bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mobility Function and Recovery After Stroke: Preliminary Insights From Sympathetic Nervous System Activity
Authors: Chatterjee Sudeshna A. , Daly Janis J. , Porges Eric C. , Fox Emily J. , Rose Dorian K. , McGuirk Theresa E. , Otzel Dana M. , Butera Katie A. , Clark David J. 
Published: August 2018

Background and Purpose:
Poststroke hemiparesis increases the perceived challenge of walking. Perceived challenge is commonly measured by self-report, which is susceptible to measurement bias. A promising approach to objectively assess perceived challenge is measuring sympathetic nervous system (SNS) activity with skin conductance to detect the physiological stress response. We investigated the feasibility of using skin conductance measurements to detect task-related differences in the challenge posed by complex walking tasks in adults poststroke.

Methods:
Adults poststroke (n = 31) and healthy young adults (n = 8) performed walking tasks including typical walking, walking in dim lighting, walking over obstacles, and dual-task walking. Measures of skin conductance and spatiotemporal gait parameters were recorded. Continuous decomposition analysis was conducted to assess changes in skin conductance level (ΔSCL) and skin conductance response (ΔSCR). A subset of participants poststroke also underwent a 12-week rehabilitation intervention.

Results:
SNS activity measured by skin conductance (both ΔSCL and ΔSCR) was significantly greater for the obstacles task and dual-task walking than for typical walking in the stroke group. Participants also exhibited “cautious” gait behaviors of slower speed, shorter step length, and wider step width during the challenging tasks. Following the rehabilitation intervention, SNS activity decreased significantly for the obstacles task and dual-task walking.

Discussion and Conclusions:
SNS activity measured by skin conductance is a feasible approach for quantifying task-related differences in the perceived challenge of walking tasks in people poststroke. Furthermore, reduced SNS activity during walking following a rehabilitation intervention suggests a beneficial reduction in the physiological stress response evoked by complex walking tasks.

Video Abstract available for more insights from the authors (See Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A234).
Feasibility of Aerobic Exercise in the Subacute Phase of Recovery From Traumatic Brain Injury: A Case Series
Authors: Morris Timothy P. , Costa-Miserachs David , Rodriguez-Rajo Pablo , Finestres Jordi , Bernabeu Montserrat , Gomes-Osman Joyce , Pascual-Leone Alvaro , Tormos-Muñoz Jose Maria 
Published: August 2018

Background and Purpose:
Aerobic exercise is as important for individuals with traumatic brain injury (TBI) as for the general population; however, the approach to aerobic training may require some adaptation. The objective of the trial program was to examine the feasibility of introducing aerobic physical exercise programs into the subacute phase of multidisciplinary rehabilitation from moderate to severe TBI, which includes computerized cognitive training.

Case Description:
Five individuals undergoing inpatient rehabilitation with moderate or severe TBIs who also have concomitant physical injuries. All of these individuals were in the subacute phase of recovery from TBIs.

Intervention:
An 8-week progressive aerobic physical exercise program. Participants were monitored to ensure that they could both adhere to and tolerate the exercise program. In addition to the physical exercise, individuals were undergoing their standard rehabilitation procedures that included cognitive training. Neuropsychological testing was performed to gain an understanding of each individual's cognitive function.

Outcomes:
Participants adhered to both aerobic exercise and cognitive training. Poor correlations were noted between heart rate reserve and ratings of perceived effort. Two minor adverse events were reported.

Discussion:
Despite concomitant physical injuries and cognitive impairments, progressive aerobic exercise programs seem feasible and well tolerated in subacute rehabilitation from moderate to severe TBI. Findings highlight the difficulty in measuring exercise intensity in this population.

Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A235)
Effect of 5-Day Nitrofurantoin vs Single-Dose Fosfomycin on Clinical Resolution of Uncomplicated Lower Urinary Tract Infection in Women: A Randomized Clinical Trial
Authors: Huttner Angela , Kowalczyk Anna , Turjeman Adi , Babich Tanya , Brossier Caroline , Eliakim-Raz Noa , Kosiek Katarzyna , Martinez de Tejada Begona , Roux Xavier , Shiber Shachaf , Theuretzbacher Ursula , von Dach Elodie , Yahav Dafna , Leibovici Leonard , Godycki-Ćwirko Maciek , Mouton Johan W. , Harbarth Stephan 
Published: August 2018

