bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transesophageal echocardiography for the assessment of left atrial appendage thrombus: Study of the additional value of systematic real time 3D imaging after regular 2D evaluation
Authors: Squara Fabien , Bres Mikael , Baudouy Delphine , Schouver Elie‐Dan , Moceri Pamela , Ferrari Emile 
Published: February 2018

BackgroundTwo‐dimensional transesophageal echocardiography (2DTEE) is currently validated for left atrial appendage (LAA) thrombus assessment but has some limitations.AimsTo evaluate the performance and interest of systematic real time three‐dimensional transesophageal echocardiography (3DTEE) for LAA thrombus assessment, when performed after 2DTEE.Methods and resultsConsecutive patients undergoing TEE were prospectively included. LAA was first evaluated using 2DTEE, and patients were classified as “2D‐NT” if no thrombus was found, “2D‐T” in case of clear thrombus, or “2D‐EQ” if equivocal. Then, 3DTEE of the LAA was performed and patients were similarly classified as “3D‐NT,” “3D‐T,” or “3D‐EQ.” Additional LAA CT scan was only performed if LAA thrombus was not clearly ruled out or confirmed by TEE. Additional value of 3DTEE after 2DTEE LAA evaluation was then assessed. We included 104 patients undergoing TEE. Agreement between 2DTEE and 3DTEE was very good for thrombus diagnosis (k = 0.936), but moderate for vacant LAA (k = 0.562) due to more frequent 2D‐EQ than 3D‐EQ (11.5% vs 2.9%; P = .016). 3DTEE allowed to refine the LAA status in 11 of 12 (91.7%) 2D‐EQ patients: 10 3D‐NT, 1 3D‐T, and 1 3D‐EQ. Coupling 3DTEE to 2DTEE permitted a definite LAA diagnosis in 103 of 104 (99%) vs 92 of 104 (88.5%) patients when 2DTEE was used alone (P = .002). Nine (8.7%) LAA thrombi were diagnosed, and 3 CT scan were performed.Conclusion3DTEE of the LAA is more effective for thrombus assessment than 2DTEE. 3DTEE should be particularly considered in case of equivocal 2DTEE, as it allows to reach a definite LAA diagnosis in almost all of the patients.
Incremental prognostic value of multichamber deformation imaging and renal function status to predict adverse outcome in heart failure with reduced ejection fraction
Authors: Saha Samir K. , Luo Xia‐Xia , Gopal Aasha S. , Govind Satish C. , Fang Fang , Liu Ming , Zhang Qing , Ma Chunyan , Dong Ming , Kiotsekoglou Anatoli , Yu Cheuk‐Man 
Published: February 2018

AimsDeformation imaging, particularly of left‐sided heart, is fast becoming an essential tool in clinical cardiology. However, data are scant regarding the value of biventricular and bi‐atrial deformation in association with comorbidities in heart failure with reduced left ventricular ejection fraction (HFREF).Methods and ResultsForty‐nine subjects (72 ± 13 years; 28 male) with HFREF and 14 age‐matched controls underwent deformation imaging including LV global longitudinal strain (LVGLS%), right ventricular strain (RVS%), and left atrial reservoir strain (LARS%). Standard echo parameters included LVEF%, E/E′ ratio, and pulmonary artery systolic pressure (PASP). Mean ± SD of LVEF, LVGLS%, and RVS% were 31% ± 8%, 7% ± 3%, and 17% ± 7%, respectively, and were significantly lower compared with controls (all P < .0001). Over a follow‐up period of 4.2 years, 24% of patients died and 48% had a composite outcome of death and heart failure hospitalization. In the logistic regression model, taking the composite of death and heart failure hospitalization as a dichotomous variable, RVS%, E/E′ ratio, and PASP were the only significant univariate predictors of adverse outcome (R2 = .68, all P < .05). In the multivariate model, however, only PASP predicted adverse outcome. PASP also had the largest AUC (0.8) in the ROC analysis. A creatinine level of >88 μmol/L (SCREAT) and a cutoff value of LA reservoir strain (LARS %) at <16.7% provided the best sensitivity (86%) and specificity (40%) with an odds ratio of 3.8. In the Kaplan–Meier survival estimate, LARS%‐SCREAT predicted all‐cause mortality and HF hospitalization.ConclusionMultichamber deformation imaging along with renal function and PASP could best predict adverse outcome in HFREF.
Relation between Mitral Annular Plane Systolic Excursion and Global longitudinal strain in normal subjects: The HUNT study
Authors: Støylen Asbjørn , Mølmen Harald E. , Dalen Håvard 
Published: February 2018

