bluuebunny/crossref_metadata_2025_split huggingface dataset:
Circulating Plasma Extracellular Vesicles from Septic Mice Induce Inflammation via MicroRNA- and TLR7-Dependent Mechanisms
Authors: Xu Jinjin , Feng Yan , Jeyaram Anjana , Jay Steven M. , Zou Lin , Chao Wei 
Published: October 2018

Abstract
We have previously reported that a group of host cellular microRNAs (miRNAs; miR-34a-5p, miR-122-5p, miR-145-5p, miR-146a-5p, miR-210-3p) are released into the blood during sepsis, some of which are capable of inducing complement activation, cytokine production, and leukocyte migration. Extracellular vesicles (EVs) have been proposed as vehicles for extracellular miRNA-mediated intercellular communication. However, the biological function of plasma EVs and the associated miRNAs in sepsis are largely unknown. In this study, we tested the hypothesis that plasma EVs in sepsis are proinflammatory and EV-associated miRNAs are responsible for EV-induced cytokine production. Compared with those of sham mice, the plasma EVs from septic mice were slightly smaller (157 ± 2 versus 191 ± 6 nm, p &lt; 0.0001), but more abundant [(1.6 ± 0.14) × 1010 versus (0.93 ± 0.14) × 1010/ml plasma, p &lt; 0.003]. miRNA array revealed that among 65 miRNAs, 8 miRNAs exhibited &gt;1.5-fold increase in septic EVs compared with sham EVs, including miR-126-3p, miR-122-5p, miR-146a-5p, miR-145-5p, miR-26a-5p, miR-150-5p, miR-222-3p, and miR-181a-5p. Septic but not sham EVs were proinflammatory, promoting IL-6, TNF-α, IL-1β, and MIP-2 production. The effects of EVs were resistant to polymyxin B (an endotoxin inhibitor) but significantly inhibited by anti-miR inhibitors against miR-34a, miR-122, and miR-146a. Moreover, the septic EV-induced cytokine production was attenuated in TLR7−/− or MyD88−/− cells but remained the same in TLR3−/− or Trif−/− cells. In vivo, mice i.p. injected with septic EVs had marked peritoneal neutrophil migration, which was significantly attenuated in MyD88−/− mice. Taken together, these data demonstrate that plasma EVs of septic animals play an important role in inflammation, and EV-associated miRNAs likely mediate the cytokine production via TLR7-MyD88 signaling.
A Consensus Approach to Identify Tiered Competencies in Quality Improvement and Patient Safety
Authors: Kruszewski Brennan D. , Spell Nathan O. 
Published: October 2018

ABSTRACT

Background
Quality improvement and patient safety (QI/PS) competencies have been proposed separately for undergraduate medical education (UME) and graduate medical education (GME). The work forms a foundation at each educational level, yet curriculum development would benefit from more specific guidance that considers the continuum of physician training.

Objective
We identified a core set of QI/PS items to be taught during medical school, residency, and independent practice, with specificity to guide curriculum development at each level.

Methods
A panel of 12 QI leaders and educators with backgrounds in internal medicine from 10 academic institutions participated in consensus development using a modified Delphi technique. Three rounds of anonymous surveys were conducted, followed by a teleconference and then a fourth survey round, until consensus regarding the relevance of candidate items was reached. Items considered relevant were recommended for teaching at 1 of the 3 stages.

Results
The panel identified 30 QI/PS items for learners. Of the 30 (80%), 24 were unanimously agreed on as relevant, while 6 of 30 (20%) had the agreement of 11 of the 12 experts and the assent of the remaining expert. Thirteen items were identified as appropriate for undergraduate medical education, 14 for graduate medical education, and 3 for the continuing professional development level.

Conclusions
There was a high degree of agreement among 12 internists from geographically diverse institutions on the relevance of 30 QI/PS items identified for trainees in competency-based educational settings.
Morphology of GPS and DPS TEC over an equatorial station: validation of IRI and NeQuick 2 models
Authors: Odeyemi Olumide Olayinka , Adeniyi Jacob , Oladipo Olushola , Olawepo Olayinka , Adimula Isaac , Oyeyemi Elijah 
Published: October 2018

