bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Do You Deal With Uncertainty? Cochlear Implant Users Differ in the Dynamics of Lexical Processing of Noncanonical Inputs
Authors: McMurray Bob , Ellis Tyler P. , Apfelbaum Keith S. 
Published: December 2018

Objectives:
Work in normal-hearing (NH) adults suggests that spoken language processing involves coping with ambiguity. Even a clearly spoken word contains brief periods of ambiguity as it unfolds over time, and early portions will not be sufficient to uniquely identify the word. However, beyond this temporary ambiguity, NH listeners must also cope with the loss of information due to reduced forms, dialect, and other factors. A recent study suggests that NH listeners may adapt to increased ambiguity by changing the dynamics of how they commit to candidates at a lexical level. Cochlear implant (CI) users must also frequently deal with highly degraded input, in which there is less information available in the input to recover a target word. The authors asked here whether their frequent experience with this leads to lexical dynamics that are better suited for coping with uncertainty.

Design:
Listeners heard words either correctly pronounced (dog) or mispronounced at onset (gog) or offset (dob). Listeners selected the corresponding picture from a screen containing pictures of the target and three unrelated items. While they did this, fixations to each object were tracked as a measure of the time course of identifying the target. The authors tested 44 postlingually deafened adult CI users in 2 groups (23 used standard electric only configurations, and 21 supplemented the CI with a hearing aid), along with 28 age-matched age-typical hearing (ATH) controls.

Results:
All three groups recognized the target word accurately, though each showed a small decrement for mispronounced forms (larger in both types of CI users). Analysis of fixations showed a close time locking to the timing of the mispronunciation. Onset mispronunciations delayed initial fixations to the target, but fixations to the target showed partial recovery by the end of the trial. Offset mispronunciations showed no effect early, but suppressed looking later. This pattern was attested in all three groups, though both types of CI users were slower and did not commit fully to the target. When the authors quantified the degree of disruption (by the mispronounced forms), they found that both groups of CI users showed less disruption than ATH listeners during the first 900 msec of processing. Finally, an individual differences analysis showed that within the CI users, the dynamics of fixations predicted speech perception outcomes over and above accuracy in this task and that CI users with the more rapid fixation patterns of ATH listeners showed better outcomes.

Conclusions:
Postlingually deafened CI users process speech incrementally (as do ATH listeners), though they commit more slowly and less strongly to a single item than do ATH listeners. This may allow them to cope more flexible with mispronunciations.
Therapeutic Plasma Exchange in Children With Thrombocytopenia-Associated Multiple Organ Failure: The Thrombocytopenia-Associated Multiple Organ Failure Network Prospective Experience
Authors: Fortenberry James D. , Nguyen Trung , Grunwell Jocelyn R. , Aneja Rajesh K. , Wheeler Derek , Hall Mark , Fleming Geoffrey , Tarrago Rod , Buttram Sandra , Dalton Heidi , Han Yong , Easley Kirk A. , Knezevic Andrea , Dai Tian , Paden Matthew , Carcillo Joseph A. 
Published: December 2018

Objective:
The objective was to compare the resolution of organ dysfunction, 28-day mortality, and biochemical markers in children with thrombocytopenia-associated multiple organ failure who received therapeutic plasma exchange versus no therapeutic plasma exchange.

Design:
Observational longitudinal cohort study.

Setting:
Nine U.S. PICUs.

Patients:
Eighty-one children with sepsis-induced thrombocytopenia-associated multiple organ failure.

Interventions:
Therapeutic plasma exchange.

Measurements and Main Results:
Adjusted relative risk for 28-day mortality was modeled using standard multivariate regression with propensity score weighting to reduce covariate confounding. Change from baseline Pediatric Logistic Organ Dysfunction scores between therapeutic plasma exchange and no therapeutic plasma exchange differed in temporal pattern during the first week (p = 0.009). By day 4, mean Pediatric Logistic Organ Dysfunction score declined by 7.9 points (95% CI, –10.8 to –5.1) in the therapeutic plasma exchange–treated group compared with no change with no therapeutic plasma exchange. Use of therapeutic plasma exchange was associated with reduced 28-day mortality by multivariate analysis (adjusted relative risk, 0.45; 95% CI, 0.23–0.90; p = 0.02) and by propensity score weighting (adjusted relative risk, 0.46; 95% CI, 0.22–0.97; p = 0.04).

