bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular Phylogeny of the Ant-Decapitating Flies, Genus Apocephalus Coquillett (Diptera: Phoridae)
Authors: Brown Brian V , Hayes Christine , Hash John M , Smith Paul T 
Published: July 2019

AbstractThe phylogenetic relationships of the large, diverse genus Apocephalus Coquillett are studied using seven loci (16S, COI, NDI, 28S, AK, CAD, and TPI). Both Bayesian and Maximum Likelihood methods were used to analyze the sequences. Pre-existing taxonomic relationships, based on morphology, were largely upheld, with the notable exception of the subgenus Mesophora Borgmeier being placed deep inside the genus. Therefore, Mesophora was synonymized with Apocephalus (new synonymy) and its species referred to as belonging to the Apocephalus wheeleri group. Both methods of analysis recovered similar results, providing what we consider reasonable explanations of the data, based on morphological information.
Burn Care and Surgical Exposure amongst Canadian Plastic Surgery Residents: Recommendations for Transitioning to a Competency-Based Medical Education Model
Authors: Shih Jessica G , Quong Whitney L , Knox Aaron D C , Zhygan Nick , Courtemanche Douglas J , Brown Mitchell H , Fish Joel S 
Published: July 2019

Abstract
With the ongoing implementation of a competency-based medical education (CMBE) model for residency programs in North America, emphasis on the duration of training has been refocused onto ability and competence. This study aims to determine the exposure of burn-related core procedural competencies (CPCs) in Canadian Plastic Surgery Residents in order to enhance curricular development and help define its goals. A retrospective review of burn-related resident case logs encompassing all 10 English-speaking plastic surgery residency programs from 2004 to 2014 was performed, including analysis of personal competence scores and resident role by Postgraduate Year (PGY)-year. Case logs of a total of 55 graduating plastic surgery residents were included in the study. Overall, 4033 procedures in burn and burn-related care were logged, accounting for 6.8% of all procedures logged. On average, each resident logged 73 burn procedures, 99% of which were CPCs. The most frequently performed procedure was harvest and application of autograft, allograft, or xenograft, while emergent procedures such as escharotomy and compartment release were performed on average less than one time per resident. Personal competence scores as well as role of the resident (surgical responsibility) increased as PGY-year progressed during residency. Canadian plastic surgery residency programs provide adequate exposure to the majority of the scope of burn care and surgery. However, infrequently encountered but critical procedures such as escharotomy and fasciotomy may require supplementation through dedicated educational opportunities. CMBE should identify these gaps in learning through facilitation of resident competency evaluation. With consideration for the amount of exposure to burn-related CPCs as identified, plastic surgery residency programs can work toward achieving competency in all aspects of burn care and surgery prior to the completion of residency.
Ticks as Soil-Dwelling Arthropods: An Intersection Between Disease and Soil Ecology
Authors: Burtis James C , Yavitt Joseph B , Fahey Timothy J , Ostfeld Richard S 
Published: July 2019

AbstractTicks are widespread vectors for many important medical and veterinary infections, and a better understanding of the factors that regulate their population dynamics is needed to reduce risk for humans, wildlife, and domestic animals. Most ticks, and all non-nidicolous tick species, spend only a small fraction of their lives associated with vertebrate hosts, with the remainder spent in or on soils and other substrates. Ecological studies of tick-borne disease dynamics have emphasized tick–host interactions, including host associations, burdens, and efficiencies of pathogen transmission, while under emphasizing tick biology during off-host periods. Our ability to predict spatiotemporal trends in tick-borne diseases requires more knowledge of soil ecosystems and their effect on host and tick populations. In this review, we focus on tick species of medical and veterinary concern and describe: 1) the relationships between soil factors and tick densities; 2) biotic and abiotic factors within the soil ecosystem that directly affect tick survival; 3) potential indirect effects on ticks mediated by soil ecosystem influences on their vertebrate hosts; 4) the potential for tick-mediated effects on vertebrate host populations to affect ecosystems; and 5) possible nontarget impacts of tick management on the soil ecosystem. Soils are complex ecosystem components with enormous potential to affect the survival and behavior of ticks during their off-host periods. Hence, tick-borne disease systems present an excellent opportunity for soil ecologists and public health researchers to collaborate and improve understanding of these medically important and ecologically complex disease cycles.
Improvement of MEFV gene variants classification to aid treatment decision making in familial Mediterranean fever
Authors: Accetturo Matteo , D’Uggento Angela Maria , Portincasa Piero , Stella Alessandro 
Published: July 2019

