bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smartphone imaging for the ophthalmic examination in primary care
Authors: Bifolck Eric , Fink Andrew , Pedersen Daniel , Gregory Tanya 
Published: July 2018

ABSTRACT
Direct ophthalmoscopy is an integral part of the physical examination and is the most widely used technique to assess the fundus, especially in primary care. The gold standard slit-lamp technique is used in specialty clinics and in some EDs. Most medical professionals own smartphones, and a smartphone ophthalmoscope could bring the quality of a slit-lamp examination into primary care. Imaging techniques with smartphones are easy to learn and use, providing a significant step toward reversing the lack of confidence that students and clinicians have in traditional methods. Current evidence supports the potential of smartphone imaging to replace direct ophthalmoscopy in primary care settings.
Progress and Control of Myopia by Light Environments
Authors: Jiang Xiaoyan , Kurihara Toshihide , Torii Hidemasa , Tsubota Kazuo 
Published: July 2018

Abstract:
During the past 30 years, the prevalence rate of myopia has been increased dramatically. Myopia has become one of the leading causes of vision loss in some countries, whereas the mechanism of the main pathological change in myopia is still largely unknown. Although several studies showed genetic background influences the phenotype of myopia to some extent, the sudden increase of morbidity cannot be explained by genetics only. The change in lifestyle results in tremendous change in the light environment, which can be considered to play an important role in the onset and progression of myopia. The difference between indoor and outdoor light environments such as intensity and wavelength of modern electronic lighting equipment may be a cue for myopia control as environmental factors. In this review, we discuss the relationship between myopia and light environment focusing on the basic and clinical studies.
The impact of age on thyroid cancer staging
Authors: Kazaure Hadiza S. , Roman Sanziana A. , Sosa Julie A. 
Published: July 2018

Purpose of review
Patient age at diagnosis is a well established prognostic factor for thyroid cancer survival; it is included in the American Joint Committee on Cancer (AJCC) thyroid cancer-staging system. This review provides an update on the epidemiology, risk stratification, and staging of differentiated thyroid cancer (DTC), in the context of patient age.

Recent findings
In the eighth edition AJCC staging system for DTC, the age cut-point was increased from 45 to 55 years. The appropriate age-cut point remains a subject of debate, as some studies have found a linear association of age and survival, and therefore, questioned the use of an age cut-point in the DTC staging system altogether. Emerging data on the additive role of molecular markers in the compromised survival of older patients with DTC raise the prospect of eventual inclusion of genetic markers in the management of patients and risk-stratification systems.

Summary
DTC staging is evolving. The pathogenesis of the compromised survival of older patients with DTC is complex, multifactorial, and not well understood. Recent advances in molecular testing are promising. More studies are needed prior to the formal inclusion of molecular markers in the staging system of DTC.
Quality of Life in Patients With Progressive Familial Intrahepatic Cholestasis
Authors: Wassman Sonja , Pfister Eva‐Doreen , Kuebler Joachim F. , Ure Benno M. , Goldschmidt Imeke , Dingemann Jens , Baumann Ulrich , Schukfeh Nagoud 
Published: July 2018

ABSTRACTObjectives:In patients with progressive familial intrahepatic cholestasis (PFIC), partial external biliary diversion (PEBD), which is associated with a permanent stoma, is recommended as first‐line therapy, whereas primary liver transplantation (LTx) is restricted to those with cirrhosis. Our aim was to quantify the health‐related quality of life (HRQOL) in patients with PFIC and to evaluate whether there is a difference in their HRQOL depending on the surgical approach.Methods:A prospective HRQOL study on a consecutive series of PFIC was conducted using Pediatric Quality of Life Inventory 4.0 child‐self and parent‐proxy reports. Patients with PFIC after PEBD who still lived with their native livers were compared to those after LTx. Both groups were compared to healthy children.Results:A total of 32 patients (53% girls) patients with a mean age of 17.7 ± 7.3 years were studied. Twenty‐two had undergone LTx at a mean age of 7.8 ± 3.8 years and 10 had undergone PEBD at a mean age of 4.1 ± 3.9 years. At the time of HRQOL assessment, the mean age was 18.9 ± 7.5 years in the LTx group and 15.3 ± 6.5 years in the PEBD group. Child‐self and parent‐proxy reports showed no significant difference in HRQOL between patients with PFIC after LTx and those after PEBD except for marginal difference in physical functioning/health (P = 0.07). Except for a lower score in patient school functioning of patients after LTx (P = 0.01), HRQOL‐results showed no difference from healthy children in any group.Conclusions:The HRQOL of patients with PFIC after PEBD was similar to those after LTx. The HRQOL in both groups was also similar to that of healthy children. Thus, our data support the current policy of PEBD as primary surgical treatment for patients with PFIC without cirrhosis.
Psychological Safety in Nursing Simulation
Authors: Kang Sook Jung , Min Hae Young 
Published: July 2018

