bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reducing calcineurin inhibitor first for treating BK polyomavirus replication after kidney transplantation: long-term outcomes
Authors: Bischof Nicole , Hirsch Hans H , Wehmeier Caroline , Amico Patricia , Dickenmann Michael , Hirt-Minkowski Patricia , Steiger Jürg , Menter Thomas , Helmut Hopfer , Schaub Stefan 
Published: October 2018

Abstract

Background
Reducing immunosuppression is the mainstay of treating BK polyomavirus (BKPyV) viraemia after kidney transplantation, but the best approach, efficacy and impact are undefined. We established a standard operating procedure (SOP) treating BKPyV viraemia based on first reducing calcineurin inhibitor (‘CNI first’). The aim of this study was to investigate long-term outcomes in 644 consecutive transplantations using this SOP.

Methods
Patients were monitored for active BKPyV infection by urinary decoy cells and, if positive, by BKPyV viraemia. In case of sustained BKPyV viraemia >1000 copies/mL, immunosuppression was reduced stepwise according to the SOP. Patients were classified as ‘no decoy cells’ [n = 432 (66%)], ‘decoy cells/no viraemia’ [n = 107 (17%)] and ‘viraemia’ [n = 105 (17%)].

Results
At 6-years post-transplant, graft survival was ∼84%, the clinical rejection rate was ∼25% and they were not different among the three groups (P = 0.14; P = 0.91). The median estimated glomerular filtration rate at the last follow-up was similar (range 49–53 mL/min, P = 0.08). Of 105 viraemic patients, 101 (96%) cleared BKPyV viraemia. In 39% of patients, viraemia clearance followed a tacrolimus reduction. A reduction of mycophenolic acid was required in 43% and discontinuation in 3%. No short-term graft loss was directly attributable to BKPyV-associated nephropathy. After a median follow-up of 5 years after clearance of BKPyV viraemia, 11/101 patients (11%) developed clinical rejection: 7 (7%) T-cell-mediated rejection and 4 (4%) antibody-mediated rejection (ABMR).

Conclusions
Immunosuppression reduction based on ‘CNI first’ leads to similar long-term outcomes in patients with/without BKPyV viraemia and is associated with a low risk for ABMR after clearance of BKPyV viraemia. Randomized trials are needed to compare the risks and benefits of immunosuppression reduction strategies in kidney transplant patients with BKPyV viraemia.
Microbial Identification Using DNA Target Amplification and Sequencing: Clinical Utility and Impact on Patient Management
Authors: Basein Tinzar , Gardiner Bradley J , Andujar Vazquez Gabriela M , Joel Chandranesan Andrew S , Rabson Arthur R , Doron Shira , Snydman David R 
Published: October 2018

AbstractBroad-range polymerase chain reaction (PCR) is increasingly used in patients with culture-negative infections; however, few studies have assessed the diagnostic utility of this test in this context. We performed a retrospective cohort study of patients who had clinical specimens sent for broad-range PCR, aiming to evaluate performance and determine impact on patient management. Organisms were identified in 21/71 samples. High numbers of polymorphonuclear leukocytes on Gram stain (odds ratio [OR], 4.17; P = .04) and acute inflammation on histopathology (OR, 5.69; P = .02) were significantly associated with a positive result. Management was altered in 18 patients, 11 with positive and 7 with negative results. Overall, broad-range PCR assay had the highest impact in patients with microscopic evidence of inflammation. Physicians ordering this complex, difficult to interpret, and expensive test should carefully consider all available clinical information on an individualized basis to optimize its performance.
Pharmacological Manipulation of Critical Period Plasticity
Authors: Guirado Ramon , Castrén Eero 
Published: October 2018

