific parameters in the DCP may help in determining treatment response.
Cross-Country Transportation Efficacy and Clinical Outcomes of Preloaded Large-Diameter Ultra-Thin Descemet Stripping Automated Endothelial Keratoplasty Grafts
Authors: Parekh Mohit , Ruzza Alessandro , Steger Bernhard , Willoughby Colin E. , Rehman Salwah , Ferrari Stefano , Ponzin Diego , Kaye Stephen B. , Romano Vito 
Published: November 2018

Purpose:
To evaluate the clinical outcomes of preloaded large-diameter ultra-thin grafts for Descemet stripping automated endothelial keratoplasty (UT-DSAEK) after cross-country shipment.

Methods:
A laboratory study in an eye bank and a clinical cohort study in an academic tertiary care center were performed. UT-DSAEK (9.5 mm diameter) grafts (n = 7) were prepared, loaded into a commercial device (iGlide; Eurobio, Les Ulis, France), preserved for 4 days at room temperature in transport medium, and analyzed. In a retrospective study, preloaded tissues (n = 39) for clinical use were prepared, transported from Italy to the United Kingdom, and surgically delivered into the eyes of patients undergoing UT-DSAEK. Central and peripheral endothelial cell density (ECD) and viability were measured before and after loading and storage of the grafts in the laboratory study. Clinically, best-corrected visual acuity, ECD before and at final follow-up, dislocation rate, primary graft failure, and surgical time were recorded.

Results:
In the laboratory study, postcut central graft thickness was 93.3 ± 17.2 μm. ECD and cell mortality did not change significantly before and after preservation (P = 0.8). Cell loss after 4 days of preservation was 1.7% ± 1.6%. Clinically, 39 eyes of 39 patients at final follow-up showed a mean central graft thickness of 88 ± 22 μm and a best-corrected visual acuity of 0.34 ± 0.24 logMAR. Nine of 39 cases (23%) needed rebubbling, and 28% cell loss was observed at final follow-up.

Conclusions:
Large-diameter UT-DSAEK grafts can be prepared and preloaded in the eye bank using the iGlide and transported to the surgical center facilitating surgery for patients undergoing UT-DSAEK, potentially reducing tissue wastage, surgical time, and costs related to surgery.
Multidisciplinary Approach to Improve Sepsis Outcomes
Authors: MacMillan Andrew , Rudinsky David , Han Gena , Elliott John O. , Jordan Kim 
Published: November 2018

ABSTRACT
Severe sepsis and septic shock cause significant morbidity and mortality with health care costs approximating $17 billion annually. The Surviving Sepsis Campaign 2012 recommended time-sensitive care bundles to improve outcomes for patients with sepsis. At our community teaching hospital, a review of sepsis management for patients admitted to a medical intensive care unit (ICU) between December 2015 and March 2016 found 70.8% compliance with timing of lactate draw, 65.3% compliance for blood cultures, and 51.4% compliance with antibiotic administration recommendations. Thus, a quality improvement initiative to improve detection and time to bundle completion for ICU-level patients was designed. Previous studies suggest that utilization of sepsis alert systems and sepsis response teams in the emergency department setting is associated with improved compliance with recommended sepsis bundles and improved hospital mortality. Therefore, a “sepsis alert” protocol was implemented that used both an electronic alert and an overhead team alert that mobilized nursing, pharmacy, phlebotomy, and a senior internal medicine resident to bedside. In addition, a template to document sepsis diagnosis and bundle adherence was created. After implementation, we noted improvement in appropriately timed serum lactate, 88.6% versus 70.8% (p = .008) with no significant improvements in blood cultures, antibiotic administration, or mortality.
Examining the Competency of Recent Graduates of an Orthotics and Prosthetics Training Program
Authors: Boe Bronwen E. , Gardner Aimee K. 
Published: November 2018

Introduction
The purpose of this study was to assess perceived competence of graduates of an orthotic and prosthetic (O&P) master's program.

Method
Recent graduates and their supervisors completed a survey adapted from the American Board for Certification in Orthotics, Prosthetics & Pedorthics (ABC) Practice.
Analysis of Certified Practitioners in the Disciplines of Orthotics and Prosthetics, with each group rating graduate ability to independently perform 66 items along the categories of the following: “patient assessment,” “formulation of treatment plan,” “implementation of treatment plan,” “follow-up of treatment plan,” “practice management,” and “promotion of professional practice” on a 1-to-7 scale (1, unable to perform independently; 7, can independently perform). Supervisors also indicated the extent to which graduates met expectations of competency. Basic descriptive and independent-sample t-tests were used to analyze data.

Results
Overall competency mean was 5.78 ± 1.01 for graduates (n = 25; 74% response rate) and 5.39 ± 0.74 for supervisors (n = 16; 53% response rate). Means for each category were similar between groups. Implementation of the treatment plan had the most items with significant differences between groups. These differences emerged in tasks related to patient shape capture method and device setup. All supervisors agreed that graduate competency met expectations or was exceptional.