Background
Although nursing students enjoy and learn from simulation practice, some experience negative feelings that may hamper their learning outcomes.

Purpose
The purpose of this study was to understand nursing students' perceptions of psychological safety in simulation practice to provide a foundation for a safe and effective simulation learning environment.

Methods
A convenient sample of 15 undergraduate nursing students was included in this study. Focus group interviews and inductive content analysis were used for this study.

Results
Four themes extracted from the study included feeling unready, anxious about having students' mistakes exposed, worry about damaging teamwork, and fear of evaluation.

Conclusions
Findings indicated that providing prebriefing and considering students' level of simulation experience in sharing their recorded video may help ensure a psychologically safe environment. An instrument measuring psychological safety and evidence-based guidelines to ensure a safe learning environment needs to be developed.
Successful Modeling of Factors Related to Recruitment and Retention of Prenursing Students
Authors: Stankus Jo-Ann , Hamner Mark , Stankey Michael , Mancuso Peggy 
Published: July 2018

Background
The traditional admission methodology used by many schools of nursing is the second-tier admission based on specified criteria. This method has been associated with a student body that is predominately female, white, and English speaking.

Problem
Rational judgment modeling (points assigned to criteria) used to evaluate applicants for admission into prenursing programs potentially overlooks students who do not fit into the traditional model.

Approach
This study compared predictive logistic regression with traditional rational judgment models to classify potential nursing school applicants.

Outcomes
A higher number of Hispanic and black prenursing students were identified for potential upper-level nursing program admission.

Conclusions
The use of logistic regression modeling can identify a more diverse student population. Advisors at both high school and university/college levels can use results of this model to help students determine their progress, identify academic weaknesses, and develop individual plans of action to help students successfully complete the prenursing curriculum requirements.
Microscopic and Macroscopic Fat Embolism: Solving the Puzzle with Case Reports
Authors: Durán Héctor , Cárdenas-Camarena Lázaro , Bayter-Marin Jorge Enrique , Ramos-Gallardo Guillermo , Robles-Cervantes José Antonio 
Published: July 2018

Background:
The frequency of fat embolism mortality after liposuction has increased. As the only dependable evidence for this problem is that available in the medical literature, a study of clinical case reports is warranted.

Methods:
The authors reviewed the medical literature by searching for case reports of fat embolism after liposuction in humans who manifested either of the variants of the condition: microscopic fat embolism or macroscopic fat embolism. The authors performed a literature search of the PubMed and PubMed Central databases from the first case of fat embolism syndrome associated with liposuction reported until March of 2017; keywords Fat Embolism (Fat Embolism Syndrome), Liposuction, and Case (((fat embolism) AND liposuction) AND case) were used. A detailed analysis of the data contained in the clinical case reports was conducted.

Results:
In total, 39 and 98 articles were found in PubMed and PubMed Central, respectively, using the keywords (((Fat + Embolism) + AND + Liposuction) + AND + Case). After analysis, only 15 reports corresponded to cases of macroscopic or microscopic fat embolism after liposuction, and the basic statistics of the two proposed variants were examined.

Conclusions:
This work provides relevant information regarding very important characteristics of microscopic and macroscopic fat embolism. Despite the diagnostic difficulty, clinical diagnosis remains the gold standard for identifying microscopic and macroscopic fat embolism. The establishment of a rapid and timely diagnosis is of great help for appropriate treatment.
Assessment of Quantitative Magnetic Resonance Imaging Background Parenchymal Enhancement Parameters to Improve Determination of Individual Breast Cancer Risk
Authors: Lam Diana L. , Hippe Daniel S. , Kitsch Averi E. , Partridge Savannah C. , Rahbar Habib 
Published: July 2018

Objectives
The aims of this study were to identify optimal quantitative breast magnetic resonance imaging background parenchymal enhancement (BPE) parameters associated with breast cancer risk and compare performance to qualitative assessments.

