bluuebunny/crossref_metadata_2025_split huggingface dataset:
The duration of reionization constrains the ionizing sources
Authors: Sharma Mahavir , Theuns Tom , Frenk Carlos 
Published: March 2018

Abstract
We investigate how the nature of the galaxies that reionized the Universe affects the duration of reionization. We contrast two sets of models: one in which galaxies on the faint side of the luminosity function dominate the ionizing emissivity, and a second in which the galaxies on the bright side of the luminosity function dominate. The faint end of the luminosity function evolves slowly, therefore the transition from mostly neutral to mostly ionized state takes a much longer time in the first set of models compared to the second. Existing observational constraints on the duration of this transition are relatively weak, but taken at face value prefer the model in which galaxies on the bright side play a major role. Measurements of the kinetic Sunyaev–Zeldovich effect in the cosmic microwave background from the epoch of reionization also point in the same direction.
Stress in Patients With (Un)ruptured Intracranial Aneurysms vs Population-Based Controls
Authors: de Wilde Arno , Greebe Paut , Rinkel Gabriël J E , Algra Ale 
Published: March 2018

Abstract

BACKGROUND
Stress is associated with increased risk of stroke and might predispose to presence and rupture of intracranial aneurysms.

OBJECTIVE
To study the association of recent and lifelong stress with unruptured intracranial aneurysm (UIA) and aneurysmal subarachnoid hemorrhage (ASAH).

METHODS
In 227 UIA patients (mean age 61 ± 11 yr), 490 ASAH patients (59 ± 11 yr), and 775 controls (51 ± 15 yr) who were randomly retrieved from the general population, we assessed occurrence of major life events and perceived stress during the preceding 12 mo and the entire life. With multivariable logistic regression analysis, we calculated odds ratios (ORs) with 95% confidence intervals (95% CIs) for 4 categories of life events (financial-related, work-related, children-related, and death of family members) and for periods of perceived stress at home and at work (never vs sometimes, often, or always). We adjusted for sex, age, alcohol consumption, smoking, and hypertension.

RESULTS
The 4 categories of life events and perceived stress at work had ORs ranging from 0.4 to 1.7, of which financial stress for UIA was statistically significant (95% CI: 1.1-2.5). ORs for chronic perceived stress at home in the previous year were 4.3 (95% CI: 1.8-10.3) for UIA and 2.5 (1.2-5.5) for ASAH, and for lifelong exposure 5.7 (2.2-14.5) for UIA and 3.0 (1.3-7.0) for ASAH.

CONCLUSION
For some components of stress, there may be a relation with UIA and ASAH. The mechanisms underlying this relation should be unraveled; strategies to improve coping with stress may reduce the risk of rupture in patients with unruptured aneurysms.
Central nervous system involvement in children and adolescents with rhabdomyosarcoma. A report from the AIEOP Soft Tissue Sarcoma Committee
Authors: Pierobon Marta , Ferrari Andrea , Scarzello Giovanni , Tamburini Angela , Quaglietta Lucia , Ruggiero Antonio , Milano Giuseppe Maria , Zin Angelica , Bisogno Gianni 
Published: March 2018

Abstract

Background
Rhabdomyosarcoma (RMS) is a highly malignant tumor typically affecting children and adolescents. Central nervous system (CNS) dissemination is rare in RMS patients, but seems to have a particularly negative impact. The aim of this study was to analyze treatment and outcome of patients with RMS and evidence of CNS disease who were registered in the protocols coordinated by the Italian Soft Tissue Sarcoma Committee from March 1979 to December 2016.

Methods
We analyzed 39 patients with CNS disease. Depending on when their CNS disease was identified, we grouped patients as: Group A, at diagnosis; Group B, progression during treatment; Group C, at first relapse.

Results
Six patients were in Group A (2.7% of metastatic RMS patients at diagnosis); 24 were in Group B and 9 in Group C (6.5% of patients with tumor progression/relapse included in the protocols). Only 5 patients (4 in Group A, 1 in Group B) survived the event and are alive in complete remission with a median follow-up of 17.5 years. These 5 patients received systemic chemotherapy and craniospinal radiotherapy, and 2 of them also received intrathecal therapy with topotecan.

