bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrating Palliative Care Into the ICU: From Core Competency to Consultative Expertise
Authors: Morrison Wynne E. , Gauvin France , Johnson Emily , Hwang Jennifer 
Published: August 2018

Objectives:
To propose a model describing levels of integration of palliative care into the care of ICU patients.

Data Sources:
Literature review and author opinion.

Conclusions:
All critical care team members should demonstrate and foster their core competencies in caring for patients with complex illness and uncertain prognosis, including at the end of life. We describe these core competencies of the ICU team member as “primary” palliative care skills. Some ICU team members will have special expertise in end-of-life care or symptom management and decision-making support and will serve as local experts within the ICU team as a resource to other team members. We call this skillset “secondary” palliative care. Some patients will benefit from the full range of expertise provided by a separate consulting team, with additional training, focused on caring for patients with palliative care needs across the full spectrum of patient locations within a health system. We term the skillset provided by such outside consultants “tertiary” palliative care. Solutions for meeting patients’ palliative care needs will be unique within each system and individual institution, depending on available resources, history, and structures in place. Providers from multiple professions will usually contribute to meeting patient needs.
Death and Dying 1987–2017: The Destination Is the Same, the Journey Is Different
Authors: Cox Peter N. 
Published: August 2018

Objective:
A personal reflection on the changing landscape with regard to case mix, care, and staffing and how mortality and expectations have evolved over the past 30 years in a multidisciplinary Pediatric Critical Care Unit in a Quaternary level academic institution in Canada.

Conclusions:
Many of the preventable deaths have been prevented with Public Health initiatives. Death now is increasingly in complex patients with complicated treatment regimes in a society that has increasingly unrealistic expectations of what modern medicine can do. Many of these complex children do not die but are dependent on our technology and skill set—something we are often ill prepared for.
Organ Donation Following Neurologic and Circulatory Determination of Death
Authors: Nakagawa Thomas A. , Shemie Sam D. , Dryden-Palmer Karen , Parshuram Christopher S. , Brierley Joe 
Published: August 2018

Objectives:
To describe important considerations during the process of caring for critically ill children who may be potential organ donors and supporting the family during the death of their child.

Design:
Literature review and expert commentary.

Measurement and Main Results:
Medical literature focusing on pediatric donation, best pediatric donation practices, donor management, and factors influencing donation were reviewed. Additional pediatric data were obtained and reviewed from the U.S. Organ Procurement and Transplantation Network. Achieving successful organ donation requires the coordinated efforts of the critical care team, organ donation organization, and transplant team to effectively manage a potential donor and recover suitable organs for transplantation. Collaboration between these teams is essential to ensure that all potential organs are recovered in optimal condition, to reduce death and morbidity in children on transplantation waiting lists as well as fulfilling the family’s wishes for their dying child to become a donor.

Conclusions:
Organ donation is an important component of end-of-life care and can help the healing process for families and medical staff following the death of a child. The process of pediatric organ donation requires healthcare providers to actively work to preserve the option of donation before the death of the child and ensure donation occurs after consent/authorization has been obtained from the family. Medical management of the pediatric organ donor requires the expertise of a multidisciplinary medical team skilled in the unique needs of caring for children after neurologic determination of death and those who become donors following circulatory death after withdrawal of life-sustaining medical therapies.
Care for Dying Children and Their Families in the PICU: Promoting Clinician Education, Support, and Resilience
Authors: Dryden-Palmer Karen , Garros Daniel , Meyer Elaine C. , Farrell Catherine , Parshuram Christopher S. 
Published: August 2018

Objectives:
To describe the consequences of workplace stressors on healthcare clinicians in PICU, and strategies for personal well-being, and professional effectiveness in providing high-quality end-of-life care.

Data Sources:
Literature review, clinical experience, and expert opinion.

Study Selection:
A sampling of foundational and current evidence was accessed.

Data Synthesis:
Narrative review and experiential reflection.