Abstract
Neuronal networks are refined through an activity-dependent competition during critical periods of early postnatal development. Recent studies have shown that critical period plasticity is influenced by a number of environmental factors, including drugs that are widely used for the treatment of brain disorders. These findings suggest a new paradigm, where pharmacological treatments can be used to open critical period–like plasticity in the adult brain. The plastic networks can then be modified through rehabilitation or psychotherapy to rewire those abnormally wired during development. This kind of combination of pharmacotherapy with physical or psychological rehabilitation may open a new opportunity for a more efficient recovery of a number of neurological and neuropsychiatric disorders.
The Territories in Israeli Politics
Authors: Perliger Arie , Pedahzur Ami 
Published: October 2018

Abstract
Even though settlers constitute a minority whose goals are not shared by the majority of Israelis, their settlements’ project still thrives. This chapter strives to explain this paradox by providing three complementary explanations for the success of the settlers’ movement in overcoming their limited representation within the political system, as well as changes in Israel’s political and strategic environment. It attributes the impressive success of the settlers to their ability to establish effective networks of influence within the Israeli public administration; their successful branding, which associated the settlements with the traditional Zionist ethos; and their movement into the mainstream of the political system. After setting the stage for its analysis with a brief overview of the origins and evolution of the settlements’ project, the chapter presents explanations and elucidates how they complement each other effectively to allow the settlers to bypass, or overcome, various political and security-related challenges. The chapter concludes by assessing the ability of the settlers’ community to continue to utilize similar methods of political activism and policymaking in the future.
Team Reflection
Authors: Otte Kai-Philip , Knipfer Kristin , Schippers Michaéla 
Published: October 2018

Abstract
This chapter posits that team reflection, which the authors conceive as the collective evaluation of prior team activities, is a major driver for the development and attainment of expertise in teams. To develop its argument, the chapter first reviews previous team reflection research (self-regulatory team reflection, as for example team reflexivity, and guided team reflection approaches, as for example team debriefings) and elaborates the mechanisms that link team reflection to expertise in teams. Secondly, the chapter discusses multiple catalysts of team reflection. Finally, the chapter elaborates two important shortcomings of previous team reflection research (level of analysis, and short- and long-term consequences) that should be further addressed by future studies in order to deepen our understanding of the effects of team reflection on the development of expertise in teams.
Skill Decay
Authors: Arthur Winfred , Day Eric Anthony 
Published: October 2018

Abstract
With a focus on its intersection with the expertise literature, a number of conclusions arise from the present review of the skill/knowledge decay and retention literature. First, decay is more a matter of interference rather than simply the forgetting of information and processes through the passage of time. Second, decay is highly dependent on task and situational factors. Third, decay on complex tasks appears to be smaller than that observed for simple tasks. Fourth, retention is generally stronger with more practice, elaborative rehearsal, and greater mastery—expertise—of the task. Fifth, although related, retention, reacquisition, and transfer are meaningfully distinct. Sixth, there is very limited empirical research that integrates the study of expertise in the context of skill acquisition with the study of decay, adaptable performance, and enhancing retention (or mitigating loss) in complex real-world performance domains. Intersecting these rich yet separate literatures would be of great theoretical and practical value and warrants future research attention.
Whose Refuge, This House?
Authors: Garcia-Mispireta Luis Manuel 
Published: October 2018

Abstract
Electronic dance music (EDM) scenes have passed through several cycles of broad popularity and exposure, often weakening their ties to the queer, Black, Latinx, and transgender urban nocturnal worlds from which they emerged. Given the importance of these originating music scenes to their minoritized participants as spaces of survival, comfort, recognition, and community-building, it is equally important to examine this pattern of estrangement and assess its stakes for the queers of color who have played a pivotal role in this music’s development. This chapter first seeks to redress the lacunae of conventional EDM historiography by providing a revisionist history that focuses on issues of sexuality, race, and ethnicity. It then traces queer counterhistories into the present, redressing the apparent disappearance of queers of color from present-day scenes and industries.
Suzaku X-ray observations of the mixed-morphology supernova remnant CTB 1
Authors: Katsuragawa Miho , Nakashima Shinya , Matsumura Hideaki , Tanaka Takaaki , Uchida Hiroyuki , Lee Shiu-Hang , Uchiyama Yasunobu , Arakawa Masanori , Takahashi Tadayuki 
Published: October 2018