BackgroundLeft ventricular (LV) systolic long‐axis shortening can be measured as Mitral Annular Plane Systolic Excursion (MAPSE). Global longitudinal strain (GLS) is relative LV shortening, equivalent to normalizing MAPSE for LV length (MAPSEn). The objective of this study was to test whether normalizing LV shortening reduced biological variability of MAPSE due to normalizing for heart size and, possibly BSA. Secondly to provide normal reference values for MAPSE.Methods and resultsA total of 1266 subjects from the Nord‐Trøndelag Health Study (HUNT), without evidence of heart disease were examined. MAPSE and wall lengths were measured in all three standard apical views, while GLS has been published previously. Mean MAPSE was 1.58 (0.25) cm, MAPSEn 16.3 (2.4)%, and GLS 16.7 (2.4)%. All measures declined with age, correlations between ‐0.50 and −0.41. MAPSE was gender independent, and less BSA dependent than MAPSEn and GLS, while relative standard deviations (SDs) were similar for all three measures.ConclusionsMAPSE, MAPSEn, and GLS have similar biological variability, which is mainly due to age variation, indicating they are equivalent in normal, and normalizing for BSA will not reduce the variability. Normalizing MAPSE for LV length (MAPSEn and GLS) normalizes for one dimension only, inducing a systematic error, which increases BSA and gender dependence. Normal age‐related, gender‐independent values for MAPSE are provided.
Role of artificial intelligence in the care of patients with nonsmall cell lung cancer
Authors: Rabbani Mohamad , Kanevsky Jonathan , Kafi Kamran , Chandelier Florent , Giles Francis J. 
Published: February 2018

AbstractBackgroundLung cancer is the leading cause of cancer death worldwide. In up to 57% of patients, it is diagnosed at an advanced stage and the 5‐year survival rate ranges between 10%‐16%. There has been a significant amount of research using machine learning to generate tools using patient data to improve outcomes.MethodsThis narrative review is based on research material obtained from PubMed up to Nov 2017. The search terms include “artificial intelligence,” “machine learning,” “lung cancer,” “Nonsmall Cell Lung Cancer (NSCLC),” “diagnosis” and “treatment.”ResultsRecent studies support the use of computer‐aided systems and the use of radiomic features to help diagnose lung cancer earlier. Other studies have looked at machine learning (ML) methods that offer prognostic tools to doctors and help them in choosing personalized treatment options for their patients based on molecular, genetics and histological features. Combining artificial intelligence approaches into health care may serve as a beneficial tool for patients with NSCLC, and this review outlines these benefits and current shortcomings throughout the continuum of care.ConclusionWe present a review of the various applications of ML methods in NSCLC as it relates to improving diagnosis, treatment and outcomes.
Upregulated N‐cadherin expression is associated with poor prognosis in epithelial‐derived solid tumours: A meta‐analysis
Authors: Luo Yong , Yu Ting , Zhang Qiongwen , Fu Qingyu , Hu Yuzhu , Xiang Mengmeng , Peng Haoning , Zheng Tianying , Lu Li , Shi Huashan 
Published: February 2018

AbstractBackgroundN‐cadherin is an important molecular in epithelial‐mesenchymal transition (EMT) and has been reported to be associated with aggressive behaviours of tumours. However, prognostic value of N‐cadherin in solid malignancies remains controversially.Materials and MethodsThe Pubmed/MELINE and EMBASE databases were used for a comprehensive literature searching. Pooled risk ratio (RR) and hazard ratio (HR) with their corresponding 95% confidence intervals (CIs) were employed to quantify the prognostic role.ResultsInvolving 36 studies with 5705 patients were performed to investigate relationships between N‐cadherin upregulation and clinicopathological features, survival. Results suggested upregulated N‐cadherin was associated with lymph node metastasis (RR = 1.16, 95% CI [1.00, 1.35]), higher histological grade (RR = 1.36, 95%CI [1.14, 1.62]), angiolymphatic invasion (RR = 1.19, 95% CI [1.06, 1.34]) and advanced clinical stage (RR = 1.32, 95% CI [1.06, 1.64]), while upregulated N‐cadherin was apt to be associated with distant metastasis (RR = 1.43, 95% CI [0.99, 2.05]). Moreover, N‐cadherin was correlated with poor prognosis of 3‐year survival (HR = 1.78, 95% CI [1.51, 2.10]), 5‐year survival (HR = 1.57, 95% CI [1.17, 2.10]) and overall survival (OS) (HR = 1.32, 95% CI [1.20, 1.44]). Subgroup analyses according to cancer types were also conducted for applying these conclusions to some tumours more properly. No publication bias was found except subgroup analysis of distant metastasis (P = .652 for Begg's test and 0.023 for Egger's test).ConclusionsTaken together, upregulation of N‐cadherin is associated with more aggressive behaviours of epithelial‐derived solid malignancies and can be regarded as a predictor of poor survival.
Coexistence between two fruit fly species is supported by the different strength of intra‐ and interspecific competition
Authors: LIENDO MARIA C. , PARREÑO MARIA A. , CLADERA JORGE L. , VERA MARIA T. , SEGURA DIEGO F. 
Published: February 2018

