bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Impact of a Multiplex Gastrointestinal Polymerase Chain Reaction Panel in Patients With Acute Gastroenteritis
Authors: Cybulski Robert J , Bateman Allen C , Bourassa Lori , Bryan Andrew , Beail Barb , Matsumoto Jason , Cookson Brad T , Fang Ferric C 
Published: April 2018

Abstract

Background
Molecular syndromic diagnostic panels can enhance pathogen identification in the approximately 2–4 billion episodes of acute gastroenteritis that occur annually worldwide. However, the clinical utility of these panels has not been established.

Methods
We conducted a prospective, multi-center study to investigate the impact of the BioFire FilmArray Gastrointestinal polymerase chain reaction panel on clinical diagnosis and decision-making, and compared the clinical acuity of patients with positive results obtained exclusively with the FilmArray with those detected by conventional stool culture. A total of 1887 consecutive fecal specimens were tested in parallel by FilmArray and stool culture. Laboratory and medical records were reviewed to determine rates of detection, turnaround times, clinical features, and the nature and timing of clinical decisions.

Results
FilmArray detected pathogens in 35.3% of specimens, compared to 6.0% for culture. Median time from collection to result was 18 hours for FilmArray and 47 hours for culture. Median time from collection to initiation of antimicrobial therapy was 22 hours for FilmArray and 72 hours for culture. Patients diagnosed by FilmArray were more likely to receive targeted rather than empirical therapy, compared to those diagnosed by culture (P = .0148). Positive Shiga-like toxin-producing E. coli results were reported 47 hours faster with FilmArray and facilitated discontinuation of empirical antimicrobials. Patients diagnosed exclusively by FilmArray had clinical characteristics similar to those identified by culture.

Conclusions
FilmArray markedly improved clinical sensitivity in patients with acute diarrhea, identified cases with clinical acuity comparable to those identified by culture, and enabled clinicians to make more timely and targeted therapeutic decisions.
Affine Wreath Product Algebras
Authors: Savage Alistair 
Published: April 2018

Abstract
We study the structure and representation theory of affine wreath product algebras and their cyclotomic quotients. These algebras, which appear naturally in Heisenberg categorification, simultaneously unify and generalize many important algebras appearing in the literature. In particular, special cases include degenerate affine Hecke algebras, affine Sergeev algebras (degenerate affine Hecke–Clifford algebras), and wreath Hecke algebras. In some cases, specializing the results of the current paper recovers known results, but with unified and simplified proofs. In other cases, we obtain new results, including proofs of two open conjectures of Kleshchev and Muth.
Prognosis vs Treatment Interaction
Authors: Cuzick Jack 
Published: April 2018

Abstract
There is a somewhat confused belief that a biomarker must show an interaction effect with a treatment before it can be used to determine the need for such a treatment. This is rarely true for well-established clinical markers such as tumor size or regional lymph node involvement. In many cases, this is also not true for biomarkers, especially when considering nontargeted therapies. Here I argue that for nontargeted treatments prognosis is often more important than interaction with treatment, because it is the absolute and not the relative benefit that matters, and when there is no treatment interaction, the same relative benefit translates into a larger absolute benefit for poor prognosis patients.
Preventable Diabetic Complications After a Cancer Diagnosis in Patients With Diabetes: A Population-Based Cohort Study
Authors: Worndl Erin , Fung Kinwah , Fischer Hadas D , Austin Peter C , Krzyzanowska Monika K , Lipscombe Lorraine L 
Published: April 2018