Conclusions:
Therapeutic plasma exchange use in thrombocytopenia-associated multiple organ failure was associated with a decrease in organ dysfunction. After accounting for several risk factors, 28-day all-cause mortality was lower in children treated with therapeutic plasma exchange compared with those receiving no therapeutic plasma exchange. A multicenter randomized clinical trial is necessary to determine a causal relationship.
Plant-based Diet and Adiposity Over Time in a Middle-aged and Elderly Population
Authors: Chen Zhangling , Schoufour Josje D. , Rivadeneira Fernando , Lamballais Sander , Ikram M. Arfan , Franco Oscar H. , Voortman Trudy 
Published: December 2018

Background:
We aimed to explore whether adhering to a more plant-based diet, beyond strict vegan or vegetarian diets, may help prevent adiposity in a middle-aged and elderly population.

Methods:
We included 9,633 participants from the Rotterdam Study, a prospective cohort in the Netherlands. Dietary data were collected using food-frequency questionnaires at baseline of three subcohorts of the Rotterdam Study (1989–1993, 2000–2001, 2006–2008). We created a plant-based diet index by giving plant-based foods positive scores and animal-based foods reverse scores. A higher score on the index reflected an overall more plant-based and less animal-based diet. Data on anthropometrics and body composition (using dual energy X-ray absorptiometry) were collected every 3–5 years from 1989 to 2016. We used multivariable linear mixed models to analyze the associations.

Results:
In the 9,633 participants, baseline plant-based diet score ranged from 21.0 to 73.0 with a mean ± SD of 49.0 ± 7.0. In multivariable-adjusted analyses, higher adherence to a plant-based diet was associated with lower BMI, waist circumference, fat mass index, and body fat percentage across a median follow-up period of 7.1 years (per 10 points higher score, BMI: β = −0.70 kg/m2 [95% CI = −0.81, −0.59]; waist circumference: −2.0 cm [−2.3, −1.7]; fat mass index: −0.66 kg/m2 [−0.80, −0.52]; body fat percentage: −1.1 points [−1.3, −0.84]).

Conclusions:
In this population-based cohort of middle-aged and elderly participants, a higher adherence to a more plant-based, less animal-based diet was associated with less adiposity over time, irrespective of general healthfulness of the specific plant- and animal-based foods.
Prenatal Metal Concentrations and Childhood Cardiometabolic Risk Using Bayesian Kernel Machine Regression to Assess Mixture and Interaction Effects
Authors: Kupsco Allison , Kioumourtzoglou Marianthi-Anna , Just Allan C. , Amarasiriwardena Chitra , Estrada-Gutierrez Guadalupe , Cantoral Alejandra , Sanders Alison P. , Braun Joseph M. , Svensson Katherine , Brennan Kasey J. M. , Oken Emily , Wright Robert O. , Baccarelli Andrea A. , Téllez-Rojo Maria M. 
Published: December 2018

Background:
Trace metal concentrations may affect cardiometabolic risk, but the role of prenatal exposure is unclear. We examined (1) the relation between blood metal concentrations during pregnancy and child cardiometabolic risk factors; (2) overall effects of metals mixture (essential vs. nonessential); and (3) interactions between metals.

Methods:
We measured 11 metals in maternal second-trimester whole blood in a prospective birth cohort in Mexico City. In children 4–6 years old, we measured body mass index (BMI), percent body fat, and blood pressure (N = 609); and plasma hemoglobin A1C (HbA1c), non–high-density lipoprotein (HDL) cholesterol, triglycerides, leptin, and adiponectin (N = 411). We constructed cardiometabolic component scores using age- and sex-adjusted z scores and averaged five scores to create a global risk score. We estimated linear associations of each metal with individual z scores and used Bayesian Kernel Machine Regression to assess metal mixtures and interactions.

Results:
Higher total metals were associated with lower HbA1c, leptin, and systolic blood pressure, and with higher adiponectin and non-HDL cholesterol. We observed no interactions between metals. Higher selenium was associated with lower triglycerides in linear (β = −1.01 z score units per 1 unit ln(Se), 95% CI = −1.84, −0.18) and Bayesian Kernel Machine Regression models. Manganese was associated with decreased HbA1c in linear models (β = −0.32 and 95% CI = −0.61, −0.03). Antimony and arsenic were associated with lower leptin in Bayesian Kernel Machine Regression models. Essential metals were more strongly associated with cardiometabolic risk than were nonessential metals.

