bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modified conditioning regimen improves outcomes of unrelated donor peripheral blood stem cell transplantation for β‐thalassaemia major patients
Authors: Huang Ke , Zhou Dun‐Hua , Li Yang , Xu Hong‐Gui , Que Li‐Ping , Chen Chun , Xue Hong‐Man , Guo Hai‐Xia , Weng Wen‐jun , Huang Shao‐Liang , Fang Jian‐Pei 
Published: March 2018

AbstractBackgroundThe objective of this study was to evaluate the feasibility of a modified conditioning regimen for the treatment of patients with β‐thalassaemia major (TM), using unrelated donor peripheral blood stem cell transplantation (UD‐PBSCT).MethodsA modified conditioning regimen based on intravenous busulfan, cyclophosphamide, fludarabine, and antithymocyte globulin was performed in 50 consecutive childhood patients with β‐TM and a median age of 4.6 years (range, 2–12 years). According to Pesaro's classification, three classes of risk are identified using the criteria of degree of hepatomegaly, portal fibrosis, and quality of the chelation treatment. Patients with three adverse criteria constituted class III, none of the adverse criteria constituted class I, and one or two of the adverse criteria formed class II. Ten patients were class I, 36 class II, and four class III. All patients were transplanted with UDs containing 37 of 10/10 human leukocyte antigen (HLA)‐matched pairs, 11 of 9/10 matched pairs, and two of 8/10 matched pairs. The median follow‐up was 36 months (range, 9–96 months).ResultsAll patients successfully achieved engraftment, two of whom developed persistent thrombocytopaenia. The incidence of acute graft‐versus‐host disease (aGVHD) grade III‐IV and chronic graft‐versus‐host disease (cGVHD) were 12% and 8%, respectively. However, 8.3% of HLA‐matched and 15.4% of HLA‐mismatched patients developed aGVHD. The incidence of severe bacterial infections and fungal pneumonia was 12% and 20%, respectively. The 3‐year overall survival, disease‐free survival, graft rejection, and transplant‐related mortality were 94%, 92%, 2%, and 6%, respectively.ConclusionThis modified conditioning protocol effectively improved outcomes of UD‐PBSCT for patients with β‐TM.
Risk of sudden sensorineural hearing loss in adults using phosphodiesterase type 5 inhibitors: Population‐based cohort study
Authors: Liu Wei , Antonelli Patrick J. , Dahm Philipp , Gerhard Tobias , Delaney Joseph A.C. , Segal Richard , Crystal Stephen , Winterstein Almut G. 
Published: March 2018

AbstractPurposeThe objective of the study was to determine the risk of sudden sensorineural hearing loss (SNHL) associated with use of phosphodiesterase type 5 (PDE5) inhibitors.MethodsWe conducted a retrospective cohort study in the MarketScan Commercial Claims and Encounters Database including adult men who initiated a PDE5 inhibitor (n = 377,722) and 1,957,233 nonusers between 1998 and 2007. Periods of drug exposure were assessed on a weekly basis based on pharmacy billing records, assuming use of 1 dose per week (current use). Incident sudden SNHL was defined based on inpatient or outpatient visits with International Classification of Diseases, Ninth Revision, Clinical Modification codes 389.1x, 389.2x, or 388.2 plus ≥2 procedure codes for audiometric hearing testing within ±30 days of sudden SNHL diagnosis. We used age‐ and propensity score‐adjusted Cox proportional hazards model to evaluate the risk of sudden SNHL during periods of current or recent use compared with that of nonuse. We conducted sensitivity analyses by varying the assumed drug utilization frequency and sudden SNHL case definition.ResultsWe evaluated 1233 sudden SNHL cases, resulting in an incidence of 4.35, 5.58, and 2.38 per 10,000 person‐years for current, recent, and nonuse of PDE5 inhibitors, respectively. Compared with nonuse, the adjusted hazard ratio was 1.25 (1.01‐1.55) for current use with a risk difference of 1.97 (1.12‐2.82) per 10,000 person‐years. For recent use, the adjusted hazard ratio was 1.60 (1.33‐1.94) and risk difference was 3.19 (2.24‐4.14). Estimates were consistent across the sensitivity analyses.ConclusionsUse of PDE5 inhibitors is associated with a small but significantly increased risk of sudden SNHL.
Surface protein components from entomopathogenic nematodes and their symbiotic bacteria: effects on immune responses of the greater wax moth, Galleria mellonella (Lepidoptera: Pyralidae)
Authors: Brivio Maurizio Francesco , Toscano Andrea , De Pasquale Simone Maria , De Lerma Barbaro Andrea , Giovannardi Stefano , Finzi Giovanna , Mastore Maristella 
Published: March 2018

