bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reasoning and Deducing
Authors: Valaris Markos 
Published: June 2018

AbstractWhat exactly is reasoning? While debate on this question is ongoing, most philosophers seem to agree on at least the following: reasoning is a mental process operating on contents, which consists in adopting or revising some of your attitudes in light of others. In this paper, I argue that this characterisation is mistaken: there is no single mental phenomenon that satisfies both of these conditions. Instead, I characterise two distinct mental phenomena, which I call ‘deducing’, on the one hand, and ‘reasoning’ or ‘inference’ on the other, to play each of these roles. Recognising this division of labour is essential to developing a better understanding of our rational economy.
A coding and non-coding transcriptomic perspective on the genomics of human metabolic disease
Authors: Timmons James A , Atherton Philip J , Larsson Ola , Sood Sanjana , Blokhin Ilya O , Brogan Robert J , Volmar Claude-Henry , Josse Andrea R , Slentz Cris , Wahlestedt Claes , Phillips Stuart M , Phillips Bethan E , Gallagher Iain J , Kraus William E 
Published: June 2018

AbstractGenome-wide association studies (GWAS), relying on hundreds of thousands of individuals, have revealed >200 genomic loci linked to metabolic disease (MD). Loss of insulin sensitivity (IS) is a key component of MD and we hypothesized that discovery of a robust IS transcriptome would help reveal the underlying genomic structure of MD. Using 1,012 human skeletal muscle samples, detailed physiology and a tissue-optimized approach for the quantification of coding (>18,000) and non-coding (>15,000) RNA (ncRNA), we identified 332 fasting IS-related genes (CORE-IS). Over 200 had a proven role in the biochemistry of insulin and/or metabolism or were located at GWAS MD loci. Over 50% of the CORE-IS genes responded to clinical treatment; 16 quantitatively tracking changes in IS across four independent studies (P = 0.0000053: negatively: AGL, G0S2, KPNA2, PGM2, RND3 and TSPAN9 and positively: ALDH6A1, DHTKD1, ECHDC3, MCCC1, OARD1, PCYT2, PRRX1, SGCG, SLC43A1 and SMIM8). A network of ncRNA positively related to IS and interacted with RNA coding for viral response proteins (P < 1 × 10−48), while reduced amino acid catabolic gene expression occurred without a change in expression of oxidative-phosphorylation genes. We illustrate that combining in-depth physiological phenotyping with robust RNA profiling methods, identifies molecular networks which are highly consistent with the genetics and biochemistry of human metabolic disease.
Measuring precarious employment in Europe 8 years into the global crisis
Authors: Matilla-Santander Nuria , Lidón-Moyano Cristina , González-Marrón Adrián , Bunch Kailey , Martín-Sánchez Juan Carlos , Martínez-Sánchez Jose M 
Published: June 2018

AbstractBackgroundThe objective of this study is to describe the prevalence of precarious employment in the European Union (EU) using a multidimensional approach, 8 years into the economic crisis (2014).MethodsWe use data from the Flash Eurobarometer 398 among salaried workers (n = 7702). We calculated the proportion and its 95% confidence intervals (CI 95%) for each of the precarious employment dimensions (not having the ability to exercise rights, vulnerability, disempowerment and temporariness), the prevalence of precarious employment (presenting at least one dimension) and the proportion of workers presenting one, two, three or four dimensions.ResultsTwo out of three workers had a precarious employment. The prevalence of precariousness was higher in Eastern (72.64%; CI 95%: 61.78; 81.34) than in Nordic European countries (51.17%; CI 95%: 44.30; 58.00). The most prevalent dimension was not having the ability to exercise rights (42.39%).ConclusionsPrecarious employment is an important social determinant of health. Therefore, the EU policy-makers should take into consideration the new forms of employment and legislate accordingly.
Implementation of a unique hepatitis C care continuum model in Rwanda
Authors: Mathur Poonam , Comstock Emily , Makuza Jean Damascene , Emmanuel Benjamin , Sebeza Jackson , Kiromera Athanase , Wilson Eleanor , Kattakuzhy Sarah , Nelson Amy , Kottilil Shyamasundaran , Riedel David J 
Published: June 2018

Abstract

Background
There has been an evolution in the treatment of chronic hepatitis C (HCV) due to highly effective direct-acting antivirals, however, restriction of treatment to medical specialists hinders escalation of HCV treatment. This is particularly true in resource-limited settings (RLS), which disproportionately represent the burden of HCV worldwide. The ASCEND study in Washington, DC, demonstrated that complete task-shifting can safely and effectively overcome a low provider-to-patient ratio and expand HCV treatment. However, this model has not been applied internationally to RLS.