Conclusions
CNS involvement at diagnosis is a rare and prognostically negative event in RMS patients, but not always fatal when it is found at diagnosis. It is more frequent during or shortly after treatment, and the more dismal prognosis in these cases underscores the need to improve our ability to identify patients at risk of CNS dissemination in order to attempt more effective treatments that can sterilize the meninges.
Color Coding of a Sterile Field to Aid in Recognition of Visual Cognition and Learning
Authors: Hannon Michele A. , Raymond Roberta A. 
Published: March 2018

Abstract
This study used color coding to determine if color promotes visual cognition and learning for students to identify the sterile field while inserting an indwelling catheter. Novice students have trouble identifying the sterile field. It was theorized that adding color would help students identify what is and is not sterile. Thirty students in the control group were instructed using a standard non-color-coded catheter kit; 30 students in the experimental group were instructed using a red color-coded catheter kit. All students were validated using the standard non-colored-coded kit. The experimental group performed better on overall sterility.
Using Simulation With Nursing Students to Promote Affirmative Practice Toward the Lesbian, Gay, Bisexual, and Transgender Population: A Multisite Study
Authors: Maruca Annette T. , Diaz Desiree A. , Stockmann Cherrill , Gonzalez Laura 
Published: March 2018

Abstract

AIM
The aim of this research was to evaluate the impact of a transgender simulation on nursing students’ affirmative practice when caring for a transgender person.

BACKGROUND
There is a paucity of research that assesses the attitudes of nursing students toward lesbian, gay, bisexual, and transgender (LGBT) persons and a deficit in nursing curricula regarding LGBT content.

METHOD
A nonexperimental, pretest-posttest design was used to evaluate nursing students’ affirmative practice when caring for a transgender patient using the Gay Affirmative Practice Scale.

RESULTS
A Wilcoxon signed-rank test revealed a statistical significance in Gay Affirmative Practice scores after the simulation with a small effect size. These results suggest that the transgender simulation supported nursing students’ attitudes and affirmative practice when providing nursing care to a transgender person.

CONCLUSION
Experiential learning in nursing education is an effective approach to teach cultural competence and sensitivity in caring for vulnerable populations.
Relationships Between the ACGME Resident and Faculty Surveys and Program Pass Rates on the ABIM Internal Medicine Certification Examination
Authors: Holt Kathleen D. , Miller Rebecca S. , Vasilias Jerry , Byrne Lauren M. , Cable Christian , Grosso Louis , Bellini Lisa M. , McDonald Furman S. 
Published: March 2018

Purpose
The Accreditation Council for Graduate Medical Education (ACGME) has surveyed residents since 2003, and faculty since 2012. Surveys are designed to assess program functioning and specify areas for improvement. The purpose of this study was to assess the association of the ACGME’s resident and faculty surveys with residency-program-specific performance on the American Board of Internal Medicine (ABIM) certification exam.

Method
Data were available from residents and faculty in 375 U.S. ACGME-accredited internal medicine programs from the 2012–2013, 2013–2014, and 2014–2015 academic years. Analysis of variance and correlations were used to examine the relationship between noncompliance with ACGME program requirements as assessed by the resident and faculty surveys, and ABIM program pass rates.

Results
Noncompliance reported on the resident and faculty surveys was highest for programs not meeting the ACGME program requirement of an 80% pass rate on the ABIM certification examination. This relationship was significant for overall noncompliance, both within the resident (P < .001) and faculty (P < .05) surveys, for many areas within the two surveys (correlations ranged between −.07 and −.25, and P values ranged between .20 and < .001), and for the highest levels of noncompliance across areas of the resident (P < .001) and faculty (P < .04) surveys.

Conclusions
ACGME resident and faculty surveys were significantly associated with ABIM program pass rates, supporting the importance of these surveys within the ACGME’s Next Accreditation System.
Mindfulness-Based Neurodevelopmental Care
Authors: Petteys Annie R. , Adoumie Dominique 
Published: March 2018