Methods
Using a matched case-control cohort of 46 high-risk women who underwent screening magnetic resonance imaging (23 who developed breast cancer matched to 23 who did not), fibroglandular tissue area, BPE area, and intensity metrics (mean, SD, quartiles, skewness, and kurtosis) were quantitatively measured at varying enhancement thresholds. Optimal thresholds for discriminating between cancer and control cohorts were identified for each metric and performance summarized using area under the receiver operating characteristic curve.

Results
Women who developed breast cancer exhibited greater BPE area (adjusted P = 0.004) and higher intensity statistics (adjusted P < 0.004, except skewness and kurtosis with P > 0.99) than did control subjects, with areas under the receiver operating characteristic curve ranging from 0.75 to 0.78 at optimized thresholds.

Conclusions
Elevated quantitative BPE parameters, related to both area and intensity of enhancement, are associated with breast cancer development.
Newly Categorized Seromucinous Tumor of the Ovary: Magnetic Resonance Imaging Findings
Authors: Han Jin Woo , Kim Kyeong Ah , Chang Hye Yoon , Kim Jeong Woo , Park Yang Shin , Lee Jongmee , Choi Jae Woong , Lee Chang Hee , Park Cheol Min 
Published: July 2018

Objective
The aim of this study was to describe magnetic resonance imaging findings of newly categorized ovarian seromucinous tumors.

Methods
We retrospectively reviewed the images of 29 patients with seromucinous tumor for the following factors: size, configuration, signal intensity (SI), and accompanying ovarian endometriosis.

Results
Thirty-two tumors (17 benign, 7 borderline, 8 carcinoma) were found on computed tomography or magnetic resonance imaging. Their mean size was 11.4 cm. Benign tumors appeared as unilocular or multilocular cystic masses. Borderline tumors and carcinomas appeared as complex cystic-solid masses. T2-weighted SI of the solid portion was hyperintense in borderline tumors and intermediate in carcinomas. Endometriosis was present in 18 tumors, and hemorrhage (on images) in 20.

Conclusions
The imaging features of seromucinous tumors varied by tumor type. More than half of tumors were accompanied by endometriosis. High T2-weighted SI of the solid portion could be a specific feature of borderline tumors. It is hard to differentiate seromucinous carcinomas from other endometriosis-related carcinomas.
Role of immunotherapy in kidney cancer
Authors: Nazzani Sebastiano , Bazinet Amélie , Karakiewicz Pierre I. 
Published: July 2018

Purpose of review
To summarize current knowledge on promising immunotherapeutic agents and to provide a brief outline of current use of immunotherapeutic agents in patients with locally advanced or metastatic renal cell carcinoma (RCC).

Recent findings
Immunotherapy with mAbs directed against programed death cell protein 1, programed death-ligand 1 (PD-L1) and cytotoxic T-Lymphocyte Antigen 4 has become new first-line standard of care for moderate and poor-risk metastatic RCC patients. Similarly, the combination immune-oncology treatment and vascular endothelial growth factor (VEGF) mAbs also showed promising results in first-line therapy despite relative data immaturity. Finally, immune-oncology monotherapy (nivolumab) already represents second or third-line standard of care after tyrosine kinase inhibitor failure.

Summary
Combination immune-oncology therapy represents the standard of care for management of intermediate-to-poor risk clear cell metastatic RCC. In addition, combination of immune-oncology and anti-VEGF antibody represents a treatment option across all risk levels in patient with elevated PD-L1 expression. Finally, nivolumab is one of two ideal treatment options in second-line clear cell metastatic RCC patients.
Structural basis of altered potency and efficacy displayed by a major in vivo metabolite of the anti-diabetic PPARγ drug pioglitazone
Authors: Mosure Sarah A. , Shang Jinsai , Brust Richard , Zheng Jie , Griffin Patrick R. , Kojetin Douglas J. 
Published: July 2018