1. Unravelling the strength and modes of interspecific interactions between resident and introduced species is necessary in order to understand the basis of their coexistence or the displacement of the former by the latter. In Argentina, the indigenous Tephritidae fly Anastrepha fraterculus overlaps its distribution and host fruit with the introduced species Ceratitis capitata.2. This study focused on the relative strength of intra‐ and interspecific competition during the larval stage as a potential factor supporting coexistence. Classical competition experiments (addition and substitution) were conducted between larvae of the two species reared in artificial larval diet. The study evaluated whether a temporal separation between oviposition events affects the outcome of the competition.3. When both species started to consume the resource at the same time, A. fraterculus experienced a negative effect in larval survival, pupal weight and duration of larval stage, while for C. capitata, pupal weight decreased. When A. fraterculus started feeding 1 day earlier than C. capitata, the negative effects became milder, and when the temporal separation increased, these effects were reversed. Substitution experiments showed an increase in pupal weight when larvae had to share the resource with heterospecific larvae, and showed negative effects suffered for both species when they shared the resource with conspecific individuals.4. These results suggest that intraspecific competition is stronger than interspecific competition, and a differential oviposition preference could generate an asynchrony of these species in nature. Such mechanisms could favour coexistence between A. fraterculus and C. capitata in an environment previously occupied only by the former.
Vitamin D supplementation for bone health in adults with epilepsy: A systematic review
Authors: Fernandez Haya , Mohammed Heba Tallah , Patel Tejal 
Published: February 2018

SummaryObjectiveSeveral antiepileptic drugs (AEDs) have been associated with a detrimental effect on bone health through a reduction in serum vitamin D. Subsequently, several studies have investigated the effect of vitamin D supplementation in persons with epilepsy being treated with AEDs. The present systematic review of published literature was conducted to determine the effect of vitamin D intervention on bone health in adults with epilepsy.MethodsThe following databases were searched using keywords including but not limited to epilepsy, bone, and vitamin D: PubMed, Medline, Embase, Scopus, Cochrane Clinical Trials, International Pharmaceutical Abstracts, Health Canada Clinical Trials Database, ClinicalTrials.gov, EU Clinical Trials, and Google. Studies were eligible if there was an epilepsy diagnosis, participants were adults (18+ years old), and vitamin D treatment and bone outcome were provided. Articles were screened independently by 2 reviewers. Methodological quality was assessed using the Cochrane Collaboration's tool and a modified Newcastle Ottawa Scale for nonrandomized studies.ResultsNine studies were found to be eligible for this review. After vitamin D treatment, there appeared to be positive changes in bone turnover markers; 3 of 8 studies found the increase in serum calcium to be significant, 6 of 8 studies found the decrease in alkaline phosphatase to be significant, and 2 of 4 studies found the decrease in parathyroid hormone to be significant. All 6 studies that investigated bone mineralization had significant findings; however, due to varying methodologies, the impact of vitamin D on bone mineralization was inconclusive.SignificanceVitamin D does appear to have some benefit to bone health in adults with epilepsy, and therefore supplementation could potentially be a requisite to using some AEDs. To clarify the role of vitamin D supplementation to manage the adverse effect of AEDs on bone health in adults with epilepsy, long‐term trials that use higher doses (>1800 IU) and measure bone mineral density are necessary.
Proposed consensus definitions for new‐onset refractory status epilepticus (NORSE), febrile infection‐related epilepsy syndrome (FIRES), and related conditions
Authors: Hirsch Lawrence J. , Gaspard Nicolas , van Baalen Andreas , Nabbout Rima , Demeret Sophie , Loddenkemper Tobias , Navarro Vincent , Specchio Nicola , Lagae Lieven , Rossetti Andrea O. , Hocker Sara , Gofton Teneille E. , Abend Nicholas S. , Gilmore Emily J. , Hahn Cecil , Khosravani Houman , Rosenow Felix , Trinka Eugen 
Published: February 2018