Background/Purpose:Experiences of premature birth and neonatal intensive care unit (NICU) hospitalizations result in stress and family separation that have far-reaching implications. Prior studies of neonatal neurodevelopmental care show improved infant outcomes. Previous studies of mindfulness show improved stress and health outcomes in varied disease processes. No neonatal studies of parent training in mindfulness-based neurodevelopmental care exist. This study examines the impact of parent education and participation in mindfulness-based neurodevelopmental care on parent outcomes (stress, bonding, and satisfaction) and infant length of stay (LOS).Methods:This randomized controlled trial pilot study utilized a convenience sample of 55 parent–infant dyads. Parametric and nonparametric statistical tests examined differences in and between study groups in demographics and dependent study variables (stress, bonding, satisfaction, and LOS).Results:No statistically significant differences in parent outcomes were seen between groups. However, experimental group (EG) parents showed a significant reduction in stress scores from enrollment to discharge (P= .012) and EG infants had significantly shorter LOS (P= .026-.047) than control.Implications for Practice and Research:While further research to confirm study results is warranted, changes in current NICU practices to incorporate additional parent education in mindfulness-based neurodevelopmental care may help alleviate parent stress and decrease LOS that impact financial, physical, and psychosocial outcomes for patients, families, healthcare systems, and society.
Comparative Evaluation of Gemcabene and Peroxisome Proliferator–Activated Receptor Ligands in Transcriptional Assays of Peroxisome Proliferator–Activated Receptors: Implication for the Treatment of Hyperlipidemia and Cardiovascular Disease
Authors: Bisgaier Charles L. , Oniciu Daniela C. , Srivastava Rai Ajit K. 
Published: March 2018

Abstract:
Gemcabene, a late-stage clinical candidate, has shown efficacy for LDL-C, non-HDL cholesterol, apoB, triglycerides, and hsCRP reduction, all risk factors for cardiovascular disease. In rodents, gemcabene showed changes in targets, including apoC-III, apoA-I, peroxisomal enzymes, considered regulated through peroxisome proliferator–activated receptor (PPAR) gene activation, suggesting a PPAR-mediated mechanism of action for the observed hypolipidemic effects observed in rodents and humans. In the current study, the gemcabene agonist activity against PPAR subtypes of human, rat, and mouse were compared with known lipid lowering PPAR activators. Surprisingly, gemcabene showed no or little PPAR-α transactivation compared with reference agonists, which showed concentration-dependent transactivation against human PPAR-α of 2.4- to 30-fold (fenofibric acid), 17-fold (GW590735), and 2.3- to 25-fold (WY-14643). These agents also showed robust transactivation of mouse and rat PPAR-α in a concentration-dependent manner. The known PPAR-δ agonists, GW1516, L165041, and GW0742, showed potent agonist activity against human, mouse, and rat receptors (ranging from 165- to 396-fold). By contrast, gemcabene at the highest concentration tested (300 μM) showed no response in mouse and rat and a marginal response against human PPAR-δ receptors (3.2-fold). For PPAR-γ, gemcabene showed no agonist activity against all 3 species at 100 μM and marginal activity (3.6- to 5-fold) at 300 μM. By contrast, the known agonists, rosiglitazone, indomethacin, and muraglitazar showed strong activation against the mouse, rat, and human PPAR-γ receptors. No clear antagonist activity was observed with gemcabene against any PPAR subtypes for all 3 species over a wide range of concentrations. In summary, the transactivation studies rule out gemcabene as a direct agonist or antagonist of PPAR-α, PPAR-γ, and PPAR-δ receptors of these 3 species. These data suggest that the peroxisomal effects observed in rodents and the lipid regulating effects observed in rodents and humans are not related to a direct activation of PPAR receptors by gemcabene.
Transplantation Blues: Inadvertent Staining of Amyloid Deposits With Trypan Blue
Authors: Marcon Agathe , Périllat Nicolas , Garcin Thibaud , Jullienne Rémy , He Zhiguo , Forest Fabien , Gauthier Anne Sophie , Gain Philippe , Thuret Gilles 
Published: March 2018

Purpose:
To describe inadvertent persistent staining of stromal amyloid deposits by trypan blue (TB) after penetrating keratoplasty (PK) and Descemet membrane endothelial keratoplasty (DMEK) performed in patients with corneal amyloidosis.

Methods:
Case series of patients with corneal amyloidosis in whom intraoperative TB was used.

Results:
One patient, hospitalized for acute rejection 6 weeks after DMEK, presented with an intense blue staining of small, spindle-shaped structures in the anterior half of the cornea. DMEK had been performed for endothelial failure of a previous PK procedure done 13 years earlier for advanced lattice corneal dystrophy (LCD). After 6 months, the stromal blue tattoo persisted with impaired visual acuity, and PK was performed. Blue-stained structures were amyloid deposits characteristic of LCD recurrence. In parallel, among 85 consecutive triple procedures (PK + cataract + intraocular lens [IOL]) performed over 7 years, in which TB was used, only patients with LCD (n = 18 eyes in 17 patients) or presumed secondary amyloidosis due to chronic inflammation (n = 1), presented an isolated intense blue ring of the graft–host interface. This persisted up to 7 years with no clinical consequence.