Conclusions:
The well-being of healthcare clinicians in the PICU influences the day-to-day quality and effectiveness of patient care, team functioning, and the retention of skilled individuals in the PICU workforce. End-of-life care, including decision making, can be complicated. Both are major stressors for PICU staff that can lead to adverse personal and professional consequences. Overresponsiveness to routine stressors may be seen in those with moral distress, and underresponsiveness may be seen in those with compassion fatigue or burnout. Ideally, all healthcare professionals in PICU can rise to the day-to-day workplace challenges—responding in an adaptive, effective manner. Strategies to proactively increase resilience and well-being include self-awareness, self-care, situational awareness, and education to increase confidence and skills for providing end-of-life care. Reactive strategies include case conferences, prebriefings in ongoing preidentified situations, debriefings, and other postevent meetings. Nurturing a culture of practice that acknowledges the emotional impacts of pediatric critical care work and celebrates the shared experiences of families and clinicians to build resilient, effective, and professionally fulfilled healthcare professionals thus enabling the provision of high-quality end-of-life care for children and their families.
Should Patients With NAFLD/NASH Be Surveyed for HCC?
Authors: Reig Maria , Gambato Martina , Man Nancy Kwan , Roberts John P. , Victor David , Orci Lorenzo A. , Toso Christian 
Published: August 2018

Background
Patients with nonalcoholic fatty liver disease (NAFLD) are at risk of developing hepatocellular carcinoma (HCC), but the magnitude of the association still needs to be determined to define the need for a specific surveillance strategy.

Methods
We based our assessment on a previously published review by White et al (1992-2011) and on a systematic review(2012-2017).

Results
The new search identified 328 abstracts. Combining both eras (1992-2011 and 2012-2017), 25 studies were included in the analysis. Four were prospective, 2 described a retrospective analysis of a prospective database, and the others were retrospective. All studies were published after 2004, but the inclusion period of half of them ended before the year 2000. Studies showed variation in the definition of NAFLD, in the incidence of fibrosis/cirrhosis, in the presence of comorbidities (potentially affecting HCC incidence), and in the type and duration of screening. Considering only studies strictly including patients with or without cirrhosis, the reported incidence of HCC in NAFLD patients with cirrhosis was between 6.7 and 15% at 5 to 10 years, whereas the incidence in NAFLD patients without cirrhosis was 2.7% at 10 years and 23 per 100 000 person-years.

Conclusions
Hepatocellular carcinoma screening in NAFLD patients with cirrhosis is mandatory. However, the currently observed low (and insufficiently documented) incidence of HCC in NAFLD patients without cirrhosis does not justify a systematic surveillance. Research efforts should focus on developing a score, which could aid the clinician in identifying NAFLD patients without cirrhosis who are at higher risk of developing HCC.
Toxic myopathies
Authors: Pasnoor Mamatha , Barohn Richard J. , Dimachkie Mazen M. 
Published: August 2018

Purpose of review
Our aim is to highlight major advances reported in the last few years in drug-induced muscle toxicity.

Recent findings
Our focus is on myopathies induced by statins and immune checkpoint inhibitors with a brief overview of rare steroid myopathies. Statin muscle injury is frequently because of direct toxicity rather than an autoimmune mechanism. Laboratory testing and muscle pathologic features distinguish these two conditions. Statin-associated necrotizing autoimmune myopathy (SANAM) is associated with an autoantibody in 66% of cases targeting the HMGCR enzyme. The later autoantibody is a marker for necrotizing autoimmune myopathy, regardless of statin exposure. In SANAM, MHC-I antigens are expressed on the surface of intact muscle fibers. Genetic HLA loci predispose patients exposed to statins to immunologic toxicity. SANAM requires long-term therapy with multiple immunosuppressive therapies. Immune checkpoint inhibitors are powerful emerging therapies for advanced cancer that pause a novel therapeutic challenge.