AbstractBACKGROUNDSteinernema carpocapsae is a nematocomplex widely used as an alternative to chemicals for the biological control of insect pests; this nematode is symbiotically associated with the bacterium Xenorhabdus nematophila and both contribute to host death. The architecture and functions of structures and molecular components of the surface of nematodes and their symbiont bacteria are integral to early interactions with their hosts; thus, we assessed the role of protein pools isolated from the surface of S. carpocapsae and from phase I X. nematophila against Galleria mellonella.RESULTSUsing high‐salt treatments, we isolated the surface proteins and assayed them on G. mellonella haemocytes; haemocyte viability and phagocytic activity were investigated in the presence of surface proteins from nematodes or bacteria. Proteins from live S. carpocapsae possessed mild cytotoxicity on the haemocytes, whereas those from live X. nematophila markedly affected the host cells' viability. Bacterial proteins inhibited phagocytic activity, although they strongly triggered the host proPO (prophenoloxidase‐phenoloxidase) system.CONCLUSIONNematocomplex surface compounds play a key role in immunoevasion/depression of insect hosts, causing a severe physiological disorder. Natural compounds newly identified as active against pests could improve the pest management of species potentially harmful to plants in urban green spaces and agriculture. © 2018 Society of Chemical Industry
Analysis of an iterative scheme for approximate regulation for nonlinear systems
Authors: Aulisa E. , Gilliam D.S. , Pathiranage T.W. 
Published: March 2018

SummaryThis paper concerns the analysis of an iterative scheme delivering approximate control laws for the tracking regulation problems for nonlinear systems. The procedure can be applied to finite‐ and infinite‐dimensional systems, and the underlying methodology derives from the geometric methods, which have been developed for both linear and nonlinear systems. In the nonlinear case, the main tool is the center manifold theorem. Indeed, in the geometric methodology, under the assumption that the signals to be tracked are generated by a finite‐dimensional exo‐system, the desired control is obtained by solving a pair of operator equations called the regulator equations. In this paper, we extend the concept of regulator equations to what we refer to as the dynamic regulator equations. Just as it is generally quite difficult to solve the regulator equations, it can be equally difficult to solve the dynamic regulator equations. As the authors have already shown in the linear case, a straightforward attempt to solve the dynamic regulator equations leads to a singular system, which can be regularized to obtain an iterative scheme that provides approximate control laws that provide accurate tracking with very a small tracking error after only a couple of iterations. In this paper, we generalize the iterative scheme to nonlinear systems and provide error estimates for the first 3 iterations. Both finite‐ and infinite‐dimensional examples are given to validate the estimates. We comment that the method has also been applied to a wide range of nonlinear distributed parameter examples described in the references.
Genetic diversity of phalaris arundinacea populations in relation to river regulation in the Merkys basin, Lithuania
Authors: Anderson N. O. , Jocienė L. , Krokaitė E. , Rekašius T. , Paulauskas A. , Kupčinskienė E. 
Published: March 2018