Conclusions:
TB can stain corneal amyloid deposits. After PK, staining is limited to the recipient peripheral cornea and has no apparent clinical consequence. However, during DMEK performed after a failed PK, TB stains fibrils accumulated during slow LCD recurrence and scattered on the whole graft. The long-term staining duration indicates strong interactions between TB and amyloid.
Changes in Local Public Health System Performance Before and After Attainment of National Accreditation Standards
Authors: Ingram Richard C. , Mays Glen P. , Kussainov Nurlan 
Published: March 2018

Objective:
The aim of this study is to investigate the impact of Public Health Accreditation Board (PHAB) accreditation on the delivery of public health services and on participation from other sectors in the delivery of public health services in local public health systems.

Design:
This study uses a longitudinal repeated measures design to identify differences between a cohort of public health systems containing PHAB-accredited local health departments and a cohort of public health systems containing unaccredited local health departments. It uses data spanning from 2006 to 2016.

Setting:
This study examines a cohort of local public health systems that serves large populations and contains unaccredited and PHAB-accredited local health departments.

Participants:
Data in this study were collected from the directors of health departments that include local public health systems followed in the National Longitudinal Study of Public Health Systems.

Intervention:
The intervention examined is PHAB accreditation.

Main Outcome Measures:
The study focuses on 4 areas: the delivery of core public health services, local health department contribution toward these services, participation in the delivery of these services by other members of the public health system, and public health system makeup.

Results:
Prior to the advent of accreditation, public health systems containing local health departments that were later accredited by PHAB appear quite similar to their unaccredited peers. Substantial differences between the 2 cohorts appear to manifest themselves after the advent of accreditation. Specifically, the accredited cohort seems to offer a broader array of public health services, involve more partners in the delivery of those services, and enjoy a higher percentage of comprehensive public health systems.

Conclusions:
The results of this study suggest that accreditation may yield significant benefits and may help public health systems develop the public health system capital necessary to protect and promote the public's health.
A Menu to Evaluate Factors Influencing Implementation of Obesity Prevention Early Care and Education Regulations
Authors: Sawicki Erin , Barker Dianne C. , Gutman Marjorie A. , Caughlan Ian , Yochelson Marissa , Grob George 
Published: March 2018

Context:
In recent years, several states have adopted new regulations concerning nutrition, physical activity, and screen time in early care and education (ECE) settings to help prevent childhood obesity.

Objective:
To disseminate a menu of factors that facilitate and/or impede implementation of obesity prevention regulations in ECE settings.

Design:
To create the menu, we condensed and categorized factors identified in the literature and through field work by placing them within domains. We applied the menu by conducting semistructured interviews during a pilot test assessing implementation of ECE regulations in Colorado.

Setting and Participants:
We first interviewed state and local government agency leaders responsible for policy oversight, and state employees and contractors who acted as intermediaries to direct implementers. We then interviewed directors at ECE centers in the Denver, Colorado, area. We selected 21 ECE centers for a site visit on the basis of feasibility, percentage of low-income families, and diversity in race and ethnicity at each center. Seven centers participated.

Main Outcome Measures:
Minor and major facilitators and impediments to implementation of childhood obesity prevention regulations in ECE settings.

Results:
The resulting menu includes 7 domains and 39 factors influential for implementation of ECE regulations. Of these 39 factors, interviewees identified 7 facilitating factors (4 major and 3 minor) and 2 impeding factors (both major). Major facilitating factors were buy-in from parents/caregivers, training and communication provided by governing authority and their contractors, and low level of change required by the regulations themselves. Major impeding factors were timing of implementation and balancing the demands of the regulations against other priorities.

Conclusions:
The menu developed by our research team, combined with existing frameworks in dissemination and implementation research, can be used by researchers, practitioners, and policy makers to anticipate factors that facilitate and/or impede implementation of ECE policies to prevent childhood obesity.
Quantification of Total and Intracellular Sodium Concentration in Primary Prostate Cancer and Adjacent Normal Prostate Tissue With Magnetic Resonance Imaging
Authors: Barrett Tristan , Riemer Frank , McLean Mary A. , Kaggie Josh , Robb Fraser , Tropp James S. , Warren Anne , Bratt Ola , Shah Nimish , Gnanapragasam Vincent J. , Gilbert Fiona J. , Graves Martin J. , Gallagher Ferdia A. 
Published: March 2018

Objectives
The aim of this study was to measure the tissue sodium concentration (TSC) within tumors and normal prostate in prostate cancer patients, using prostatectomy as pathological criterion standard.