ABSTRACTThe thiazolidinedione (TZD) pioglitazone (Pio) is an FDA-approved drug for type 2 diabetes mellitus that binds and activates the nuclear receptor peroxisome proliferator-activated receptor gamma (PPARγ). Although TZDs have potent antidiabetic effects, they also display harmful side effects that have necessitated a better understanding of their mechanisms of action. In particular, little is known about the effect of in vivo TZD metabolites on the structure and function of PPARγ. Here, we present a structure-function comparison of Pio and a major in vivo metabolite, 1-hydroxypioglitazone (PioOH). PioOH displayed a lower binding affinity and reduced potency in coregulator recruitment assays compared to Pio. To determine the structural basis of these findings, we solved an X-ray crystal structure of PioOH bound to PPARγ ligand-binding domain (LBD) and compared it to a published Pio-bound crystal structure. PioOH exhibited an altered hydrogen bonding network that could underlie its reduced affinity and potency compared to Pio. Solution-state structural analysis using NMR spectroscopy and hydrogen/deuterium exchange mass spectrometry (HDX-MS) analysis revealed that PioOH stabilizes the PPARγ activation function-2 (AF-2) coactivator binding surface better than Pio. In support of AF-2 stabilization, PioOH displayed stabilized coactivator binding in biochemical assays and better transcriptional efficacy (maximal transactivation response) in a cell-based assay that reports on the activity of the PPARγ LBD. These results, which indicate that Pio hydroxylation affects both its potency and efficacy as a PPARγ agonist, contribute to our understanding of PPARγ-binding drug metabolite interactions and may assist in future PPARγ drug design efforts.
Direct purification of CRISPR/Cas ribonucleoprotein from E. coli in a single step
Authors: Lin Siyu , Qiao Jie , Ma Lixin , Liu Yi 
Published: July 2018

AbstractCRISPR/Cas ribonucleoprotein (RNP) complexes have been recently used as promising biological tools with plenty of applications, however, there are by far no efficient methods to prepare them at large scale and low cost. Here, we present a simple method to directly produce and purify Cas RNP, including the widely used Cas9 and Cas12a nuclease, from E.coli in a single step using an ultra-high-affinity CL7/Im7 purification system. The prepared Cas RNP shows high stability, solid nuclease activity in vitro, and profound genome editing efficiency in vivo. Our method is convenient, cost-effective, and applicable to prepare other CRISPR associated nucleases.
A novel maize gene,glossy6involved in epicuticular wax deposition and drought tolerance
Authors: Li LI , Du Yicong , He Cheng , Dietrich Charles R. , Li Jiankun , Ma Xiaoli , Wang Rui , Liu Qiang , Liu Sanzhen , Wang Guoying , Schnable Patrick S , Zheng Jun 
Published: July 2018

SUMMARYEpicuticular waxes, long-chain hydrocarbon compounds, form the outermost layer of plant surfaces in most terrestrial plants. The presence of epicuticular waxes protects plants from water loss and other environmental stresses. Cloning and characterization of genes involved in the regulation, biosynthesis, and extracellular transport of epicuticular waxes on to the surface of epidermal cells have revealed the molecular basis of epicuticular wax accumulation. However, intracellular trafficking of synthesized waxes to the plasma membrane for cellular secretion is poorly understood. Here, we characterized a maize glossy (gl6) mutant that exhibited decreased epicuticular wax load, increased cuticle permeability, and reduced seedling drought tolerance relative to wild type. We combined an RNA-sequencing based mapping approach (BSR-Seq) and chromosome walking to identify thegl6candidate gene, which was confirmed via the analysis of multiple independent mutant alleles. Thegl6gene represents a novel maize glossy gene containing a conserved, but uncharacterized domain. Functional characterization suggests that the GL6 protein may be involved in the intracellular trafficking of epicuticular waxes, opening a door to elucidating the poorly understood process by which epicuticular wax is transported from its site of biosynthesis to the plasma membrane.SIGNIFICANCE STATEMENTPlant surface waxes provide an essential protective barrier for terrestrial plants. Understanding the composition and physiological functions of surface waxes, as well as the molecular basis underlying wax accumulation on plant surfaces provides opportunities for the genetic optimization of this protective layer. Genetic studies have identified genes involved in wax biosynthesis, extracellular transport, as well as spatial and temporal regulation of wax accumulation. In this study, a maize mutant,gl6was characterized that exhibited reduced wax load on plant surfaces, increased water losses, and reduced seedling drought tolerance compared to wild type controls. Thegl6gene is a novel gene harboring a conserved domain with an unknown function. Quantification and microscopic observation of wax accumulation as well as subcellular localization of the GL6 protein provided evidence thatgl6may be involved in the intracellular trafficking of waxes, opening a door for studying this necessary yet poorly understood process for wax loading on plant surfaces.
Stabilizing Obligatory Non-native Intermediates Along Co-transcriptional Folding Trajectories of SRP RNA Affects Cell Viability
Authors: Fukuda Shingo , Yan Shannon , Komi Yusuke , Sun Mingxuan , Gabizon Ronen , Bustamante Carlos 
Published: July 2018

