bluuebunny/crossref_metadata_2025_split huggingface dataset:
Landscape genomic signatures indicate reduced gene flow and forest‐associated adaptive divergence in an endangered neotropical turtle
Authors: Gallego‐García Natalia , Forero‐Medina Germán , Vargas‐Ramírez Mario , Caballero Susana , Shaffer Howard Bradley 
Published: April 2019

AbstractHuman‐induced transformations of ecosystems usually result in fragmented populations subject to increased extinction risk. Fragmentation is also often associated with novel environmental heterogeneity, which in combination with restricted gene flow may increase the opportunity for local adaptation. To manage at‐risk populations in these landscapes, it is important to understand how gene flow is changing, and how populations respond to habitat loss. We conducted a landscape genomics analysis using Restriction‐site Associated DNA sequencing to investigate the evolutionary response of the critically endangered Dahl's Toad‐headed turtle (Mesoclemmys dahli) to severe habitat modification. The species has lost almost all of its natural habitat in the southwestern part of its range and about 70% in the northeast. Based on least cost path analysis across different resistance surfaces for 3,211 SNPs, we found that the landscape matrix is restricting gene flow, causing the fragmentation of the species into at least six populations. Genome scans and allele‐environment association analyses indicate that the population fragments in the deforested grasslands of the southwest are adaptively different from those in the more forested northeast. Populations in areas with no forest had low levels of adaptive genetic diversity and the fixation of ancestrally‐polymorphic SNPs, consistent with directional selection in this novel environment. Our results suggest that this forest‐stream specialist is adapting to pond‐grassland conditions, but it is also suffering from negative consequences of habitat loss, including genetic erosion, isolation, small effective population sizes, and inbreeding. We recommend gene flow restoration via genetic rescue to counteract these threats, and provide guidance for this strategy.
Beyond the struggles: a scoping review on the transition to undergraduate clinical training
Authors: Atherley Anique , Dolmans Diana , Hu Wendy , Hegazi Iman , Alexander Sonita , Teunissen Pim W 
Published: April 2019

ContextThe transition to clinical training within medical school is often seen as a struggle and students remain in distress despite numerous efforts to minimise threats. Efforts to change this may be misdirected if they are based on narrow conceptualisations of transitions. The authors conducted a scoping review to explore existing conceptual perspectives regarding the transition within medical school from pre‐clinical training to clinical training to suggest a research agenda and practical implications.MethodsBetween October 2017 and February 2018 the authors searched PubMed, MEDLINE, ERIC, PsycINFO, Web of Science and CINAHL for English language literature with no date limits and retrieved 1582 articles; 46 were included in this review. Two reviewers independently screened articles and extracted data. Data were then charted, analysed and discussed with the research team.ResultsThe transition to clinical training was often described negatively as ‘difficult’, ‘a problem’ and ‘a struggle’. Our analysis found that researchers in medical education conducted studies on the transition to clinical training from three conceptual perspectives: educational; social, and developmental. Most research approached the transition to clinical training as a problem to be addressed from an educational perspective through transition to clerkship courses and curriculum innovations. Some research was conducted from a social perspective, focusing on building relationships. Regarding development, authors found a few articles highlighting opportunities for personal and professional development by nurturing transferrable learning strategies and reflection.ConclusionsThis review provides an empirical base on which future research can be built to better understand and support medical students’ ability to navigate change. Finding new perspectives to approach the transition to clinical training could allow researchers to look beyond preparing students for struggles.
School‐level factors associated with obesity: A systematic review of longitudinal studies
Authors: Gray Heewon L. , Buro Acadia W. , Barrera Ikan Janelle , Wang Wei , Stern Marilyn 
Published: April 2019

