bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasound risk evaluation of thyroid nodules that are “unspecified” in the 2015 American Thyroid Association management guidelines
Authors: Gao Luying , Xi Xuehua , Wang Juanjuan , Yang Xiao , Wang Ying , Zhu Shenling , Lai Xingjian , Zhang Xiaoyan , Zhao Ruina , Zhang Bo 
Published: December 2018

Abstract
This study sought to assess the malignant risks of “unspecified” thyroid nodules; that is, nodules that were not of a type described in the 2015 American Thyroid Association (ATA) guidelines.
We retrospectively reviewed medical records and ultrasound (US) data for 1808 consecutive patients with 2614 thyroid nodules who underwent thyroidectomy between January 2015 and December 2015. Nodules with US features that did not satisfy the criteria for any risk category in the 2015 ATA guidelines were defined as “unspecified” nodules. These thyroid nodules were retrospectively assessed using the Thyroid Imaging, Reporting and Data System proposed by Kwak (Kwak-TIRADS) and the American College of Radiology Thyroid Imaging, Reporting and Data System (ACR-TIRADS).
There were 70 “unspecified” nodules (2.7%, 70/2614), and 18.6% (13/70) of these nodules were malignant. The percentages of nodules with Kwak-TIRADS grades 4a, 4b and 4c were 53.3%, 40.0%, and 6.7%, respectively. The percentages of nodules with ACR-TIRADS grades TR2, TR3, TR4, and TR5 were 5.7%, 2.9%, 70.0%, and 21.4%, respectively. Among the “unspecified” nodules, there were significantly more nodules in Kwak-TIRADS categories 4b and 4c in the malignant pathology group than in the benign pathology group (P <.01).
Our results imply that “unspecified” thyroid nodules based on the ATA guidelines could partly be evaluated using the Kwak-TIRADS and that the ATA guidelines could incorporate more accurate malignant risk stratification.
Transradial vs transfemoral access in patients with hepatic malignancy and undergoing hepatic interventions
Authors: Chen Yuan-Yuan , Liu Pan , Wu Yu-Shen , Lin Huapeng , Chen Xiaopin 
Published: December 2018

Abstract

Background:
The aim of this study was to compare transradial access (TRA) approach with transfemoral access (TFA) approach in patients undergoing hepatic interventions.

Methods:
We conducted a comprehensive search of the PubMed, Embase, and the Cochrane Library database to identify relevant available articles. Patients’ preference, success rate, intra- and postoperative outcomes were analyzed. The risk difference (RD), relative risk (RR), and weighted mean difference (WMD) values were reported with 95% confidence intervals (CIs). We used RevMan 5.3 to perform the pooled analyses.

Results:
Nine cohort studies were included. A total of 1096 procedures were performed in 877 patients. Of those, 545 procedures (49.7%) were performed by TRA, and 551 procedures (50.3%) were performed by TFA. Patients were significantly prefer the TRA (86.5%) to the TFA (13.5%) (RD = 0.88, P < .00001). The procedure time in TRA groups was longer (WMD = 3.36, 95% CI 1.24–5.47, P = .002). But there were no significant difference in terms of success rate, fluoroscopy time, radiation dosage, contrast volume, and postoperative vascular complications.

Conclusion:
For patients suffer from primary or secondary hepatic malignancy and undergoing hepatic interventions, the present meta-analysis demonstrated that patients prefer the TRA approach to the TFA approach. But the procedure time is longer in TRA group.
Gd-EOB-DTPA dynamic contrast-enhanced magnetic resonance imaging is more effective than enhanced 64-slice CT for the detection of small lesions in patients with hepatocellular carcinoma
Authors: Li Jiangfa , Li Xiaoqing , Weng Jun , Lei Liping , Gong Jianhua , Wang Junyi , Li Zhenghang , Zhang Longmiao , He Songqing 
Published: December 2018

