bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effects of Abdominal Massage in the Management of Constipation in Elderly People
Authors: Baran Ayşe , Ateş Sebahat 
Published: April 2019

Objective:
This study was conducted to evaluate the efficacy of abdominal massage in the management of age-related constipation.

Subject and Methods:
Thirty participant control groups and 30 other participants constituted the treatment group. When the abdominal massage was applied to the treatment group for 15 minutes for 4 weeks, it was not applied to the control group.

Results:
As a result of applying abdominal massage for 4 weeks, both groups had a significant increase in the diagnostic criteria of Rome III. According to Bristol Stool Scale, the constipation problems were improved in the treatment group.

Conclusions:
Abdominal massage has been found as an effective method for the management of constipation commonly seen in the elderly.
Building Legitimacy by Valuing the Expert Opinion in the Conservative Treatment of Thumb Carpometacarpal Joint Osteoarthritis
Authors: Cantero-Téllez Raquel , Valdes Kristin , O'Brien Virgina , Berjano Pedro , Pedersini Paolo , Villafañe Jorge Hugo 
Published: April 2019

Background:
This article describes and provide information regarding the expert opinion on the conservative treatment of thumb carpometacarpal (CMC) joint osteoarthritis (OA). The aim of this study was to elucidate expert opinion on the conservative treatment of thumb CMC joint OA.

Methods:
A 21-item survey to determine the practice patterns of international hand researchers who treat arthritis of the CMC joint was developed and distributed through a professional online survey service to ensure confidentiality and anonymity.

Results:
All experts assessed the intensity of pain in CMC joint OA, and the visual analog scale was the method that was most frequently used by 87.5% of respondents.

Conclusions:
This survey provides valuable data regarding current practice patterns by valuing the expert opinion on the conservative treatment of thumb CMC joint OA.
Efficacy and Safety of Empagliflozin in the Management of Diabetes Mellitus in Heart Transplant Recipients
Authors: Cehic Matthew G. , Muir Christopher A. , Greenfield Jerry R. , Hayward Christopher , Jabbour Andrew , Keogh Anne , Kotlyar Eugene , Muthiah Kavitha , Macdonald Peter S. 
Published: April 2019

Background.Type 2 diabetes mellitus (T2DM) is prevalent in patients undergoing heart transplant, and in those without preexisting T2DM, posttransplant diabetes mellitus may develop. Both T2DM and posttransplant diabetes mellitus have been associated with increased morbidity and mortality following heart transplantation. Empagliflozin is an effective glucose-lowering therapy that reduces the incidence of major cardiovascular events in patients with T2DM. The safety and efficacy of empagliflozin in transplant patients with diabetes mellitus has yet to be established.Methods.Clinical outcomes were retrospectively examined in 22 heart transplant recipients treated with empagliflozin and compared with those of 79 heart transplant patients with diabetes mellitus receiving alternative glucose-lowering therapies.Results.Three adverse events were recorded in empagliflozin-treated patients, leading to treatment discontinuation in 1. There were no genitourinary infections. Treatment with empagliflozin for 12 months was associated with reductions in weight, body mass index, glycated hemoglobin, and frusemide dose that were not seen in the control group. There were no large changes observed in blood pressure (systolic or diastolic) or renal function (serum urea, creatinine, or estimated glomerular filtration rate) after 12 months of treatment with empagliflozin or alternative glucose-lowering therapies.Conclusions.Empagliflozin appears safe and effective in the management of selected patients with diabetes mellitus following heart transplantation.
Survival Outcomes Are Not Affected When Liver Transplant Surgery Is Done at Night, During Weekends, or Summer Months
Authors: Thuluvath Paul J. , Amjad Waseem , Savva Yulia , Thuluvath Avesh J. , LaMattina John 
Published: April 2019

Background.
It has been suggested that hospitalized patients may get suboptimal care in nights or on weekends or summer holidays due to sleep deprivation, physician fatigue, or reduced medical staffing. Our objective was to determine whether there were differences in outcomes when surgery was performed in the night (10 pm–6 am), on weekends (Saturday or Sunday), or during summer months (June–August).

