bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effects of Natural Daylight on Length of Hospital Stay
Authors: Park Man Young , Chai Choul-Gyun , Lee Hae-Kyung , Moon Hani , Noh Jai Sung 
Published: December 2018

Background and Purpose: While providing medical services, hospitals generate many data about patients. Such medical data could contribute to better treatments once their associations or patterns have been identified. With properly analyzed medical data, traditional knowledge at an individual level could be further extended to broader populations. This comprehensive study was performed to demonstrate the effectiveness of light using medical data accumulated over 15 years. Methods: Patients who were admitted to the window or door side of a six-bedded room were included. Patients admitted to the emergency room and elderly people aged >80 years were excluded. Patients’ length of stay was compared per what bed they were in (excluding middle beds). A multiple regression analysis was performed with patients admitted to the window or door side to determine whether the window affected their hospital stay. In addition, a multiple regression analysis was performed after adjusting for confounders by 1:1 matching between the two groups (ie, age, sex, and admitting department). Results: Participants were 38 788 patients with a bed near the window and 46 233 patients with a bed near the door. Results revealed that patients’ length of stay was shorter for those near the window compared with those near the door, which was also true after group matching (33 921 participants in each group). Conclusions: Clinical trials that test evidence-based designs of physical environments in wards or hospital rooms are usually difficult to perform. As an alternative strategy, using accumulated electronic medical data, we assessed this key element of hospital design.
Pregnancy and multiple sclerosis in the DMT era: A cohort study in Western Austria
Authors: Bsteh Gabriel , Algrang Laura , Hegen Harald , Auer Michael , Wurth Sebastian , Di Pauli Franziska , Deisenhammer Florian , Berger Thomas 
Published: December 2018

Background: Multiple sclerosis (MS) predominantly affects women of child-bearing potential. Pregnancy in MS is still a controversial issue lacking standardized treatment recommendations. Objective: To examine the reciprocal effects of pregnancy, MS, and disease-modifying treatment (DMT). Methods: We analyzed 387 pregnancies in 239 women with relapsing remitting multiple sclerosis (RRMS) and ⩾1 pregnancy, establishment of diagnosis >1 year before conception, and ⩾2 years of follow-up after delivery. Relapse rates and Expanded Disability Status Scale (EDSS) scores were compared in the year before conception, during pregnancy, and 2 years postpartum. Binary logistic regression was used to investigate predictors of risk for relapses and disability progression during pregnancy and postpartum. Results: Risk of relapse and disability progression during pregnancy was predicted by pre-conception relapse activity, higher EDSS score at conception, use of highly effective disease-modifying treatment (H-DMT) pre-conception, and prolonged washout period. Postpartum relapse and disability progression was associated with relapse activity pre-conception and during pregnancy and use of H-DMT pre-conception. Early restart of DMT reduced the risk of postpartum relapse. Conclusion: A personalized approach in planning pregnancy in women with MS while on H-DMT needs to be adopted. It seems reasonable maintaining natalizumab closer to conception and restarting the drug early postpartum to reduce the considerable risk of disease reactivation during early pregnancy and after delivery.
Fatigue at enrollment predicts EDSS worsening in the New York State Multiple Sclerosis Consortium
Authors: Vaughn Caila B , Kavak Katelyn S , Dwyer Michael G , Bushra Aisha , Nadeem Muhammad , Cookfair Diane L , Ramanathan Murali , Benedict Ralph HB , Zivadinov Robert , Goodman Andrew , Krupp Lauren , Motl Robert W , Weinstock-Guttman Bianca , Kolb Channa , Robb Jessica F. , Jubelt Burk , Gerber Allen , Kister Ilya , Ryerson Lana Zhovtis , Coyle Patricia , Perel Allan , Gottesman Malcolm , Lenihan Michael , Edwards Keith , Garten Lore , Picone Mary Ann 
Published: December 2018