(Abstracted from JAMA 2018;319:1781–1789)
Guidelines for the treatment of uncomplicated lower urinary tract infections (UTIs) were modified in 2010 because of increasing antimicrobial resistance. The new guidelines recommend nitrofurantoin and fosfomycin as first-line agents.
Fight or Flight: The Role of Staged Approaches to Complex Abdominal Wall Reconstruction
Authors: Petro Clayton C. , Rosen Michael J. 
Published: August 2018

Summary:
Surgeons’ comfort with abdominal wall reconstruction techniques and use of prosthetic reinforcement in contaminated fields has made repair of complex hernias during concomitant procedures an attractive endeavor. Understanding the precarious nature of this practice, tenets of thoughtful patient selection, and principles of repair that mitigate morbidity can allow for an educated thought process when deciding whether or not to pursue concomitant abdominal wall reconstruction.
Optimal Pain Control in Abdominal Wall Reconstruction
Authors: Khansa Ibrahim , Jefferson Ryan , Khansa Lara , Janis Jeffrey E. 
Published: August 2018

Summary:Lack of physician familiarity with alternative pain control strategies is a major reason why opioids remain the most commonly used first-line treatment for pain after surgery. This is perhaps most problematic in abdominal wall reconstruction, where opioids may delay ambulation and return of bowel function, while negatively affecting mental status. In this article, we discuss multimodal strategies for optimal pain control in abdominal wall reconstruction. These strategies are straightforward and are proven to improve pain control while minimizing opioid-associated side effects.
Prophylactic Mesh for Hernia Prevention: Has the Time Arrived?
Authors: Fox Sarah S. , Johnson Robert , Fischer John P. , Eckhauser Frederick , Hope William W. 
Published: August 2018

Summary:
Incisional and parastomal hernias continue to be vexing problems for patients and surgeons. Risk factors are generally patient-related and/or technical in nature, and in some cases, can be altered, resulting in improved outcomes. Improved fascial closure techniques can only partly reduce the risk of incisional hernia formation. Even under optimal circumstances, using time tested closure techniques and materials, the rate remains high, due primarily to factors that are not modifiable or are unidentifiable. In such cases, there may be a beneficial role for prophylactic mesh augmentation (PMA), wherein mesh is implanted at the time of initial surgery or stoma formation. Several high-risk groups that might benefit from PMA have been identified, including patients undergoing open abdominal aneurysm repair or colorectal procedures, obese patients, and patients requiring creation of permanent gastrointestinal or urological stomas. Although the initial results of PMA are promising, the benefits of this strategy must be weighed against potential risks. Outcome measures to assess efficacy should include not only hernia recurrence but also quality of life, surgical-site occurrences, and cost. Further studies are warranted to predict which specific patient populations might benefit most from PMA and to identify ideal mesh materials as well as preferred implantation sites and methods of mesh fixation.
Prevalence and Clinical Relevance of Extracardiac Findings in Cardiovascular Magnetic Resonance Imaging
Authors: Mantini Cesare , Mastrodicasa Domenico , Bianco Francesco , Bucciarelli Valentina , Scarano Michele , Mannetta Gianluca , Gabrielli Daniela , Gallina Sabina , Petersen Steffen E. , Ricci Fabrizio , Cademartiri Filippo 
Published: August 2018

Purpose:
To assess the prevalence of extracardiac findings (ECF) during cardiovascular magnetic resonance (CMR) examinations and their downstream effect on clinical management.

Materials and Methods:
We retrospectively identified 500 consecutive patients. Trans-axial balanced steady-state free precession nongated images acquired from the upper thorax to the upper abdomen were evaluated independently by 2 radiologists. ECF were classified as nonsignificant (benign, with no need for further investigation), significant (mandatory to be reported/monitored), and major (clinically remarkable pathology, mandatory to be reported/investigated/treated). Fifteen-month clinical follow-up information was collected through hospital records.