Methods.
We used United Network for Organ Sharing (UNOS) data sets of adults transplanted between February 27, 2002, and September 30, 2016. We estimated the start time of liver transplant surgery by utilizing the cross-clamp time and cold ischemia time (cross-clamp time + cold ischemia time – 2 h). The survival outcomes were estimated by Kaplan-Meier survival analysis. Patients with hepatocellular carcinoma (HCC) were analyzed separately. The independent effect of time of transplant on outcomes was analyzed after adjusting for common confounders, including Model for End-stage Liver Diseases scores and transplant center volume.

Results.
During the study period, 4 434 (9.6%) were done in the night, 12 147 (26.4%) over weekends, and 11 976 (26%) during summer months. The graft and patient survival and complications were not influenced by the time of transplant for both HCC and non-HCC population. Cox regression analysis after adjusting for risk factors, including Model for End-stage Liver Diseases, donor risk index, and liver center volume, confirmed that there were no significant differences in outcomes.

Conclusions.
Our study showed that the time of transplant surgery whether done during nights, weekends, or summer months had no effect on graft or patient survival irrespective of center volume, patient, or donor risk factors.
A ride in the park: Cycling in different outdoor environments modulates the auditory evoked potentials
Authors: Scanlon Joanna E. M. , Redman Eden X. , Kuziek Jonathan W. P. , Mathewson Kyle E. 
Published: April 2019

AbstractIn this study, we investigated the effect of environmental sounds on ERPs during an auditory task, by having participants perform the same dual task in two different outdoor environments. Participants performed an auditory oddball task while cycling outside both in a quiet park and near a noisy roadway. While biking near the roadway, an increased N1 amplitude was observed when evoked by both standard and target tones. This may be due to attentional processes of enhancing sound processing in the noisier environment. No behavioural differences were found. Future directions include investigating auditory ERPs in more realistic studies outside of laboratory.
Google searches accurately forecast RSV hospitalizations
Authors: Althouse Benjamin M , Weinberger Daniel M , Scarpino Samuel V , Pitzer Virginia E , Ayers John W , Wenger Edward , Fung Isaac Chun-Hai , Dredze Mark , Hu Hao 
Published: April 2019

AbstractBackgroundHospitalization of children with respiratory syncytial virus (RSV) is common and costly. Traditional sources of hospitalization data, useful for public health decision-makers and physicians to make decisions, are themselves costly to acquire and are subject to delays from gathering to publication. Here we use Google searches for RSV as a proxy for RSV hospitalizations.MethodsSearches for “RSV” and numbers of RSV hospitalizations in WA, MD, FL, and CT were examined from 2004–2018. Running correlation coefficients and phase angles between search and hospitalizations were calculated. Various machine learning models were compared to assess the ability of searches to forecast hospitalizations. Using search data from all 50 US states, we use K-means clustering to identify RSV transmission clusters. We calculate the timing of the optimal timing of RSV prophylaxis initiation as the week beginning the 24-week period covering 95% of all RSV cases.ResultsHigh correlations (> 0.95) and low phase differences were seen between counts of hospitalizations and search volume in WA, MD, FL, and CT. Searching for RSV began in FL and radiated outward and three distinct transmission clusters were identified: the south and northeast, the northwest and Appalachia, and the center of the country. Calculated initiation dates for prophylaxis closely followed those calculated using traditional data sources (correlation = 0.84).ConclusionsThis work validates searches as a proxy for RSV hospitalizations. Search query surveillance of RSV is a rapid and no-cost addition to traditional RSV hospitalization surveillance and may be useful for medical and public health decision-making.
A microfabricated, 3D-sharpened silicon shuttle for insertion of flexible electrode arrays through dura mater into brain
Authors: Joo Hannah R. , Lan Fan Jiang , Chen Supin , Pebbles Jeanine A. , Liang Hexin , Chung Jason E. , Yorita Allison M. , Tooker Angela C. , Tolosa Vanessa M. , Geaghan-Breiner Charlotte , Roumis Demetris K. , Liu Daniel F. , Haque Razi , Frank Loren M. 
Published: April 2019