Background: Fatigue is one of the most common and distressing symptoms among persons with multiple sclerosis (pwMS). Objective: The aim of this study is to evaluate fatigue as a predictor for disease worsening among pwMS. Methods: In this retrospective cohort study of New York State MS Consortium (NYSMSC) registry, MS patients reporting moderate-to-severe fatigue at study enrollment ( n = 2714) were frequency matched to less-fatigued subjects ( n = 2714) on age, baseline Kurtzke Expanded Disability Status Scale (EDSS), disease duration, and MS phenotype. Change from baseline patient-reported outcomes (PROs), as measured by LIFEware™, categorized participants into two groups: those with stable/improved outcomes and those who worsened. In a subgroup of patients with longitudinal data ( n = 1951), sustained EDSS worsening was analyzed using Cox proportional hazards modeling to explore the effect of fatigue. Results: The median survival time from study enrollment to sustained EDSS worsening was 8.7 years (CI: 7.2–10.1). Participants who reported fatigue at baseline were more likely to experience sustained EDSS worsening during follow-up (HR: 1.4, 95% CI: 1.2–1.7). Patients who were fatigued at baseline were also more likely to report worsening psychosocial limitations (all ps ⩽ 0.01). Conclusion: In addition to being a common symptom of MS, severe fatigue was a significant predictor for EDSS worsening in the NYSMSC.
Scatter Artifact with Ga-68-PSMA-11 PET: Severity Reduced With Furosemide Diuresis and Improved Scatter Correction
Authors: Lawhn-Heath Courtney , Flavell Robert R. , Korenchan David E. , Deller Timothy , Lake Spencer , Carroll Peter R. , Hope Thomas A. 
Published: December 2018

Purpose: To assess the utility of furosemide diuresis and the role of an improved scatter correction algorithm in reducing scatter artifact severity on Ga-68- Prostate-specific membrane antigen (PSMA)-11 positron emission tomography (PET). Materials and Methods: A total of 139 patients underwent Ga-68-PSMA-11 PET imaging for prostate cancer: 47 non-time-of-flight (non-TOF) PET/computed tomography, 51 PET/magnetic resonance imaging (MRI) using the standard TOF scatter correction algorithm, and 41 PET/MRI using an improved TOF scatter correction algorithm. Whole-body PET acquisitions were subdivided into 3 regions: around kidneys; between kidneys and bladder; and around bladder. The images were reviewed, and scatter artifact severity was rated using a Likert-type scale. Results: The worst scatter occurred when using non-TOF scatter correction without furosemide, where 42.1% of patients demonstrated severe scatter artifacts in 1 or more regions. Improved TOF scatter correction resulted in the smallest percentage of studies with severe scatter (6.5%). Scatter ratings by region were lowest using improved TOF scatter correction. Furosemide reduced mean scatter severity when using non-TOF and standard TOF. Conclusions: Both furosemide and scatter correction algorithm play a role in reducing scatter in PSMA PET. Improved TOF scatter correction resulted in the lowest scatter severity.
Procalcitonin as a Biomarker in Rhinosinusitis: A Systematic Review
Authors: Dilger Amanda E. , Peters Anju T. , Wunderink Richard G. , Tan Bruce K. , Kern Robert C. , Conley David B. , Welch Kevin C. , Holl Jane L. , Smith Stephanie Shintani 
Published: December 2018