Results:
Of 500 patients, 108 (21.6%) showed a total of 153 ECF: 59 (11.8% of the entire study population; 38.5% of all ECF) nonsignificant, 76 (15.2%; 49.7%) significant, and 18 (3.6%; 11.8%) major ECF. The most frequent ECF were pleural effusion, hepatic cyst, renal cyst, and ascending aorta dilatation. Of 94 significant and major ECF, 46 were previously unknown and more common in older patients. Newly diagnosed major ECF (n=11, 2.2% of the entire study population, and 7.2% of all ECF)—including 5 tumors (1% of study population)—were confirmed by downstream evaluations and required specific treatment. Patients with major ECF were significantly older than patients without with major ECF. Newly diagnosed clinically significant and major ECF prompted downstream diagnostic tests in 44% and 100% of cases, respectively.

Conclusions:
The detection of significant and major ECF is common during CMR reporting. The knowledge and the correct identification of most frequent ECF enable earlier diagnoses and faster treatment initiation of unknown extracardiac pathologies in patients referred to CMR imaging.
Association of Sex With Clinical Outcome in Critically Ill Sepsis Patients: A Retrospective Analysis of the Large Clinical Database MIMIC-III
Authors: Xu Jinghong , Tong Li , Yao Jiyou , Guo Zilu , Lui Ka Yin , Hu XiaoGuang , Cao Lu , Zhu Yanping , Huang Fa , Guan Xiangdong , Cai Changjie 
Published: August 2018

ABSTRACT

Introduction:
The objective of our study was to explore the association between sex and clinical outcome in sepsis patients in a large, diverse population.

Materials and Methods:
We analyzed 6,134 adult patients with sepsis from the critical care units of Beth Israel Deaconess Medical Center between 2001 and 2012. Study data were retrospectively extracted from Medical Information Mart for Intensive Care-III, a multiparameter intensive care database.

Results:
There were 2,677 (43.6%) female and 3,457 (56.4%) male patients. Compared with female patients, male patients with sepsis had a higher 1-year mortality rate (55.6% vs. 51.4%, P = 0.001), and so did the 90-day mortality rate (45.1% vs. 42.1%, P = 0.018). 33.8% of male and 31.3% of female patients with sepsis died during hospitalization (P = 0.041). The median length of hospitalization and intensive care unit (ICU) stay for male patients was 19.54 and 7.54 days, while that for female patients was 16.49 and 6.75 days (P < 0.001, P = 0.002, respectively). Male patients were more likely to require dialysis therapy (P = 0.109), ventilation support (P = 0.012) and more vasoactive agents (dopamine P = 0.113, norepinephrine P = 0.016, and epinephrine P = 0.093) during the ICU period than female patients. Our Cox proportional hazard regression model confirmed that the risk of death within 1 year of ICU admission in male patients is 1.083 times that in female.

Conclusion:
Female patients with sepsis have better clinical outcomes than male patients in terms of mortality and length of hospitalization and ICU stay.
Perspectives on Quality of Care in Kidney Transplantation: A Semistructured Interview Study
Authors: Brett Kendra E. , Ertel Emily , Grimshaw Jeremy , Knoll Greg A. 
Published: August 2018

Background
There is currently no agreement as to what constitutes quality transplant care, and there is a lack of consistency in the approach to assessing transplantation quality. We aimed to ascertain the views of patients, clinicians, and program administrators about quality care for kidney transplant patients.

Methods
Semistructured qualitative interviews were conducted with 20 patients, 17 physicians, and 11 program administrators. Transcripts were analyzed using inductive thematic analysis.

Results
We identified 8 themes: access to treatment (standardized transplant referral, lengthy transplant evaluation process, lengthy living donor evaluation); accessibility of services (alternative access options, flexible appointment availability, appropriate amount of follow-up, barriers for accessing care); program resources (comprehensive multidisciplinary care, knowledgeable staff, peer support groups, educational resources, patient navigators/ advocates); communication of information (taking time to answer questions, clear communication about treatment, communication tailored to patients, health promotion and illness prevention); attitude of care providers (positive and supportive attitude, patient centered care); health outcomes (freedom from dialysis, Long-term health, short-term health, fear of infections); patient satisfaction (returning to normal life, patient satisfaction with care); and safety (reducing infection risk, quick response to complications, patient health status on the waitlist).