Summary
This review is focused on statins, the most prevalent myotoxic drug class. In addition, we examine the accumulating body of evidence of muscle injury and its management with immune checkpoint inhibitors. We anticipate the reader to become more knowledgeable in recent discoveries related to these myotoxic drugs, and their mechanisms of action and management.
Algorithms: transparency and accountability
Authors: Blacklaws Christina 
Published: August 2018

This opinion piece explores the issues of accountability and transparency in relation to the growing use of machine learning algorithms. Citing the recent work of the Royal Society and the British Academy, it looks at the legal protections for individuals afforded by the EU General Data Protection Regulation and asks whether the legal system will be able to adapt to rapid technological change. It concludes by calling for continuing debate that is itself accountable, transparent and public.
This article is part of a discussion meeting issue ‘The growing ubiquity of algorithms in society: implications, impacts and innovations'.
Improving reproducibility by using high-throughput observational studies with empirical calibration
Authors: Schuemie Martijn J. , Ryan Patrick B. , Hripcsak George , Madigan David , Suchard Marc A. 
Published: August 2018

Concerns over reproducibility in science extend to research using existing healthcare data; many observational studies investigating the same topic produce conflicting results, even when using the same data. To address this problem, we propose a paradigm shift. The current paradigm centres on generating one estimate at a time using a unique study design with unknown reliability and publishing (or not) one estimate at a time. The new paradigm advocates for high-throughput observational studies using consistent and standardized methods, allowing evaluation, calibration and unbiased dissemination to generate a more reliable and complete evidence base. We demonstrate this new paradigm by comparing all depression treatments for a set of outcomes, producing 17 718 hazard ratios, each using methodology on par with current best practice. We furthermore include control hypotheses to evaluate and calibrate our evidence generation process. Results show good transitivity and consistency between databases, and agree with four out of the five findings from clinical trials. The distribution of effect size estimates reported in the literature reveals an absence of small or null effects, with a sharp cut-off at
p
= 0.05. No such phenomena were observed in our results, suggesting more complete and more reliable evidence.

This article is part of a discussion meeting issue ‘The growing ubiquity of algorithms in society: implications, impacts and innovations’.
Algorithm-assisted decision-making in the public sector: framing the issues using administrative law rules governing discretionary power
Authors: Oswald Marion 
Published: August 2018

This article considers some of the risks and challenges raised by the use of algorithm-assisted decision-making and predictive tools by the public sector. Alongside, it reviews a number of long-standing English administrative law rules designed to regulate the discretionary power of the state. The principles of administrative law are concerned with human decisions involved in the exercise of state power and discretion, thus offering a promising avenue for the regulation of the growing number of algorithm-assisted decisions within the public sector. This article attempts to re-frame key rules for the new algorithmic environment and argues that ‘old’ law—interpreted for a new context—can help guide lawyers, scientists and public sector practitioners alike when considering the development and deployment of new algorithmic tools.This article is part of a discussion meeting issue ‘The growing ubiquity of algorithms in society: implications, impacts and innovations'.
Humanitarian applications of machine learning with remote-sensing data: review and case study in refugee settlement mapping
Authors: Quinn John A. , Nyhan Marguerite M. , Navarro Celia , Coluccia Davide , Bromley Lars , Luengo-Oroz Miguel 
Published: August 2018

The coordination of humanitarian relief, e.g. in a natural disaster or a conflict situation, is often complicated by a scarcity of data to inform planning. Remote sensing imagery, from satellites or drones, can give important insights into conditions on the ground, including in areas which are difficult to access. Applications include situation awareness after natural disasters, structural damage assessment in conflict, monitoring human rights violations or population estimation in settlements. We review machine learning approaches for automating these problems, and discuss their potential and limitations. We also provide a case study of experiments using deep learning methods to count the numbers of structures in multiple refugee settlements in Africa and the Middle East. We find that while high levels of accuracy are possible, there is considerable variation in the characteristics of imagery collected from different sensors and regions. In this, as in the other applications discussed in the paper, critical inferences must be made from a relatively small amount of pixel data. We, therefore, consider that using machine learning systems as an augmentation of human analysts is a reasonable strategy to transition from current fully manual operational pipelines to ones which are both more efficient and have the necessary levels of quality control.
This article is part of a discussion meeting issue ‘The growing ubiquity of algorithms in society: implications, impacts and innovations’.
Cortical Microcircuits from a Generative Vision Model
Authors: George Dileep , Lavin Alexander , Guntupalli J. Swaroop , Mely David , Hay Nick , Lázaro-Gredilla Miguel 
Published: August 2018