Method
The validated ASCEND model was translated to an international clinical program in Kigali, Rwanda, aimed at training general medicine providers on HCV management and obtaining HCV prevalence data.

Results
The didactic training program administered to 11 new HCV providers in Rwanda increased provider’s knowledge about HCV management. Through the training program, 26% of patients seen during the follow-up period were screened for HCV and a prevalence estimate of 2% was ascertained. Of these patients, 30% were co-infected with hepatitis B.

Conclusion
The ASCEND paradigm can be successfully implemented in RLS to escalate HCV care, in a self-sustaining fashion that educates more providers about HCV management, while increasing the public’s awareness of HCV and access to treatment.
Maternal Western diet during gestation and lactation modifies adult offspring's cognitive and hedonic brain processes, behavior, and metabolism in Yucatan minipigs
Authors: Gautier Yentl , Luneau Isabelle , Coquery Nicolas , Meurice Paul , Malbert Charles‐Henri , Guerin Sylvie , Kemp Bas , Bolhuis J. Elizabeth , Clouard Caroline , Le Huërou‐Luron Isabelle , Blat Sophie , Val‐Laillet David 
Published: June 2018

ABSTRACTThis study explores the long‐term effects of exposure to a maternal Western diet (WD) vs. standard diet (SD) in the Yucatan minipig, on the adult progeny at lean status (n = 32), and then overweight status. We investigated eating behavior, cognitive abilities, brain basal glucose metabolism, dopamine transporter availability, microbiota activity, blood lipids, and glucose tolerance. Although both groups demonstrated similar cognitive abilities in a holeboard test, WD pigs expressed a higher stress level than did SD pigs (immobility, P < 0.05) and lower performance in an alley maze (P = 0.06). WD pigs demonstrated lower dopamine transporter binding potential in the hippocampus and parahippocampal cortex (P < 0.05 for both), as well as a trend in putamen (P=0.07), associated with lower basal brain activity in the prefrontal cortex and nucleus accumbens (P < 0.05) compared with lean SD pigs. Lean WD pigs demonstrated a lower glucose tolerance than did SD animals (higher glucose peak, P < 0.05) and a tendency to a higher incremental area under the curve of insulin from 0 to 30 minutes after intravenous glucose injection (P < 0.1). Both groups developed glucose intolerance with overweight, but WD animals were less impacted than SD animals. These results demonstrate that maternal diet shaped the offspring's brain functions and cognitive responses long term, even after being fed a balanced diet from weaning, but behavioral effects were only revealed in WD pigs under anxiogenic situation; however, WD animals seemed to cope better with the obesogenic diet from a metabolic standpoint.—Gautier, Y., Luneau, I., Coquery, N., Meurice, P., Malbert, C.‐H., Guerin, S., Kemp, B., Bolhuis, J. E., Clouard, C., Le Huerou‐Luron, I., Blat, S., Val‐Laillet, D. Maternal Western diet during gestation and lactation modifies adult offspring's cognitive and hedonic brain processes, behavior, and metabolism in Yucatan minipigs. FASEB J. 32, 6478–6494 (2018). www.fasebj.org
Management of adverse reactions to first-line tuberculosis antibiotics
Authors: Nagarajan Sowmya , Whitaker Paul 
Published: June 2018

Purpose of review
Tuberculosis (TB) is the commonest infectious cause of death globally. Adverse reactions to first-line tuberculosis antibiotics are common and have a major impact on the outcomes of patients as second-line antibiotics are less effective and more toxic. The present review addresses the most recent literature regarding epidemiology, investigating reactions, and reintroducing treatment in patients who have had their treatment interrupted.

