bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improved motor unit number estimate when motor unit alternation is addressed
Authors: DeForest Bradley A. , Winslow Jeffrey , Thomas Christine K. 
Published: May 2018

Motor unit number estimation (MUNE) is important for determining motoneuron survival with age or in conditions such as amyotrophic lateral sclerosis or spinal cord injury. The original incremental method and approaches that were introduced to minimize alternation (e.g., multiple-point stimulation) are most commonly used, but one must accept the limitation that alternation of motor units may still inflate the estimate. Alternation occurs because axon thresholds are probabilistic and overlap for different axons; therefore, different combination of motor units may respond at a given stimulus intensity. Our aims were to quantify motor unit alternation systematically in the thenar muscles of 35 healthy adults by digital subtraction of EMG and force, and to compare MUNE with and without alternation. Alternation was prevalent, with one to nine occurrences in the first 7 to 11 steps in EMG in 34 of 35 muscles. It occurred in the first 3 steps in EMG in 49% of muscles. This alternation resulted in fewer units than steps in EMG (3 to 10 units at step 7 to 11). Accounting for alternation using digital subtraction reduced MUNE by up to 50%, day-to-day, and between-participant variability in MUNE. These results highlight the need to quantify alternation to improve the reliability and precision of motor unit number estimates, which will allow for detection of smaller changes in motoneuron survival with age, various health conditions, and/or due to an intervention. NEW & NOTEWORTHY Motor unit alternation was quantified systematically for the first time, addressing a major limitation of motor unit number estimates. Accounting for alternation decreased motor unit number estimates, and improved the reliability and precision of the motor unit number estimate, which will allow smaller, clinically relevant changes in motoneuron survival to be detected.
Validation of the 16-Gene Recurrence Score in Patients with Locoregional, High-Risk Renal Cell Carcinoma from a Phase III Trial of Adjuvant Sunitinib
Authors: Rini Brian I. , Escudier Bernard , Martini Jean-Francois , Magheli Ahmed , Svedman Christer , Lopatin Margarita , Knezevic Dejan , Goddard Audrey D. , Febbo Phillip G. , Li Rachel , Lin Xun , Valota Olga , Staehler Michael , Motzer Robert J. , Ravaud Alain 
Published: May 2018

Abstract
Purpose: Adjuvant sunitinib prolonged disease-free survival (DFS; HR, 0.76) in patients with locoregional high-risk renal cell carcinoma (RCC) in the S-TRAC trial (ClinicalTrials.gov NCT00375674). The 16-gene Recurrence Score (RS) assay was previously developed and validated to estimate risk for disease recurrence in patients with RCC after nephrectomy. This analysis further validated the prognostic value of RS assay in patients from S-TRAC and explored the association of RS results with prediction of sunitinib benefit.
Patients and Methods: The analysis was prospectively designed with prespecified genes, algorithm, endpoints, and analytical methods. Primary RCC was available from 212 patients with informed consent; primary analysis focused on patients with T3 RCC. Gene expression was quantitated by RT-PCR. Time to recurrence (TTR), DFS, and renal cancer–specific survival (RCSS) were analyzed using Cox proportional hazards regression.
Results: Baseline characteristics were similar between patients with and those without RS results, and between the sunitinib and placebo arms among patients with RS results. RS results predicted TTR, DFS, and RCSS in both arms, with the strongest results observed in the placebo arm. When high versus low RS groups were compared, HR for recurrence was 9.18 [95% confidence interval (CI), 2.15–39.24; P &lt; 0.001) in the placebo arm; interaction of RS results with treatment was not significant.
Conclusions: The strong prognostic performance of the 16-gene RS assay was confirmed in S-TRAC, and the RS assay is now supported by level IB evidence. RS results may help identify patients at high risk for recurrence who may derive higher absolute benefit from adjuvant therapy. Clin Cancer Res; 24(18); 4407–15. ©2018 AACR.
Undertreatment of Vascular Risk Factors in Patients with Monocular Ischaemic Visual Loss
Authors: Zarkali Angeliki , Cheng Suk Fun , Dados Agnes , Simister Robert , Chandratheva Arvind 
Published: May 2018