AbstractBackgroundA cancer diagnosis may disrupt diabetes management, increasing the risk of preventable complications. The objective was to determine whether a cancer diagnosis in patients with diabetes is associated with an increased risk of diabetic complications.MethodsThis retrospective cohort study using health care data from Ontario, Canada, included persons age 50 years or older diagnosed with diabetes from 2007 to 2011 and followed until 2014. We examined the effects of cancer as a time-varying covariate: breast cancer (in women), prostate cancer (in men), colorectal cancer, and other cancers (in men and women). Each cancer exposure was categorized as stage I–III, IV, or unknown, and by time since cancer diagnosis (0–1 year, >1–3 years, and >3 years). The primary outcome was hospital visits for diabetic emergencies. Secondary outcomes were hospital visits for skin and soft tissue infections and cardiovascular events.ResultsOf 817 060 patients with diabetes (mean age = 64.9 +/- 10.7 years), there were 9759 (1.2%) colorectal and 45 705 (5.6%) other cancers, 6714 (1.7%) breast cancers among 384 257 women and 10 331 (2.4%) prostate cancers among 432 803 men. For all cancers except stage I–III prostate cancer, rates of diabetic complications were significantly higher zero years to one year after diagnosis compared with no cancer (adjusted relative rates ranging from 1.26, 95% confidence interval [CI] = 1.08 to 1.49, to 4.07, 95% CI = 3.80 to 4.36); these differences were attenuated in the subsequent periods after cancer diagnosis.ConclusionsPatients with diabetes are at increased risk for preventable complications after a cancer diagnosis. Better diabetes care is needed during this vulnerable period.
The Association Between Dietary Quality and Overall and Cancer-Specific Mortality Among Cancer Survivors, NHANES III
Authors: Deshmukh Ashish A , Shirvani Shervin M , Likhacheva Anna , Chhatwal Jagpreet , Chiao Elizabeth Y , Sonawane Kalyani 
Published: April 2018

Abstract
Given the recent emphasis on the totality of the diet by national guidelines, we examined the relationship between the quality of diet and overall and cancer-specific mortality among cancer survivors. From the Third National Health and Nutrition Examination Survey (NHANES III), 1191 participants diagnosed with cancer were identified. Healthy Eating Index (HEI) scores were utilized; higher HEI score indicated better adherence to dietary recommendations. During a median follow-up of 17.2 years, a total of 607 cancer-specific deaths occurred. A high-quality diet (highest-quartile HEI score) was associated with decreased risk of overall (hazard ratio [HR] = 0.59, 95% confidence interval [CI] = 0.45 to 0.77) and cancer-specific (HR = 0.35, 95% CI = 0.19 to 0.63) mortality when compared with a poor-quality diet (lowest-quartile HEI score). Among individual dietary components, the highest-quartile score for saturated fat intake was associated decreased cancer-specific mortality (HR = 0.55, 95% CI = 0.36 to 0.86). Our results highlight the importance of a “total diet” approach to improving survival among cancer patients.
The spin-down state change and mode change associated with glitch activity of PSR B2035+36
Authors: Kou F F , Yuan J P , Wang N , Yan W M , Dang S J 
Published: April 2018

Abstract
We presented timing results of PSR B2035+36 using ∼9-yr observations with the Nanshan 25-m radio telescope. PSR B2035+36 was reported to exhibit significant changes in pulse profile correlated with spin-down state variations. We found that the pulsar underwent a glitch with a jump in frequency of $\Delta {\nu }\sim 12.4(5)\, \rm nHz$ around MJD 52950. Unusually, the spin-down rate increased persistently over 800 d after the glitch, and the average spin-down rate post-glitch was about $9.6 \, {per\,cent}$ larger than that pre-glitch. After the glitch activity, the pulse profile became narrower and the pulsar began to switch between two emission modes, with pulse widths ($W_{\ 50 \rm mean}$) of 8.5(7)° and 3.7(3)°, respectively. In addition to that, the relatively narrow pulse profile gradually became dominant. All of the observations indicate that there should be a connection between magnetospheric behaviour and glitch activity. We discuss one possibility of magnetosphere fluctuation triggered by the glitch event.
Informational needs of brain metastases patients and their
caregivers
Authors: Papadakos Janet , Agarwal Arnav , Charow Rebecca , Quartey Naa Kwarley , D’souza Anna , Giuliani Meredith , Millar Barbara-Ann , Massey Christine , Shultz David , Chung Caroline 
Published: April 2018

Abstract

Background
In response to a dearth of formal health information targeted towards patients with brain metastases and their caregivers, a formal informational and supportive care needs assessment was conducted.

Methods
Brain metastases patients and caregivers who attended a clinic focused on the treatment of brain metastases at a tertiary medical center completed a self-report survey to assess informational needs across 6 domains: medical, physical, practical, social, emotional, and spiritual informational needs. Univariate and multivariate analyses of associations between variables was conducted using linear regression models.

Results
A total of 109 patients and 77 caregivers participated. Patients and caregivers both prioritized medical and physical informational domains, with a large focus on symptoms and side-effect profiles, significance of brain metastases locations and their implications, available treatment options and their risks and benefits, prognoses and follow-ups if treatment is completed, and end-of-life experiences and supports. One-on-one counseling was preferred by both caregivers and patients for these domains, as well as for practical informational needs; while patients preferred pamphlets to address social, emotional and spiritual informational needs, caregivers preferred one-on-one counseling for the former two domains as well.