AbstractElectrode arrays for chronic implantation in the brain are a critical technology in both neuroscience and medicine. Recently, flexible, thin-film polymer electrode arrays have shown promise in facilitating stable, single-unit recordings spanning months in rats. While array flexibility enhances integration with neural tissue, it also requires removal of the dura mater, the tough membrane surrounding the brain, and temporary bracing to penetrate the brain parenchyma. Durotomy increases brain swelling, vascular damage, and surgical time. Insertion using a bracing shuttle results in additional vascular damage and brain compression, which increase with device diameter; while a higher-diameter shuttle will have a higher critical load and more likely penetrate dura, it will damage more brain parenchyma and vasculature. One way to penetrate the intact dura and limit tissue compression without increasing shuttle diameter is to reduce the force required for insertion by sharpening the shuttle tip. We describe a novel design and fabrication process to create silicon insertion shuttles that are sharp in three dimensions and can penetrate rat dura, for faster, easier, and less damaging implantation of polymer arrays. Sharpened profiles are obtained by reflowing patterned photoresist, then transferring its sloped profile to silicon with dry etches. We demonstrate that sharpened shuttles can reliably implant polymer probes through dura to yield high quality single unit and local field potential recordings for at least 95 days. On insertion directly through dura, tissue compression is minimal. This is the first demonstration of a rat dural-penetrating array for chronic recording. This device obviates the need for a durotomy, reducing surgical time and risk of damage to the blood-brain barrier. This is an improvement to state-of-the-art flexible polymer electrode arrays that facilitates their implantation, particularly in multi-site recording experiments. This sharpening process can also be integrated into silicon electrode array fabrication.
Machine learning predicts early-onset acute organ failure in critically ill patients with sickle cell disease
Authors: Mohammed Akram , Podila Pradeep S. B. , Davis Robert L. , Ataga Kenneth I. , Hankins Jane S. , Kamaleswaran Rishikesan 
Published: April 2019

AbstractBackgroundSickle cell disease (SCD) is a genetic disorder of the red blood cells, resulting in multiple acute and chronic complications including pain episodes, stroke, and kidney disease. Patients with SCD develop chronic organ dysfunction, which may progress to organ failure during disease exacerbations. Early detection of acute physiological deterioration leading to organ failure is not always attainable. Machine learning techniques that allow for prediction of organ failure may enable earlier identification and treatment, and potentially reduce mortality. We tested the hypothesis that machine learning physiomarkers could predict the development of organ dysfunction in an adult sample of patients with SCD admitted to intensive care units.Methods and FindingsWe studied 63 sequential SCD patients with 163 patient encounters, mean age 33.0±11.0 years, admitted to intensive care units, some of whom (6.7%) had pre-existing cardiovascular or kidney disease. A subset of these patient encounters (37; 23%) met sequential organ failure assessment (SOFA) criteria. The site of organ failure included: central nervous system (32), cardiovascular (11), renal (10), liver (7), respiratory (5) and coagulation (2) systems. Most (81.5%) of the patient encounters who experienced organ failure had single organ failure. The other 126 SCD patient encounters served as controls. A set of signal processing features (such as fast fourier transform, energy, continuous wavelet transform, etc.) derived from heart rate, blood pressure, and respiratory rate were identified to distinguish patients with SCD who developed acute physiological deterioration leading to organ failure, from SCD patients who did not meet the criteria. A random forest model accurately predicted organ failure up to six hours prior to onset, with a five-fold cross-validation accuracy of 94.57% (average sensitivity and specificity of 90.24% and 98.9% respectively).ConclusionsThis study demonstrates the viability of using machine learning to predict acute physiological deterioration heralded organ failure among hospitalized adults with SCD. The discovery of salient physiomarkers through machine learning techniques has the potential to further accelerate the development and implementation of innovative care delivery protocols and strategies for medically vulnerable patients.
Neurocognitive mechanisms of d-cycloserine augmented single-session exposure therapy for anxiety
Authors: Reinecke Andrea , Nickless Alecia , Browning Michael , Harmer Catherine J. 
Published: April 2019