<b><i>Background and Purpose:</i></b> Ischaemic visual loss is often considered a lower risk factor than other transient ischaemic attacks (TIA). We aimed to determine the recurrence risk, prevalence and management of vascular risk factors in these patients. <b><i>Methods:</i></b> The study took place in the University College Hospital London daily TIA clinic, main referral centre for North-Central London and Moorfields Eye Hospital. Consecutive records for patients with transient (&#x3c; 24 h) or permanent (&#x3e; 24 h) ischaemic visual loss were reviewed during the period January 2014–October 2016. Patients diagnosed with temporal arteritis were excluded. <b><i>Results:</i></b> Of 400 patients, 224 (56%) were male with mean age 64.5 years (SD 15.1); 263 patients (65.8%) presented with transient and 137 patients (34.2%) with permanent ischaemic visual loss; 51.3% had hypertension (HTN), 35.3% hypercholesterolaemia, 14.5% diabetes, 11.8% ischaemic ocular events, 10.0% ischaemic heart disease, 7.3% atrial fibrillation (AF), 6.3% TIA, 5.3% stroke, and 12.3% were smokers. Median vascular risk factors were 2 (range 1–6), but 122 (30.5%) had ≥3. Those with diabetes (<i>p</i> &#x3c; 0.001), HTN (<i>p</i> = 0.008), previous myocardial infarction (<i>p</i> = 0.005), or ≥3 vascular risk factors (<i>p</i> = 0.012) were more likely to present with permanent visual loss, while patients with history of transient events, TIA (<i>p</i> = 0.002), or ocular (<i>p</i> = 0.002) presented with transient visual loss. Ninety-day recurrence was 10.5%; this was higher in patients with ≥3 risk factors (hazard ratio 1.42, 95% CI 0.95–2.11, <i>p</i> = 0.111). Patients with past TIA were more likely to be on secondary prevention than those with ocular ischaemia; 60.0 vs. 34.1% received antiplatelets and 76.0 vs. 43.9% statins. At presentation, only 55.2% (16 patients) with known AF were anticoagulated, despite all of them having CHADSVASC ≥1. <b><i>Conclusions:</i></b> Approximately one-third of patients with ocular ischaemia had ≥3 vascular risk factors with recurrences higher in these patients. Yet only half of those with previous ischaemic ocular events were on antiplatelets or statins. These patients should be investigated and treated as aggressively as other forms of TIA or stroke.
Evaluation of Inhaled Procaterol for Potential Assist Use in Patients with Stable Chronic Obstructive Pulmonary Disease
Authors: Kodaka Norio , Yamagishi Toru , Watanabe Kayo , Kishimoto Kumiko , Nakano Chihiro , Oshio Takeshi , Niitsuma Kumiko , Shimada Nagashige , Matsuse Hiroto 
Published: May 2018

<b><i>Objectives:</i></b> International guidelines recommend the use of long-acting bronchodilators for the treatment of chronic obstructive pulmonary disease (COPD), but the usefulness of short-acting bronchodilator assist use for stable COPD remains uncertain. The purpose of the present study was to objectively demonstrate the effects of assist use of procaterol, a short-acting β<sub>2</sub>-agonist, on the respiratory mechanics of stable COPD patients treated with a long-acting bronchodilator using forced oscillation technique (FOT) and conventional spirometry. We also confirmed the length of time for which procaterol assist could significantly improve the pulmonary function. <b><i>Methods:</i></b> We enrolled 28 outpatients with mild to severe COPD (Global Initiative for Obstructive Lung Disease stages I–III), who had used the same long-acting bronchodilator for longer than 3 months and who were in stable condition. All measures were performed using both FOT and spirometry sequentially from 15 min to 2 h after inhalation. <b><i>Results:</i></b> Compared to baseline, inhaled procaterol assist use modestly but significantly improved spirometric and FOT measurements within 2 h after inhalation. These significant effects continued for at least 2 h. ­Significant correlations were found between parameters ­measured by spirometry and those measured by FOT. <b><i>Conclusions:</i></b> Procaterol assist use modestly but significantly improved pulmonary function determined by spirometry and respiratory mechanics in patients with stable COPD treated with long-acting bronchodilators. Thus, inhaled procaterol has the potential for assist use for COPD.
Use Rate and Outcome in Bilateral Internal Thoracic Artery Grafting: Insights From a Systematic Review and Meta‐Analysis
Authors: Gaudino Mario , Bakaeen Faisal , Benedetto Umberto , Rahouma Mohamed , Di Franco Antonino , Tam Derrick Y. , Iannaccone Mario , Schwann Thomas A. , Habib Robert , Ruel Marc , Puskas John D. , Sabik Joseph , Girardi Leonard N. , Taggart David P. , Fremes Stephen E. 
Published: May 2018

Background
This meta‐analysis was designed to assess whether center experience affects the short‐ and long‐term results and the relative benefits of bilateral internal thoracic artery grafting (BITA) for coronary artery bypass grafting.

