bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hepatitis, Interstitial Nephritis, and Pancreatitis in Association With Clozapine Treatment
Authors: Lally John , al Kalbani Hana , Krivoy Amir , Murphy Kieran C. , Gaughran Fiona , MacCabe James H. 
Published: July 2018

Abstract

Purpose/Background
Clozapine is the criterion standard in treatment-resistant schizophrenia. We sought to review data on several inflammatory effects associated with clozapine, specifically interstitial nephritis, hepatitis, and pancreatitis.

Methods/Procedures
We conducted a systematic review to identify studies, published up until December 2017, describing clozapine-induced hepatitis, nephritis, and pancreatitis. The primary objective was to characterize the clinical characteristics associated with each of the specific inflammatory reactions to clozapine.

Findings/Results
We identified 42 cases of inflammatory reactions associated with clozapine treatment- 20 :cases of clozapine-induced hepatitis, 11 cases of nephritis, and 11 of pancreatitis. The mean (SD) age was 38.8 (11.9) years. The mean (SD) dose of clozapine used was 252.4 (133.7) mg. Time to onset of pancreatitis (17.9 [11.2] days; range 4–35 days) was shorter than that for hepatitis (34.2 [20.1] days; range, 12–90 days) and nephritis (27.9 [27.0]; range, 8–90 days) but was not statistically significant (F = 2.267, P = 0.117). The mean (SD) time to recovery was shorter for cases of pancreatitis (15.7 [18.4] days) compared with cases of hepatitis (25.9 [16.5] days) and nephritis (24.5 [18.9] days). Three cases with hepatitis died. Seven of the cases had a clozapine rechallenge (hepatitis [n = 3], nephritis [n = 1], pancreatitis [n = 3]), with 5 having a recurrence at a mean (SD) onset of 3.5 (2.5) days (range, 1–7 days); 2 hepatitis cases were successfully rechallenged.

Implications/Conclusions
Clozapine-induced hepatitis, nephritis, and pancreatitis are uncommon adverse events, reflected in the paucity of case studies in the literature. Early recognition of the signs and symptoms of clozapine-associated hepatitis, nephritis, and pancreatitis is important, as when identified, clozapine should be urgently discontinued. Clozapine is associated with evidence of benign inflammatory processes; the extent to which hepatitis, and other inflammatory reactions, may be on a continuum with these more benign and self-limiting reactions is unclear, and this can only be resolved by prospectively following cohorts of clozapine-treated patients.
Clinical and Pathological Features of Solid Pseudopapillary Neoplasms of the Pancreas
Authors: Hanada Keiji , Kurihara Keisuke , Itoi Takao , Katanuma Akio , Sasaki Tamito , Hara Kazuo , Nakamura Masafumi , Kimura Wataru , Suzuki Yutaka , Sugiyama Masanori , Ohike Nobuyuki , Fukushima Noriyoshi , Shimizu Michio , Ishigami Kousei , Gabata Toshifumi , Okazaki Kazuichi 
Published: July 2018

Objective
The aim of this study was to evaluate the clinicopathological features of solid pseudopapillary neoplasms (SPNs).

Methods
In this retrospective study, 288 SPNs were analyzed.

Results
Overall, 214 patients (74%) were female. Distant metastases occurred in 4 patients, and splenic vein tumor thrombus occurred in 1 patient. Although imaging findings showed large (>2.0 cm) SPNs with clear, regular border, and heterogeneous internal structure, small SPNs appeared as almost entirely solid. Surgical resection was performed in 278 cases. The 5-year survival rate was 98.8%. Six patients had tumor recurrence after the initial resection. The detection rate in typical pathological findings was low for small SPNs. Tumor extension to the pancreatic parenchyma was detected in greater than 70% of the cases. Tumor invasion to adjacent organs was detected in 13 cases. One was given a diagnosis of apparent high-grade malignant transformation.