Abstract

Objective
FMF is an inherited autoinflammatory syndrome caused by mutations in the MEFV gene. MEFV variants are still largely classified as acvariant of uncertain significance, or with unresolved classification, posing significant challenges in FMF diagnosis. Rare Exome Variant Ensemble Learner (REVEL) is a recently developed variant metapredictor tool. To reduce the number of MEFV variants with ambiguous classification, we extracted REVEL scores for all missense variants present in the INFEVERS database, and analysed its correlation with expert-based classification and localization in the MEFV-encoded pyrin functional domains.

Methods
The data set of 216 MEFV missense variants was divided into four categories (likely benign, variant of uncertain significance, likely pathogenic and unresolved). Variants were plotted onto the pyrin protein, the distribution of REVEL scores in each category was computed and means, confidence intervals, and area under the receiver operating curve were calculated.

Results
We observed a non-random distribution of pathogenic variants along the pyrin functional domains. The REVEL scores demonstrated a good correlation with the consensus classification of the International Study Group for Systemic Autoinflammatory Diseases. Sensitivity, specificity and accuracy were calculated for different cut-off values of REVEL scores and a gene-specific-threshold of 0.298 was computed with confidence boundary limits. This cut-off value allowed us to propose a reclassification of 96 MEFV gene variants, thus reducing the variant of uncertain significance proportion from 61.6% to 17.6%.

Conclusion
The combination of available expert information with sensitive predictor tools could result in a more accurate interpretation of clinical consequences of MEFV gene variants, and to a better genetic counselling and patient management.
Unique Sjögren’s syndrome patient subsets defined by molecular features
Authors: James Judith A , Guthridge Joel M , Chen Hua , Lu Rufei , Bourn Rebecka L , Bean Krista , Munroe Melissa E , Smith Miles , Chakravarty Eliza , Baer Alan N , Noaiseh Ghaith , Parke Ann , Boyle Karen , Keyes-Elstein Lynette , Coca Andreea , Utset Tammy , Genovese Mark C , Pascual Virginia , Utz Paul J , Holers V. Michael , Deane Kevin D , Sivils Kathy L , Aberle Teresa , Wallace Daniel J , McNamara James , Franchimont Nathalie , St. Clair E. William 
Published: July 2019

AbstractObjectiveTo address heterogeneity complicating primary SS (pSS) clinical trials, research and care by characterizing and clustering patients by their molecular phenotypes.MethodspSS patients met American–European Consensus Group classification criteria and had at least one systemic manifestation and stimulated salivary flow of ⩾0.1 ml/min. Correlated transcriptional modules were derived from gene expression microarray data from blood (n = 47 with appropriate samples). Patients were clustered based on this molecular information using an unbiased random forest modelling approach. In addition, multiplex, bead-based assays and ELISAs were used to assess 30 serum cytokines, chemokines and soluble receptors. Eleven autoantibodies, including anti-Ro/SSA and anti-La/SSB, were measured by Bio-Rad Bioplex 2200.ResultsTranscriptional modules distinguished three clusters of pSS patients. Cluster 1 showed no significant elevation of IFN or inflammation modules. Cluster 2 showed strong IFN and inflammation modular network signatures, as well as high plasma protein levels of IP-10/CXCL10, MIG/CXCL9, BLyS (BAFF) and LIGHT. Cluster 3 samples exhibited moderately elevated IFN modules, but with suppressed inflammatory modules, increased IP-10/CXCL10 and B cell–attracting chemokine 1/CXCL13 and trends toward increased MIG/CXCL9, IL-1α, and IL-21. Anti-Ro/SSA and anti-La/SSB were present in all three clusters.ConclusionMolecular profiles encompassing IFN, inflammation and other signatures can be used to separate patients with pSS into distinct clusters. In the future, such profiles may inform patient selection for clinical trials and guide treatment decisions.
Ethnic Disparities in Autism Spectrum Disorder Screening and Referral: Implications for Pediatric Practice
Authors: Rea Kelly E. , Armstrong-Brine Melissa , Ramirez Lisa , Stancin Terry 
Published: July 2019