SummaryAlthough school has been an important intervention venue for obesity prevention, the role of school‐level factors in obesity development or prevention has not been well‐documented. This study aimed to systematically examine the current evidence on school‐level factors associated with obesity outcomes in longitudinal studies. The literature search was performed in PubMed, EMBASE, CINHAL, and PsycINFO. Peer‐reviewed articles using longitudinal study designs and published in English from 1991 to 2018 were eligible. Twelve articles met eligibility criteria for final systematic review. Nine studies reported significant long‐term associations between school‐level factors and obesity outcomes. Higher parental education, longer minutes of recess, meeting recommended recess and physical education time, higher socio‐economic status, suburban compared with rural area, higher parental involvement in school, and healthful school food environment were significantly associated with lower rates of obesity or obesity trajectory. However, due to the small number of studies and heterogeneity of measures and variables used in their analytic models, the overall level of evidence from this review suggests the importance of further, systematic study. Empirically rigorous research is needed to identify additional aspects of the school context and environment that may contribute to the risk of obesity throughout the life course.
Dental management of lymphangiomatosis: case report
Authors: Charrette D. , Mulvihill C. , Brady P. 
Published: April 2019

AbstractLymphangiomatosis is a rare type of diffuse tumour, which develops from an aberrant growth of the lymphatic vessels, and can produce progressive osteolysis of bone in multiple organ systems. In this article, we illustrate a rare case of a 14‐year‐old female patient with lymphangiomatosis affecting the maxillofacial bones. The patient showed a marked deviation from normal maxillofacial growth patterns resulting in significant malocclusion and oral complications. The present study examines and considers the multidisciplinary management of the case with a brief review of the literature.
Success of chemotherapy and a liver transplant in a pediatric patient with hepatic angiosarcoma: A case report
Authors: Pilbeam Kristy , Eidenschink Ben , Sulciner Megan , Luquette Mark , Neglia Joseph , Chinnakotla Srinath 
Published: April 2019

AbstractHepatic angiosarcoma is an extremely rare diagnosis in children, with fewer than 50 pediatric cases reported in the literature worldwide. This aggressive vascular sarcoma carries a very dismal prognosis and is known to be resistant to radiation, chemotherapy, and other vascular‐targeted agents. Complete surgical resection is felt to provide the best chance for long‐term survival. In patients with tumors not amenable to resection, a liver transplant can be considered. However, very few such transplants have been reported, given that they remain controversial due to high cancer recurrence and mortality post‐transplant. Herein, we report the unique case of a 2‐year‐old child with localized hepatic angiosarcoma not amendable to resection who successfully underwent a liver transplant and received chemotherapy with six cycles of doxorubicin, docetaxel, and ifosfamide.
Hepatic artery reconstruction with interposition of donor’s right gastroepiploic artery graft in pediatric living donor liver transplantation for metabolic disease
Authors: Chen Xiaojie , Wei Lin , Zhu Zhijun , Sun Liying , Qu Wei , Zeng Zhigui 
Published: April 2019

AbstractObjectiveWe introduce the indications, technique, results of our experience using donor's RGEA as interposition vessel to solve hepatic artery reconstruction problems in P‐LDLT.MethodsA retrospective analysis of P‐LDLT for children with metabolic diseases from June 2013 to November 2018 in our center was carried out. The arterial conditions, reconstruction methods, and prognosis were analyzed.ResultsA total of 73 children with metabolic diseases underwent P‐LDLT during the period. The LLF was the main graft, accounting for 71.2%. The donor's RGEA was utilized in five cases. There were three children with OTCD and two children with deficiency of CPS1 and MSUD, respectively. In three cases, the grafts’ left hepatic arteries were anastomosed with the recipients’ PHA using donors’ RGEA as interposition vessel. In other two cases, the donors’ RGEA was interposed between graft's MHA and the recipient's bifurcation of PHA and GDA. The average follow‐up time was 19.7 ± 15.9 month. There were two cases of artery thrombosis or occlusion, and the incidence was 2.7%. No arterial complications occurred in children using RGEA (follow‐up time 5.0 ± 3.4 months).ConclusionIn P‐LDLT for patients with metabolic diseases, the application of RGEA as an interposition vessel can solve caliber mismatch and short arteries problem and achieve good results. Compared with traditional arterial anastomosis, it may reduce the incidence of arterial complications.
Low‐dose azacitidine for relapse prevention after allogeneic hematopoietic cell transplantation in children with myeloid malignancies
Authors: Oshrine Benjamin R. , Shyr David , Hale Gregory , Petrovic Aleksandra 
Published: April 2019