SummaryWe convened an international group of experts to standardize definitions of New‐Onset Refractory Status Epilepticus (NORSE), Febrile Infection‐Related Epilepsy Syndrome (FIRES), and related conditions. This was done to enable improved communication for investigators, physicians, families, patients, and other caregivers. Consensus definitions were achieved via email messages, phone calls, an in‐person consensus conference, and collaborative manuscript preparation. Panel members were from 8 countries and included adult and pediatric experts in epilepsy, electroencephalography (EEG), and neurocritical care. The proposed consensus definitions are as follows: NORSE is a clinical presentation, not a specific diagnosis, in a patient without active epilepsy or other preexisting relevant neurological disorder, with new onset of refractory status epilepticus without a clear acute or active structural, toxic or metabolic cause. FIRES is a subcategory of NORSE, applicable for all ages, that requires a prior febrile infection starting between 2 weeks and 24 hours prior to onset of refractory status epilepticus, with or without fever at onset of status epilepticus. Proposed consensus definitions are also provided for Infantile Hemiconvulsion‐Hemiplegia and Epilepsy syndrome (IHHE) and for prolonged, refractory and super‐refractory status epilepticus. This document has been endorsed by the Critical Care EEG Monitoring Research Consortium. We hope these consensus definitions will promote improved communication, permit multicenter research, and ultimately improve understanding and treatment of these conditions.
Greenhouse gas fluxes over managed grasslands in Central Europe
Authors: Hörtnagl Lukas , Barthel Matti , Buchmann Nina , Eugster Werner , Butterbach‐Bahl Klaus , Díaz‐Pinés Eugenio , Zeeman Matthias , Klumpp Katja , Kiese Ralf , Bahn Michael , Hammerle Albin , Lu Haiyan , Ladreiter‐Knauss Thomas , Burri Susanne , Merbold Lutz 
Published: February 2018

AbstractCentral European grasslands are characterized by a wide range of different management practices in close geographical proximity. Site‐specific management strategies strongly affect the biosphere–atmosphere exchange of the three greenhouse gases (GHG) carbon dioxide (CO2), nitrous oxide (N2O), and methane (CH4). The evaluation of environmental impacts at site level is challenging, because most in situ measurements focus on the quantification of CO2 exchange, while long‐term N2O and CH4 flux measurements at ecosystem scale remain scarce. Here, we synthesized ecosystem CO2, N2O, and CH4 fluxes from 14 managed grassland sites, quantified by eddy covariance or chamber techniques. We found that grasslands were on average a CO2 sink (−1,783 to −91 g CO2 m−2 year−1), but a N2O source (18–638 g CO2‐eq. m−2 year−1), and either a CH4 sink or source (−9 to 488 g CO2‐eq. m−2 year−1). The net GHG balance (NGB) of nine sites where measurements of all three GHGs were available was found between −2,761 and −58 g CO2‐eq. m−2 year−1, with N2O and CH4 emissions offsetting concurrent CO2 uptake by on average 21 ± 6% across sites. The only positive NGB was found for one site during a restoration year with ploughing. The predictive power of soil parameters for N2O and CH4 fluxes was generally low and varied considerably within years. However, after site‐specific data normalization, we identified environmental conditions that indicated enhanced GHG source/sink activity (“sweet spots”) and gave a good prediction of normalized overall fluxes across sites. The application of animal slurry to grasslands increased N2O and CH4 emissions. The N2O‐N emission factor across sites was 1.8 ± 0.5%, but varied considerably at site level among the years (0.1%–8.6%). Although grassland management led to increased N2O and CH4 emissions, the CO2 sink strength was generally the most dominant component of the annual GHG budget.
A global spatially explicit database of changes in island palaeo‐area and archipelago configuration during the late Quaternary
Authors: Norder Sietze J. , Baumgartner John B. , Borges Paulo A. V. , Hengl Tomislav , Kissling W. Daniel , van Loon E. Emiel , Rijsdijk Kenneth F. 
Published: February 2018