AbstractDuring the 1950s–1960s, the Merkys river basin, the largest protected area of Lithuania, underwent severe anthropogenic regulations. Within the Baltic States, the genetic diversity of Phalaris arundinacea populations is unknown and how they might be affected by anthropogenic activities such as river regulation. The objectives of this study were to compare molecular parameters (SSRs or microsatellite loci) within and among populations from natural river fragments with populations from regulated river parts. Study populations have greater genetic diversity within, rather than among, populations. The upstream portion of the Merkys basin populations had lower genetic diversity compared with further downstream. The mean number of polymorphic SSR loci was lower for populations from regulated parts of the river basin compared with natural ones. Main principle coordinate analysis revealed populations of regulated rivers at marginal positions. Bayesian clustering showed that current populations are admixtures of 3 distinct genetic groups, based on STRUCTURE analysis (K = 3 groupings) in geographic subdivisions of (a) downstream populations (Varėnė, Verseka, Upper Grūda, Lower Grūda, Upper Merkys, Lower Merkys), (b) upstream populations (Upper Šalčia, Beržė, Lower Šalčia, Visinčia, Lower Šaltykščia, Nedilė), and (c) the 2 regulated sites in the distinct geographic area of Taurupis and Upper Šaltykščia. P. arundinacea in the Merkys river basin does not all belong to a single, random‐mating population encompassing its tributaries or among populations across its geographic scales. In several instances, river regulation might impair the genetic diversity of P. arundinacea populations.
Fault‐based test generation for regular expressions by mutation
Authors: Arcaini Paolo , Gargantini Angelo , Riccobene Elvinia 
Published: March 2018

SummaryRegular expressions are used to characterize sets of strings (ie, languages) using a pattern‐based syntax. They are applied in different contexts as, for example, data validation in Web forms. However, writing a regular expression that exactly captures the desired set of strings could be particularly difficult, and techniques are sought to validate regular expressions or test their use in applications. A common means to regular expression validation and testing is the generation of a set of labelled strings (ie, strings together with their evaluation).We here propose a fault‐based approach for generating strings usable as tests for regular expressions. We define some fault classes representing mistakes that could be made when writing a regular expression, and we introduce the notion of distinguishing string, ie, a string that is able to expose a fault. Given a regular expression, our approach generates a test suite composed of distinguishing strings that are able to detect possible faults in the regular expression. We present different versions of the approach, which provide different results in terms of test suite size and generation time. Experiments show that the proposed approach can generate compact test suites and that, using suitable optimizations, the generation time is reasonable.Exploiting the proposed fault classes, we use the notion of mutation score to assess the ability of a generic set of strings in exposing possible faults contained in the regular expression under test. A comparison with other test generation tools in terms of mutation score, size, and generation time shows the advantages and limits of our approach.
Mindfulness Among Genetic Counselors Is Associated with Increased Empathy and Work Engagement and Decreased Burnout and Compassion Fatigue
Authors: Silver Julia , Caleshu Colleen , Casson‐Parkin Sylvie , Ormond Kelly 
Published: March 2018

AbstractGenetic counselors experience high rates of compassion fatigue and an elevated risk for burnout, both of which can negatively impact patient care and retention in the profession. In other healthcare professions, mindfulness training has been successfully used to address similar negative psychological sequelae and to bolster empathy, which is the foundation of our counseling work. We aimed to assess associations between mindfulness and key professional variables, including burnout, compassion fatigue, work engagement, and empathy. Data were collected via an anonymous, online survey that included validated measures of mindfulness and these key professional variables. The survey was completed by 441 genetic counselors involved in direct patient care. Half of the respondents (50.1%) reported engaging in yoga, meditation, and/or breathing exercises. Mindfulness was positively correlated with work engagement (r = 0.24, p < 0.001) and empathy (as measured through four subscales: perspective taking (r = 0.15,p = 0.002), empathic concern (r = 0.11,p = 0.03), fantasy (r = − 0.11,p = 0.03) and personal distress (r = − 0.15,p = 0.001)). Mindfulness was negatively correlated with compassion fatigue (r = − 0.48,p < 0.001) and burnout (r = − 0.50,p < 0.001). Given these findings, mindfulness training may be a valuable addition to graduate and continuing education for genetic counselors. The integration of mindfulness into the genetic counseling field will likely improve professional morale and well‐being, while promoting workforce retention and bolstering the relational and counseling aspects of our clinical work.
Long-term effect of prenatal exposure to malnutrition on risk of schizophrenia in adulthood: Evidence from the Chinese famine of 1959–1961
Authors: He Ping , Chen Gong , Guo Chao , Wen Xu , Song Xinming , Zheng Xiaoying 
Published: March 2018