AbstractBackgroundThe prognosis of children who relapse after allogeneic hematopoietic cell transplant (alloHCT) for myeloid malignancies remains poor.ProcedureTo describe the safety and feasibility of post‐transplant azacitidine for relapse prevention, we retrospectively reviewed the charts of 18 children undergoing alloHCT for myeloid malignancies.ResultsThere were 15 evaluable patients since three patients did not receive planned azacitidine due to early relapse or TRM. Azacitidine (32 mg/m2/dose for 5 days, in 28‐day cycles as tolerated up to 1 year post‐transplant) was started at a median of 66 days post‐transplant (range 42‐118). Two‐thirds (10/15) of patients received eight or more cycles. Five patients stopped therapy early, only one attributable to toxicity. Mild myelosuppression was the most common reason for cycle delays. Dose modifications were made in three patients. There were three relapses, two of which occurred in patients in CR2 and one in CR1, with a median follow‐up of 20 months (range 12.5‐28), and no TRM in patients who received azacitidine.ConclusionsPost‐transplant azacitidine in children is safe and feasible, with most patients successfully receiving all planned cycles. Despite the limitations of a small cohort, low relapse incidence suggests a potential benefit in disease control that warrants further investigation.
SrfC of Pseudomonas cichorii JBC1 affects its attachment to the host surface and host tissue infection
Authors: Nagendran R. , Lee Y. H. 
Published: April 2019

Plant pathogenic Pseudomonas species produce effectors, toxins and cyclic lipopeptides to infect various host plants. Despite many studies aiming to understand the underlying mechanisms of virulence in Pseudomonas spp., the function of genes in the srf gene cluster including srfC, which was formerly known as HopL1, remains undetermined. To investigate the roles of srf genes in the virulence of the bacterial pathogen, each srfA, srfB, srfC and srfD gene from the srf cluster of Pseudomonas cichorii JBC1 was knocked out. When tomato seedlings were infected with the knockout mutants by flood inoculation, disease incidence was suppressed only in srfC‐defective mutants (∆srfC) compared to wildtype. Interestingly, when the ∆srfC strain was inoculated directly into the apoplast of tomato leaves by vacuum infiltration, disease developed similar to that of the wildtype. In addition, the ∆srfC strain showed defective swarming motility and biofilm formation, and the attachment of ∆srfC cells on the leaf surface was significantly reduced compared to wildtype. Furthermore, droplets of the ∆srfC culture supernatant did not spread on a hydrophobic surface, unlike the wildtype. The results indicate that the SrfC protein plays important roles in swarming motility, biofilm formation and attachment/colonization on host surfaces; thus, it is beneficial for the pathogen's dispersion and entry into host tissues and consequently contributes to disease development. This study elucidates for the first time the functional role of srfC in P. cichorii virulence. The results will broaden understanding of plant and bacterial pathogen interactions.
The Intimate Link Between Income Levels and Life Expectancy: Global Evidence from 213 Years*
Authors: Jetter Michael , Laudage Sabine , Stadelmann David 
Published: April 2019