Recent findings
Studies have demonstrated that up to 60% of patients experience adverse reactions to TB treatment; around a third of these are idiosyncratic and may relate to immune sensitization. There is an increased risk in patients with HIV. For patients with severe cutaneous reactions patch testing has an important role; however, systemic reactions to patch testing are common in patients with HIV. In-vitro testing remains limited to specialist centers but studies have identified drug-specific lymphocyte responses in patients with cutaneous and liver reactions. Desensitization of patients with severe cutaneous reactions have been demonstrated to be possible, albeit at high risk.

Summary
Management of these patients remains suboptimal. Better identification of predisposing factors, such as HLA alleles, are needed to identify patients at risk. Improved in-vitro diagnostics will reduce the need to re-expose the patient to the drug and optimized desensitization regimens will improve patient safety when drugs have to be re-introduced.
Organizational Factors Contributing to Incivility at an Academic Medical Center and Systems-Based Solutions: A Qualitative Study
Authors: Pattani Reena , Ginsburg Shiphra , Mascarenhas Johnson Alekhya , Moore Julia E. , Jassemi Sabrina , Straus Sharon E. 
Published: June 2018

Purpose
A rise in incivility has been documented in medicine, with implications for patient care, organizational effectiveness, and costs. This study explored organizational factors that may contribute to incivility at one academic medical center and potential systems-level solutions to combat it.

Method
The authors completed semistructured individual interviews with full-time faculty members of the Department of Medicine (DOM) at the University of Toronto Faculty of Medicine, Toronto, Ontario, Canada, with clinical appointments at six affiliated hospitals, between June and September 2016. They asked about participants’ experiences with incivility, potential contributing factors, and possible solutions. Two analysts independently coded a portion of the transcripts until a framework was developed with excellent agreement within the research team, as signified by the Kappa coefficient. A single coder completed analysis of the remaining transcripts.

Results
Forty-nine interviews with physicians from all university ranks and academic position descriptions were completed. All participants had collegial relationships with colleagues but had observed, heard of, or been personally affected by uncivil behavior. Incivility occurred furtively, face-to-face, or online. The participants identified several organizational factors that bred incivility including physician nonemployee status in hospitals, silos within the DOM, poor leadership, a culture of silence, and the existence of power cliques. They offered many systems-level solutions to combat incivility through prevention, improved reporting, and clearer consequences.

Conclusions
Existing strategies to combat incivility have focused on modifying individual behavior, but opportunities may exist to reduce incivility through a greater understanding of the role of health care organizations in shaping workplace culture.
How Theory Can Inform Our Understanding of Experiential Learning in Quality Improvement Education
Authors: Goldman Joanne , Kuper Ayelet , Wong Brian M. 
Published: June 2018

It is widely accepted that quality improvement (QI) education should be experiential. Many training programs believe that making QI learning “hands-on” through project-based learning will translate into successful learning about QI. However, this pervasive and overly simplistic interpretation of experiential QI learning, and the general lack of empirical exploration of the factors that influence experiential learning processes, may limit the overall impact of project-based learning on educational outcomes.
In this Perspective, the authors explore the opportunities afforded by a theoretically informed approach, to deepen understanding of the diverse factors that affect experiential QI learning processes in the clinical learning environment. The authors introduce the theoretical underpinnings of experiential learning more generally, and then draw on their experiences and data, obtained in organizing and studying QI education activities, to illuminate how sociocultural theories such as Billett’s workplace learning theory, and sociomaterial perspectives such as actor–network theory, can provide valuable lenses for increasing our understanding of the varied individuals, objects, contexts, and their relationships that influence project-based experiential learning. The two theoretically informed approaches that the authors describe are amongst numerous others that can inform a QI education research agenda aimed at optimizing educational processes and outcomes. The authors conclude by highlighting how a theoretically informed QI education research agenda can advance the field of QI education; they then describe strategies for achieving this goal.
Weight Loss Maintenance and Cellular Aging in the Supporting Health Through Nutrition and Exercise Study
Authors: Mason Ashley E. , Hecht Frederick M. , Daubenmier Jennifer J. , Sbarra David A. , Lin Jue , Moran Patricia J. , Schleicher Samantha G. , Acree Michael , Prather Aric A. , Epel Elissa S. 
Published: June 2018