AbstractObjectiveDrugs targeting the N-Methyl-D-aspartic acid (NMDA) system and the ability to learn new associations have been proposed as potential adjunct treatments to boost the success of exposure therapy for anxiety disorders. However, the effects of the NMDA partial agonist d-cycloserine on psychological treatment have been mixed. We investigated potential neurocognitive mechanisms underlying the clinical effects of d-cycloserine-augmented exposure, to inform the optimal combination of this and similar agents with psychological treatment.MethodsUnmedicated patients with panic disorder were randomised to single-dose d-cycloserine (250mg; N=17) or matching placebo (N=16) 2hrs before one session of exposure therapy. Neurocognitive markers were assessed one day after treatment, including reaction-time based threat bias for fearful faces and amygdala response to threat. Clinical symptom severity was measured using self-report and clinician-rated scales the day before and after treatment, and at 1- and 6-months follow-up. Analysis was by intention-to-treat.ResultsOne day after treatment, threat bias for fearful faces and amygdala threat response were attenuated in the drug compared to the placebo group. Lower amygdala magnitude predicted greater clinical improvement during follow-up across groups. D-cycloserine led to greater clinical recovery at 1-month follow-up (d-cycloserine 71% versus placebo 25%).DiscussionD-cycloserine-augmented single-session exposure therapy reduces amygdala threat response, and this effect predicts later clinical response. These findings highlight a neurocognitive mechanism by which d-cycloserine may exert its augmentative effects on psychological treatment and bring forward a marker that may help understand and facilitate future development of adjunct treatments with CBT for anxiety disorders. (D-cycloserine Augmented CBT for Panic Disorder; clinicaltrials.gov;NCT01680107)
Parasitoid community responds indiscriminately to fluctuating spruce budworm and other caterpillars on balsam fir
Authors: Greyson-Gaito Christopher J. , McCann Kevin S. , Fründ Jochen , Lucarotti Christopher J. , Smith M. Alex , Eveleigh Eldon S. 
Published: April 2019

AbstractThe world is astoundingly variable, and individuals to whole communities must respond to variability to survive. One example of nature’s variability is the massive fluctuations in spruce budworm (Choristoneura fumiferanaClemens, Lepidoptera: Tortricidae) populations that occur over 35 years. We examined how the parasitoid community altered its parasitism of budworm and other caterpillar species in response to these fluctuations. Budworm and other caterpillar species were sampled from balsam fir in three plots for 14 years in Atlantic Canada, and then reared to identify any emerging parasitoids. We found that the parasitoid community showed a simple linear, indiscriminate response (i.e., no preference, where densities purely dictated parasitism rates) to changes in budworm densities relative to other caterpillar species on balsam fir. We also observed strong changes in topology and distributions of interaction strengths between the parasitoids, budworm and other caterpillar species as budworm densities fluctuated. Our study contributes to the suggestion that hardwood trees are a critical part of the budworm-parasitoid food web, where parasitoids attack other caterpillar species on hardwood trees when budworm populations are low. Taken together, our study shows that a parasitoid community collectively alters species interactions in response to variable budworm densities, fundamentally shifting food web pathways.
The impact of geographic targeting of oral cholera vaccination in sub-Saharan Africa: a modeling study
Authors: Lee Elizabeth C. , Azman Andrew S. , Kaminsky Joshua , Moore Sean M. , McKay Heather S. , Lessler Justin 
Published: April 2019

AbstractBackgroundIn May 2018, the World Health Assembly committed to reducing worldwide cholera deaths by 90% by 2030. Oral cholera vaccine (OCV) plays a key role in reducing the near-term risk of cholera, although global supplies are limited. Characterizing the potential impact and cost-effectiveness of mass OCV deployment strategies is critical for setting expectations and developing cholera control plans that maximize chances of success.Methods and FindingsWe compared the projected impacts of vaccination campaigns across sub-Saharan Africa from 2018 through 2030 when targeting geographically according to historical cholera burden and risk factors. We assessed the number of averted cases, deaths, disability-adjusted life-years, and cost-effectiveness with models that account for direct and indirect vaccine effects and population projections over time. Under current vaccine supply projections, an approach optimized to targeting by historical burden is projected to avert 828,971 (95% CI: 803,370-859,980) cases (equivalent to 34.0% of projected cases; 95% CI: 33.2-34.8). An approach that balances logistical feasibility with targeting historical burden is projected to avert 617,424 (95% CI: 599,150-643,891) cases. In contrast, approaches optimized for targeting locations with limited access to water and sanitation are projected to avert 273,939 (95% CI: 270,319-277,002) and 109,817 (95% CI: 103,735-114,110) cases, respectively. We find that the most logistically feasible targeting strategy costs $1,843 (95% CI: 1,328-14,312) per DALY averted during this period and that effective geographic targeting of OCV campaigns can have a greater impact on cost-effectiveness than improvements to vaccine efficacy and moderate increases in coverage. Although our modeling approach did not project annual changes in baseline cholera risk or incorporate immunity from natural cholera infection, our estimates of the relative performance of different vaccination strategies should be robust to these factors.ConclusionsOur study suggests that geographic targeting is critical to the cost-effectiveness and impact of oral cholera vaccination campaigns. Districts with the poorest access to improved water and sanitation are not the same as districts with the greatest historical cholera incidence. While OCV campaigns can improve cholera control in the near-term, without rapid progress in developing water and sanitation services, our results suggest that vaccine use alone are unlikely to allow us to achieve the 2030 goals.
Maize Kernel Development Stage the Primary Factor in Differential Gene Expression in Response to Two Methods of Field Inoculation withAspergillus flavus
Authors: Wahl Nancy J. , Murray Seth C. , Zhang Hong-Bin , Zhang Meiping , Dickens C. Michael , Isakeit Thomas S. 
Published: April 2019