Conclusions
The proportion of male cases was higher than that in previous studies, and there were statistically significant differences in the onset age and tumor diameter between male and female patients. Therefore, women seemed to have an early occurrence of SPNs, suggesting a difference in the developmental stage between men and women. Images and pathological findings of SPNs varied according to tumor size. Our findings indicated that SPN patients have excellent survival after margin-negative surgical resection.
Implementing Posthospital Interprofessional Care Team Visits to Improve Care Transitions and Decrease Hospital Readmission Rates
Authors: Baldwin Stacy M. , Zook Sharon , Sanford Julie 
Published: July 2018

Purpose/Objectives:
Today's health care climate is composed of patients who experience complex conditions with multiple comorbidities, requiring higher utilization of acute care services. It is imperative for acute care and primary care landscapes to bridge silos and form collaborative relationships to ensure safe and effective transitions of care from hospital to home. An interprofessional, posthospital follow-up clinic (Discharge Clinic) is one approach that can be used to improve transitions of care and decrease preventable hospital readmissions. The purpose of the Discharge Clinic is to improve transitions of care and decrease 30-day hospital readmission rates. The clinic's objective is to utilize an interprofessional care team to improve transitions of care posthospital, for complex care patients.

Primary Practice Setting:
The posthospital Discharge Clinic is an innovative, interprofessional clinic located in a large western state that was initiated to improve transitions of care for its patients discharged from an acute care setting. The interprofessional care team consists of a certified family nurse practitioner, a clinical pharmacist, a nurse case manager, and a social worker.

Findings/Conclusions:
In 2013, Medicare and private coverage data reveal 30-day readmission rates of 17.3% and 8.6%, respectively (Agency for Health Care Quality and Research, 2013). From February 2016 to September 2016, Discharge Clinic project participants achieved a 30-day readmission rate of 2.7%. The Discharge Clinic enrolled 75 patients in the project (n = 75). The 30-day readmission rate achieved by the Discharge Clinic represents a significant decrease compared with national benchmark data. Two patients enrolled in the project were readmitted within 30 days of hospital discharge. For fiscal year 2015, the medical group's estimated cost of readmissions was $7,156,800 and 30-day all-cause readmission rate was 12.3%. This equated to the Discharge Clinic's estimated impact in reducing readmissions at 9.63% and an estimated savings of $689,199.84. The Discharge Clinic estimated its operating costs at $354,000, which gave a total estimated net savings of $335,199.84.

Implications for Case Management Practice:
The current health care landscape is composed of an aging population, rising in complexity. New approaches are needed to bridge gaps between acute care and primary care settings. The Discharge Clinic serves as an innovative model that health systems throughout the country can replicate to improve transitions of care for complex patients. The interprofessional care team model can be implemented to advance and bridge the management of acute and ambulatory care patient populations.
Cognitive and Behavioral Consequences of Pediatric Delirium: A Pilot Study*
Authors: Meyburg Jochen , Ries Markus , Zielonka Matthias , Koch Karin , Sander Anja , von Haken Rebecca , Reuner Gitta 
Published: July 2018

Objectives:
To investigate the long-term impact of postoperative delirium in children.

Design:
Single-center point prevalence study.

Setting:
Twenty-two bed PICU.

Patients:
Forty-seven patients 1–16 years old.

Interventions:
Standardized neuropsychologic follow-up investigation after a mean time of 17.7 ± 2.9 months after PICU discharge.

Measurements and Main Results:
Pediatric delirium did not have significant long-term impact on global cognition, executive functions, or behavior. Severity of delirium did not influence the outcome. Different predictors were identified for later cognitive functioning, executive functions, and behavioral problems. Younger age was confirmed to be a relevant risk factor for delirium as well as for the cognitive and behavioral outcome.

Conclusions:
Contrary to the findings in adults, there was no clear association between pediatric delirium and long-term cognition or behavior in this cohort. However, this is a first pilot study with several limitations that should promote more comprehensive prospective trials.
Contribution of SPECT/CT to Evaluate Urinary Leakage Suspicion in Renal Transplant Patients
Authors: Yazici Bulent , Oral Aylin , Akgün Aysegül 
Published: July 2018