Abstract
This study aimed to compare the sensitivity and accuracy for the detection of small lesions in patients with hepatocellular carcinoma (HCC) using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and 64-slice computed tomography (CT) enhanced scanning, and to evaluate the necessity to perform MRI in patients diagnosed with HCC by CT.
The clinical data from 209 patients with HCC diagnosed prior to surgery in the Affiliated Hospital of Guilin Medical University, China were retrospectively analyzed. The 64-slice dynamic contrast-enhanced multi-detector CT (MDCT) and 3.0 T Gd-EOB-DTPA DCE MRI procedures were successively carried out on all patients who were enrolled in a self-controlled study including detection and diagnosis of HCC lesions by MRI and CT, respectively.
A total of 243 lesions were detected and both imaging methods could accurately detect lesions of diameter >2 cm. For lesions <2 cm, MRI detected 47, while CT detected 25 lesions indicating that the detection rate of MRI was 88% higher than that of CT. In addition, MRI detected lesions in 15 cases (7.81% in the total of 209 cases) that were not diagnosed by CT. Among these cases, 2 patients were diagnosed to have no lesion by CT.
Gd-EOB-DTPA DCE-MRI performed as a routine check prior to surgery in HCC patients can improve the detection of small HCC lesions.
Could larger diameter of 4th generation ceramic bearing increase the rate of squeaking after THA?
Authors: Luo Yuan , Sun Xue-Feng , Chen Jin , Cui Wei , Wang Tao 
Published: December 2018

Abstract
The present study aimed to evaluate the clinical outcomes and bearing-specific complications in a single center of 135 delta ceramic-on-ceramic (COC) total hip arthroplasties (THAs) and explore the occurrence rate of squeaking in 4th generation COC THAs and collate the risk factors for squeaking.
We retrospectively analyzed consecutive cohorts of 127 patients (135 hips) who had primary THA with delta COC bearings in our hospital between April 2010 and April 2012. Preoperative Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and University of California Los Angeles (UCLA) activity score were evaluated preoperatively and postoperatively. We also evaluated ceramic fracture, squeak, mid-term results, and survival.
In our study, the final patient final follow-up date was July 31, 2016. The mean preoperative HHS improved from 39.5 to 93.1 points. Mean preoperative UCLA score was 3.2 points, improving to 8.2 points. The mean preoperative total WOMAC score was 55.5 points and the mean total WOMAC score was 13.3 points at the final follow-up. The Kaplan–Meier survival plot of revision for any reason as the end point was 98.5% and survival with ceramic fracture as the end point was 99.2% at a mean of 70 months’ follow-up. One post-operative ceramic liner rim fracture occurred at 50 months after surgery. Thirteen of the 135 hips produced a squeaking sound. There were no significant differences in gender (P = .56), age (P = .20), body mass index (BMI) (P = .11), diagnosis (P = .46), cup inclination (P = .36), or cup anteversion (P = 1.0) between the squeaking and non-squeaking groups. However, the incidence of squeaking in the 36 mm COC femoral head bearings was higher than in the 28 mm size (13.6% vs 2.1%, P = .033).
The 4th generation COC bearing performed well and provides an encouraging rate of survival with no osteolysis or loosening. However, we found that a squeaking sound associated with use of the delta ceramic occurred at a rate of 9.6%, with the larger-diameter heads having significantly higher incidence.
Conceptual Model for Predicting Academic Success in Prelicensure Nursing Programs Through Expanded Cognitive Aptitude Assessment
Authors: Twidwell Julie , Sanner-Stiehr Ericka , Allen Kimberly , Records Kathie , Hsueh Kuei-Hsiang 
Published: December 2018

Background
Attrition from prelicensure nursing programs is a serious issue with implications for students, nursing programs, and the nursing workforce. Academic failure due to insufficient cognitive aptitude often contributes to this problematic attrition rate. Thus, cognitive aptitude could be included in admission criteria, as a predictor of academic success and a strategy to minimize attrition.

Problem
Currently, admissions practices are often incomplete and lack standardization for measuring cognitive aptitude.

Approach
The Nursing Cognitive Aptitude Model (NCAM) presented in this article is an innovative conceptual model to guide educators in expanding current admissions processes.