Conclusions
Both graduates and supervisors agree on high levels of competency across all competency areas defined by certification bodies. Opportunities exist to enhance curricula related to implementation of treatment plan.
Gastrointestinal hormones and regulation of gastric emptying
Authors: Camilleri Michael 
Published: November 2018

Purpose of review
This review examines the hormonal regulation of gastric emptying, a topic of increasing relevance, given the fact that medications that are analogs of some of these hormones or act as agonists at the hormonal receptors, are used in clinical practice for optimizing metabolic control in the treatment of type 2 diabetes and in obesity.

Recent findings
The major effects on gastric emptying result from actions of incretins, particularly gastric inhibitory polypeptide, glucagon-like peptide-1, and peptide tyrosine–tyrosine, the duodenal and pancreatic hormones, motilin, glucagon, and amylin, and the gastric orexigenic hormones, ghrelin and motilin. All of these hormones delay gastric emptying, except for ghrelin and motilin which accelerate gastric emptying. These effects on gastric emptying parallel the effects of the hormones on satiation (by those retarding emptying) and increase appetite by those that accelerate emptying. Indeed, in addition to the effects of these hormones on hypothalamic appetite centers and glycemic control, there is evidence that some of their biological effects are mediated through actions on the stomach, particularly with the glucagon-like peptide-1 analogs or agonists used in treating obesity.

Summary
Effects of gastrointestinal hormones on gastric emptying are increasingly recognized as important mediators of satiation and postprandial glycemic control.
Evolution of a Schmorl’s Node and a Degenerative Osteophyte on Sequential 68Ga-DOTATATE PET/CT Scans
Authors: Hod Nir , Levin Daniel , Anconina Reut , Benkovich Elya , Ezroh Kazap Dina , Lantsberg Sophie 
Published: November 2018

Abstract
Schmorl's node (SN) arises from the herniation of the nucleus pulposus of the disc through the cartilaginous endplate into the body of the vertebra. Our report describes a patient with carcinoid tumor who underwent a series of 68Ga-DOTATATE PET/CT scans for follow-up, demonstrating gradually increasing focal vertebral uptake in absence of CT abnormality, suspicious for a metastasis. Both CT and MRI eventually revealed classical findings of a SN. Also observed in the same vertebra is a degenerative osteophyte showing intense 68Ga-DOTATATE uptake. This interesting case shows 2 benign spinal lesions, which potentially can simulate bone metastasis in patients with neuroendocrine tumors.
Synchronous Metastatic Breast Carcinoma and Parathyroid Adenoma on 18F-FDG PET/CT and 99mTc-Sestamibi Imaging
Authors: Singh Harkamal , Wale Daniel J. , Wong Ka Kit , Gross Milton D. , Viglianti Benjamin L. 
Published: November 2018

Abstract
In addition to nuclear cardiac and breast imaging, 99mTc-sestamibi scintigraphy is often used to localize parathyroid adenomas. 18F- fluorodeoxyglucose (FDG) PET is heavily utilized in oncology, although its use in identifying parathyroid adenomas is limited. We describe a case of a 57-year-old woman who underwent parathyroid scintigraphy and 18F-FDG PET/CT in the same week due to hyperparathyroidism and an enlarging breast mass, respectively. A right paratracheal mediastinal mass that otherwise would be suspicious for nodal metastases by CT alone was correctly identified to be an ectopic parathyroid adenoma using a combination of the nuclear medicine studies performed.
Patterns of Cortical Visual Field Defects From Embolic Stroke Explained by the Anastomotic Organization of Vascular Microlobules
Authors: Horton Jonathan C. , Adams Daniel L. 
Published: November 2018

Abstract:
The cerebral cortex is supplied by vascular microlobules, each comprised of a half dozen penetrating arterioles that surround a central draining venule. The surface arterioles that feed the penetrating arterioles are interconnected via an extensively anastomotic plexus. Embolic occlusion of a small surface arteriole rarely produces a local infarct, because collateral blood flow is available through the vascular reticulum. Collateral flow also protects against infarct after occlusion of a single penetrating arteriole. Cortical infarction requires blockage of a major arterial trunk, with arrest of blood flow to a relatively large vascular territory. For striate cortex, the major vessels compromised by emboli are the inferior calcarine and superior calcarine arteries, as well as the distal branches of the middle cerebral artery. Their vascular territories have a fairly consistent relationship with the retinotopic map. Consequently, occlusion by emboli results in stereotypical visual field defects. The organization of the arterial supply to the occipital lobe provides an anatomical explanation for a phenomenon that has long puzzled neuro-ophthalmologists, namely, that of the myriad potential patterns of cortical visual field loss, only a few are encountered commonly from embolic cortical stroke.