AbstractUnderstanding the information processing roles of cortical circuits is an outstanding problem in neuroscience and artificial intelligence. The theoretical setting of Bayesian inference has been suggested as a framework for understanding cortical computation. Based on a recently published generative model for visual inference (George et al., 2017), we derive a family of anatomically instantiated and functional cortical circuit models. In contrast to simplistic models of Bayesian inference, the underlying generative model’s representational choices are validated with real-world tasks that required efficient inference and strong generalization. The cortical circuit model is derived by systematically comparing the computational requirements of this model with known anatomical constraints. The derived model suggests precise functional roles for the feedforward, feedback and lateral connections observed in different laminae and columns, and assigns a computational role for the path through the thalamus.
Effects of cochlear synaptopathy on spontaneous and sound-evoked activity in the mouse inferior colliculus
Authors: Shaheen Luke A. , Liberman M. Charles 
Published: August 2018

ABSTRACTTinnitus and hyperacusis are life-disrupting perceptual abnormalities that are often preceded by acoustic overexposure. Animal models of overexposure have suggested a link between these phenomena and neural hyperactivity, i.e. elevated spontaneous rates (SRs) and sound-evoked responses. Prior work has focused on changes in central auditory responses, with less attention paid to the exact nature of the associated peripheral damage. The demonstration that acoustic overexposure can cause cochlear nerve damage without permanent threshold elevation suggests this type of peripheral damage may be a key elicitor of tinnitus and hyperacusis in humans with normal audiograms. We addressed this idea by recording responses in the mouse inferior colliculus (IC) following a bilateral, neuropathic noise exposure. Two wks post-exposure, mean SRs were unchanged in mice recorded while awake, or under anesthesia. SRs were also unaffected by more intense, or unilateral exposures. These results suggest that neither neuropathy nor hair cell loss are sufficient to raise SRs in the IC, at least in mice. However, it’s not clear whether our mice had tinnitus. Tone-evoked rate-level functions at the CF were steeper following exposure, specifically in the region of maximal neuropathy. Furthermore, suppression driven by off-CF tones and by ipsilateral noise were also reduced. Both changes were especially pronounced in neurons of awake mice. These findings align with prior reports of elevated acoustic startle in neuropathic mice, and indicate that neuropathy may initiate a compensatory response in the central auditory system leading to the genesis of hyperacusis.
Focus of attention modulates the heartbeat evoked potential
Authors: Petzschner Frederike H. , Weber Lilian A. , Wellstein Katharina V. , Paolini Gina , Tri Do Cao , Stephan Klaas E. 
Published: August 2018

AbstractTheoretical frameworks such as predictive coding suggest that the perception of the body and world – interoception and exteroception – involve intertwined processes of inference, learning, and prediction. In this framework, attention is thought to gate the influence of sensory information on perception. In contrast to exteroception, there is limited evidence for purely attentional effects on interoception. Here, we empirically tested if attentional focus modulates cortical processing of single heartbeats, using a newly-developed experimental paradigm to probe purely attentional differences between exteroceptive and interoceptive conditions in the heartbeat evoked potential (HEP). We found that the HEP is significantly higher during interoceptive compared to exteroceptive attention, in a time window of 520-580ms after the R-peak. Furthermore, this effect predicted self-report measures of autonomic system reactivity. This study thus provides direct evidence that the HEP is modulated by attention and supports recent interpretations of the HEP as a neural correlate of interoceptive prediction errors.
Pathogens, parasites, and parasitoids of ants: a synthesis of parasite biodiversity and epidemiological traits
Authors: Quevillon Lauren E. , Hughes David P. 
Published: August 2018