Conclusions
Brain metastases patients and their caregivers prioritize medical and physical informational needs, with one-on-one counseling and pamphlets being the most preferred modalities for information provision. Further exploration regarding existing non-validated resources and the development of tailored resources to address the unique needs of these patient and caregiver populations are warranted.
Smoking, Systemic Inflammation, and Airflow Limitation: A Mendelian Randomization Analysis of 98 085 Individuals From the General Population
Authors: Çolak Yunus , Afzal Shoaib , Lange Peter , Nordestgaard Børge G 
Published: April 2018

AbstractIntroductionSmoking is associated with systemic and local inflammation in the lungs. Furthermore, in chronic obstructive pulmonary disease, which is often caused by smoking, there is often systemic inflammation that is linked to lung function impairment. However, the causal pathways linking smoking, systemic inflammation, and airflow limitation are still unknown. We tested whether higher tobacco consumption is associated with higher systemic inflammation, observationally and genetically and whether genetically higher systemic inflammation is associated with airflow limitation.MethodsWe included 98 085 individuals aged 20–100 years from the Copenhagen General Population Study; 36589 were former smokers and 16172 were current smokers. CHRNA3 rs1051730 genotype was used as a proxy for higher tobacco consumption and the IL6R rs2228145 genotype was used for higher systemic inflammation. Airflow limitation was defined as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <70%.ResultsDifference in plasma level of C-reactive protein was 4.8% (95% CI = 4.4% to 5.2%) per 10 pack-year increase and 1.6% (95% CI = 0.4% to 2.8%) per T allele. Corresponding differences were 1.2% (95% CI = 1.1% to 1.3%) and 0.5% (95% CI = 0.3% to 0.8%) for fibrinogen, 1.2% (95% CI = 1.2% to 1.3%) and 0.7% (95% CI = 0.5% to 1.0%) for α1-antitrypsin, 2.0% (95% CI = 1.8% to 2.1%) and 0.7% (95% CI = 0.4% to 1.1%) for leukocytes, 1.9% (95% CI = 1.8% to 2.1%) and 0.8% (95% CI = 0.4% to 1.2%) for neutrophils, and 0.8% (95% CI = 0.7% to 1.0%) and 0.4% (95% CI = 0.1% to 0.7%) for thrombocytes. The differences in these levels were lower for former smokers compared with current smokers. The IL6R rs2228145 genotype was associated with higher plasma acute-phase reactants but not with airflow limitation. Compared with the C/C genotype, the odds ratio for airflow limitation was 0.95 (95% CI = 0.89 to 1.02) for A/C genotype and 0.94 (95% CI = 0.87 to 1.01) for A/A genotype.ConclusionsHigher tobacco consumption is associated with higher systemic inflammation both genetically and observationally, whereas systemic inflammation was not associated with airflow limitation genetically.ImplicationsThe association between higher tobacco consumption and higher systemic inflammation may be causal, and the association is stronger among current smokers compared to former smokers, indicating that smoking cessation may reduce the effects of smoking on systemic inflammation. Systemic inflammation does not seem to be a causal driver in development of airflow limitation. These findings can help to understand the pathogenic effects of smoking and the interplay between smoking, systemic inflammation, and airflow limitation and hence development and progression of chronic obstructive pulmonary disease.
Incidental Findings on Coronary Computed Tomography Angiography in Human Immunodeficiency Virus (HIV)-Positive and HIV-Negative Persons
Authors: Reinschmidt Sara , Turk Teja , Tarr Philip E , Kouyos Roger , Hauser Christoph , Schmid Patrick , Weber Rainer , Kaufmann Philipp , Buechel Ronny R , Kovari Helen ,   Swiss HIV Cohort Study, Anagnostopoulos A , Battegay M , Bernasconi E , Böni J , Braun D L , Bucher H C , Calmy A , Cavassini M , Ciuffi A , Dollenmaier G , Egger M , Elzi L , Fehr J , Fellay J , Furrer H , Fux C A , Günthard H F , Haerry D , Hasse B , Hirsch H H , Hoffmann M , Hösli I , Huber M , Kahlert C , Kaiser L , Keiser O , Klimkait T , Kouyos R D , Kovari H , Ledergerber B , Martinetti G , Martinez de Tejada B , Marzolini C , Metzner K J , Müller N , Nicca D , Paioni P , Pantaleo G , Perreau M , Rauch A , Rudin C , Scherrer A U , Schmid P , Speck R , Stöckle M , Tarr P , Trkola A , Vernazza P , Wandeler G , Weber R , Yerly S 
Published: April 2018