AbstractBackground:Schizophrenia is a common major mental disorder and prenatal nutritional deficiency may increase its risk. We aimed to investigate long-term impact of prenatal exposure to malnutrition on risk of schizophrenia in adulthood using the Chinese famine of 1959–1961 as a natural experiment.Methods:We obtained data from the Second National Sample Survey on Disability implemented in 31 provinces in 2006, and restricted our analysis to 387,093 individuals born from 1956 to 1965. Schizophrenia was ascertained by psychiatrists based on the International Statistical Classification of Diseases, Tenth Revision. Famine severity was defined as cohort size shrinkage index. The famine effect on adult schizophrenia was estimated by difference-in-difference models, established by examining the variations of famine exposure across birth cohorts.Results:Compared with the reference cohort of 1965, famine cohorts (1959–1962) had significantly higher odds (OR: 1.84; 95% CI: 1.13, 3.00; P = 0.014) of schizophrenia in the rural population. After adjusting for multiple covariates, this association remained significant (OR: 1.82; 95% CI: 1.11, 2.98; P = 0.018). We did not observe statistically significant differences in odds of schizophrenia among famine cohorts compared with the reference cohort in the urban population.Conclusions:Prenatal malnutrition exposure has a detrimental impact on risk of schizophrenia in adulthood in the rural population. Further studies were needed to investigate corresponding mechanisms on this topic.
Altered anatomical connections of associative and limbic cortico-basal-ganglia circuits in obsessive-compulsive disorder
Authors: Haynes William I.A. , Clair Anne-Hélène , Fernandez-Vidal Sara , Gholipour Bahar , Morgiève Margot , Mallet Luc 
Published: March 2018

AbstractBackground:Current neurocognitive models suppose dysfunctions of associative and limbic cortico-basal ganglia circuits to be at the core of obsessive-compulsive disorder (OCD). As little is known about the state of underlying anatomical connections, we investigated whether these connections were reduced and/or not properly organised in OCD patients compared to control.Methods:Diffusion magnetic resonance images were obtained in 37 OCD patients with predominant checking symptoms and 37 matched healthy controls. We developed indices to characterise the quantity (spatial extent and density) and the organisation (topography and segregation) of 24 anatomical connections between associative and limbic cortical (anterior cingulate, dorsolateral prefrontal, orbitofrontal cortices and the frontal pole), and subcortical (caudate nucleus, putamen and thalamus) areas in each hemisphere.Results:Associative and limbic cortico-basal-ganglia connections were reduced in OCD patients compared to controls: 19/24 connections had a reduced subcortical spatial extent, 9/24 had a reduced density. Moreover, while the general topography was conserved, the different cortical projection fields in the striatum and thalamus were hyper-segregated in OCD patients compared to controls.Conclusion:These quantitative and qualitative differences of anatomical connections go beyond the current model of a reduced cortical control of automatic behaviour stored in the basal ganglia. The hyper-segregation in OCD could also impair the integration of cortical information in the thalamus and striatum and distort the subsequent behavioural selection process. This provides new working hypotheses for functional and behavioural studies on OCD.
Measuring costs of community mental health care in Italy: A prevalence-based study
Authors: Senese F. , Rucci P. , Fantini M.P. , Gibertoni D. , Semrov E. , Nassisi M. , Messina R. , Travaglini C. 
Published: March 2018

AbstractBackground:Information on individual mental healthcare costs and utilization patterns in Italy is scant. We analysed the use and the annual costs of community mental health services (MHS) in an Italian local health authority (LHA). Our aims are to compare the characteristics of patients in the top decile of costs with those of the remaining 90%, and to investigate the demographic and clinical determinants of costs.Methods:This retrospective study is based on administrative data of adult patients with at least one contact with MHS in 2013. Costs of services were estimated using a microcosting method. We defined as high cost (HC) those patients whose community mental health services costs place them in the top decile of the cost distribution. The predictors of costs were investigated using multiple linear regression.Results:The overall costs borne for 7601 patients were 17 million €, with HC accounting for 87% of costs and 73% of services. Compared with the rest of the patients, HC were younger, more likely to be male, to have a diagnosis of psychosis, and longer and more intensive MHS utilization. In multiple linear regression, younger age, longer duration of contact with MHS, psychosis, bipolar disorder, personality disorder, depression, dementia and Italian citizenship accounted for 20.7% of cost variance.Conclusion:Direct mental health costs are concentrated among a small fraction of patients who receive intensive socio-rehabilitation in community services. One limitation includes the unavailability of hospital costs. Our methodology is replicable and useful for national and cross-national benchmarking.
Sovereign credit and political survival in democracies
Authors: DiGiuseppe Matthew , Shea Patrick E. 
Published: March 2018