AbstractBackgroundAflatoxins, produced by the fungusAspergillus flavus, often contaminate preharvest maize (Zea maysL.) grain under heat and drought stresses, posing serious health hazards to humans and livestock, and resulting in significant costs to identify and dispose of contaminated grain. This study was designed to investigate the changes in differential gene expression during seed morphogenesis and maturation in the “aflatoxin resistant” Argentinian inbred line Tx772 when challenged by the introduction ofA. flavusthrough two different methods of ear inoculation; non-wounding (silk channel, used to select Tx772), wounding (side needle) and a non-inoculated control.Method and FindingsGrain maturity had the largest effect on overall RNA-Seq differential gene expression (DGE) as measured by edgeR of the Bioconductor platform. However, within each stage of development, ranging from blister to dent, similar up-regulation in expression of many maize genes following inoculation with either method was observed; a total of 16 genes previously associated with resistance to pathogens were identified among the transcripts differentially expressed (DE) at p ≤ .05, FDR ≤ .10, and fold change ≥ 2.0 over all stages. The side needle technique produced a larger effect of infection as evidenced by 6,324 fungal reads versus 518 in silk channel and a higher level of aflatoxin. Correlations between approximately 7,000 fungal reads and the number of maize DE genes for each of the eight treatment groups was 0.56 (p = .152) and was 0.65 (p < .001) with levels of aflatoxin ranging from 0 to 137 ng g-1.ConclusionThese correlations provided an internal measure of effectiveness of inoculation methods that were associated with the mostly up-regulation of defense-related genes in response to the presence ofAspergillus flavusin a unique maize genetic background.
Genetic modification of primary human B cells generates translationally-relevant models of high-grade lymphoma
Authors: Caeser Rebecca , Di Re Miriam , Krupka Joanna A , Gao Jie , Lara-Chica Maribel , Dias João M.L , Cooke Susanna L , Fenner Rachel , Usheva Zelvera , Runge Hendrik , Beer Philip A , Eldaly Hesham , Pak Hyo-Kyung , Park Chan-Sik , Vassiliou George , Huntly Brian J.P , Mupo Annalisa , Bashford-Rogers Rachael JM , Hodson Daniel J 
Published: April 2019

AbstractSequencing studies of Diffuse Large B Cell Lymphoma (DLBCL) have identified hundreds of recurrently altered genes. However, it remains largely unknown whether and how these mutations may contribute to lymphomagenesis, either individually or in combination. Existing strategies to address this problem predominantly utilize cell lines, which are limited by their initial characteristics and subsequent adaptions to prolongedin vitroculture. Here, we describe a novel co-culture system that enables theex vivoexpansion and viral transduction of primary human germinal center B cells. The incorporation of CRISPR/Cas9 technology enables high-throughput functional interrogation of genes recurrently mutated in DLBCL. Using a backbone ofBCL2with eitherBCL6orMYCwe have identified co-operating oncogenes that promote growth and survival, or even full transformation into synthetically engineered models of DLBCL. The resulting tumors can be expanded and sequentially transplantedin vivo, providing a scalable platform to test putative cancer genes and for the creation of mutation-directed, bespoke lymphoma models.