ABSTRACT:

Objective:
Autism spectrum disorder (ASD) screening completion rates are often low despite their validity and influence on earlier intervention and positive treatment outcomes. This study sought to examine the use of one ASD screening tool, the Modified Checklist for Autism in Toddlers-Revised (MCHAT-R), in a racially and ethnically diverse urban pediatric clinic to review potential disparities within screening rates and referral practices.

Methods:
A retrospective chart review was conducted for children (N = 999) within the ages of 17 to 34 months seen for a well-child appointment at one of 3 pediatric clinics: a general pediatric clinic, resident pediatric clinic, and Hispanic pediatric clinic.

Results:
MCHAT-R screening completion rates were low for all clinics. There were no significant differences in MCHAT-R screening completion based on ethnicity; however, the percentage of children screening positive on the MCHAT-R was significantly higher for Hispanic versus non-Hispanic children. Referral practices were highly variable across positive screenings, and few children received the appropriate combination of referrals.

Conclusion:
Ethnic disparities in ASD positive screening rates and inconsistent referrals represent a critical issue in current pediatric practice. There is a great need for the development of more culturally sensitive ASD screening instruments. Additionally, to help increase ASD screening rate and accuracy, as well as consistency in referrals, greater emphasis is needed on professional training, parental education, and technology use within pediatric clinics.
Parental Attitudes and Beliefs Surrounding Play Among Predominantly Low-income Urban Families: A Qualitative Study
Authors: Shah Reshma , Gustafson Erika , Atkins Marc 
Published: July 2019

ABSTRACT:

Objective:
Parents' perceived benefits and barriers to participation in cognitively stimulating activities may help explain why income-related discrepancies in early and frequent participation in such activities exist. We sought to develop an improved understanding of attitudes and beliefs surrounding play among families who live in predominantly low-income urban communities.

Methods:
Using qualitative methods, focus groups were conducted with parents of children 2 weeks to 24 months of age who attended a primary care clinic serving predominantly low-income urban communities. Discussions were recorded, transcribed verbatim, and analyzed using thematic analysis.

Results:
Thirty-five parents participated in 6 focus groups. Participants were 61% female and 94% nonwhite; 71% had children who received public health insurance. Analyses revealed 7 major themes that mapped onto the Health Belief Model's core domains of perceived need, barriers, and cues to action: (1) play as important for developing parent-child relationships, (2) toy- and media-focused play as important for developmental and educational benefit, (3) lack of time due to household and work demands, (4) lack of knowledge regarding the importance of play, (5) media-related barriers, (6) need for reminders, and (7) need for ideas for play.

Conclusion:
Caregivers of young children describe many important benefits of play, yet they have misconceptions regarding use of toys and media in promoting development as well as notable barriers to participating in play, which may be opportunities for intervention. Public health programs may be more effectively implemented if they consider these attitudes to develop new or refine existing strategies for promoting parent-child learning activities.
A Conceptual Approach to Designing Transposition Flaps
Authors: Scott Jeffrey F. , Bordeaux Jeremy S. 
Published: July 2019

BACKGROUND
The large number of transposition flap geometries available for cutaneous reconstruction often makes the design of these flaps difficult for less experienced dermatologic surgeons.

OBJECTIVE
To present a conceptual approach to designing transposition flaps based on 2 elementary angles.

MATERIALS AND METHODS
First, a simplified framework for designing transposition flaps is presented, based on: (1) the takeoff point of the flap, (2) the angle between the primary limb and the primary defect (Angle A), and (3) the angle between the secondary limb and the primary limb (Angle B). Next, a comprehensive literature review highlights applications of the above conceptual approach in the design of z-plasties and single-lobed and multi-lobed transposition flaps.