Objectives (1) To describe the existing literature on procalcitonin (PCT) as a biomarker in patients with acute rhinosinusitis (ARS), (2) to analyze outcomes in ARS patients who were treated with PCT-guided therapy versus traditional management, and (3) to compare PCT to other biomarkers used in diagnosis of bacterial ARS. Data Sources: PubMed and Embase. Review Methods: A systematic search in the PubMed and Embase databases was performed to identify studies related to PCT as a biomarker in ARS. After critical appraisal of validity by 2 authors, 6 studies with a total of 313 patients were selected for data extraction and analysis. We identified 2 randomized control trials (RCTs) of PCT-based guidelines for antibiotic management of ARS in outpatient settings and 4 observational studies that compared PCT to other biomarkers in patients with ARS. Results The 2 RCTs demonstrated a reduction (41.6% in 1 study and 71% in the other) in antibiotic prescription rate in the PCT-guided group versus the control group with no change in the number of days with impaired activity due to illness (9.0 vs 9.0 days [ P = .96]; 8.1 vs 8.2 days [95% confidence interval −0.7 to 0.7]), number of days of work missed, and percentage of patients with persistent symptoms at 28 days. In the observational cohort studies, PCT did not consistently correlate with C-reactive protein, body temperature, and/or white blood cell counts. Conclusions The limited existing literature on the role of PCT in diagnosis, management, and prediction of clinical outcomes in ARS suggests that PCT-based guidelines for antibiotic prescription are a safe and effective method of minimizing unnecessary antibiotic use.
Accuracy of diffusion-weighted imaging-magnetic resonance in differentiating functional from non-functional pituitary macro-adenoma and classification of tumor consistency
Authors: Sanei Taheri Morteza , Kimia Farnaz , Mehrnahad Mersad , Saligheh Rad Hamidreza , Haghighatkhah Hamidreza , Moradi Afshin , Kazerooni Anahita Fathi , Alviri Mohammadreza , Absalan Abdorrahim 
Published: December 2018

Purpose The purpose of this study was to determine the accuracy of selected first or second-order histogram features in differentiation of functional types of pituitary macro-adenomas. Materials and methods Diffusion-weighted imaging magnetic resonance imaging was performed on 32 patients (age mean±standard deviation = 43.09 ± 11.02 years; min = 22 and max = 65 years) with pituitary macro-adenoma (10 with functional and 22 with non-functional tumors). Histograms of apparent diffusion coefficient were generated from regions of interest and selected first or second-order histogram features were extracted. Collagen contents of the surgically resected tumors were examined histochemically using Masson trichromatic staining and graded as containing <1%, 1–3%, and >3% of collagen. Results Among selected first or second-order histogram features, uniformity ( p = 0.02), 75th percentile ( p = 0.03), and tumor smoothness ( p = 0.02) were significantly different between functional and non-functional tumors. Tumor smoothness > 5.7 × 10−9 (area under the curve = 0.75; 0.56–0.89) had 70% (95% confidence interval = 34.8–93.3%) sensitivity and 33.33% (95% confidence interval = 14.6–57.0%) specificity for diagnosis of functional tumors. Uniformity ≤179.271 had a sensitivity of 60% (95% confidence interval = 26.2–87.8%) and specificity of 90.48% (95% confidence interval = 69.6–98.8%) with area under the curve = 0.76; 0.57–0.89. The 75th percentile >0.7 had a sensitivity of 80% (95% confidence interval = 44.4–97.5%) and specificity of 66.67% (95% confidence interval = 43.0–85.4%) for categorizing tumors to functional and non-functional types (area under the curve = 0.74; 0.55–0.88). Using these cut-offs, smoothness and uniformity are suggested as negative predictive indices (non-functional tumors) whereas 75th percentile is more applicable for diagnosis of functional tumors. Conclusion First or second-order histogram features could be helpful in differentiating functional vs non-functional pituitary macro-adenoma tumors.
Anterolateral Ligament Reconstruction Practice Patterns Across the United States
Authors: Tramer Joseph S. , Fidai Mohsin S. , Kadri Omar , Jildeh Toufic R. , Hooda Zamaan , Makhni Eric C. , Lock Terrence 
Published: December 2018