Conclusion
The NCAM model depicts the cognitive domains involved in student academic success including current scholastic knowledge, previous academic performance, and critical-thinking ability. Together, these three domains predict student academic success and are a useful reference for the admissions process.
An Analysis of Female Plastic Surgery Authorship: Where Are We Today?
Authors: Andry Danielle , Moliver Clayton , Phillips Linda G. 
Published: December 2018

Background:
Authorship in a peer-reviewed journal is highly regarded in both the academic and private sectors of plastic surgery. Recently, several articles have cited an increased contribution from women in the plastic surgery literature; however, none to date has analyzed the demographic trends of these female authors. The purpose of this study was to conduct an analysis of female authors in three well-known plastic surgery journals.

Methods:
Articles published in Plastic and Reconstructive Surgery, Annals of Plastic Surgery, and Aesthetic Surgery Journal between January of 2015 and December of 2015 were reviewed. Supplemental journal, review, and CME articles were excluded. First, second, and last authors from the United States were reviewed and stratified by a number of categories, including sex, geographic location, and title.

Results:
Two-thousand fifty authors were reviewed. Of these, 20 percent of first authors, 24 percent of second authors, and 15 percent of last authors were women. Female representation was fairly equal among the journals, and 39 percent of women authors were international. Overall, 16 percent of fully trained plastic surgeon authors and 25 percent of resident authors were women, as compared to 15 percent female fully trained plastic surgeons and 36.2 percent female residents represented in the overall community.

Conclusions:
Faculty are on par with national percentages of women plastic surgeons; however, women residents have lower representation in the literature than in the community as a whole. Residents and faculty must promote productivity of the younger generation of women plastic surgeons to continue increasing contributions of women to the specialty.
Risk Factors for Preoperative Developmental Delay in Patients with Nonsyndromic Sagittal Craniosynostosis
Authors: Imahiyerobo Thomas A. , Johns Alexis L. , Christian Eisha A. , Sanchez-Lara Pedro A. , Krieger Mark D. , McComb J. Gordon , Urata Mark M. 
Published: December 2018

Background:
Some patients with isolated sagittal craniosynostosis have demonstrated mild neurodevelopmental delays. This study examined potential preoperative risk factors for developmental delay.

Methods:
Patients completed preoperative Bayley Scales of Infant and Toddler Development, Third Edition, and medical records were reviewed. Multivariate analyses of covariance and correlations were calculated.

Results:
Participants (n = 77) were predominantly male (77.9 percent) and were aged 2 to 12 months (mean, 5.1 ± 2.3 months). Patients were classified with no delays [n = 63 (82 percent)] or delays [n = 14 (18 percent)] in one or more developmental area(s). There were no group sociodemographic differences. Prenatally, patients with delays versus no delays had lower mean gestational age in weeks (36.9 ± 2.8 weeks versus 39.1 ± 1.7 weeks; p = 0.001) with higher rates of gestational diabetes (36 percent versus 5 percent; p = 0.006) and premature rupture of membranes (14 percent versus 2 percent; p = 0.026). At birth, patients with delays had lower mean birth weight (2982 ± 714 g versus 3374 ± 544 g; p = 0.053), higher rates of respiratory distress (29 percent versus 5 percent; p = 0.005), additional medical diagnoses (57 percent versus 13 percent; p = 0.001), and longer mean neonatal intensive care unit stays (1.4 ± 1.8 weeks versus 0.2 ± 0.9 week; p = 0.002). Variables differing by group had moderate correlations.

Conclusions:
Patients with nonsyndromic sagittal craniosynostosis that had delays in development had lower gestational age and birth weight, with more prenatal and birth complications. These factors can help identify patients who might be at risk for delay and need close monitoring.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.
Evaluating an Interdisciplinary EEG Initiative on In-Training Examination EEG-Related Item Scores for Anesthesiology Residents
Authors: Fahy Brenda G. , Vasilopoulos Terrie , Bensalem-Owen Meriem , Chau Destiny F. 
Published: December 2018

Purpose:
Clinical neurophysiology is an evolving area of medicine with clinical applications in intensive care unit and intraoperative settings, where EEG is used. An interdisciplinary module was implemented over 7 years in one institution to strengthen anesthesiology residents' EEG education. This study researched the module's outcome by evaluating participants' specific performance on EEG-related questions (keywords) through independent testing, i.e., the in-training examinations (ITEs).