Abstract. We investigated total electron content (TEC) at Ilorin (8.50∘ N
4.65∘ E, dip lat. 2.95) for the year 2010, a year of low solar
activity in 2010 with Rz=15.8. The investigation involved the use of TEC
derived from GPS, estimated TEC from digisonde portable sounder data (DPS),
and the International Reference Ionosphere (IRI) and NeQuick 2 (NeQ) models.
During the sunrise period, we found that the rate of increase in DPS TEC, IRI
TEC, and NeQ TEC was higher compared with GPS TEC. One reason for this can be
attributed to an overestimation of plasmaspheric electron content (PEC)
contribution in modeled TEC and DPS TEC. A correction factor around the
sunrise, where our finding showed a significant percentage deviation between
the modeled TEC and GPS TEC, will correct the differences. Our finding
revealed that during the daytime when PEC contribution is known to be absent
or insignificant, GPS TEC and DPS TEC in April, September, and December
predict TEC very well. The lowest discrepancies were observed in May, June,
and July (June solstice) between the observed values and all the model values
at all hours. There is an overestimation in DPS TEC that could be due to
extrapolation error while integrating from the peak electron density of F2
(NmF2) to around ∼1000 km in the Ne profile. The
underestimation observed in NeQ TEC must have come from the inadequate
representation of contribution from PEC on the topside of the NeQ model
profile, whereas the exaggeration of PEC contribution in IRI TEC amounts to
overestimation in GPS TEC. The excess bite-out observed in DPS TEC and
modeled TEC indicates over-prediction of the fountain effect in these models.
Therefore, the daytime bite-out observed in these models requires a modifier
that could moderate the perceived fountain effect morphology in the models
accordingly. The daytime DPS TEC performs better than the daytime IRI TEC and
NeQ TEC in all the months. However, the dusk period requires attention due to
the highest percentage deviation recorded, especially for the models, in
March, November, and December. Seasonally, we found that all the TECs
maximize and minimize during the March equinox and June solstice,
respectively. Therefore, GPS TEC and modeled TEC reveal the semiannual
variations in TEC.
Epistemic uncertainties and natural hazard risk assessment – Part 1: A review of different natural hazard areas
Authors: Beven Keith J. , Almeida Susana , Aspinall Willy P. , Bates Paul D. , Blazkova Sarka , Borgomeo Edoardo , Freer Jim , Goda Katsuichiro , Hall Jim W. , Phillips Jeremy C. , Simpson Michael , Smith Paul J. , Stephenson David B. , Wagener Thorsten , Watson Matt , Wilkins Kate L. 
Published: October 2018

Abstract. This paper discusses how epistemic uncertainties are currently considered in the most widely occurring natural hazard areas, including floods, landslides and debris flows, dam safety, droughts, earthquakes, tsunamis, volcanic ash clouds and pyroclastic flows, and wind storms. Our aim is to provide an overview of the types of epistemic uncertainty in the analysis of these natural hazards and to discuss how they have been treated so far to bring out some commonalities and differences. The breadth of our study makes it difficult to go into great detail on each aspect covered here; hence the focus lies on providing an overview and on citing key literature. We find that in current probabilistic approaches to the problem, uncertainties are all too often treated as if, at some fundamental level, they are aleatory in nature. This can be a tempting choice when knowledge of more complex structures is difficult to determine but not acknowledging the epistemic nature of many sources of uncertainty will compromise any risk analysis. We do not imply that probabilistic uncertainty estimation necessarily ignores the epistemic nature of uncertainties in natural hazards; expert elicitation for example can be set within a probabilistic framework to do just that. However, we suggest that the use of simple aleatory distributional models, common in current practice, will underestimate the potential variability in assessing hazards, consequences, and risks. A commonality across all approaches is that every analysis is necessarily conditional on the assumptions made about the nature of the sources of epistemic uncertainty. It is therefore important to record the assumptions made and to evaluate their impact on the uncertainty estimate. Additional guidelines for good practice based on this review are suggested in the companion paper (Part 2).
Epistemic uncertainties and natural hazard risk assessment – Part 2: What should constitute good practice?
Authors: Beven Keith J. , Aspinall Willy P. , Bates Paul D. , Borgomeo Edoardo , Goda Katsuichiro , Hall Jim W. , Page Trevor , Phillips Jeremy C. , Simpson Michael , Smith Paul J. , Wagener Thorsten , Watson Matt 
Published: October 2018

