bluuebunny/crossref_metadata_2025_split huggingface dataset:
MULTIMODAL IMAGING OF FOCAL CHOROIDAL EXCAVATION COMPLICATED BY CHOROIDAL NEOVASCULARIZATION IN A PATIENT WITH ANGIOID STREAKS AND PSEUDOXANTHOMA ELASTICUM
Authors: Ferreira Bruno Fortaleza de Aquino , Preti Rony Carlos , Schmidt Marina Brandão , Zacharias Leandro Cabral , Takahashi Walter Yukihiko , Monteiro Mário Luiz Ribeiro 
Published: June 2018

Purpose:
To describe a case of focal choroidal excavation (FCE) complicated with Type-2 choroidal neovascularization (CNV) in a patient with angioid streaks secondary to pseudoxanthoma elasticum before and after treatment with bevacizumab.

Methods:
Fundus photography, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, spectral-domain optical coherence tomography (SD-OCT) and SD-OCT angiography were performed in a 60-year-old white woman with angioid streaks and bilateral FCE. Spectral domain OCT images were taken before and after three-monthly intravitreal injections of bevacizumab. Histopathological analysis of the dermis established the diagnosis of pseudoxanthoma elasticum.

Results:
Multimodal imaging revealed bilateral FCE and CNV. Spectral domain OCT diagnosed bilateral FCE and Type-1 and Type-2 CNV in the right eye, and irregular vascular network, along macular streak, in both eyes, which were not observed on fluorescein neither on indocyanine green angiography, but only on SD-OCT angiography. Patient presented good anatomical and functional response to intravitreal injections of bevacizumab.

Conclusion:
Focal choroidal excavation is a rare condition detected mainly by SD-OCT, which may be associated with angioid streaks secondary to pseudoxanthoma elasticum and complicated by CNV. Multimodal imaging is important for diagnosis and follow-up of such patients, even in the absence of signs of CNV, and anatomical and functional response to anti–vascular endothelial growth factor therapy is good.
Evaluation of Pupil Fields Using a Newly Developed Head-mounted Perimeter in Healthy Subjects
Authors: Asakawa Ken , Nanno Mami , Ishikawa Hitoshi , Shoji Nobuyuki 
Published: June 2018

Purpose:
The purpose of this study was to evaluate the accuracy of pupil fields and determine the normative pupillary response data by age using a newly developed head-mounted perimeter.

Methods:
A total of 100 healthy subjects (age, 20 to 68 y) were enrolled. The newly developed head-mounted perimeter “imo” was used to measure the percentage pupil constriction (PPC) as response to a stimulus at all 36 test points of the visual field. Goldmann size III and V stimuli at 0, 8, and 11 decibels (dB) under 31.4, 6, and 3 apostilbs (asb) background were presented. The PPC correlations (r) of the right and left eyes were examined. Reproducibility was determined with the coefficient of variation (CV) and a Bland-Altman plot. By a simple bootstrap method, the mean PPC were analyzed as normative data in all 36 test points.

Results:
Excellent correlation between both eyes was obtained for Goldmann size V stimuli, target luminance of 0 dB, and a background luminance of 31.4 asb (r=0.83; P<0.001). From the test-retest CV peripheral areas have low reproducibility compared with central areas. With a Goldmann size V target, there was a steeper decline of the PPC from the center field to the periphery field, and the temporal field PPC was larger than the nasal field. No major differences were observed between the PPC data and the age groups by decade (eg, center 3 degrees; P=0.223-0.913).

Conclusions:
Normative PPC data might well be useful for assessing objective visual fields with the newly developed head-mounted perimeter.
A multiplex real-time PCR technique for simultaneous detection of Listeria monocytogenes and Streptococcus agalactiae among asymptomatic pregnant women
Authors: Ghasemian Abdolmajid , Nojoomi Farshad , Heidari Abhari Mina , Fallah Mehrabadi Jalil 
Published: June 2018

Objective:

Listeria monocytogenes and Streptococcus agalactiae are important causes of urogenital and infantile infections. This study was performed to design a multiplex-real-time PCR technique for simultaneous detection of L. monocytogenes and S. agalactiae.