Methods:
Residency program ITE performance reports from 2002 to 2014 were searched for EEG keyword items. The ITE uses images for assessment. Analysis of variance was used to evaluate differences in the composite performance (mean percent correct on EEG-related keywords) of anesthesiology trainees from their clinical anesthesia year 1 (CA-1) to their clinical anesthesia year 3 (CA-3) who received the education module and compared with those who did not receive the training module, as well as compared with the national average for the corresponding training level.

Results:
Residents who received the education module (mean percent correct = 83.3%, 95% CI: 74.0–92.7) performed significantly better than residents within the same program who did not receive the module (P = 0.04; mean difference = 22.0%, 95% CI: 1.0–43.0), as well as national residents on the same keywords (P = 0.01; mean difference = 23.4%, 95% CI: 3.9–42.9). Differences between residents who did not receive the module and national residents (matched for same keywords) were not statistically significant (P = 0.983, mean difference = 5.2%, 95% CI: −17.3 to 27.7).

Conclusions:
The multidisciplinary education module was effective for the EEG-specific topics as measured by the national ITE examination performance that resulted in sustained learning over time.
PLZF limits enhancer activity during hematopoietic progenitor aging
Authors: Poplineau Mathilde , Vernerey Julien , Platet Nadine , N’guyen Lia , Hérault Léonard , Esposito Michela , Saurin Andrew J. , Guilouf Christel , Iwama Atsushi , Duprez Estelle 
Published: December 2018

ABSTRACTPLZF (promyelocytic leukemia zinc finger) is a transcription factor acting as a global regulator of hematopoietic commitment. PLZF displays an epigenetic specificity by recruiting chromatin-modifying factors but little is known about its role in remodeling chromatin of cells committed towards a given specific hematopoietic lineage. In murine myeloid progenitors, we decipher a new role for PLZF in restraining active genes and enhancers by targeting acetylated lysine 27 of Histone H3 (H3K27ac). Functional analyses reveal that active enhancers bound by PLZF are involved in biological processes related to metabolism and associated with hematopoietic aging. Comparing the epigenome of young and old myeloid progenitors, we reveal that H3K27ac variation at active enhancers is a hallmark of hematopoietic aging. Taken together, these data suggest that PLZF, associated with active enhancers, appears to restrain their activity as an epigenetic gatekeeper of hematopoietic aging.
The Unique Evolutionary Trajectory and Dynamic Conformations of DR and IR/DR- coexisting Plastomes of the Early Vascular Plant Selaginellaceae (Lycophyte)
Authors: Zhang Hong-Rui , Xiang Qiao-Ping , Zhang Xian-Chun 
Published: December 2018

AbstractBoth direct repeats (DR) and inverted repeats (IR) are documented in the published plastomes of four Selaginella species indicating the unusual and diverse plastome structure in the family Selaginellaceae. In this study, we newly sequenced complete plastomes of seven species from five main lineages of Selaginellaceae and also re-sequenced three species (S. tamariscina, S. uncinata and S. moellendorffii) to explore the evolutionary trajectory of Selaginellaceae plastomes. Our results showed that the plastomes of Selaginellaceae vary remarkably in size, gene contents, gene order and GC contents. Notably, both DR and IR structure existed in the plastomes of Selaginellaceae with DR structure being an early diverged character. The occurrence of DR structure was right after the Permian-Triassic (P-T) extinction (ca. 246 Ma) and remained in most subgenera of Selaginellaceae, whereas IR structure only reoccurred in the most derived subg. Heterostachys (ca. 23 Ma). The presence of a pair of large repeats psbK-trnQ, together with DR/IR region in S. bisulcata, S. pennata, S. uncinata, and S. hainanensis, could frequently mediate diverse homologous recombination and create approximately equal stoichiometric isomers (IR/DR-coexisting) and subgenomes. High proportion of repeats is presumably responsible for the dynamic IR/DR-coexisting plastomes, which possess a lower synonymous substitution rate (dS) compared with DR-possessing plastomes. We propose that the occurrence of DR structure, together with few repeats, is possibly selected to adapt to the environmental upheaval during the P-T crisis and the IR/DR-coexisting plastomes also reached an equilibrium in plastome organization through highly efficient homologous recombination to maintain stability.Data depositionAll the plastomes were deposited in GenBank under accession numbers MG272483-MG272484, MH598531-MH598537 and MK156800.
Dynamics of Spaetzle morphogen shuttling in theDrosophilaembryo shapes pattern
Authors: Rahimi Neta , Averbukh Inna , Carmon Shari , Schejter Eyal D. , Barkai Naama , Shilo Ben-Zion 
Published: December 2018