Methods and Results
MEDLINE and EMBASE were searched to identify all articles reporting the outcome of BITA in patients undergoing coronary artery bypass grafting. The BITA center experience was gauged according to the percentage use of BITA in the institutional overall coronary artery bypass grafting population (%BITA). The primary outcome was long‐term all‐cause mortality. Secondary outcomes were operative mortality, perioperative myocardial infarction, perioperative stroke, deep sternal wound infections (DSWIs), and major postoperative adverse event. The rates of the primary and secondary outcomes were calculated after adjusting for %BITA. Primary and secondary outcomes were also compared between the BITA and the single internal thoracic artery arms in the adjusted studies. Meta‐regression was used to evaluate the effect of %BITA on the primary and secondary outcomes. Thirty‐four studies (27 894 patients undergoing BITA) were included. In the pooled analysis, the incidence rate for long‐term mortality was 2.83% (95% confidence interval, 2.21%–3.61%). %BITA was significantly and inversely associated with long‐term mortality and the rate of DSWI. In the pairwise comparison, %BITA was significantly and inversely associated with the risk of long‐term mortality and DSWI in the group undergoing BITA.

Conclusions
BITA series with higher %BITA report significantly lower long‐term mortality and DSWI rate as well as higher long‐term survival advantage and lower relative risk of DSWI in their BITA cohort. These findings suggest that a specific volume‐outcome relationship exists for BITA grafting.
Implicit Association Effects Between Sound and Food Images
Authors: Padulo Caterina , Tommasi Luca , Brancucci Alfredo 
Published: May 2018

Abstract
A growing body of empirical research documents the existence of several interesting crossmodal correspondences between auditory and gustatory/flavor stimuli, demonstrating that people can match specific acoustic and musical parameters with different tastes and flavors. In this context, a number of researchers and musicians arranged their own soundtracks so as to match specific tastes and used them for research purposes, revealing explicit crossmodal effects on judgments of taste comparative intensity or of taste/sound accordance. However, only few studies have examined implicit associations related to taste–sound correspondences. Thus, the present study was conducted in order to assess possible implicit effects associated to the crossmodal congruency/incongruency between auditory cues and food images during the classification of food tastes. To test our hypothesis, we used ‘salty’ and ‘sweet’ soundtracks with salty and sweet food images, and asked 88 participants to classify the taste of each food image while listening to the soundtracks. We found that sweet food images were classified faster than salty food images, regardless of which soundtrack was presented. Moreover, we found a congruency effect, demonstrating that such soundtracks are effective in eliciting facilitating effects of taste quality classification with congruent food images.
Great Lakes Basin Snow-Cover Ablation and Synoptic-Scale Circulation
Authors: Suriano Zachary J. , Leathers Daniel J. 
Published: May 2018

AbstractSynoptic-scale atmospheric conditions play a critical role in determining the frequency and intensity of snow-cover-ablation events. Using a synoptic weather-classification technique, distinct regional circulation patterns influencing the Great Lakes basin of North America are identified and examined in conjunction with daily snow-ablation events from 1960 to 2009. An ablation event is considered in this study to be an interdiurnal decrease in areal-weighted average snow depth of greater than 2.54 cm in magnitude over the entire Great Lakes basin. General meteorological characteristics associated with ablation-causing synoptic types are examined, and three individual case studies from prominent synoptic types are presented to understand the diversity of meteorological influences on regional snow ablation. Results indicate that a variety of synoptic weather conditions lead to snow ablation in the Great Lakes basin. The 10 most common synoptic types accounted for 66% of the 349 ablation events detected from 1960 to 2009. Snow ablation in the Great Lakes basin most commonly occurs when there is advection of warm and moist air into the region to provide the sensible and latent heat fluxes that are needed for melt, but ablation frequently occurs during rain-on-snow events and in instances of high pressure overhead. Ablation magnitude is highest during rain-on-snow synoptic types, and the interannual frequency of these types significantly decreased by 37% over 1960–2009. Conversely, the frequency of high-pressure-overhead synoptic types significantly increased by more than 30% from 1960 to 2009. Such changes may influence the hydrologic impact of these synoptic types on ablation over time.
The development of a mouse model of mTBI-induced post-traumatic migraine, and identification of the delta opioid receptor as a novel therapeutic target
Authors: Moye Laura S , Novack Madeline L , Tipton Alycia F , Krishnan Harish , Pandey Subhash C , Pradhan Amynah AA 
Published: May 2018