Conclusions
There is a need to move beyond basic clinical outcomes and focus on increasing ease of access, the patient-provider relationship, and outcomes that are most important to the patients.
Pericentromeric hypomethylation elicits an interferon response in an animal model of ICF syndrome
Authors: Rajshekar Srivarsha , Yao Jun , Arnold Paige K. , Payne Sara G. , Zhang Yinwen , Bowman Teresa V. , Schmitz Robert J. , Edwards John R. , Goll Mary G. 
Published: August 2018

AbstractPericentromeric satellite repeats are enriched in 5-methylcytosine (5mC). Loss of 5mC at these sequences is common in cancer and is a hallmark of Immunodeficiency, Centromere and Facial abnormalities (ICF) syndrome. While the general importance of 5mC is well-established, the specific functions of 5mC at pericentromeres are less clear. To address this deficiency, we generated a viable animal model of pericentromeric hypomethylation through mutation of the ICF-geneZBTB24. Deletion of zebrafishzbtb24caused a progressive loss of 5mC at pericentromeres and ICF-like phenotypes. Hypomethylation of these repeats triggered derepression of pericentromeric transcripts and activation of an interferon-based innate immune response. Injection of pericentromeric RNA is sufficient to elicit this response in wild-type embryos, and mutation of the MDA5-MAVS dsRNA-sensing machinery blocks the response in mutants. These findings identify activation of the innate immune system as an early consequence of pericentromeric hypomethylation, implicating derepression of pericentromeric transcripts as a trigger of autoimmunity.
Small molecule inhibition of IRE1α kinase/RNase has anti-fibrotic effects in the lung
Authors: Thamsen Maike , Ghosh Rajarshi , Auyeung Vincent C. , Brumwell Alexis , Chapman Harold A. , Backes Bradley J. , Perara Gayani , Maly Dustin J. , Sheppard Dean , Papa Feroz R. 
Published: August 2018

AbstractEndoplasmic reticulum stress (ER stress) has been implicated in the pathogenesis of idiopathic pulmonary fibrosis (IPF), a disease of progressive fibrosis and respiratory failure. ER stress activates a signaling pathway called the unfolded protein response (UPR) that either restores homeostasis or promotes apoptosis. The bifunctional kinase/RNase IRE1α is a UPR sensor that promotes apoptosis if ER stress remains high (i.e., a “terminal” UPR). Using multiple small molecule inhibitors against IRE1α, we show that ER stress-induced apoptosis of murine alveolar epithelial cells can be mitigated in vitro. In vivo, we show that bleomycin exposure to murine lungs causes early ER stress to activate IRE1α and the terminal UPR prior to development of pulmonary fibrosis. Small-molecule IRE1α kinase-inhibiting RNase attenuators (KIRAs) that we developed were used to evaluate the importance of IRE1α activation in bleomycin-induced pulmonary fibrosis. One such KIRA—KIRA7—provided systemically to mice at the time of bleomycin exposure decreases terminal UPR signaling and prevents lung fibrosis. Administration of KIRA7 14 days after bleomycin exposure even promoted the reversal of established fibrosis. Finally, we show that KIRA8, a nanomolar-potent, monoselective KIRA compound derived from a completely different scaffold than KIRA7, likewise promoted reversal of established fibrosis. These results demonstrate that IRE1α may be a promising target in pulmonary fibrosis and that kinase inhibitors of IRE1α may eventually be developed into efficacious anti-fibrotic drugs.
CA3 place cells that represent a novel waking experience are preferentially reactivated during sharp wave-ripples in subsequent sleep
Authors: Hwaun Ernie , Colgin Laura Lee 
Published: August 2018

AbstractA popular model of memory consolidation posits that recent memories stored in the hippocampus are reactivated during sleep and thereby transferred to neocortex for long-term storage. This process is thought to occur during sharp wave-ripples (SWRs) in non-rapid eye movement (NREM) sleep. But whether the hippocampus consolidates all recent memories in the same manner remains unclear. An efficient memory system may extract novel information from recent experiences for preferential consolidation. In the hippocampus, memories are thought to be stored initially in CA3. Therefore, CA3 place cells that encode novel experiences may be preferentially reactivated during SWRs in subsequent sleep. To test this hypothesis, we recorded CA3 place cells in rats during exposure to a familiar and a novel environment and during subsequent overnight sleep. We found that cells that preferentially coded a novel environment showed larger firing rate increases during SWRs in NREM sleep than cells that preferentially coded a familiar environment. Moreover, CA3 place cell ensembles replayed trajectories from a novel environment during NREM sleep with higher fidelity than trajectories from a familiar environment. Together, these results suggest that CA3 representations of novel experiences are preferentially processed during subsequent sleep.
Toward a 3D model of phyllotaxis based on a biochemically plausible auxin-transport mechanism
Authors: Hartmann Félix P. , Reuille Pierre Barbier de , Kuhlemeier Cris 
Published: August 2018