Materials and Methods
Fifteen patients with biopsy-proven, magnetic resonance imaging (MRI) visible, intermediate- or high-risk prostate cancer underwent a dedicated research sodium MRI, before treatment with radical prostatectomy. All participants signed written informed consent for this institutional review board–approved prospective study. 3 T MRI acquired using a dedicated multinuclear clamshell transmit coil and a bespoke dual-tuned 1H/23Na endorectal receive coil, with intracellular-sodium imaging acquired using inversion recovery sequences; a phantom-based calibration enabled quantitative sodium maps. Regions of interest were defined for normal peripheral zone (PZ) and transition zone (TZ) and tumor regions, referenced from histopathology maps. A 1-way analysis of variance compared normal and tumor tissue, using Tukey test for multiple comparisons.

Results
Two patients were excluded due to artifact; software error resulted in 1 further intracellular-sodium failure. Fifteen tumors were detected (13 PZ, 2 TZ) in 13 patients: Gleason 3 + 3 (n = 1), 3 + 4 (6), 3 + 5 (2), 4 + 3 (5), 4 + 5 (1). Both mean TSC and intracellular-sodium were significantly higher in normal PZ (39.2 and 17.5 mmol/L, respectively) versus normal TZ (32.9 and 14.7; P < 0.001 and P = 0.02). Mean TSC in PZ tumor (45.0 mmol/L) was significantly higher than both normal PZ and TZ tissue (P < 0.001). Intracellular sodium in PZ tumors (19.9 mmol/L) was significantly higher than normal TZ (P < 0.001) but not normal PZ (P = 0.05). Mean TSC and intracellular-sodium was lower in Gleason ≤3 + 4 tumors (44.4 and 19.5 mmol/L, respectively) versus ≥4 + 3 (45.6 and 20.2), but this was not significant (P = 0.19 and P = 0.29).

Conclusions
Tissue sodium concentration and intracellular sodium concentrations of prostate tumors were quantified, with PZ tumors demonstrating a significantly increased TSC.
Effect of hypobaria and hyperoxia during sepsis on survival and energy metabolism
Authors: Choi Myeongjin , Tamrakar Pratistha , Schuck Patricia F. , Proctor Julie L. , Moore Ashley , Asbury Katrina , Fiskum Gary , Coksaygan Turhan , Cross Alan S. 
Published: March 2018

BACKGROUND
Injured warfighters air evacuated to tertiary medical care facilities are subjected to many stresses that may promote the development of sepsis. In this study, we tested the hypothesis that exposure to “in-flight” hypobaria and/or hyperoxia within 24 hours after onset of intra-abdominal infection in rats accelerates the development and/or severity of sepsis and neurologic injury in survivors.

METHODS
Sprague-Dawley rats underwent cecal ligation/puncture (CLP) or sham procedures. Twenty-four hours later, rats were then placed in hypobaric chambers for 6 hours and assigned to normobaric conditions and maintained at either 21% or 100% O2, or under hypobaric conditions (pressure equivalent to an altitude of 8,000 ft) but maintained under either 28% or 100% O2. Two days after CLP or sham, blood samples were obtained for cytokine levels, and mitochondria were isolated from the brain and heart of a subset of animals for analysis of mitochondrial oxygen consumption. Animals were also evaluated for neuromotor impairment before and 15 days postsurgery.

RESULTS
Among the 70 rats studied, 16.7% of CLP but none of the sham-treated rats died. All of the CLP but none of the sham rats had evidence of peritonitis at 2 days. Twenty percent (6 of 30) CLP rats undergoing hypobaria versus 12.5% (3 of 24) of CLP rats exposed to normobaria died (p = 0.715) while 12% (3 of 25) of CLP rats exposed to hyperoxia versus 20.7% (6 of 29) of CLP rats exposed to normoxia died (p = 0.48). The ratio of mitochondrial ATP-generating O2 consumption to resting respiration was higher in the CLP plus hypobaria under 100% compared with shams. The only difference in H2O2 production was observed in mitochondria from CLP rats exposed to hyperoxia under normobaric conditions. Composite neurologic scores obtained 15 days postinjury were lower than those at baseline for shams.

CONCLUSION
We conclude that neither “in-flight” hyperoxia nor hypobaria exacerbate sepsis or neurologic injury.