AbstractBackgroundIncidental findings on coronary computed tomography angiography (CCTA) have a great impact on the benefits and costs of testing for cardiovascular disease. The number of incidental findings might be increased in human immunodeficiency virus (HIV)-positive individuals compared with the general population. Data are limited regarding the association between incidental findings and HIV infection.MethodsWe assessed the prevalence and factors associated with incidental findings among HIV-positive and HIV-negative participants ≥45 years undergoing CCTA. Logistic regression was performed to evaluate the factors associated with incidental findings in the HIV-positive and HIV-negative groups. For the analysis of the HIV effect, a propensity score-matched dataset of HIV-positive/HIV-negative participants was used.ResultsWe included 553 participants, 341 with and 212 without HIV infection. Incidental findings were observed in 291 of 553 (53%) patients. In 42 of 553 (7.6%) participants, an incidental finding resulted in additional workup. A malignancy was diagnosed in 2 persons. In the HIV-positive group, age (1.31 per 5 years, 1.10–1.56) and smoking (2.29, 1.43–3.70) were associated with incidental findings; in the HIV-negative group, age (1.26, 1.01–1.59) and a CAC score &gt;0 (2.08, 1.09–4.02) were associated with incidental findings. Human immunodeficiency virus seropositivity did not affect the risk of incidental findings.ConclusionsIncidental findings were highly prevalent among HIV-positive and HIV-negative persons. Human immunodeficiency virus infection was not associated with an increased risk of incidental findings.
Student Satisfaction With Blackboard-Style Videos
Authors: Wolf Andrew B. , Peyre Sarah E. 
Published: April 2018

Abstract
Blackboard-style videos with simple drawings illustrating concepts have become immensely popular in recent years. However, there has been no published research evaluating their efficacy in nursing education. This pilot study evaluates the use of blackboard-style videos in an online pathophysiology course. Quantitative and qualitative evaluation data were analyzed to evaluate student satisfaction. The data indicated that students were highly satisfied with the course and the delivery of content using blackboard-style videos. The qualitative analysis uncovered two key themes explaining the high level of satisfaction: visual plus narrative explanations support learning and student control over pacing enhances learning.
Intracranial Space–occupying Lesion Inducing Intracranial Hypertension Increases the Encephalographic Effects of Isoflurane in a Swine Model
Authors: Kurita Tadayoshi , Kawashima Shingo , Morita Koji , Nakajima Yoshiki 
Published: April 2018

Background:
Patients with a brain tumor are susceptible to the hypnotic effect of anesthetics depending on the tumor’s size. We investigated whether intracranial space–occupying lesions (ICSOLs) inducing intracranial hypertension increase isoflurane’s effect on electroencephalographic (EEG) results.

Materials and Methods:
After anesthetic induction with isoflurane, 11 swine were studied with regard to isoflurane’s effect on EEGs at 0.5% to 2.0% inhalational concentration at sequential stages: baseline 1, ICSOL 1, baseline 2, ICSOL 2, baseline 3. At each ICSOL stage, an intracranial epidural balloon catheter was inflated and the intracranial pressure maintained at twice the baseline pressure. The balloon was deflated after each ICSOL stage (baselines 2 and 3). A 95% spectral edge frequency (SEF), which correlates with anesthetic hypnosis, was used to measure isoflurane’s effect. Pharmacodynamics was characterized using a sigmoidal inhibitory maximum effect model for the SEF versus end-tidal concentration.

Results:
ICSOL shifted the relations between SEF and the effect-site concentration (C
e) downward. Baseline and 50% of the maximum spectral edge effect levels significantly decreased during balloon inflation. The C
e that produced SEF=15 was 1.12 (1.04-1.20) (mean [95% confidence interval])% for baseline 1; 0.92 (0.81-1.03) for ICSOL 1; 1.02 (0.94-1.11) for baseline 2; 0.88 (0.82-0.94) for ICSOL 2; 1.05 (0.93-1.17) for baseline 3. Isoflurane’s effect on EEGs increased during balloon inflation, with the alteration tending to recover after balloon deflation.