ObjectivesWhat is the main driver of life expectancy across societies and over time? This study aims to document a systematic and quantitatively sizeable relationship between income levels and life expectancy.MethodA panel data set of 197 countries over 213 years is analyzed with different regression methods. Robustness tests are provided.ResultsBy itself, GDP per capita explains more than 64 percent of the variation in life expectancy. The Preston curve prevails even when accounting for country‐ and time‐fixed effects, country‐specific time trends, and alternative explanatory variables such as health‐care expenditure, malaria prevalence, or political institutions. If anything, this link has become stronger over recent decades when data quality has improved. Results from instrumental variable estimations suggest this finding to be largely unaffected by reverse causality. Quantile regression results suggest the relationship between income and life expectancy to be persistent across different levels of life expectancy.ConclusionIncome matters for life expectancy. If policymakers want to prolong people's lives, economic growth appears to be the predominant medicine.
Effectiveness of blood donor screening by HIV, HCV, HBV‐NAT assays, as well as HBsAg and anti‐HBc immunoassays in Germany (2008–2015)
Authors: Fiedler Sarah A. , Oberle Doris , Chudy Michael , Scheiblauer Heinrich , Henseler Olaf , Halbauer Jochen , Heiden Margarethe , Funk Markus 
Published: April 2019

Background and ObjectivesIn Germany, in addition to standard blood donor screening, further mandatory tests were introduced for HCV‐RNA, HIV‐1‐RNA and for anti‐HBc. Screening for HBV‐DNA is optional. This study investigates the benefits of these additional tests for the detection of HIV, HCV, and HBV infections among German blood donors.Materials and MethodsFrom 2008 to 2015 we collected data on blood donations exclusively testing NAT positive (NAT yield) or reactive in only one of the screening assays. Assuming a Poisson distribution, we calculated NAT yield/reactive only rates on a per donation basis (number of yield/reactive only cases divided by the number of donations tested in the period under review) with 95% confidence intervals.ResultsResponding establishments covered 95% of the donations. We identified 20 HIV‐1‐NAT, 61 HCV‐NAT and 29 HBV‐NAT yield cases among approximately 46 million blood donations tested corresponding to 0·43 HIV‐1 NAT, 1·32 HCV‐NAT, and 0·64 HBV‐NAT yield cases per million blood donations tested. For one HBsAg reactive only case and 23 anti‐HBc reactive only cases in repeat donors, infection was confirmed by ID‐NAT which translates into 0·02 and 0·55 cases per million donations tested. During the 8‐year‐observation period, one HIV‐1, no HCV and four HBV transmissions associated with donations in the viremic pre‐seroconversion window period were reported.ConclusionAnnually, NAT screening alone detected 2·5 HIV‐1, 7·6 HCV, and 3·6 HBV infectious donations; anti‐HBc screening alone identified 2·9 infectious donations of repeat donors with occult HBV infection. Overall, the survey results support that the currently practiced donor HIV/HCV/HBV screening strategy in Germany does ensure a high standard of blood safety.
Prolonged survival after craniectomy with skull reconstruction and adjuvant definitive radiation therapy in three dogs with multilobular osteochondrosarcoma
Authors: Holmes Molly E. , Keyerleber Michele A. , Faissler Dominik 
Published: April 2019

AbstractMultilobular osteochondrosarcoma is an uncommon canine tumor but presents a treatment challenge when arising on the skull. This retrospective case series study aimed to describe outcome of a multimodality treatment approach involving aggressive surgical resection and adjuvant definitive radiation therapy in a group of dogs with multilobular osteochondrosarcoma of the calvarium. Clinical, imaging, treatment, and outcome data were collected from retrospective review of medical records. Three dogs met inclusion criteria. The presenting clinical complaint was the presence of a mass effect of the skull in all three dogs and concurrent neurologic abnormalities in one dog. Advanced imaging revealed aggressive lytic and proliferative tumors arising from the calvarium in all three dogs. All dogs were treated surgically with a modified craniectomy, repaired with a titanium mesh—polymethyl methacrylate bone cement implant or a low prolife titanium mesh plate and followed by adjuvant definitive radiation therapy with 2.5 Gy per fraction for 22 daily fractions. There were no major immediate surgical complications and radiation was well tolerated overall. Neurologic improvement was seen in the patient that presented with neurologic disease. Survival times from surgery were 387, 422, and 730 days and from the time of radiation were 358, 397, and 677 days. Findings in this sample of three dogs supported the use of aggressive therapy with a combination of surgical craniectomy and cranioplasty utilizing a titanium mesh implant and high dose definitive radiation therapy for local control and prolonged survival times in dogs with multilobular osteochondrosarcoma of the skull.
Improving Provider Readiness for Intimate Partner Violence Screening
Authors: Lee Amy S. D. , McDonald Lynn R. , Will Susan , Wahab Maybel , Lee Judy , Coleman Jenell S. 
Published: April 2019