Conclusions:
Low essential metals during pregnancy were associated with increased cardiometabolic risk factors in childhood.
Panax Notoginseng Saponins Attenuate Myocardial Ischemia-Reperfusion Injury Through the HIF-1α/BNIP3 Pathway of Autophagy
Authors: Liu Xin-Wen , Lu Meng-Kai , Zhong Hui-Ting , Wang Li-Hong , Fu Yong-Ping 
Published: December 2018

Background and Objective:
Panax Notoginseng Saponins (PNS) is a formula of Chinese medicine commonly used for treating ischemia myocardial in China. However, its mechanism of action is yet unclear. This study investigated the effect and the mechanism of PNS on myocardial ischemia-reperfusion injury (MIRI) through the hypoxia-inducible factor 1α (HIF-1α)/bcl-2/adenovirus E1B19kDa-interacting protein3 (BNIP3) pathway of autophagy.

Methods:
We constructed a rat model of myocardial injury and compared among 4 groups (n = 10, each): the sham-operated group (Sham), the ischemia-reperfusion group (IR), the PNS low-dose group, and the PNS high-dose group were pretreated with PNS (30 and 60 mg/kg, respectively). Serum creatine kinase, malonaldehyde (MDA), lactate dehydrogenase, myocardial tissue superoxide dismutase, and reactive oxygen species were detected in rats with myocardial ischemia-reperfusion after the intervention of PNS. The rat myocardial tissue was examined using hematoxylin and eosin (H&E) staining, and the mitochondria of myocardial cells were observed using transmission electron microscopy. The expressions of microtubule-associated protein light chain 3 (LC3), HIF-1α, BNIP3, Beclin-1, and autophagy-related gene-5 (Atg5) in rat myocardial tissue were detected using Western blotting.

Results:
The results showed that PNS was significantly protected against MIRI, as evidenced by the decreasing in the concentration of serum CK, MDA, lactate dehydrogenase, and myocardial tissue superoxide dismutase, reactive oxygen species, the attenuation of myocardial tissue histopathological changes and the mitochondrial damages of myocardial cells, and the increase of mitochondria autophagosome in myocardial cells. In addition, PNS significantly increased the expression of LC3 and the ratio of LC3II/LC3I in rat myocardial tissue. Moreover, PNS significantly increased the expression of HIF-1α, BNIP3, Atg5, and Beclin-1 in rat myocardial tissue.

Conclusions:
The protective effect of PNS on MIRI was mainly due to its ability to enhance the mitochondrial autophagy of myocardial tissue through the HIF-1α/BNIP3 pathway.
CYP1B1 Gene and Phenotypic Correlation in Patients From Northeastern Brazil With Primary Congenital Glaucoma
Authors: Coêlho Rodrigo E.A. , Sena Dayse R. , Santa Cruz Fernando , Moura Bárbara C.F.S. , Han Cristal C. , Andrade Flaviano N. , Lira Rodrigo P.C. 
Published: December 2018

Purpose:
To identify variants in the CYP1B1 gene in northeastern Brazilian patients with primary congenital glaucoma (PCG) and possible genotype-phenotype correlations.

Materials and Methods:
This is a cross-sectional observational study of 17 nonrelated patients with PCG, performed at the Altino Ventura Foundation, Recife, Brazil, between December 2017 and February 2018. All patients underwent an examination, including gathering information from their medical records, slit-lamp examination, fundoscopy, tonography, and measuring corneal diameter and thickness.

Results:
The mean age at the time of the examination was 27.7 years; 52.9% (n=9) were male, 29.4% (n=5) had history of parental consanguinity. The mean age when the diagnosis was confirmed was 0.53±2.18 years. Horizontal corneal diameter ranged from 12 to 16 mm (mean: 14.05±1.42 mm) and the IOP mean value was 17.31±9.84 mm Hg. Predicted pathogenic variants of the CYP1B1 gene were identified in 4 patients (23.5%). The differences among all clinical parameters did not reach statistical significance between individuals with and without CYP1B1 variants (P-values >0.05).