Abstract. Part 1 of this paper has discussed the uncertainties arising from gaps in
knowledge or limited understanding of the processes involved in different
natural hazard areas. Such deficits may include uncertainties about
frequencies, process representations, parameters, present and future boundary
conditions, consequences and impacts, and the meaning of observations in
evaluating simulation models. These are the epistemic uncertainties that can
be difficult to constrain, especially in terms of event or scenario
probabilities, even as elicited probabilities rationalized on the basis of
expert judgements. This paper reviews the issues raised by trying to quantify
the effects of epistemic uncertainties. Such scientific uncertainties might
have significant influence on decisions made, say, for risk management, so it
is important to examine the sensitivity of such decisions to different
feasible sets of assumptions, to communicate the meaning of associated
uncertainty estimates, and to provide an audit trail for the analysis. A
conceptual framework for good practice in dealing with epistemic
uncertainties is outlined and the implications of applying the principles to
natural hazard assessments are discussed. Six stages are recognized, with
recommendations at each stage as follows: (1) framing the analysis, preferably with
input from potential users; (2) evaluating the available data for epistemic uncertainties,
especially when they might lead to inconsistencies; (3) eliciting information on sources
of uncertainty from experts; (4) defining a workflow that will give reliable and accurate
results; (5) assessing robustness to uncertainty, including the impact on any
decisions that are dependent on the analysis; and (6) communicating the findings and meaning
of the analysis to potential users, stakeholders, and decision makers. Visualizations are
helpful in conveying the nature of the uncertainty outputs, while recognizing that the
deeper epistemic uncertainties might not be readily amenable to visualizations.
Proximal Interphalangeal Joint Arthroplasty in Young Patients
Authors: Wagner Eric R. , Robinson William A. , Houdek Matthew T. , Moran Steven L. , Rizzo Marco 
Published: October 2018

Introduction:
This investigation compares the outcomes of proximal interphalangeal (PIP) arthroplasty in patients older than and younger than 60 years.

Methods:
Overall, 299 consecutive, primary PIP arthroplasties were performed over a 14-year period, including 126 arthroplasties performed in patients younger than 60 years. In younger patients group, a higher rate of posttraumatic and inflammatory arthritis was observed.

Results:
In patients younger than 60 years, 32 (25%) revision surgeries occurred. Risk of revision surgery was associated with younger age. The 10-year implant survival rate was 72% for the patients younger than 60 years versus 86% for those older than 60 years. Silicone implants decreased the risk of revision surgery, although it was increased in posttraumatic arthritis. The most common complication in young patients was dislocation (n = 21). At a mean follow-up of 6.4 years, pain levels had significantly improved in patients younger than 60 years, and PIP range of motion and pinch strength were maintained. However, older patients had improved PIP motion compared with younger patients.

Conclusions:
Younger age leads higher revision rates after PIP arthroplasty, particularly in the posttraumatic setting.

Level of Evidence:
Therapeutic, level III
The Association of Financial Distress With Disability in Orthopaedic Surgery
Authors: Mertz Kevin , Eppler Sara L. , Thomas Kevin , Alokozai Aaron , Yao Jeffrey , Amanatullah Derek F. , Chou Loretta , Wood Kirkham B. , Safran Marc , Steffner Robert , Gardner Michael , Kamal Robin N. 
Published: October 2018

Introduction:
Increased out-of-pocket costs have led to patients bearing more of the financial burden for their care. Previous work has shown that financial burden and distress can affect outcomes, symptoms, satisfaction, and adherence to treatment. We asked the following questions: (1) Does patients' financial distress correlate with disability in patients with nonacute orthopaedic conditions? (2) Do patient demographic factors affect this correlation?

Methods:
We conducted a cross-sectional, observational study of new patients presenting to a multispecialty orthopaedic clinic with a nonacute orthopaedic complication. Patients completed a demographics questionnaire, the InCharge Financial Distress/Financial Well-Being Scale, and the Health Assessment Questionnaire Disability Index. Statistical analysis was done using Pearson's correlation.

Results:
The mean score for financial distress was 4.10 (SD, 2.09; scale 1 [low distress] to 10 [high distress]; range, 1.13 to 10.0), and the mean disability score was 0.54 (SD, 0.65; scale 0 to 3; range, 0 to 2.75). A moderate positive correlation exists between financial distress and disability (r = 0.43; P < 0.01). Financial distress and disability were highest for poor, uneducated, Medicare patients.

Conclusions:
A moderate correlation exists between financial distress and disability in patients with nonacute orthopaedic conditions, particularly in patients with low socioeconomic status. Orthopaedic surgeons may benefit from identifying patients in financial distress and discussing the cost of treatment because of its association with disability and potentially inferior outcomes. Further investigation is needed to test whether decreasing financial distress decreases disability.