AbstractMotivationPast sea level fluctuations have shaped island area and archipelago configuration. The availability of global high‐resolution data on bathymetry and past sea levels allows reconstruction of island palaeo‐geography. Studies on the role of palaeo‐area often consider only the Last Glacial Maximum, which neglects the dynamics of island fusion and fission resulting from cyclic sea level fluctuations throughout the Quaternary. Currently, no global database is available to test the role of changing island geographies driven by Quaternary sea level change on evolutionary, ecological and archaeological patterns. However, data on island palaeo‐environments is crucial for understanding insular biodiversity distributions and human settlement patterns. Here, we present the Palaeo‐Islands and Archipelago Configuration (PIAC) database, containing sea level‐driven palaeo‐geography changes over the late Quaternary of 178 islands in 27 archipelagos, and discuss its relevance, limitations and uncertainties. The R functions developed to create the PIAC database are provided to allow calculations for other islands, time steps, sea‐level curves and higher spatio‐temporal resolutions.Main types of variables containedPolygon shapefiles with archipelago configuration and tables with palaeo‐area per island.Spatial location and grainThe database has a global representation, with 27 archipelagos being covered: Aldabra, Azores, Balearic Islands, California Channel Islands, Canary Islands, Cape Verde, Comoros, Cook Islands, Crozet Islands, Dutch Caribbean, Galápagos, Gulf of Guinea, Hawaii, Inner Seychelles, Juan Fernández, Kuril Islands, Madeira, Marianas, Marquesas, Mascarenes, Phoenix Islands, Pitcairn Islands, Prince Edward Islands, Revillagigedo, Samoan Islands, Society Islands and Tristan da Cunha. All data are at 1 km2 spatial resolution.Time period and grainThe focus of this paper is on the last 35 kyr; data for the last 140 kyr are also provided. The grain is 1 kyr temporal resolution.Level of measurementData are per island, grouped per archipelago.Software formatThe data were produced in the R programming language.
RETAKING IN HIGH STAKES EXAMS: IS LESS MORE?
Authors: Krishna Kala , Lychagin Sergey , Frisancho Veronica 
Published: February 2018

AbstractPlacement, both in university and in the civil service, according to performance in competitive exams is the norm in much of the world. Repeat taking of such exams is common despite the private and social costs it imposes. We develop and estimate a structural model of exam retaking using data from Turkey's university placement exam. Limiting retaking results in all agents gaining ex ante and most gaining ex post. This result comes from a general equilibrium effect: Retakers crowd the market and impose negative spillovers on others by raising acceptance cutoffs.
A new mobile learning module using smartphone wallpapers in identification of medical fungi for medical students and residents
Authors: Liu Ren‐Feng , Wang Fang‐Ying , Yen Hsi , Sun Pei‐Lun , Yang Chih‐Hsun 
Published: February 2018

AbstractIntroductionMedical students and residents will encounter many cutaneous fungal infections in medical practice. However, the training for identification of medical fungi has been insufficient due to limited lecture‐based courses. The objective of this study was to evaluate the impact of using smartphone‐based wallpapers in learning the microscopic morphology and colony characteristics of medical fungi for medical students and residents.MethodsA smartphone‐based wallpaper learning module using a wallpaper‐changing software application (app) was introduced in this 3‐week training course. Twenty‐six participants were enrolled and divided into two groups: nondermatology trainees, including medical students and postgraduate year one (PGY‐1) doctors who have not yet specialized, and dermatology trainees (dermatology residents). All of the participants completed a 3‐week training course, and the effectiveness of the module was evaluated by pre‐ and post‐course multiple‐choice examinations.ResultsBoth nondermatology and dermatology trainees scored significantly higher in post‐course examinations than pre‐course examinations (P < 0.001). The dermatology trainees performed better than nondermatology trainees in the pre‐course examinations (P < 0.001). In the post‐course examinations, no significant difference in scores was noted between dermatology and nondermatology trainees (P = 0.573).DiscussionThe smartphone‐based wallpaper learning module was effective in helping medical students and residents learn and memorize morphologic characteristics of fungi. In comparison to conventional lecture‐based learning, this new mobile module was more readily accessible and convenient for learners to engage in learning.