AbstractPolar auxin transport lies at the core of many self-organizing phenomena sustaining continuous plant organogenesis. In angiosperms, the shoot apical meristem is a potentially unique system in which the two main modes of auxin-driven patterning— convergence and canalization—co-occur in a coordinated manner and in a fully three-dimensional geometry. In the epidermal layer, convergence points form, from which auxin is canalized towards inner tissue. Each of these two patterning processes has been extensively investigated separately, but the integration of both in the shoot apical meristem remains poorly understood. We present here a first attempt of a three-dimensional model of auxin-driven patterning during phyllotaxis. We base our simulations on a biochemically plausible mechanism of auxin transport proposed by Cieslak et al. (2015) which generates both convergence and canalization patterns. We are able to reproduce most of the dynamics of PIN1 polarization in the meristem, and we explore how the epidermal and inner cell layers act in concert during phyllotaxis. In addition, we discuss the mechanism by which initiating veins connect to the already existing vascular system.Author summaryThe regularity of leaf arrangement around stems has long puzzled scientists. The key role played by the plant hormone auxin is now well established. On the surface of the tissue responsible for leaf formation, auxin accumulates at several points, from which new leaves eventually emerge. Auxin also guides the progression of new veins from the nascent leaves to the vascular system of the plant. Models of auxin transport have been developed to explain either auxin accumulation or auxin-driven venation. We propose the first three-dimensional model embracing both phenomena using a unifying mechanism of auxin transport. This integrative approach allows an assessment of our present knowledge on how auxin contributes to the early development of leaves. Our model reproduces many observations of auxin dynamics. It highlights how the inner and epidermal tissues act together to position new leaves. We also show that an additional, yet unknown, mechanism is required to attract new developing veins towards the main vasculature of the plant.
Genome-wide Estrogen Receptor-αactivation is sustained, not cyclical
Authors: Holding Andrew N , Cullen Amy E , Markowetz Florian 
Published: August 2018

AbstractEstrogen Receptor-α(ER) is the key driver of 75% of all breast cancers. Upon stimulation by its ligand estra-2-diol, ER forms a transcriptionally active complex binding chromatin. Previous studies have reported that ER binding follows a cyclical binding pattern with a periodicity of 90 minutes. However, these studies have been limited to individual ER target genes and most were done without replicates. Thus, the robustness and generality of ER cycling are not well understood.Here we present a comprehensive genome-wide analysis of the time dependence of ER binding affinity up to 90 minutes after activation, based on 6 replicates at 10 time points using our previously reported method for precise quantification of binding, Parallel-Factor ChIP-seq (pfChIP-seq). In contrast to previously described cyclical binding, our approach identifies a unidirectional sustained increase in ER binding affinity, as well as a class of estra-2-diol independent binding sites. Our results are corrob-orated by a quantitative re-analysis of data from multiple independent studies.Our new model reconciles the results of multiple conflicting studies into the activation of ER at the TFF1 promoter. We provide a detailed understanding of ER’s response to estra-2-diol in the context of the receptor’s fundamental role as both the main driver and therapeutic target of breast cancer.
Neuronal Adaptation to the Value Range in the Macaque Orbitofrontal Cortex
Authors: Conen Katherine E. , Padoa-Schioppa Camillo 
Published: August 2018

AbstractEconomic choice involves computing and comparing the subjective values of different options. The magnitude of these values can vary immensely in different situations. To compensate for this variability, decision-making neural circuits adapt to the current behavioral context. In orbitofrontal cortex (OFC), neurons encode the subjective value of offered and chosen goods in a quasi-linear way. Previous work found that the gain of the encoding is lower when the value range is wider. However, previous studies did not disambiguate between neurons adapting to the value range or to the maximum value. Furthermore, they did not examine changes in baseline activity. Here we investigated how neurons in the macaque OFC adapt to changes in the value distribution. We found that neurons adapt to both the maximum and the minimum value, but only partially. Concurrently, the baseline response is higher when the minimum value is larger. Using a simulated decision circuit, we showed that higher baseline activity increases choice variability, and thus lowers the expected payoff in high value contexts.