Abstract
It is known that renal scintigraphy is the best imaging modality in the diagnosis of urinary leakage. Usually, only planar images are diagnostic but sometimes they are unclear when urinoma is small and adjacent to kidney or bladder. In other respects, planar images can be false-positive in the case of increased blood flow of abdominal wall. We suggested using SPECT/CT in differential diagnosis. An atlas of SPECT/CT is presented, which includes 3 cases that urinoma was diagnosed by SPECT/CT, which were unclear on planar images, and one case that urinary leakage suspicion on planar image was ruled out by SPECT/CT.
Hidden burden of venous thromboembolism after trauma: A national analysis
Authors: Rattan Rishi , Parreco Joshua , Eidelson Sarah A. , Gold Joann , Dharmaraja Arjuna , Zakrison Tanya L. , Dante Yeh D. , Ginzburg Enrique , Namias Nicholas 
Published: July 2018

BACKGROUND
Trauma patients are at increased risk for venous thromboembolism (VTE). One in four trauma readmissions occur at a different hospital. There are no national studies measuring readmissions to different hospitals with VTE after trauma. Thus, the true national burden in trauma patients readmitted with VTE is unknown and can provide a benchmark to improve quality of care.

METHODS
The Nationwide Readmission Database (2010–2014) was queried for patients ≥18 years non-electively admitted for trauma. Patients with VTE or inferior vena cava filter placement on index admission were excluded. Outcomes included 30-day and 1-year readmission to both index and different hospitals with a new diagnosis of VTE. Multivariable logistic regression identified risk factors. Results were weighted for national estimates.

RESULTS
Of the 5,151,617 patients admitted for trauma, 1.2% (n = 61,800) were readmitted within 1 year with VTE. Of those, 29.6% (n = 18,296) were readmitted to a different hospital. Risk factors for readmission to a different hospital included index admission to a for-profit hospital (OR 1.33 [1.27–1.40], p < 0.001), skull fracture (OR 1.20 [1.08–1.35], p < 0.001), Medicaid (OR 1.16 [1.06–1.26], p < 0.001), hospitalization >7 days (OR 1.12 [1.07–1.18], p < 0.001), and the lowest quartile of median household income for patient ZIP code (OR 1.13 [1.07–1.19], p < 0.01). The yearly cost of 1-year readmission for VTE was $256.9 million, with $90.4 million (35.2%) as a result of different hospital readmission.

CONCLUSIONS
Previously unreported, over one in three patients readmitted with VTE a year after hospitalization for trauma, accounting for over a third of the cost, present to another hospital and are not captured by current metrics. Risk factors are unique. This has significant implications for benchmarking, outcomes, prevention, and policy.

LEVEL OF EVIDENCE
Epidemiological study, level II.
Safety of early tracheostomy in trauma patients after anterior cervical fusion
Authors: Lozano Claudia P. , Chen Kevin A. , Marks Joshua A. , Jenoff Jay S. , Cohen Murray J. , Weinstein Michael S. 
Published: July 2018

BACKGROUND
Cervical spine injuries (CSIs) can have major effects on the respiratory system and carry a high incidence of pulmonary complications. Respiratory failure can be due to spinal cord injuries, concomitant facial fractures or chest injury, airway obstruction, or cognitive impairments. Early tracheostomy (ET) is often indicated in patients with CSI. However, in patients with anterior cervical fusion (ACF), concerns about cross-contamination often delay tracheostomy placement. This study aimed to demonstrate the safety of ET within 4 days of ACF.

METHODS
Retrospective chart review was performed for all trauma patients admitted to our institution between 2001 and 2015 with diagnosis of CSI who required both ACF and tracheostomy, with or without posterior cervical fusion, during the same hospitalization. Thirty-nine study patients with ET (within 4 days of ACF) were compared with 59 control patients with late tracheostomy (5–21 days after ACF). Univariate and logistic regression analyses were performed to compare risk of wound infection, length of intensive care unit and hospital stay, and mortality between both groups during initial hospitalization.

RESULTS
There was no difference in age, sex, preexisting pulmonary or cardiac conditions, Glasgow Coma Scale score, Injury Severity Score, Chest Abbreviated Injury Scale score, American Spinal Injury Association score, cervical spinal cord injury levels, and tracheostomy technique between both groups. There was no statistically significant difference in surgical site infection between both groups. There were no cases of cervical fusion wound infection in the ET group (0%), but there were five cases (8.47%) in the late tracheostomy group (p = 0.15). Four involved the posterior cervical fusion wound, and one involved the ACF wound. There was no statistically significant difference in intensive care unit stay (p = 0.09), hospital stay (p = 0.09), or mortality (p = 0.06) between groups.