Background: A proposed mechanism for recurrent instability following anterior cruciate ligament (ACL) reconstruction is failure of the anterolateral ligament (ALL). Presently, there are a number of approaches to treating ALL pathology. Purpose: To determine practice patterns among orthopaedic surgeons regarding ALL during ACL reconstruction. Study Design: Cross-sectional study. Methods: An online 7-question survey was sent to all physicians registered with the American Orthopaedic Society for Sports Medicine between June and July 2017. Results were analyzed with the survey website. Results: Overall, 225 of 3467 surgeons responded to the survey, 86 of whom performed ALL reconstruction and completed each question in the survey. Eighty-six (38.2%) surgeons who responded to the questionnaire stated that they perform ALL reconstruction/lateral extra-articular tenodesis in conjunction with ACL reconstruction. The most common indications for ALL reconstruction were grade III pivot-shift test (46.0%) on physical examination and revision ACL reconstruction (46.0%). The most common technique used to perform ALL reconstruction was hamstring autograft (48.2%). The majority of participating surgeons (87.5%) stated that they do not make any alterations to their postoperative rehabilitation protocol after they perform ALL reconstruction. In addition, most surgeons responding to the survey (91.3%) anticipated either an increase in or the same number of ALL procedures performed in the coming year. Conclusion: The majority of surgeons who responded to the survey did not routinely reconstruct the ALL. Revision procedures and grade III pivot shift were the most cited indications for performing lateral augmentation. Anatomic reconstruction with hamstring was the most commonly used procedure, although there was no consensus among surgeons responding to the survey. Understanding the ALL and its contribution to knee stability is essential. For a community of physicians, it is useful to discover how fellow sports orthopaedic surgeons address ALL pathology to integrate effective and efficient treatment strategies into practice.
Empagliflozin on top of metformin treatment improves arterial function in patients with type 1 diabetes mellitus
Authors: Lunder Mojca , Janić Miodrag , Japelj Miha , Juretič Andrej , Janež Andrej , Šabovič Mišo 
Published: December 2018

Abstract
Background
Deteriorated arterial function and high incidence of cardiovascular events characterise diabetes mellitus. Metformin and recent antidiabetic drugs, SGLT2 inhibitors, reduce cardiovascular events. We explored the possible effects of empagliflozin’s effect on top of metformin treatment on endothelial function and arterial stiffness parameters in type 1 diabetes mellitus (T1DM) patients.

Methods
Forty T1DM patients were randomised into three treatment groups: (1) empagliflozin (25 mg daily), (2) metformin (2000 mg daily) and (3) empagliflozin/metformin (25 mg daily and 2000 mg daily, respectively). The fourth group received placebo. Arterial function was assessed at inclusion and after 12 weeks treatment by: endothelial function [brachial artery flow-mediated dilation (FMD), reactive hyperaemia index (RHI)], arterial stiffness [pulse wave velocity (PWV) and common carotid artery stiffness (β-stiffness)]. For statistical analysis one-way analysis of variance with Bonferroni post-test was used.

Results
Empagliflozin on top of metformin treatment significantly improved endothelial function as did metformin after 12 weeks of treatment: FMD [2.6-fold (P < 0.001) vs. 1.8-fold (P < 0.05)] and RHI [1.4-fold (P < 0.01) vs. 1.3-fold (P < 0.05)]. Empagliflozin on top of metformin treatment was superior to metformin in improving arterial stiffness parameters; it significantly improved PWV and β-stiffness compared to metformin [by 15.8% (P < 0.01) and by 36.6% (P < 0.05), respectively]. Metformin alone did not influence arterial stiffness.