Abstract
We present an X-ray study of the mixed-morphology supernova remnant CTB 1 (G116.9+0.2) observed with Suzaku. The 0.6–2.0 keV spectra in the northeastern breakout region of CTB 1 are well represented by a collisional ionization-equilibrium plasma model with an electron temperature of ∼0.3 keV, whereas those in the southwestern inner-shell region can be reproduced by a recombining plasma model with an electron temperature of ∼0.2 keV, an initial ionization temperature of ∼3 keV, and an ionization parameter of ∼9 × 1011 cm−3 s. This is the first detection of the recombining plasma in CTB 1. The electron temperature in the inner-shell region decreases outwards, which implies that the recombining plasma is likely formed by the thermal conduction via interaction with the surrounding cold interstellar medium. The Ne abundance is almost uniform in the observed regions whereas Fe is more abundant toward the southwest of the remnant, suggesting an asymmetric ejecta distribution. We also detect a hard tail above the 2-keV band that is fitted with a power-law function with a photon index of 2–3. The flux of the hard tail in the 2–10 keV band is ∼5 × 10−13 erg cm−2 s−1 and peaks at the center of CTB 1. Its origin is unclear but one possibility is a putative pulsar wind nebula associated with CTB 1.
Comparative Effectiveness of mHealth-Supported Exercise Compared With Exercise Alone for People With Parkinson Disease: Randomized Controlled Pilot Study
Authors: Ellis Terry D , Cavanaugh James T , DeAngelis Tamara , Hendron Kathryn , Thomas Cathi A , Saint-Hilaire Marie , Pencina Karol , Latham Nancy K 
Published: October 2018

Abstract

Background
Declining physical activity commonly occurs in people with Parkinson disease (PD) and contributes to reduced functional capacity and quality of life.

Objective
The purpose of this study was to explore the preliminary effectiveness, safety, and acceptability of a mobile health (mHealth)–mediated exercise program designed to promote sustained physical activity in people with PD.

Design
This was a 12-month single-blind (assessor), pilot, comparative-effectiveness, randomized controlled study.

Methods
An mHealth-mediated exercise program (walking with a pedometer plus engagement in planned exercise supported by a mobile health application) was compared over 1 year with an active control condition (walking with a pedometer and exercise only). There were 51 participants in a community setting with mild-to-moderately severe (Hoehn and Yahr stages 1–3) idiopathic PD. Daily steps and moderate-intensity minutes were measured using a step activity monitor for 1 week at baseline and again at 12 months. Secondary outcomes included the 6-Minute Walk Test, Parkinson Disease Questionnaire 39 mobility domain, safety, acceptability, and adherence.

Results
Both groups increased daily steps, moderate-intensity minutes, and 6-Minute Walk Test, with no statistically significant between-group differences observed. In the less active subgroup, changes in daily steps and moderate-intensity minutes were clinically meaningful. An improvement in the Parkinson Disease Questionnaire 39 mobility score favored mHealth in the overall comparison and was statistically and clinically meaningful in the less active subgroup.

Limitations
The limitation of the current study was the small sample size.

Conclusions
Both groups improved physical activity compared with expected activity decline over 1 year. The addition of the mHealth app to the exercise intervention appeared to differentially benefit the more sedentary participants. Further study in a larger group of people with low activity at baseline is needed.
A FULLY AUTOMATED SECONDARY STANDARD X-RAY CALIBRATION FACILITY FOR PERSONAL DOSEMETERS
Authors: Bandalo V , Brönner J , Greiter M B , Hoedlmoser H 
Published: October 2018