SummarySignal recognition particle (SRP) inEscherichia colicomprises protein Ffh and SRP RNA. Its essential functionality—co-translational protein-targeting/delivery to cellular membranes— hinges on the RNA attaining a native long-hairpin fold that facilitates protein conformational rearrangements within the SRP complex. Since RNA folds co-transcriptionally on RNA polymerase, we use high-resolution optical tweezers to first characterize the mechanical unfolding/refolding of incrementally lengthened RNAs from stalled transcription complexes until reaching the full-length transcript. This analysis allows identification of folding intermediates adopted during the real-time co-transcriptional folding of SRP RNA. The co-transcriptional folding trajectories are surprisingly invariant to transcription rates, and involve formation of an obligatory non-native hairpin intermediate that eventually resolves into the native fold. SRP RNA variants designed to stabilize this non-native intermediate—likely sequestering the SRP ribonucleoprotein complex in an inactive form—greatly reduce cell viability, indicating that the same co-transcriptional folding mechanism operatesin vivoand possible alternative antibiotic strategies.HighlightsFolding pathway of an essential functional RNA has been resolved co-transcriptionally.The co-transcriptional folding pathway of SRP RNA is invariant to transcription rates.Nascent SRP RNA obligatorily forms a non-native intermediate before adopting the native fold.Modulating transitions from the non-native to native SRP RNA hairpin fold alters cell viability.
The export competitiveness of Italian coffee roasting industry
Authors: Pascucci Federica 
Published: July 2018

Purpose
The purpose of this paper is to analyze the competitive position of Italian roasting firms in the international market, thus developing a multidimensional framework for measuring industry export competitiveness.

Design/methodology/approach
Considering that the objective is to evaluate the export competitiveness of Italian roasting firms, the author chooses “positive” and “ex-post” indicators, combined in a multidimensional and a multivariable framework. The two dimensions of competitiveness implemented are competitive performance and competitive potential; the author used four indices to evaluate the first dimension (export market share, net export share, net export index, revealed comparative advantage) and three indices for the second dimension (unit export price, relative quality index, relative export growth).

Findings
The evolution of the international context, with the emergence of new competitors and the spread of coffee consumption worldwide, creates new opportunities but also new challenges for Italian companies. In fact, both competitive performance and competitive potential have been worsening since the second half of the early twenty-first century because of the lack of innovation. A mix of external and internal factors explain this lack.

Practical implications
In order to recover their international competitiveness, firms should leverage on the combination of “traditional elements”–such as Made in Italy effect and the rich technical know-how, depending on their long tradition in the espresso coffee market niche–with “innovative elements,” depending on new marketing skills and competences; these new elements could be developed internally or, most fruitfully, acquired externally, through collaboration with other firms. In this way, Italian businesses could improve the relative quality perceptions of their offering.

Social implications
Coffee roasting industry in Italy is a significant component of the Italian economic system and it contributes to the development of the Made in Italy abroad. Therefore, an improvement of its export competitiveness could be beneficial to the whole domestic market.

Originality/value
This paper constitutes the first attempt to study the evolution of the coffee industry in regards to the international competitive landscape. This is quite surprising, considering that coffee is one of the main segments of the food and beverage industry; it is the second most important commodity exchanged worldwide after oil and the third most popular beverage after water, tea and carbonated beverages. Then, the analysis of export competitiveness is developed combing two main research streams: the industrial organization literature and the strategic management literature. Moreover, this paper offers a methodological framework useful to measure export competitiveness also in other industries and countries.