Conclusions:
ICSOLs inducing intracranial hypertension increase the EEG effect of isoflurane, and external compression from the brain surface enhances the anesthetic hypnosis despite minimum brain injury.
Evolution of Acute Kidney Injury and Its Association With Systemic Hemodynamics in Children With Fluid-Refractory Septic Shock
Authors: Deep Akash , Sagar Hiremath , Goonasekera Chulananda , Karthikeyan Palaniswamy , Brierley Joe , Douiri Abdel 
Published: April 2018

Objectives:
There are no studies in pediatrics evaluating the progression of acute kidney injury in septic shock. We investigated the evolution of sepsis-associated acute kidney injury and its association with systemic hemodynamics in children with fluid-refractory septic shock.

Design:
Prospective cohort study.

Setting:
PICU of a tertiary care hospital.

Patients:
All patients with fluid-refractory septic shock (n = 61) between September 2010 and February 2014.

Interventions:
Hemodynamic variables using noninvasive ultrasound cardiac output monitor were measured at admission and 6 hourly thereafter till 48 hours. We used the Kidney Disease: Improving Global Outcomes criteria to define and stage acute kidney injury. Associations between various hemodynamic variables and development of acute kidney injury were evaluated. Severe acute kidney injury was defined as stage 2 or 3 acute kidney injury and was compared with no acute kidney injury or stage 1 acute kidney injury.

Measurements and Main Results:
Severe acute kidney injury developed in 29.5% (n = 18) of the 61 children with fluid-refractory septic shock, whereas 43 patients (70.49%) had either no or stage 1 acute kidney injury. Most patients who developed acute kidney injury did so within the first 48 hours of PICU admission. Severe acute kidney injury conferred a three-fold increased risk of death by day 28 (hazard ratio, 3.23; 95% CI, 1.52–6.67; p = 0.002), longer ICU stay, and increased duration of mechanical ventilation. Central venous pressure at presentation was higher in severe acute kidney injury by 5 cm H2O. Highest lactate in the first 24 hours of PICU admission, low diastolic blood pressure, low systemic vascular resistance index at admission were associated with severe acute kidney injury. This model reliably predicted stage 2/3 acute kidney injury by day 3 with area under the curve equals to 94%; 95% CI, 88.3–99.99. None of the other hemodynamic variables showed any association with severe acute kidney injury.

Conclusions:
Manifestations of sepsis-associated acute kidney injury often occur early after PICU admission and is associated with increased morbidity and mortality. There is a need to develop a predictive model in septic shock which could facilitate early detection of acute kidney injury.
Ultrasonography-guided Cannula Method for Hyaluronic Acid Filler Injection with Evaluation using Laser Speckle Flowgraphy
Authors: Iwayama Takanori , Hashikawa Kazunobu , Osaki Takeo , Yamashiro Kenjiro , Horita Nobuyuki , Fukumoto Takeshi 
Published: April 2018

Summary:Hyaluronic acid (HA) is present in the connective tissues of the skin and decreases with age. HA fillers are popular as facial rejuvenation treatments. They are generally considered safe; however, complications, such as cutaneous necrosis and blindness due to vascular embolism, sometimes occur. Because vascular embolisms are likely associated with the deep placement of HA fillers, a strategy that involves injection into superficial regions (the conventional method) is commonly used to reduce risks. However, deep injections to achieve revolumization are becoming common, even in high-risk areas for intravascular infusion. We aimed to study the usefulness of the ultrasonography-guided cannula method for preventing intravascular infusion of HA fillers. An HA filler was injected into the region just under the dermis on the left side of the face of a 38-year-old man using the conventional method, and another HA filler was injected into the periosteum on the right side using the ultrasonography-guided cannula method. The skin blood flow on both sides was compared using laser speckle flowgraphy (LSFG). The ultrasonography-guided method was successful in detecting the cannula and the blood vessel, and the HA filler was safely injected into a deep region. Using LSFG, a difference in skin blood flow between the 2 methods was detected. The ultrasonography-guided cannula method was effective in aiding the safe injection of an HA filler in a deep high-risk area and maintained skin blood flow. LSFG may be adopted to evaluate skin blood flow after HA filler injections.