Methods:
A total of 233 vaginal samples from pregnant patients (35–37 weeks of pregnancy) were collected. For L. monocytogenes, after swab lawn the plates were incubated at 37 °C for up to 48 h and after bacterial growth, 50 ml of broth medium was inoculated to blood agar. The isolates were also identified by phenotypic tests. The PCR and real-time PCR techniques were performed to amplify the hly and cfo genes from L. monocytogenes and S. agalactiae, respectively.

Results:
In the PCR technique, 17 (7.29%) and 25 (10.72%) isolates were identified as L. monocytogenes and S. agalactiae by amplification of hly and cfo genes, respectively, and similarly in the culture method 16 (6.68%) and 23 (9.87%) isolates were obtained and identified, respectively. By the real-time PCR, L. monocytogenes and S. agalactiae were detected in 24 (10.30%) and 34 (14.60%) samples, respectively. Real-time PCR demonstrated the highest the sensitivity and specificity results.

Conclusion:
The real-time PCR was the most advantageous method due to its higher sensitivity and specificity and rapidity in results, especially among asymptomatic patients. L. monocytogenes and S. agalactiae infections need to be diagnosed rapidly because of complications occurred among infants and asymptomatic pregnant women.
Physical Findings Mimicking Sexual Abuse in a Drowning Patient Who Was Treated in the Intensive Care Unit
Authors: Sener Mustafa Talip , Vural Talip , Sahpaz Ahmet 
Published: June 2018

Abstract
Specific or nonspecific findings of sexual abuse may be observed upon examination of a child. Examination of the genital area is extremely important for the identification of child sexual abuse (CSA). However, medical conditions detected in the child's genital area may be misinterpreted as signs of CSA. Herein, we present a case of a child with suspected CSA who was treated in the intensive care unit. The following incidental findings were obtained upon anal examination: dilatation, ecchymosis, laceration, and hemorrhage. This report aims to discuss the anal examination findings that can mimic CSA.
The Psychiatry Morbidity and Mortality Incident Reporting Tool Increases Psychiatrist Participation in Reporting Adverse Events
Authors: Kroll David S. , Shellman Andrea D. , Gitlin David F. 
Published: June 2018

Objectives
Although the reporting of adverse events (AEs) is widely thought to be a key first step to improving patient safety in hospital systems, underreporting remains a common problem, particularly among physicians. We aimed to increase the number of safety reports filed by psychiatrists in our hospital system.

Methods
We piloted an online survey for psychiatry-specific AE reporting, the Psychiatry Morbidity and Mortality Incident Reporting Tool (PMIRT) for a 1-year period. An e-mail prompt containing a link to the survey was sent on a weekly basis to all psychiatry department clinical staff. The primary outcome was the total number of events reported by psychiatrists through PMIRT; secondary outcomes were the total number of AEs and the number of serious harm events filed by psychiatrists in our hospital's formal event reporting system before and after implementation of the new protocol.

Results
Psychiatrists filed 65 reports in PMIRT during the study period. The average number of AEs reported by psychiatrists in the hospital's formal event reporting system significantly increased after the intervention (P = 0.0251), and the average number of serious harm events reported by psychiatrists increased nonsignificantly (P = 0.1394).

Conclusions
The combination of an increase in awareness of event reporting with a psychiatry-specific AE reporting tool resulted in a significant improvement in the number of reports by psychiatrists.
Preoperative Autologous Blood Collection in Adult Living Liver Donors: Are We Wasting Donor Blood and Increasing Exposure to Risk?
Authors: Manuel Solmaz Poorsattar , Roberts John P. , Bakhtary Sara 
Published: June 2018

Background
Despite waning indications in the general population for preoperative autologous blood donation (PABD), it is a procedure that continues to be offered to healthy living liver donor (LLD). In this study, we sought to understand the impact of PABD on the LLD population.

Methods
We retrospectively reviewed charts of one institution's LLDs over a 2-year period. Per institutional protocol, all accepted LLDs donated 1 unit of autologous blood before living donor hepatectomy.