CONCLUSION
Early tracheostomy within 4 days of ACF is safe without increased risk of infection compared with late tracheostomy.

LEVEL OF EVIDENCE
Evidence, level III.
Reorganization of the connectivity between elementary functions as a common mechanism of phenomenal consciousness and working memory: from functions to strategies
Authors: Mogensen Jesper , Overgaard Morten 
Published: July 2018

In the present communication, phenomenal consciousness, access consciousness and the closely related concept of working memory are presented in the context of a neurocognitive model—the REF (reorganization of elementary functions) framework. The REF framework is based on connectionist networks within which the ‘units’ are advanced processing modules called elementary functions (EFs). In this framework, the focus is on dynamically changeable ‘strategies’—based on reorganizations of the connectivity between EFs—rather than on the more traditional ‘cognitive functions’. The background for the REF framework and especially how the neural correlate of consciousness is understood within these models is summarized. According to the REF framework, phenomenal consciousness cannot ‘overflow’ availability of information for action. Phenomenal consciousness may, however, overflow working memory because working memory in the present context is seen as a surface phenomenon reflecting underlying dynamic strategies—influenced by both experience and situational factors.
This article is part of the theme issue ‘Perceptual consciousness and cognitive access'.
Downgraded phenomenology: how conscious overflow lost its richness
Authors: Ward Emily J. 
Published: July 2018

Our in-the-moment experience of the world can feel vivid and rich, even when we cannot describe our experience due to limitations of attention, memory or other cognitive processes. But the nature of visual awareness is quite sparse, as suggested by the phenomena of failures of awareness, such as change blindness and inattentional blindness. I will argue that once failures of memory or failures of comparison are ruled out as explanations for these phenomena, they present strong evidence against rich awareness. To accommodate and explain these massive failures of awareness, any theory of phenomenal consciousness must downgrade phenomenology to a degree where it is functionless or, ironically, does not reflect what we experience.
This article is part of the theme issue ‘Perceptual consciousness and cognitive access’.
Glutathione-S-transferase from the arsenic hyperaccumulator fernPteris vittatacan confer increased arsenate resistance inEscherichia coli
Authors: Khan Aftab A. , Ellis Danielle R. , Huang Xinyuan , Norton Gareth J. , Meharg Andrew A. , Salt David E. , Csonka Laszlo N. 
Published: July 2018

AbstractAlthough arsenic is generally a toxic compound, there are a number of ferns in the genusPteristhat can tolerate large concentrations of this metalloid. In order to probe the mechanisms of arsenic hyperaccumulation, we expressed aPteris vittatacDNA library in anEscherichia coli ΔarsC(arsenate reductase) mutant. We obtained three independent clones that conferred increased arsenate resistance on this host. DNA sequence analysis indicated that these clones specify proteins that have a high sequence similarity to the phi class of glutathione-S-transferases (GSTs) of higher plants. Detoxification of arsenate by theP. vittataGSTs inE. coliwas abrogated by agshAmutation, which blocks the synthesis of glutathione, and by agormutation, which inactivates glutathione reductase. Direct measurements of the speciation of arsenic in culture media of theE. colistrains expressing theP. vittataGSTs indicated that these proteins facilitate the reduction of arsenate. Our observations suggest that the detoxification of arsenate by theP. vittataGSTs involves reduction of As(V) to As(III) by glutathione or a related sulfhydro compound.FundingThe authors acknowledge support from the Indiana 21st Century Research and technology Fund (912010479) to DES and LNC, from the U.S. Department of Energy (grant no. DE-FG02-03ER63622) to DES, and from BBSRC-DFID (grant no. BBF0041841GJN) to AAM. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. There are no financial, personal, or professional interests that could be construed to have influenced the paper.
Strategies to improve photosynthetic nitrogen-use efficiency with no yield penalty: lessons from late-sown winter wheat
Authors: Yin Lijun , Xu Haicheng , Dong Shuxin , Chu Jinpeng , Dai Xinglong , He Mingrong 
Published: July 2018