AbstractEstablishment of morphogen gradients in the earlyDrosophilaembryo is challenged by a diffusible extracellular milieu, and rapid nuclear divisions that occur at the same time. To understand how a sharp gradient is formed within this dynamic environment, we followed the generation of graded nuclear Dorsal (Dl) protein, the hallmark of pattern formation along the dorso-ventral axis, in live embryos. We show that a sharp gradient is formed through extracellular, diffusion-based morphogen shuttling that progresses through several nuclear divisions. Perturbed shuttling inwntDmutant embryos results in a flat activation peak and aberrant gastrulation. Re-entry of Dl into the nuclei at each cycle refines the signaling output, by guiding graded accumulation of theT48transcript that drives patterned gastrulation. We conclude that diffusion-based ligand shuttling, coupled with dynamic readout, establishes a refined pattern within the diffusible environment of early embryos.
The division of amyloid fibrils – Systematic comparison of fibril fragmentation stability by linking theory with experiments
Authors: Beal David M. , Tournus Magali , Marchante Ricardo , Purton Tracey , Smith David P. , Tuite Mick F. , Doumic Marie , Xue Wei-Feng 
Published: December 2018

ABSTRACTThe division of amyloid protein fibrils is required for the propagation of the amyloid state, and is an important contributor to their stability, pathogenicity and normal function. Here, we combine kinetic nano-scale imaging experiments with analysis of a mathematical model to resolve and compare the division stability of amyloid fibrils. Our theoretical results show that the division of any type of filament is uniquely described by a set of three characteristic properties, resulting in convergence to self-similar length distributions distinct to each fibril type and conditions applied. By applying these results to profile the dynamical stability towards breakage for four different amyloid types, we reveal particular differences in the division properties of disease-related amyloid formed from alpha-synuclein compared with non-disease associated model amyloid, the former showing lowered intrinsic stability towards breakage and increased likelihood of shedding smaller particles. Our results enable the comparison of protein filaments’ intrinsic dynamic stabilities, which are key to unravelling their toxic and infectious potentials.
S3norm: simultaneous normalization of sequencing depth and signal-to-noise ratio in epigenomic data
Authors: Xiang Guanjue , Keller Cheryl A. , Giardine Belinda , An Lin , Li Qunhua , Zhang Yu , Hardison Ross C. 
Published: December 2018

ABSTRACTQuantitative comparison of epigenomic data across multiple cell types or experimental conditions is a promising way to understand the biological functions of epigenetic modifications. However, differences in sequencing depth and signal-to-noise ratios in the data from different experiments can hinder our ability to identify real biological variation from raw epigenomic data. Proper normalization is required prior to data analysis to gain meaningful insights. Most existing methods for data normalization standardize signals by rescaling either background regions or peak regions, assuming that the same scale factor is applicable to both background and peak regions. While such methods adjust for differences in sequencing depths, they do not address differences in the signal-to-noise ratios across different experiments. We developed a new data normalization method, called S3norm, that normalizes the sequencing depths and signal-to-noise ratios across different data sets simultaneously by a monotonic nonlinear transformation. We show empirically that the epigenomic data normalized by our method, compared to existing methods, can better capture real biological variation, such as impact on gene expression regulation.