Results
Sixty-six LLDs underwent PABD and 59 of these donors underwent living donor hepatectomy. In this cohort, there was a significant 1.2 g/dL drop in hemoglobin (HB) from baseline (before PABD) to the evening before surgery. Mean (standard deviation [SD]) procedure estimated blood loss was 260 mL (±100), mean (SD) resected graft weight was 592 g (±174). No allogeneic blood was transfused. Forty-two percent of LLD received autologous transfusion. Mean (SD) pretransfusion HB of transfused LLDs was 11.7 g/dL (±1.2). All LLDs had negative antibody screens. Sixty-three percent of donated autologous units were discarded.

Conclusions
Preoperative autologous blood donation in our population is associated with decreased preoperative HB, increased exposure of healthy LLD to unnecessary transfusion-related risks and high rates of discarded blood product. We encourage further investigation and reconsideration of the practice of PABD and autologous transfusion in LLDs.
Barriers and Enablers to Organ Donation After Circulatory Determination of Death: A Qualitative Study Exploring the Beliefs of Frontline Intensive Care Unit Professionals and Organ Donor Coordinators
Authors: Squires Janet E. , Graham Nicole , Coughlin Mary , Chassé Michaël , Linklater Stefanie , Greenough Megan , Grimshaw Jeremy M. , Shemie Sam D. , Dhanani Sonny , Knoll Gregory A. 
Published: June 2018

Background
A shortage of transplantable organs is a global problem. The purpose of this study was to explore frontline intensive care unit professionals' and organ donor coordinators' perceptions and beliefs around the process of, and the barriers and enablers to, donation after circulatory determination death (DCDD).

Methods
This qualitative descriptive study used a semistructured interview guide informed by the Theoretical Domains Framework to interview 55 key informants (physicians, nurses, and organ donation coordinators) in intensive care units (hospitals) and organ donation organizations across Canada.

Results
Interviews were analyzed using a 6-step systematic approach: coding, generation of specific beliefs, identification of themes, aggregation of themes into categories, assignment of barrier or enabler and analysis for shared and unique discipline barriers and enablers. Seven broad categories encompassing 29 themes of barriers (n = 21) and enablers (n = 4) to DCDD use were identified; n = 4 (14%) themes were conflicting, acting as barriers and enablers. Most themes (n = 26) were shared across the 3 key informant groups while n = 3 themes were unique to physicians. The top 3 shared barriers were: (1) DCDD education is needed for healthcare professionals, (2) a standardized and systematic screening process to identify potential DCDD donors is needed, and (3) practice variation across regions with respect to communication about DCDD with families. A limited number of differences were found by region.

Conclusions
Multiple barriers and enablers to DCDD use were identified. These beliefs identify potential individual, team, organization, and system targets for behavior change interventions to increase DCDD rates which, in turn, should lead to more transplantation, reducing patient morbidity and mortality at a population level.
Nuclear Factor of Activated T Cell-regulated Cytokine Gene Expression for Adjustment of Tacrolimus in Kidney Transplant Recipients: A Randomized Controlled Pilot Trial
Authors: Webber Allison B. , Tatapudi Vasishta , Maw Thin T. , Peralta Carmen , Leung Joey C.Y. , Vincenti Flavio 
Published: June 2018

Background
The aim of this pilot study was to assess the feasibility of a pharmacodynamics assay that measures Nuclear Factor of Activated T Cell–dependent cytokines expressed as % mean residual expression (MRE) to adjust tacrolimus (tac) dose (intervention [INT] arm) in comparison with the standard of care of tac trough levels (control [CTL] arm).

Methods
We conducted a single-center randomized controlled trial involving 40 stable kidney transplant recipients over 1 year. In the INT arm, the dose of tac was reduced by 15% if the MRE was less than 20% and was increased by 15% if the MRE was greater than 60%. Controls were adjusted based on tac trough levels.