ABSTRACTObjectiveThe aim of the study was to determine, within a weight loss clinical trial for obesity, the impact of intervention arm, weight change, and weight loss maintenance on telomere length (TL).MethodsAdults (N= 194) with a body mass index between 30 and 45 were randomized to a 5.5-month weight loss program with (n= 100) or without (n= 94) mindfulness training and identical diet-exercise guidelines. We assessed TL at baseline and 3-, 6-, and 12-month postbaseline in immune cell populations (primarily in peripheral blood mononuclear cells [PBMCs], but also in granulocytes and T and B lymphocytes). We defined weight loss maintenance as having lost at least 5% or 10% of body weight (tested in separate models) from preintervention to postintervention, and having maintained this loss at 12 months. We predicted that greater weight loss and weight loss maintenance would be associated with TL lengthening.ResultsNeither weight loss intervention significantly predicted TL change nor did amount of weight change, at any time point. Across all participants, weight loss maintenance of at least 10% was associated with longer PBMC TL (b= 239.08, 95% CI = 0.92 to 477.25,p= .049), CD8+ TL (b= 417.26, 95% CI = 58.95 to 775.57,p= .023), and longer granulocyte TL (b= 191.56, 95% CI = −4.23 to 387.35,p= .055) at 12 months after accounting for baseline TL. Weight loss maintenance of 5% or more was associated with longer PBMC TL (b= 163.32, 95% CI = 4.00 to 320.62,p= .045) at 12 months after accounting for baseline TL. These tests should be interpreted in light of corrections for multiple tests.ConclusionsAmong individuals with obesity, losing and maintaining a weight loss of 10% or more may lead to TL lengthening, which may portend improved immune and metabolic function. TL lengthening in this study is of unknown duration beyond 12 months and requires further study.Trial Registration: Clinicaltrials.gov identifier NCT00960414; Open Science Framework (OSF) preregistration: https://osf.io/t3r2g/.
Patient and Physician Experience with Interhospital Transfer: A Qualitative Study
Authors: Mueller Stephanie K. , Shannon Evan , Dalal Anuj , Schnipper Jeffrey L. , Dykes Patricia 
Published: June 2018

Objectives
Although existing data suggest marked variability in interhospital transfer (IHT), little is known about specific factors that may impact the quality and safety of this care transition. We aimed to explore transferred patients’ and involved physicians’ experience with IHT to better understand the components of the transfer continuum and identify potential targets for improvement.

Methods
We performed a qualitative study using individual interviews of adult patients recently transferred to cardiology, general medicine, and oncology services at a tertiary care academic medical center, as well as their transferring physician, accepting attending physician, and accepting/admitting resident physician. We conducted a thematic analysis, using an inductive approach and an a priori framework from pre-established domains.

Results
Participants included 10 hospitalized adults (6 cardiology, 2 general medicine, and 2 oncology), 9 accepting attending physicians, 12 accepting and/or admitting resident physicians, and 5 transferring physicians (N = 36). Emergent themes demonstrated that participants held a shared understanding of the reason for transfer (most commonly access to more specialized care), and relayed a general dissatisfaction regarding the timing and lack of advanced notification of transfer. We also found distinct differences in IHT experience by stakeholder group: physician participants relayed discontent with intrahospital chains of communication and interhospital information exchange, and patient participants focused more readily on the physical aspects of IHT.