Level of Evidence:
Level III prospective cohort
Follow-up after acute Pulmonary Embolism
Authors: Barco Stefano , Klok Frederikus 
Published: October 2018

SummaryIn addition to among others major bleeding from anticoagulant therapy and recurrent venous thromboembolism (VTE), patients who survived acute pulmonary embolism (PE) face an increased risk of chronic functional limitations and decreased quality of life. In recent years, this latter complications have been better framed within the evolving definition of “post-PE syndrome” of which chronic thromboembolic pulmonary hypertension (CTEPH) represents the most extreme presentation. The post-PE syndrome in all its aspects is a frequent and clinically relevant long-term complication of PE but -except for CTEPH- has been largely understudied. There is great need to better define and understand the natural course of acute PE, to predict the development of the post-PE syndrome and to evaluate the potential benefits evolving treatments such as cardiopulmonary rehabilitation.
Diagnosis of acute Pulmonary Embolism
Authors: Robert-Ebadi Helia , Righini Marc 
Published: October 2018

SummaryDuring the last three decades, considerable advances in the management of patients with suspected pulmonary embolism (PE) have improved diagnostic accuracy and made management algorithms safer, easier to use and well standardized. These diagnostic algorithms are mainly based on the assessment of clinical pretest probability, D-Dimer measurement and imaging tests, mainly computed tomography pulmonary angiography (CTPA). These diagnostic algorithms allow a safe and cost-effective diagnosis for most patients with suspected PE.In this review, we discuss current existing evidence for PE diagnosis, the challenge of diagnosing PE in special patient populations, as well as novel imaging tests for PE diagnosis.
Het fideicommis en temporele problemen bij plaatsvervulling voor verwachters
Authors: Brinkman R.E. 
Published: October 2018

Het fideicommis en temporele problemen bij plaatsvervulling voor verwachters
In dit artikel worden enkele problemen besproken bij plaatsvervullings- en aanwasregelingen in fideicommissen. De problemen kunnen ontstaan door gebeurtenissen (zoals het overlijden van de eerstaangewezen verwachter) hangende de voorwaarde.
Testeren door minderjarigen en de maatschappelijke behoefte van artikel 4:58 BW
Authors: de Jonge H.J. 
Published: October 2018

Testeren door minderjarigen en de maatschappelijke behoefte van artikel 4:58 BW
Minderjarigen die de leeftijd van 16 jaar hebben bereikt, kunnen uiterste wilsbeschikkingen maken. Uit cijfers verstrekt door de KNB blijkt dat op jaarbasis gemiddeld enkele tientallen testamenten door minderjarigen worden opgesteld. Dat was onder het oude erfrecht al zo. Indien een minderjarige testeert, mag hij op grond van artikel 4:58 BW geen uiterste wilsbeschikking maken ten voordele van zijn leermeester, met wie hij tezamen woont. In de literatuur wordt gesteld dat artikel 4:58 BW thans vrijwel achterhaald is en nauwelijks nog betekenis heeft. Ondanks het feit dat de resultaten van een door mij verricht praktijkonderzoek anders laten zien dan de heersende opvatting in de literatuur, ben ik het met deze stelling eens. Naar mijn mening is er voldoende reden om te stellen dat artikel 4:58 BW thans niet meer in een maatschappelijke behoefte voorziet. Daarnaast is er de bijstand van een notaris bij het opstellen van uiterste wilsbeschikkingen om ongewenste beïnvloeding van de testateur te voorkomen.
Measurements of 50 Non-polar Organic Compounds Including Polycyclic Aromatic Hydrocarbons, n-Alkanes and Phthalate Esters in Fine Particulate Matter (PM2.5) in an Industrial Area of Chiba Prefecture, Japan
Authors: Ichikawa Yujiro , Watanabe Takehisa , Horimoto Yasuhide , Ishii Katsumi , Naito Suekazu 
Published: October 2018