Background Post-traumatic headache is the most common and long-lasting impairment observed following mild traumatic brain injury, and frequently has migraine-like characteristics. The mechanisms underlying progression from mild traumatic brain injury to post-traumatic headache are not fully understood. The aim of this study was to develop a mouse model of post-traumatic headache and identify mechanisms and novel targets associated with this disorder. Methods We combined the closed head weight-drop method and the nitroglycerin chronic migraine model. To induce mild traumatic brain injury, a weight was dropped onto intact crania of mildly anesthetized mice, and mechanical responses to chronic-intermittent administration of nitroglycerin, a human migraine trigger, were determined at multiple time points post-injury. Results Low dose nitroglycerin (0.1 mg/kg) evoked acute periorbital and hind paw allodynia in both mild traumatic brain injury and sham animals. However, only mild traumatic brain injury mice developed chronic hypersensitivity to low dose nitroglycerin. Migraine medications, sumatriptan and topiramate, inhibited post-traumatic headache-associated allodynia. In addition, the delta opioid receptor agonist, SNC80, also blocked post-traumatic headache-associated allodynia. Finally, we examined the expression of calcitonin gene-related peptide within this model and found that it was increased in trigeminal ganglia two weeks post-mild traumatic brain injury. Conclusions Overall, we have established a mouse model of post-traumatic headache and identified the delta opioid receptor as a novel therapeutic target for this disorder.
The Woven EndoBridge (WEB) as primary treatment for unruptured intracranial aneurysms
Authors: van Rooij Sanne BT , van Rooij Willem Jan , Peluso Jo P , Sluzewski Menno 
Published: May 2018

Purpose The intrasaccular flow disruptor Woven EndoBridge (WEB) device is developed for the treatment of wide-necked aneurysms without supportive devices. We used the WEB as primary treatment for unruptured aneurysms suitable for the device, regardless of neck size. Methods Between February 2015 and June 2017, 59 aneurysms in 51 patients were selectively treated with the WEB. There were 15 men and 36 women with a mean age of 59 years. Mean aneurysm size was 7.0 mm (range 3–22 mm). Of 59 aneurysms, 45 (76%) had a wide neck defined as ≥4 mm or dome-neck ratio ≤1.5. No stents or supporting balloons were used. Results Initial WEB position was judged good in all 59 unruptured aneurysms. One patient with a basilar tip aneurysm had a late thrombotic posterior cerebral artery occlusion by protrusion of the WEB over the artery. There were no procedural ruptures. Overall complication rate was 2.0% (1 of 51, 95% CI 0.01–11.3%). Imaging follow-up was available in 55 of 59 aneurysms (93%). At 3 months, 41 of 57 aneurysms (72%) were completely occluded, 12 (21%) had a neck remnant and 4 (7%) were incompletely occluded. Conclusion WEB treatment is safe and effective in selected unruptured aneurysms suitable for the device, regardless of neck size or location. There was no need for supportive devices. Three-quarters of all unruptured small aneurysms could be treated with the WEB. In our opinion, the WEB is a valuable alternative to coils, especially in wide-necked aneurysms.
Inside help: An integrative review of champions in healthcare-related implementation
Authors: Miech Edward J , Rattray Nicholas A , Flanagan Mindy E , Damschroder Laura , Schmid Arlene A , Damush Teresa M 
Published: May 2018