Conclusions:
Two variants which had not been previously related to PCG in Brazil (c.182G>A, c.241T>A) were identified. No statistically significant genotype-phenotype correlations were found.
Distance Versus On-Site Educational Strategies for Competency-Based Screening, Brief Intervention, and Referral to Treatment Education
Authors: Kelly Patricia , Gotham Heather J. , Knopf-Amelung Sarah , Kohnle Kendall , Kuofie Araba 
Published: December 2018

Abstract

Background:
Although the individual and public health consequences of alcohol and drug use are substantial, nursing education programs generally lack content on addiction. The goal of this evaluation was to compare the initial outcomes of on-site versus distance methods for training graduate nurse practitioner students in Screening, Brief Intervention, and Referral to Treatment (SBIRT) for substance use.

Method:
A nonrandomized two-group pretest–posttest design was used to compare knowledge, attitudes, and skills learning outcomes between on-site (n = 45) and distance (n = 18) family or adult/geriatric Master of Science in Nursing nurse practitioner students receiving SBIRT training.

Results:
Overall, students increased their knowledge, attitudes, and confidence about screening and intervening with patients who use substances; showed a high level of skills in conducting a brief intervention to motivate patients to reduce their substance use; and were highly satisfied with the education provided. Counseling confidence and gains in knowledge were similar across groups. Compared with distance students, on-site students reported significantly more positive attitudes about their role adequacy, role legitimacy, and role support for intervening with alcohol use and about their role support for intervening with drug use. On-site students had greater training satisfaction, but distance students’ skills assessed through standardized patient interactions were significantly better.

Conclusions:
Both on-site and distance training were effective instructional methods to increase SBIRT knowledge and skills. However, differences in attitudes, training satisfaction, and skills demonstration should be taken into account when designing addiction training using distance technologies.
The Explosion of a New Designer Drug, Flakka
Authors: Salani Deborah , Albuja Laura D. , Zdanowicz Martin M. 
Published: December 2018

Abstract
There are many challenges facing healthcare professionals. One such challenge is the continuous introduction of new synthetic drugs. Synthetic drugs pose many difficulties to providers, including identification of the drug ingested, management of symptoms, ensuring safety of the patient and his or her environment, and continual monitoring after the initial symptoms, because synthetic cathinones have many long-term effects on an individual. One such synthetic drug, flakka, is a potent second-generation synthetic cathinone. Because flakka inhibits the reuptake of norepinephrine and dopamine, which are involved in one’s perception of pleasure, it causes inflated feelings and also causes signs and symptoms of psychosis. Flakka also induces various exaggerated symptoms, such as feelings of incredible strength, disorientation, aggression, and altered thought processes, and also can cause hyperthermia, coma, and death. Healthcare professionals need to understand the nature of flakka ingestion, the various symptoms a user may exhibit, and the long-term symptoms a person may have once the acute recovery phase has ended. Once the initial phase of ingestion is over and the patient is medically stabilized, the patient may experience signs and symptoms of psychosis or other psychiatric disorders. It is paramount that healthcare professionals are able to recognize the signs and symptoms of flakka ingestion, know the steps to take to ensure safety of the patient and those around him or her, and also know how to facilitate the patient’s recovery.
Gender Differences in Smartphone Addiction Behaviors Associated With Parent–Child Bonding, Parent–Child Communication, and Parental Mediation Among Korean Elementary School Students
Authors: Lee Eun Jee , Kim Hee Sun 
Published: December 2018

Abstract

Objective:
This study investigated the gender differences in smartphone addiction (SA) behaviors associated with parent–child bonding, parent–child communication, and parental mediation among Korean elementary school students aged 11–13 years.

Method:
A sample of 224 smartphone users (112 boys and 112 girls) was surveyed in a cross-sectional study. Descriptive statistics and multiple regression analysis were conducted to investigate the predictors of SA behaviors based on gender differences using SPSS Win 23.0 software.

Results:
Of the participants, 14.3% (15.18% boys and 13.39% girls) were in the SA behaviors risk group, and the prevalence of SA behaviors was not significantly different between gender groups. In multiple stepwise regression analysis, less active safety mediation; longer duration of smartphone use; more use of smartphones for games, videos, or music; and less restrictive mediation were linked to higher SA behaviors in boys, and these indicators accounted for 22.1% of the variance in SA behaviors. Longer duration of smartphone use, less active use mediation, worse parent–child communication, and more use of smartphones for text, chatting, or social network sites were linked to higher SA behaviors in girls, and these indicators accounted for 38.2% of the variance in SA behaviors.