Conclusion
Empagliflozin on top of metformin treatment significantly improved arterial stiffness compared to metformin in T1DM patients. Endothelial function was similarly improved in all treatment groups. Empagliflozin seems to possess a specific capacity to decrease arterial stiffness, which could support its cardioprotective effects observed in large clinical studies.
Trial registration Clinical trial registration: NCT03639545
Hygro-mechanical response of oak wood cabinet door panels under relative humidity fluctuations
Authors: Luimes R. A. , Suiker A. S. J. , Jorissen A. J. M. , van Duin P. H. J. C. , Schellen H. L. 
Published: December 2018

Abstract
Indoor climate fluctuations are regarded as one of the major risks for the emergence of damage in historical works of art. For a safe preservation of their art objects museums try to minimize this risk, which is typically done by imposing strict limitations on the indoor temperature and humidity conditions. The high energy demand resulting from this approach, however, undermines the aim of preeminent museums to execute a sustainable preservation strategy of their collections. A rational improvement of this aspect asks for detailed information on the history of museum objects, complemented by a thorough comprehension of the failure and deformation behaviour of museum objects under indoor climate fluctuations. Accordingly, in this paper the hygro-mechanical response of mock-ups of historical Dutch cabinet door panels made of oak wood is examined under several relative humidity variations. In specific, the mock-ups were subjected to (i) an instantaneous decrease of 40% relative humidity, (ii) eight successive, instantaneous drops of 5% relative humidity, and (iii) a varying relative humidity profile ranging between 35 and 71%. The shrinkage characteristics of mock-ups are translated to their damage susceptibility using an analytical hygro-mechanical bi-layer model. This model shows that restrained hygral shrinkage may originate from: (i) a difference in moisture content across the thickness direction of the panel, or (ii) a directional difference in the coefficient of hygroscopic expansions of structural components forming a coherent connection. The first type of shrinkage occurs in the outer regions of the panel thickness, while the second type of shrinkage takes place at the cleated ends. Further, by accounting for the age-dependency of the fracture strength of oak wood, a clear distinction can be made between the damage susceptibility of new door panels and historical door panels present in museum cabinets. The six main conclusions of the experimental study—conveniently summarized at the end of this paper—provide a scientific basis for the understanding of shrinkage cracks and dimensional changes observed on decorated oak wooden panels in historical Dutch cabinets, and thus may assist in advising museums on future sustainable preservation strategies and rational guidelines for indoor climate specifications.
SGPL1 Deficiency: A Rare Cause of Primary Adrenal Insufficiency
Authors: Settas Nikolaos , Persky Rebecca , Faucz Fabio R , Sheanon Nicole , Voutetakis Antonis , Lodish Maya , Metherell Louise A , Stratakis Constantine A 
Published: December 2018

Abstract

Context
Multiple autosomal recessive genes have been etiologically linked to primary adrenal insufficiency (PAI). Recently, sphingosine-1-phosphate lyase 1 (SGPL1) gene mutations were recognized as a cause of steroid-resistant nephrotic syndrome type 14 (NPHS14), a sphingolipidosis with multisystemic manifestations, including PAI.

Objective
To check if SGPL1 mutations are involved in the pathogenesis of PAI in patients who do not exhibit nephrotic syndrome.

Methods
Sequencing of the SGPL1 gene in 21 patients with familial glucocorticoid disease or triple A syndrome.

Results
We identified two missense SGPL1 variants in four patients, two of whom were first cousins. We describe in detail the proband, a boy born to Saudi Arabian consanguineous parents with a homozygous c.665G&gt;A, p.R222Q SGPL1 variant. The patient presented with hypoglycemia and seizures at age 2 years and was ultimately diagnosed with PAI (isolated glucocorticoid deficiency). Brain MRI showed abnormalities in the basal ganglia consistent with a degenerative process albeit the patient had no neurologic symptoms.