Conclusions
This study offers insight into IHT from the perspective of those most affected by this process, thereby identifying potential targets in addressing the quality and safety of this transition.
Contrast-enhanced Magnetic Resonance Imaging of Pelvic Bone Metastases at 3.0 T: Comparison Between 3-dimensional T1-weighted CAIPIRINHA-VIBE Sequence and 2-dimensional T1-weighted Turbo Spin-Echo Sequence
Authors: Yoon Min A , Hong Suk-Joo , Lee Kyu-Chong , Lee Chang Hee 
Published: June 2018

Objective
This study aimed to compare 3-dimensional T1-weighted gradient-echo sequence (CAIPIRINHA–volumetric interpolated breath-hold examination [VIBE]) with 2-dimensional T1-weighted turbo spin-echo sequence for contrast-enhanced magnetic resonance imaging (MRI) of pelvic bone metastases at 3.0 T.

Methods
Thirty-one contrast-enhanced MRIs of pelvic bone metastases were included. Two contrast-enhanced sequences were evaluated for the following parameters: overall image quality, sharpness of pelvic bone, iliac vessel clarity, artifact severity, and conspicuity and edge sharpness of the smallest metastases. Quantitative analysis was performed by calculating signal-to-noise ratio and contrast-to-noise ratio of the smallest metastases. Significant differences between the 2 sequences were assessed.

Results
CAIPIRINHA-VIBE had higher scores for overall image quality, pelvic bone sharpness, iliac vessel clarity, and edge sharpness of the metastatic lesions, and had less artifacts (all P < 0.05). There was no significant difference in conspicuity, signal-to-noise ratio, or contrast-to-noise ratio of the smallest metastases (P > 0.05).

Conclusions
Our results suggest that CAIPIRINHA-VIBE may be superior to turbo spin-echo for contrast-enhanced MRI of pelvic bone metastases at 3.0 T.
Limits of intravascular contrast extravasation on computed tomography scan to define the need for pelvic angioembolization in pelvic blunt trauma: a specific assessment on the risk of false positives
Authors: Ramin Séverin , Hermida Margaux , Millet Ingrid , Murez Thibault , Monnin Valerie , Hamoui Mazen , Capdevila Xavier , Charbit Jonathan 
Published: June 2018

BACKGROUND
The objective was to assess the predictive performance of different intravascular contrast extravasation (ICE) characteristics for need for pelvic transarterial embolization (TAE) to determine the risk factors of false positives.

METHODS
A retrospective study was performed in our trauma center between 2010 and 2015. All severe trauma patients with pelvic fracture were included. Pelvic ICE characteristics on computed tomography (CT) scan were studied: arterial (aS2
ICE), portal surface (pS2
ICE), and extension (exS2
ICE) anatomic relationships. The overall predictive performance of ICE surfaces for pelvic TAE was analyzed using receiver operating characteristic curves. The analysis focused on risk factors for false positives.

RESULTS
Among 311 severe trauma patients with pelvic ring fracture (mean age, 42 ± 19 years; mean Injury Severity Score, 27 ± 19), 94 (30%) had at least one pelvic ICE on the initial CT scan. Patients requiring pelvic TAE had significantly larger aS2
ICE and pS2
ICE than others (p = 0.001 and p = 0.035, respectively). The overall ability of ICE surfaces to predict pelvic TAE was modest (aS2
ICE area under the receiver operating characteristic curve, 0.76 [95% confidence interval, 0.64–0.90]; p = 0.011) or nonsignificant (pS2
ICE and exS2
ICE). The high-sensitivity threshold was defined as aS2
ICE 20 mm2 or more. Using this threshold, 76% of patients were false positives. Risk factors for false positives were admission systolic blood pressure of 90 mm Hg or greater (63% vs 20%; p = 0.03) and low transfusion needs (63% vs 10%; p = 0.009), extravasation in contact with complex bone fracture (78% vs 30%; p = 0.008), or the absence of a direct relationship between extravasation and a large retroperitoneal hematoma (100% vs 38%; p < 0.001).

CONCLUSION
A significant pelvic ICE during the arterial phase does not guarantee the need for pelvic TAE. Three quarters of patients with aS2
ICE of 20 mm2 or more did not need pelvic TAE. Several complementary CT scan criteria will help to identify this risk of false positives to determine adequate hemostatic pelvic procedures.

LEVEL OF EVIDENCE
Therapeutic study, level IV.