Conclusion:
The study provides insights into SA behaviors and predictors of SA behaviors among children based on gender differences. Development of SA behavior prevention programs is needed, not only for children but also to teach parents to use active safety mediation and restrictive mediation for boys and better communication and active use mediation for girls.
Incidence, Clearance, and Persistence of Anal Human Papillomavirus in Men Who Have Sex With Men Living With Human Immunodeficiency Virus: Implications for Human Papillomavirus Vaccination
Authors: Ong Jason J. , Walker Sandra , Grulich Andrew , Hoy Jennifer , Read Tim R.H. , Bradshaw Catriona , Chen Marcus , Garland Suzanne M. , Cornall Alyssa , Hillman Richard , Templeton David J. , Hocking Jane , Eu Beng , Tee BK , Chow Eric P.F. , Fairley Christopher K. 
Published: December 2018

Background
Men who have sex with men living with human immunodeficiency virus have a high risk of anal cancer. We estimate the likely benefit of human papillomavirus (HPV) vaccination among participants of the Anal Cancer Examination study.

Methods
Anal swabs were collected for the detection and genotyping of anal HPV DNA by linear array (Roche Diagnostics) in this 2-year multicenter prospective cohort. We calculated the proportion of men, stratified by age, without detectable vaccine type-specific DNA.

Results
Overall, 255 men, with a median age of 50 years (interquartile range, 44–56 years) contributed 488.9 person-years of follow-up. After 2 years of follow-up, 149 (58%; 95% confidence interval [CI], 52–65) had at least 1 high-risk HPV (HRHPV), and 71 (28%, 95% CI, 22–34) had HPV types 16/18 detected. Assuming that DNA-negative men would receive vaccine protection, vaccination at baseline could potentially prevent HRHPV infection in 10.2% of men (95% CI, 6.8–14.6, 26 of 255) 2 years later from incident HRHPV covered by the bivalent and quadrivalent vaccine, and 29.4% of men (95% CI, 23.9–35.4, 75/255) from incident HRHPV covered by the nonavalent vaccine.

Conclusion
Though there is high prevalence of anal HPV in men who have sex with men living with human immunodeficiency virus, there was also a high incidence of HRHPV vaccine types in the 2-year follow-up, indicating potential for prevention if these men were not previously infected with HPV vaccine types and were vaccinated at their baseline visit.
Comparing Vasoactive-Inotropic Score Reporting Strategies in the PICU Relative to Mortality Risk*
Authors: Musick Matthew A. , Loftis Laura L. , Kennedy Curtis E. 
Published: December 2018

Objectives:
High Vasoactive-Inotropic Scores have demonstrated association with poor outcomes in pediatric cardiac ICUs and are being calculated more frequently in studies of critically ill noncardiac patients. Available studies differ in their approach to assigning Vasoactive-Inotropic Scores, making direct comparisons difficult. The goal of this investigation is to compare multiple approaches to Vasoactive-Inotropic Score assignment to determine their strength of association with mortality in a general pediatric intensive care population. In doing so, we aim to help validate the use of the Vasoactive-Inotropic Score in noncardiac patients and to help inform future studies of the relative strength of available approaches in assigning this score.

Design:
Retrospective chart review.

Setting:
PICU at an academic freestanding children’s hospital.

Patients:
Two-thousand seven-hundred fifty-two consecutive patients admitted over a 17-month time period were screened for receiving inotrope or vasopressor therapies regardless of disease process. Four-hundred seventy-four patients met inclusion criteria.

Interventions:
None.

Measurements and Main Results:
For each patient treated with continuous infusions of vasoactive medications, a Vasoactive-Inotropic Score was calculated (and then recalculated) every time they had a documented dose change. Multiple strategies were evaluated to generate receiver operating characteristic curves in relation to mortality. Area under the curve was greatest when evaluating the maximum Vasoactive-Inotropic Score (Max Any) during the initial treatment course (0.788) with an increasing relative risk as the score increased. The Vasoactive-Inotropic Score at 48 hours after treatment initiation had next highest area under the curve (0.736). Primary diagnosis categories were also analyzed, and area under the curve was greatest for the cardiovascular group (0.879).

Conclusions:
Increasing Vasoactive-Inotropic Scores for patients in the PICU are associated with mortality risk. The scoring strategy used can influence the strength of the association, as can the primary diagnosis category.