Background/aims: The idea that champions are crucial to effective healthcare-related implementation has gained broad acceptance; yet the champion construct has been hampered by inconsistent use across the published literature. This integrative review sought to establish the current state of the literature on champions in healthcare settings and bring greater clarity to this important construct. Methods: This integrative review was limited to research articles in peer-reviewed, English-language journals published from 1980 to 2016. Searches were conducted on the online MEDLINE database via OVID and PubMed using the keyword “champion.” Several additional terms often describe champions and were also included as keywords: implementation leader, opinion leader, facilitator, and change agent. Bibliographies of full-text articles that met inclusion criteria were reviewed for additional references not yet identified via the main strategy of conducting keyword searches in MEDLINE. A five-member team abstracted all full-text articles meeting inclusion criteria. Results: The final dataset for the integrative review consisted of 199 unique articles. Use of the term champion varied widely across the articles with respect to topic, specific job positions, or broader organizational roles. The most common method for operationalizing champion for purposes of analysis was the use of a dichotomous variable designating champion presence or absence. Four studies randomly allocated of the presence or absence of champions. Conclusions: The number of published champion-related articles has markedly increased: more articles were published during the last two years of this review (i.e. 2015–2016) than during its first 30 years (i.e. 1980–2009). The number of champion-related articles has continued to increase sharply since the year 2000. Individual studies consistently found that champions were important positive influences on implementation effectiveness. Although few in number, the randomized trials of champions that have been conducted demonstrate the feasibility of using experimental design to study the effects of champions in healthcare.
Impact of nutritional status on pulmonary function after lung transplantation for cystic fibrosis
Authors: Staufer Katharina , Halilbasic Emina , Hillebrand Peter , Harm Solveig , Schwarz Stefan , Jaksch Peter , Kivaranovic Danijel , Klepetko Walter , Trauner Michael , Kazemi-Shirazi Lili 
Published: May 2018

BackgroundNutritional status is an important prognostic factor in patients with cystic fibrosis (CF) prior to lung transplantation.ObjectiveTo investigate the impact of nutritional status on pulmonary function in CF transplant recipients.MethodsAdult double lung transplanted CF patients were consecutively included. The predictive value of nutritional status on lung function – measured by spirometry – was longitudinally assessed by body composition serially evaluated by a three‐compartment model bioelectrical impedance analysis (BIA) in comparison to body mass index (BMI).ResultsOverall, 147 spirometries and 147 BIAs were performed in 58 patients (59% female, median age: 30.1 years, median BMI: 19.6 kg/m2). Malnourished patients (BMI < 18.5 kg/m2; 27.6%) had a significantly reduced lung function compared to normal/overweight patients (forced expiratory volume in 1 second in percent (FEV1%pred), 57% vs 77%; p = 0.024). BMI, as well as the BIA parameters phase angle, total body water, fat free mass, body cell mass (BCM) and extracellular mass (ECM)/BCM ratio, were univariate predictors of FEV1%pred. When included in a linear mixed model, ECM/BCM ratio remained the only significant predictor of lung function (p = 0.012).ConclusionNutritional status assessed by BIA predicted lung function in CF transplant recipients. Serial BIA measurements to monitor patients’ nutritional status might help to improve or maintain lung function.
Addressing the targeting range of the ABILHAND-56 in relapsing–remitting multiple sclerosis: A mixed methods psychometric study
Authors: Cleanthous Sophie , Strzok Sara , Pompilus Farrah , Cano Stefan , Marquis Patrick , Cohan Stanley , Goldman Myla D , Kresa-Reahl Kiren , Petrillo Jennifer , Castrillo-Viguera Carmen , Cadavid Diego , Chen Shih-Yin 
Published: May 2018

Background ABILHAND, a manual ability patient-reported outcome instrument originally developed for stroke patients, has been used in multiple sclerosis clinical trials; however, psychometric analyses indicated the measure’s limited measurement range and precision in higher-functioning multiple sclerosis patients. Objective The purpose of this study was to identify candidate items to expand the measurement range of the ABILHAND-56, thus improving its ability to detect differences in manual ability in higher-functioning multiple sclerosis patients. Methods A step-wise mixed methods design strategy was used, comprising two waves of patient interviews, a combination of qualitative (concept elicitation and cognitive debriefing) and quantitative (Rasch measurement theory) analytic techniques, and consultation interviews with three clinical neurologists specializing in multiple sclerosis. Results Original ABILHAND was well understood in this context of use. Eighty-two new manual ability concepts were identified. Draft supplementary items were generated and refined with patient and neurologist input. Rasch measurement theory psychometric analysis indicated supplementary items improved targeting to higher-functioning multiple sclerosis patients and measurement precision. The final pool of Early Multiple Sclerosis Manual Ability items comprises 20 items. Conclusion The synthesis of qualitative and quantitative methods used in this study improves the ABILHAND content validity to more effectively identify manual ability changes in early multiple sclerosis and potentially help determine treatment effect in higher-functioning patients in clinical trials.