Abstract
The individual monitoring service at the Helmholtz Zentrum München has extended the calibration facilities provided at the Munich IAEA/WHO secondary standard dosimetry laboratory with a new fully automated X-ray calibration facility for the calibration of personal dosemeters according to the ISO 4037 standard series. This work describes the X-ray irradiation system and the automated dosemeter transport system as well as the measurements performed to characterize the photon fields and to ascertain conformity to the ISO standard. Standard uncertainties of the radiation quantities provided by the system are given together with a discussion of some of the problems that are encountered in fulfilling the requirements of a matched field according to the latest drafts of the ISO 4037-1 standard.
Evaluating the Validity of the DSM-5 Alcohol Use Disorder Diagnostic Criteria in a Sample of Treatment-seeking Native Americans
Authors: Serier Kelsey N. , Venner Kamilla L. , Sarafin Ruth E. 
Published: October 2018

Objective:
Despite high rates of alcohol use disorder (AUD) and alcohol-induced deaths among Native Americans, there has been limited study of the construct validity of the AUD diagnostic criteria. The purpose of the current study was to examine the validity of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) AUD criteria in a treatment-seeking group of Native Americans.

Methods:
As part of a larger study, 79 Native Americans concerned about their alcohol or drug use were recruited from a substance use treatment agency located on a reservation in the southwestern United States. Participants were administered the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (SCID for DSM-IV-TR) reworded to assess 11 DSM-5 criteria for AUD. Confirmatory factor analysis (CFA) was used to test the validity of the AUD diagnostic criteria, and item response theory (IRT) was used to examine the item characteristics of the AUD diagnostic criteria in this Native American sample.

Results:
CFA indicated that a 1-factor model of the 11 items provided a good fit of the data. IRT parameter estimates suggested that “withdrawal,” “social/interpersonal problems,” and “activities given up to use” had the highest magnitude of discrimination. “Much time spent using” and “activities given up to use” were associated with the greatest severity.

Conclusions:
The current study provided support for the validity of the AUD DSM-5 criteria and a unidimensional latent construct of AUD in this sample of treatment-seeking Native Americans. IRT analyses replicate findings from previous studies. To our knowledge, this is the first study to examine the validity of the DSM-5 AUD criteria in a treatment-seeking sample of Native Americans. Continued research in other Native American samples is needed.
Nitrous Oxide Compared With Intravenous Sedation for Second-Trimester Abortion
Authors: Thaxton Lauren , Pitotti Jennifer , Espey Eve , Teal Stephanie , Sheeder Jeanelle , Singh Rameet H. 
Published: October 2018

OBJECTIVE:
To assess whether inhaled nitrous oxide is noninferior to intravenous (IV) sedation for pain control during outpatient surgical abortion between 12 and 16 weeks of gestation.

METHODS:
We enrolled women undergoing surgical abortion at 12–16 weeks of gestation into a multisite, double-blind clinical trial. Participants were randomized to sedation with nitrous oxide (70% nitrous/30% oxygen) or IV fentanyl (100 micrograms) and midazolam (2 mg). Paracervical block was administered to both groups. The primary outcome measure was immediate postabortion recall of maximum pain on a 100-mm visual analog scale.

RESULTS:
Between August 2016 and March 2017, we assessed 170 women for eligibility and enrolled 39, 19 in the nitrous group and 20 in the IV sedation group. Seven participants in the nitrous group (36.8%) required conversion to IV sedation for inadequate pain control. No participants in the IV sedation group required additional medication. The proportion of women requiring additional pain control in the nitrous group exceeded our predefined stopping rule. Intention-to-treat analysis demonstrated that immediate postabortion visual analog scale pain scores were lower by 20.1 mm (95% CI 1.6–38.6) in women randomized to IV sedation than in women randomized to nitrous.