AbstractBackgroundIntimate partner violence (IPV) is a significant public health issue. Healthcare providers (e.g., nurses, advanced practice nurses, physicians, social workers) have a unique opportunity to prevent and reduce IPV through screening and referral. The objective of this project was to determine the impact of education and a brief screening tool integrated into the electronic medical record (EMR) on readiness to screen for IPV.MethodsAn intervention was implemented that included the EMR integration of a screening tool, creation of an automated resource telephone system and healthcare provider IPV screening and response education. Readiness for screening was evaluated pre‐ and postintervention using the Domestic Violence Health Care Provider Survey Scale (DVHCPSS), which is scored cumulatively and by each of six domains. An unpaired Student's t test was performed.ResultsMean age (31–40 years of age) and years of clinical practice (11–15 years) was the same for pre‐ (n = 96) and postintervention (n = 83) survey respondents. There was an overall significant increase in screening readiness (p = .003) with significant improvement in “professional role resistance/fear of offending the patient” (p < .0001), “blame victim items” (p = .0029), “perceived self‐efficacy” (p = .0064), and “victim/provider safety” (p = .003).Linking Evidence to ActionAdopting and integrating a validated IPV screening tool into the EMR combined with education was associated with an improvement in overall readiness for IPV screening. Reducing and preventing IPV through universal screening and referral can be accomplished by embedding a standardized readily accessible validated IPV screening tool in the EMR.
Understanding and applying practitioner and patient views on the implementation of a novel automated Computer-Aided Risk Score (CARS) predicting the risk of death following emergency medical admission to hospital: qualitative study
Authors: Dyson Judith , Marsh Claire , Jackson Natalie , Richardson Donald , Faisal Muhammad , Scally Andrew J , Mohammed Mohammed 
Published: April 2019

ObjectivesThe Computer-Aided Risk Score (CARS) estimates the risk of death following emergency admission to medical wards using routinely collected vital signs and blood test data. Our aim was to elicit the views of healthcare practitioners (staff) and service users and carers (SU/C) on (1) the potential value, unintended consequences and concerns associated with CARS and practitioner views on (2) the issues to consider before embedding CARS into routine practice.SettingThis study was conducted in two National Health Service (NHS) hospital trusts in the North of England. Both had in-house information technology (IT) development teams, mature IT infrastructure with electronic National Early Warning Score (NEWS) and were capable of integrating NEWS with blood test results. The study focused on emergency medical and elderly admissions units. There were 60 and 39 acute medical/elderly admissions beds at the two NHS hospital trusts.ParticipantsWe conducted eight focus groups with 45 healthcare practitioners and two with 11 SU/Cs in two NHS acute hospitals.ResultsStaff and SU/Cs recognised the potential of CARS but were clear that the score should not replace or undermine clinical judgments. Staff recognised that CARS could enhance clinical decision-making/judgments and aid communication with patients. They wanted to understand the components of CARS and be reassured about its accuracy but were concerned about the impact on intensive care and blood tests.ConclusionRisk scores are widely used in healthcare, but their development and implementation do not usually involve input from practitioners and SU/Cs. We contributed to the development of CARS by eliciting views of staff and SU/Cs who provided important, often complex, insights to support the development and implementation of CARS to ensure successful implementation in routine clinical practice.