Conclusions
New genetic causes of PAI continue to be identified. We suggest that screening for SGPL1 mutations should not be reserved only for patients with nephrotic syndrome but may also include patients with PAI who lack other clinical manifestations of NPHS14 because, in certain cases, kidney disease and accompanying features might develop. Timely diagnosis of this specific sphingolipidosis while the kidneys still function normally can lead to prompt initiation of therapy and improve outcome.
Auditory perception exhibits sexual dimorphism and left telencephalic dominance inXenopus laevis
Authors: Fan Yanzhu , Yue Xizi , Xue Fei , Cui Jianguo , Brauth Steven E. , Tang Yezhong , Fang Guangzhan 
Published: December 2018

ABSTRACTSex differences in both vocalization and auditory processing have been commonly found in vocal animals, although the underlying neural mechanisms associated with sexual dimorphism of auditory processing are not well understood. In this study we investigated whether auditory perception exhibits sexual dimorphism in Xenopus laevis. To do this we measured event-related potentials (ERPs) evoked by white noise (WN) and conspecific calls in the telencephalon, diencephalon and mesencephalon respectively. Results showed that (1) the N1 amplitudes evoked in the right telencephalon and right diencephalon of males by WN are significantly different from those evoked in females; (2) in males the N1 amplitudes evoked by conspecific calls are significantly different from those evoked by WN; (3) in females the N1 amplitude for the left mesencephalon was significantly lower than for other brain areas, while the P2 and P3 amplitudes for the right mesencephalon were the smallest; in contrast these amplitudes for the left mesencephalon were the smallest in males. These results suggest auditory perception is sexually dimorphic. Moreover, the amplitude of each ERP component (N1, P2 and P3) for the left telencephalon was the largest in females and/or males, suggesting that left telencephalic dominance exists for auditory perception in Xenopus.
Αξιοποίηση των φορητών τεχνολογιών και της ρομποτικής για την διδασκαλία του προγραμματισμού σε όλες τις εκπαιδευτικές βαθμίδες
Authors: Παπαδάκης Σταμάτιος 
Published: December 2018

Παρότι διεθνώς ο προγραμματισμός θεωρείται ως ο νέος γραμματισμός, η διδασκαλία του σε όλες τις εκπαιδευτικές βαθμίδες παρουσιάζει αρκετά προβλήματα τα οποία σχετίζονται τόσο με την φύση του μαθήματος όσο και με τον τρόπο διδασκαλίας του. Απόρροια τούτου είναι το γεγονός ότι αφενός οι μαθητές θεωρούν τον προγραμματισμό ως ένα δύσκολο και βαρετό μάθημα, αφετέρου όταν τους δίδεται η δυνατότητα είτε δεν επιλέγουν μαθήματα πληροφορικής είτε στην περίπτωση επιλογής τους παρουσιάζουν ιδιαίτερα υψηλά ποσοστά αποχωρήσεων. Στην παρούσα εργασία παρουσιάζεται ένα διδακτικό σενάριο το οποίο προσπαθεί να κεντρίσει το ενδιαφέρον των μαθητών για τον προγραμματισμό και τις συναφείς του έννοιες. Το συγκεκριμένο σενάριο είναι ελεύθερα διαθέσιμο τόσο στην Πλατφόρμα «Αίσωπος» στη διεύθυνση http://aesop.iep.edu.gr/node/11425/2723 όσο και στον εθνικό συσσωρευτή εκπαιδευτικού περιεχομένου με την ονομασία «Φωτόδεντρο» στην διεύθυνση http://photodentro.edu.gr/aggregator/lo/photodentro-aggregatedcontent8526-8403. Το σενάριο έχει χαρακτηριστεί ως «Βέλτιστο», ύστερα από αξιολόγηση που πραγματοποιήθηκε από δύο ανεξάρτητους αξιολογητές έπειτα από σχετική πρόσκληση του Ινστιτούτου Εκπαιδευτικής Πολιτικής (ΙΕΠ). Το διδακτικό σενάριο διδάσκει στους μαθητές τις βασικές προγραμματιστικές δομές συνδυάζοντας ένα εργαλείο καθημερινής χρήσης των μαθητών-μαθητριών όπως είναι το έξυπνο κινητό τους τηλέφωνο με δραστηριότητες οι οποίες έχει αποδειχτεί ότι προσελκύουν το ενδιαφέρον τους όπως είναι η αξιοποίηση ρομποτικών κατασκευών.