Abstract
Quantitative data of 50 non-polar organic compounds constituting PM2.5 were continuously collected and analyzed from June 2016 to October 2017 (approximately 17 months) at Ichihara, one of the largest industrial areas in Japan. Target non-polar organic compounds including 21 species of polycyclic aromatic hydrocarbons (PAHs), 24 species of n-alkanes and 5 species of phthalate esters (PAEs) were simultaneously measured by gas chromatography/mass spectrometry. Basically, the average concentrations of the total PAHs, n-alkanes and PAEs in each season remained nearly level, and seasonal variations were little throughout the study period. These results suggest that the emission sources, which are not influenced by the seasons, are the dominant inputs for the target organic compounds. Diagnostic ratios of PAHs, assessment of n-alkane homologue distributions, carbon preference index, and the contribution of wax n-alkanes from plants were used to estimate source apportionments. These results indicate that anthropogenic sources were the main contributor for most PAHs and n-alkanes throughout the study period. The concentrations of PAEs selected in this study were low because emission amounts of these chemicals were little within the source areas of the sampling site. To our knowledge, this study is the first attempt to simultaneously measure a high number of non-polar organic compounds in PM2.5 collected from the ambient air of Japan, and the resultant data will provide valuable data and information for environmental researchers.
Molecular Testing for Cutaneous Melanoma: An Update and Review
Authors: Lee Jonathan J. , Lian Christine G. 
Published: October 2018

Context.—The steady rise in the incidence of cutaneous malignant melanoma and its inherently difficult-to-interpret histopathology continues to fuel an increasing demand for diagnostically and prognostically insightful adjunctive molecular tests among both clinicians and dermatopathologists. A number of DNA, RNA, and epigenetically based assays have now been developed and are at various stages of experimental and/or clinical use.Objective.—To examine the evidence for the utility and limitations of these leading candidates for the diagnosis and risk stratification of melanoma and related melanocytic neoplasms.Data Sources.—The available English medical literature was reviewed in the preparation of this manuscript.Conclusions.—Comparative genomic hybridization, fluorescence in situ hybridization, RNA-based gene expression profiling, and immunohistochemical assays for novel genetic and epigenetic markers will help bring diagnostic and prognostic accuracy to the assessment of melanocytic neoplasms.
A avaliação em um discurso do presidente Michel Temer: uma análise a partir dos recursos de gradação
Authors: Farencena Gessélda Somavilla , Santos Marli Ferraz dos 
Published: October 2018

O presente trabalho é o resultado de uma análise do discurso do Presidente da República, Michel Temer, proferido durante a cerimônia de comemoração do Dia Internacional da Mulher de 2017. A questão principal deste estudo foi verificar como os recursos de gradação contribuíam para a construção da avaliação e para a caracterização do discurso quanto ao grau de envolvimento do Presidente. Nesse intuito, adotamos como principal aporte teórico o Sistema de Avaliatividade (WHITE, 2004; MARTIN; WHITE, 2015), de modo especial o subsistema de gradação. Resultados mostraram a predominância de recursos de gradação do tipo força intensificação que contribuíram para construir a ideia de assertividade do discurso.
Are seductive details seductive only when you think they are relevant? An experimental test of the moderating role of perceived relevance
Authors: Eitel Alexander , Bender Lisa , Renkl Alexander 
Published: October 2018

SummaryWe investigated whether seductive details (i.e., interesting but irrelevant adjuncts) are harmful to learning only when students (mistakenly) think that they are relevant. We therefore conducted a study in which participants (N = 86) learned either without seductive details (control condition) or with seductive details—in the latter case with or without being informed about the seductive details' irrelevance. In line with our hypotheses, only participants who were not informed about the irrelevance of seductive details revealed worse learning outcomes than those in the control condition, thereby revealing a seductive details effect. Extraneous cognitive load, but not perceived time pressure, mediated the negative effects of being uninformed about the irrelevance of seductive details on learning outcomes. Taken together, our results suggest that the perceived relevance of seductive details is a boundary condition of the seductive details effect.
Distributing mathematical practice of third and seventh graders:Applicability of the spacing effect in the classroom
Authors: Barzagar Nazari Katharina , Ebersbach Mirjam 
Published: October 2018

SummaryWe examined the effect of distributed practice on the mathematical performance of third and seventh graders (N = 213) in school. Students first received an introduction to a mathematical topic, derived from their curriculum. Thereafter, they practiced in one of two conditions. In the massed condition, they worked on three practice sets in 1 day. In the distributed condition, they worked on one practice set per day for 3 consecutive days. Bayesian analyses of the performance in two follow‐up tests 1 and 6 weeks after the last practice set revealed a positive effect of distributed practice as compared with massed practice in Grade 7. In Grade 3, a positive effect of distributed practice was supported by the data only in the test 1 week after the last practice set. The results suggest that distributed practice is a powerful learning tool for both elementary and secondary school students in the classroom.