HighlightOptimal N allocation at several integration levels accounts for improved canopy PNUE while maintaining high grain yield in winter wheatAbstractImproving canopy photosynthetic nitrogen-use efficiency (PNUE) may maintain or even increase yield with reduced N input. In this study, later-sown winter wheat was studied to reveal the mechanism underlying improved canopy PNUE while maintaining high yield. N allocation at several levels was optimised in late-sown wheat plants. N content per plant increased. Increased N was allocated to the flag leaf and second leaf, and to ribulose-1, 5-bisphosphate carboxylase/oxygenase (Rubisco) in upper leaves. Constant or reduced N was allocated to leaf 3, leaf 4, and Rubisco in lower leaves. The specific green leaf area nitrogen (SLN) of upper leaves increased, while that of lower leaves remained unchanged or decreased. N allocation to the cell wall decreased in all leaves. As a result, the maximum carboxylation rate of upper leaves increased, and that of lower leaves remained constant or decreased. CO2 diffusion capacity was enhanced in all leaves. Outperformance by light-saturated net photosynthetic rate (Pmax) over SLN led to improved PNUE in upper leaves. Enhanced Pmax coupled with unchanged or decreased SLN resulted in improved PNUE in lower leaves. High yield was maintained because enhanced photosynthetic capacity at the leaf and whole plant levels compensated for reduced canopy leaf area.
RNAlater and flash freezing storage methods nonrandomly influence observed gene expression in RNAseq experiments
Authors: Passow Courtney N. , Kono Thomas J. Y. , Stahl Bethany A. , Jaggard James B. , Keene Alex C. , McGaugh Suzanne E. 
Published: July 2018

AbstractRNA-sequencing is a popular next-generation sequencing technique for assaying genome-wide gene expression profiles. Nonetheless, it is susceptible to biases that are introduced by sample handling prior gene expression measurements. Two of the most common methods for preserving samples in both field-based and laboratory conditions are submersion in RNAlater and flash freezing in liquid nitrogen. Flash freezing in liquid nitrogen can be impractical, particularly for field collections. RNAlater is a solution for stabilizing tissue for longer-term storage as it rapidly permeates tissue to protect cellular RNA. In this study, we assessed genome-wide expression patterns in 30 day old fry collected from the same brood at the same time point that were flash-frozen in liquid nitrogen and stored at −80°C or submerged and stored in RNAlater at room temperature, simulating conditions of fieldwork. We show that sample storage is a significant factor influencing observed differential gene expression. In particular, genes with elevated GC content exhibit higher observed expression levels in liquid nitrogen flash-freezing relative to RNAlater-storage. Further, genes with higher expression in RNAlater relative to liquid nitrogen experience disproportionate enrichment for functional categories, many of which are involved in RNA processing. This suggests that RNAlater may elicit a physiological response that has the potential to bias biological interpretations of expression studies. The biases introduced to observed gene expression arising from mimicking many field-based studies are substantial and should not be ignored.
Performance of gene expression analyses usingde novoassembled transcripts in polyploid species
Authors: Chen Ling-Yun , Morales-Briones Diego F. , Passow Courtney N. , Yang Ya 
Published: July 2018

AbstractMotivationQuality of gene expression analyses usingde novoassembled transcripts in species experienced recent polyploidization is yet unexplored.ResultsFive plant species with various polyploidy history were used for differential gene expression (DGE) analyses. DGE analyses using putative genes inferred by Trinity performed similar to or better than Corset and Grouper in precision, but lower in sensitivity. In species that lack polyploidy event in the past few million years, DGE analyses usingde novoassembled transcriptome identified 50–76% of the differentially expressed genes recovered by mapping reads to the reference genes. However, in species with more recent polyploidy event, the percentage decreased to 7–30%. In addition, 7–89% of differentially expressed genes fromde novoassembly are contaminations. Gene co-expression network analyses usingde novoassemblies vs. mapping to the reference genes recovered the same module that significantly correlated with treatment in one of the five species tested.Availability and ImplementationCommands and scripts used in this study are available athttps://bitbucket.org/lychen83/chen_et_al_2018_benchmark_dge/; Analysis files are available at Dryad doi: XXXXXX.Contactlychen83@qq.comSupplementary informationSupplementary data are available atBioinformaticsonline