1.AbstractAnts are among the most ecologically successful organisms on Earth, with a global distribution and diverse nesting and foraging ecologies. Ants are also social organisms, living in crowded, dense colonies that can range up to millions of individuals. Understanding the ecological success of the ants requires understanding how they have mitigated one of the major costs of social living-infection by parasitic organisms. Additionally, the ecological diversity of ants suggests that they may themselves harbor a diverse, and largely unknown, assemblage of parasites. As a first step, we need to know the taxonomic and functional diversity of the parasitic organisms infecting ants. To that end, we provide a comprehensive review of the parasitic organisms infecting ants by collecting all extant records. We synthesize major patterns in parasite ecology by categorizing how parasites encounter their ant hosts, whether they require host death as a developmental necessity, and how they transmit to future hosts.We report 1,415 records of parasitic organisms infecting ants, the majority of which come from order Diptera (34.8%), phylum Fungi (25.6%), and order Hymenoptera (25.1%). Most parasitic organisms infecting ants are parasitoids (89.6%), requiring the death of their host as developmental necessity and most initially encounter their hosts in the extranidal environment (68.6%). Importantly, though most parasitic organisms infecting ants only need a single host to complete their life cycle (89.2%), the vast majority need to leave the nest before transmission to the next ant host can occur (88.3%), precluding ant-to-ant transmission within the nest. With respect to the host, we only found records for 9 out of 17 extant ant sub-families, and for 82 out of the currently recognized 334 ant genera. Though there is likely bias in the records reported, both host and parasite ecological traits and evolutionary histories underlie the pattern of ant-parasite association reported here. This work provides a foundation for future work that will begin to untangle the ecological drivers of ant-parasite relationships and the evolutionary implications thereof.
Conserved cell types with divergent features between human and mouse cortex
Authors: Hodge Rebecca D , Bakken Trygve E , Miller Jeremy A , Smith Kimberly A , Barkan Eliza R , Graybuck Lucas T , Close Jennie L , Long Brian , Penn Osnat , Yao Zizhen , Eggermont Jeroen , Hollt Thomas , Levi Boaz P , Shehata Soraya I , Aevermann Brian , Beller Allison , Bertagnolli Darren , Brouner Krissy , Casper Tamara , Cobbs Charles , Dalley Rachel , Dee Nick , Ding Song-Lin , Ellenbogen Richard G , Fong Olivia , Garren Emma , Goldy Jeff , Gwinn Ryder P , Hirschstein Daniel , Keene C Dirk , Keshk Mohamed , Ko Andrew L , Lathia Kanan , Mahfouz Ahmed , Maltzer Zoe , McGraw Medea , Nguyen Thuc Nghi , Nyhus Julie , Ojemann Jeffrey G , Oldre Aaron , Parry Sheana , Reynolds Shannon , Rimorin Christine , Shapovalova Nadiya V , Somasundaram Saroja , Szafer Aaron , Thomsen Elliot R , Tieu Michael , Scheuermann Richard H , Yuste Rafael , Sunkin Susan M , Lelieveldt Boudewijn , Feng David , Ng Lydia , Bernard Amy , Hawrylycz Michael , Phillips John W. , Tasic Bosiljka , Zeng Hongkui , Jones Allan R , Koch Christof , Lein Ed S 
Published: August 2018

AbstractElucidating the cellular architecture of the human neocortex is central to understanding our cognitive abilities and susceptibility to disease. Here we applied single nucleus RNA-sequencing to perform a comprehensive analysis of cell types in the middle temporal gyrus of human cerebral cortex. We identify a highly diverse set of excitatory and inhibitory neuronal types that are mostly sparse, with excitatory types being less layer-restricted than expected. Comparison to a similar mouse cortex single cell RNA-sequencing dataset revealed a surprisingly well-conserved cellular architecture that enables matching of homologous types and predictions of human cell type properties. Despite this general conservation, we also find extensive differences between homologous human and mouse cell types, including dramatic alterations in proportions, laminar distributions, gene expression, and morphology. These species-specific features emphasize the importance of directly studying human brain.