AbstractModels of distributive politics often assume that fixed budgets constrain the efforts of incumbents to retain power. Yet, significant variation exists in politicians' abilities to push distributive costs forward by funding current fiscal policy through sovereign borrowing. This article theorizes how and when variation in sovereign credit access influences the central goal of democratic incumbents: political survival. Credit allows incumbents to reward supporters without immediately extracting domestic revenue. Excessive borrowing, however, risks higher interest rates or possible market exclusion. Considering sovereign borrowing's benefits and costs, we argue that the marginal effect of credit access on political survival is greatest for those incumbents that require other parties to implement fiscal policy. An analysis of incumbent party tenure in seventy-one democracies from 1977–2007 demonstrates that affordable sovereign finance is associated with longer tenures under divided government but has no significant effect on survival under unified governments.
Ectopic pregnancy outcomes in patients discharged from the emergency department
Authors: Hawrylyshyn Krista , McLeod Shelley L. , Thomas Jackie , Varner Catherine 
Published: March 2018

AbstractObjectiveThe objective of this study was to determine the proportion of women who had a ruptured ectopic pregnancy after being discharged from the emergency department (ED) where ectopic pregnancy had not yet been excluded.MethodsThis was a retrospective chart review of pregnant (<12-week gestational age) women discharged home from an academic tertiary care ED with a diagnosis of ectopic pregnancy, rule-out ectopic pregnancy, or pregnancy of unknown location over a 7-year period.ResultsOf the 550 included patients, 83 (15.1%) had a viable pregnancy, 94 (17.1%) had a spontaneous or missed abortion, 230 (41.8%) had an ectopic pregnancy, 72 (13.1%) had unknown outcomes, and 71 (12.9%) had other outcomes that included therapeutic abortion, molar pregnancy, or resolution of βHCG with no location documented. Of the 230 ectopic pregnancies, 42 (7.6%) underwent expectant management, 131 (23.8%) were managed medically with methotrexate, 29 (5.3%) were managed with surgical intervention, and 28 (5.1%) patients had a ruptured ectopic pregnancy after their index ED visit. Of the 550 included patients, 221 (40.2%) did not have a transvaginal ultrasound during their index ED visit, and 73 (33.0%) were subsequently diagnosed with an ectopic pregnancy.ConclusionThese results may be useful for ED physicians counselling women with symptomatic early pregnancies about the risk of ectopic pregnancy after they are discharged from the ED.
Creation of a national emergency medicine enhanced competency directory for residency training
Authors: Argintaru Niran , Baylis Jared , Pritchard Jodie , Mulla Ali , Gray Alice , Hart Alexander , Bova Christina , Armstrong Teri-Leigh , Taher Ahmed 
Published: March 2018

AbstractCanadian emergency medicine Royal College residency training allows for pursuing extra training in enhanced competency areas. A wealth of enhanced competency training opportunities exist nationally. However, the search for the right fit is a challenging one because there is no centralized resource that catalogues all of these opportunities. A working group of the Canadian Association of Emergency Physicians (CAEP) Resident Section was assembled in 2016 to create a freely accessible and comprehensive directory of Canadian enhanced competency areas. The working group used stakeholder surveys (of residents, recent graduates, and faculty members), social media engagement, and program website searches. Information was collated into the first edition of a national enhanced competency directory, which is available at no cost at http://caep.ca/sites/caep.ca/files/enhancedcompdoc.pdf. Limitations include the scope defined by the working group and survey responses. A biannual update is also incorporated into the CAEP Resident Section portfolio to ensure it remains up-to-date.