Results
There was a median of 2 tac dose changes per arm. Ten subjects had 1 or more infections in the INT arm and 6 subjects had 1 or more infection in the CTL arm. Rates for hospitalizations, rejections, malignancies and death were similar in both arms. In subjects whose tac dose was not adjusted in the first 6 months, those with infections had a lower MRE at enrollment compared with those without infections (P = 0.049). This was not true for tac trough levels (P = 0.80). There was no correlation between MRE and rejection.

Conclusions
Our study suggests that adjusting tac based on this pharmacodynamics assay is feasible. Quantitative analysis of nuclear factor of activated T-regulated gene expression may serve as a reliable assay to lower tac dosing. Further studies with larger populations are needed.
Transcranial Direct Current Stimulation as a Therapeutic Tool for Chronic Pain
Authors: Pinto Camila Bonin , Teixeira Costa Beatriz , Duarte Dante , Fregni Felipe 
Published: June 2018

Abstract
Transcranial direct current stimulation (tDCS) modulates spontaneous neuronal activity that can generate long-term neuroplastic changes. It has been used in numerous therapeutic trials showing significant clinical effects especially when combined with other behavioral therapies. One area of intensive tDCS research is chronic pain. Since the initial tDCS trials for chronic pain treatment using current parameters of stimulation, more than 60 clinical trials have been published testing its effects in different pain syndromes. However, as the field moves in the direction of clinical application, several aspects need to be taken into consideration regarding tDCS effectiveness and parameters of stimulation. In this article, we reviewed the evidence of tDCS effects for the treatment of chronic pain and critically analyzed the literature pertaining its safety and efficacy, and how to optimize tDCS clinical effects in a therapeutic setting. We discuss optimization of tDCS effects in 3 different domains: (i) parameters of stimulation, (ii) combination therapies, and (iii) subject selection. This article aims to provide insights for the development of future tDCS clinical trials.
HSP90 buffers newly induced mutations in massively mutated plant lines
Authors: Alex Mason G. , Carlson Keisha D , Press Maximilian O , Bubb Kerry L , Queitsch Christine 
Published: June 2018

AbstractRobustness to both genetic and environmental change is an emergent feature of living systems. Loss of phenotypic robustness can be associated with increased penetrance of genetic variation. In model organisms and in humans, the phenotypic consequences of standing genetic variation can be buffered by the molecular chaperone HSP90. However, it has been argued that HSP90 has the opposite effect on newly introduced genetic variation. To test the buffering effect of HSP90 on new mutations, we introduced vast numbers of mutations into wild-type and HSP90-reduced plants and assessed embryonic lethality and early seedling phenotypes for thousands of offspring. Although the levels of newly introduced mutations were similar in the two backgrounds, the HSP90-reduced plants showed a significantly greater frequency of embryonic lethality and severe phenotypic abnormalities, consistent with higher penetrance and expressivity of newly introduced genetic variation. We further demonstrate that some mutant phenotypes were heritable in an HSP90-dependent manner, and we map candidate HSP90-dependent polymorphisms. Moreover, both sequence and phenotypic analyses of wild-type and HSP90-reduced plants suggest that the HSP90-dependent phenotypes are largely due the newly introduced mutations rather than to an increased mutation rate in HSP90-reduced plants. Taken together, our results support a model in which HSP90 buffers newly introduced mutations, and the phenotypic consequences of such mutations outweigh those of mutations arising de novo in response to HSP90 perturbation.
Pathway specific drive of cerebellar Golgi cells reveals integrative rules of cortical inhibition
Authors: Tabuchi Sawako , Gilmer Jesse I. , Purba Karen , Person Abigail L. 
Published: June 2018