CONCLUSION:
Intravenous sedation is a better choice than inhaled nitrous oxide for pain control in second-trimester abortion.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT02755090.
Torsemide for Prevention of Persistent Postpartum Hypertension in Women With Preeclampsia
Authors: Viteri Oscar A. , Alrais Mesk A. , Pedroza Claudia , Hutchinson Maria , Chauhan Suneet P. , Blackwell Sean C. , Sibai Baha M. 
Published: October 2018

OBJECTIVE:
To evaluate whether torsemide reduces the rate of persistent postpartum hypertension in women with preeclampsia.

METHODS:
We conducted a randomized, double-blind, placebo-controlled trial of women with preeclampsia at a tertiary center from August 2016 to September 2017. Those with gestational hypertension or renal or cardiopulmonary failure were excluded. Within 24 hours of delivery, women were randomized one to one to oral torsemide, 20 mg/d, or placebo, for 5 days. Our primary outcome was blood pressure greater than or equal to 150 mm Hg systolic or 100 mm Hg diastolic (or both) on two occasions at least 4 hours apart by postpartum day 5 or by the time of hospital discharge. Assuming a 50% rate of persistent hypertension in women with preeclampsia, 118 participants were required to detect a 50% rate reduction. Analyses were by intention to treat.

RESULTS:
From August 2016 to September 2017, 118 women were randomized: 59 were allocated to torsemide and 59 to placebo. Overall, 43 (73%) women in the torsemide and 45 (76%) in the placebo group had either preeclampsia with severe features or preeclampsia superimposed on chronic hypertension. The rate of persistent postpartum hypertension was 44% in the torsemide and 58% in the placebo group (relative risk 0.76, 95% CI 0.5–1.1). No differences were seen in rate of hypertension 7–10 days or 6 weeks postpartum, severe hypertension, length of postpartum hospital stay, readmission for hypertension, or adverse events. There were no cases of severe composite morbidity or deaths.

CONCLUSION:
In this trial of women with preeclampsia, a 5-day course of postpartum torsemide did not have a significant effect on the rate of postpartum hypertension.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT02813551.
Evaluating Delivery of Low Tidal Volume Ventilation in Six ICUs Using Electronic Health Record Data*
Authors: Sjoding Michael W. , Gong Michelle N. , Haas Carl F. , Iwashyna Theodore J. 
Published: October 2018

Objectives:
Mechanical ventilation with low tidal volumes is recommended for all patients with acute respiratory distress syndrome and may be beneficial to other intubated patients, yet consistent implementation remains difficult to obtain. Using detailed electronic health record data, we examined patterns of tidal volume administration, the effect on clinical outcomes, and alternate metrics for evaluating low tidal volume compliance in clinical practice.

Design:
Observational cohort study.

Setting:
Six ICUs in a single hospital system.

Patients:
Adult patients who received invasive mechanical ventilation more than 12 hours.

Interventions:
None.

Measurements and Main Results:
Tidal volumes were analyzed across 1,905 hospitalizations. Although mean tidal volume was 6.8 mL/kg predicted body weight, 40% of patients were exposed to tidal volumes greater than 8 mL/kg predicted body weight, with 11% for more than 24 hours. At a patient level, exposure to 24 total hours of tidal volumes greater than 8 mL/kg predicted body weight was associated with increased mortality (odds ratio, 1.82; 95% CI, 1.20–2.78), whereas mean tidal volume exposure was not (odds ratio, 0.87/1 mL/kg increase; 95% CI, 0.74–1.02). Initial tidal volume settings strongly predicted exposure to volumes greater than 8 mL/kg for 24 hours; the adjusted rate was 21.5% when initial volumes were greater than 8 mL/kg predicted body weight and 7.1% when initial volumes were less than 8 mL/kg predicted body weight. Across ICUs, correlation of mean tidal volume with alternative measures of low tidal volume delivery ranged from 0.38 to 0.66.

Conclusions:
Despite low mean tidal volume in the cohort, a significant percentage of patients were exposed to a prolonged duration of high tidal volumes which was correlated with higher mortality. Detailed ventilator records in the electronic health record provide a unique window for evaluating low tidal volume delivery and targets for improvement.