AbstractCerebellar granule cells (GrCs) constitute over half of all neurons in the vertebrate brain and are proposed to decorrelate convergent mossy fiber inputs in service of learning. Interneurons within the granule cell layer, Golgi cells (GoCs), are the primary inhibitors of this vast population and therefore play a major role in influencing the computations performed within the layer. Despite this central function for GoCs, few studies have directly examined how GoCs integrate inputs from specific afferents which vary in density to regulate GrC population activity. We used a variety of methods in mice of either sex to study feedforward inhibition recruited by identified MFs, focusing on features that would influence integration by GrCs. Comprehensive 3D reconstruction and quantification of GoC axonal boutons revealed tightly clustered boutons that focus feedforward inhibition in the neighborhood of GoC somata. Acute whole cell patch clamp recordings from GrCs in brain slices showed that despite high bouton density, fast phasic inhibition was very sparse relative to slow spillover mediated inhibition. Furthermore, dynamic clamp simulating inhibition combined with optogenetic mossy fiber activation supported the predominant role of slow spillover mediated inhibition. Whole cell recordings from GoCs revealed a role for the density of active MFs in preferentially driving them. Thus, our data provide empirical conformation of predicted rules by which MFs activate GoCs to regulate GrC activity levels.
Maintenance of homeostatic plasticity at theDrosophilaneuromuscular synapse requires continuous IP3-directed signaling
Authors: James Thomas D. , Zwiefelhofer Danielle J. , Frank C. Andrew 
Published: June 2018

ABSTRACTSynapses and circuits rely on neuroplasticity to adjust output and meet physiological needs. Forms of homeostatic synaptic plasticity impart stability at synapses by countering destabilizing perturbations. TheDrosophila melanogasterlarval neuromuscular junction (NMJ) is a model synapse with robust expression of homeostatic plasticity. At the NMJ, a homeostatic system detects impaired postsynaptic sensitivity to neurotransmitter and activates a retrograde signal that restores synaptic function by adjusting neurotransmitter release. This process has been separated into temporally distinct phases, induction and maintenance. One prevailing hypothesis is that a shared mechanism governs both phases. Here we show the two phases are separable. Combining genetics, pharmacology, and electrophysiology, we find that a signaling system consisting of PLCβ, inositol triphosphate (IP3), IP3receptors, and Ryanodine receptors is required only for the maintenance of homeostatic plasticity. We also find that the NMJ is capable of inducing homeostatic signaling even when its sustained maintenance process is absent.
Supervised learning on synthetic data for reverse engineering gene regulatory networks from experimental time-series
Authors: Ganscha Stefan , Fortuin Vincent , Horn Max , Arvaniti Eirini , Claassen Manfred 
Published: June 2018

AbstractThe reconstruction of gene regulatory networks from time resolved gene expression measurements is a key challenge in systems biology with applications in health and disease. While the most popular network inference methods are based on unsupervised learning approaches, supervised learning methods have proven their potential for superior reconstruction performance. However, obtaining the appropriate volume of informative training data constitutes a key limitation for the success of such methods.Here, we introduce a supervised learning approach to detect gene-gene regulation based on exclusively synthetic training data, termed surrogate learning, and show its performance for synthetic and experimental time-series. We systematically investigate different simulation configurations of biologically representative time-series of transcripts and augmentation of the data with a measurement model. We compare the resulting synthetic datasets to experimental data, and evaluate classifiers trained on them for detection of gene-gene regulation from experimental time-series. For classifiers, we consider hybrid convolutional recurrent neural networks, random forests and logistic regression, and evaluate the reconstruction performance of different simulation settings, data pre-processing and classifiers.When training and test time-courses are generated from the same distribution, we find that the largest tested neural network architecture achieves the best performance of 0.448 ± 0.047 (mean ± std) in maximally achievable F1 score over all datasets outperforming random forests by 32.4 % ± 14 % (mean ± std). Reconstruction performance is sensitive to discrepancies between synthetic training and test data, highlighting the importance of matching training and test data domains. For an experimental gene expression dataset from E.coli, we find that training data generated with measurement model, multi-gene perturbations, but without data standardization is best suited for training classifiers for network reconstruction from the experimental test data. We further demonstrate superiority to multiple unsupervised, state-of-the-art methods for networks comprising 20 genes of the experimental data from E.coli (average AUPR best supervised = 0.22 vs best unsupervised = 0.07).We expect the proposed surrogate learning approach to be broadly applicable. It alleviates the requirement for large, difficult to attain volumes of experimental training data and instead relies on easily accessible synthetic data. Successful application for new experimental conditions and other data types is only limited by the automatable and scalable process of designing simulations which generate suitable synthetic data.