RESULTS
Different types of transposition flaps all share the same key design elements, and modifications to Angle A and Angle B predict flap biomechanics.

CONCLUSION
The design of transposition flaps can be simplified by understanding how 2 elementary angles influence the geometry and biomechanics of various transposition flaps.
A Dried Blood Spot Analysis for Solithromycin in Adolescents, Children, and Infants: A Short Communication
Authors: Beechinor Ryan J. , Cohen-Wolkowiez Michael , Jasion Theresa , Hornik Christoph P. , Lang Jason E. , Hernandez Robert , Gonzalez Daniel 
Published: July 2019

Background:
Solithromycin is a fourth-generation macrolide antibiotic with potential efficacy in pediatric community-acquired bacterial pneumonia. Pharmacokinetic (PK) studies of solithromycin in pediatric subjects are limited, therefore application of minimally invasive drug sampling techniques, such as dried blood spots (DBS), may enhance the enrollment of children in PK studies. The objectives of this study were to compare solithromycin concentrations in DBS with those in liquid plasma samples (LPS) and to quantify the effects of modeling DBS concentrations on the results of a population PK model.

Methods:
Comparability analysis was performed on matched DBS and LPS solithromycin concentrations collected from two different phase 1 clinical trials of solithromycin treatment in children (clinicaltrials.gov #NCT01966055 and #NCT02268279). Comparability of solithromycin concentrations was evaluated based on DBS:LPS ratio, median percentage prediction error, and median absolute percentage prediction error. The effect of correcting DBS concentrations for both hematocrit and protein binding was investigated. In addition, a previously published population PK model (NONMEM®) was leveraged to compare parameter estimates resulting from either DBS or LPS concentrations.

Results:
A total of 672 paired DBS-LPS concentrations were available from 95 subjects (age: 0–17 years of age). The median (range) LPS and DBS solithromycin concentrations were 0.3 (0.01–12) mcg/mL and 0.32 (0.01–14) mcg/mL, respectively. Median percentage prediction error and median absolute percentage prediction error of raw DBS to LPS solithromycin concentrations were 5.26% and 22.95%, respectively. In addition, the majority of population PK parameter estimates resulting from modeling DBS concentrations were within 15% of those obtained from modeling LPS concentrations.

Conclusions:
Solithromycin concentrations in DBS were similar to those measured in LPS and did not require correction for hematocrit or protein binding.
Association of Psychache and Alexithymia With Suicide in Patients With Schizophrenia
Authors: Demirkol Mehmet Emin , Tamam Lut , Namli Zeynep , Karaytuğ Mahmut Onur , Uğur Kerim 
Published: July 2019

AbstractSuicide is a leading cause of death in patients with schizophrenia. Previous studies have mostly investigated the association between suicide and sociodemographics, positive and negative symptoms, and depressive symptoms. This study evaluated psychache and alexithymia in patients with schizophrenia, which have both been associated with suicide attempts and thoughts in patients with other psychiatric disorders. Positive and Negative Syndrome Scale (PANSS), Psychache Scale (PAS), Beck Scale for Suicidal Ideation (BSSI), Calgary Depression Scale for Schizophrenia (CDSS), and Toronto Alexithymia Scale (TAS) scores were obtained in 113 patients with schizophrenia, including 50 with suicide attempts. PANSS positive symptoms and general psychopathology subscale, CDSS, BSSI, TAS, and PAS scores were significantly higher in patients with suicide attempts. In multivariate logistic regression analysis, only the PAS score was an independent predictor of attempted suicide. Mediation analysis demonstrated that psychache (both directly and indirectly) and alexithymia (indirectly) might be associated with the risk of suicide in these patients.
Increased Word Spacing Improves Performance for Reading Scrolling Text with Central Vision Loss
Authors: Harvey Hannah , Anderson Stephen J. , Walker Robin 
Published: July 2019

SIGNIFICANCE
Scrolling text can be an effective reading aid for those with central vision loss. Our results suggest that increased interword spacing with scrolling text may further improve the reading experience of this population. This conclusion may be of particular interest to low-vision aid developers and visual rehabilitation practitioners.

PURPOSE
The dynamic, horizontally scrolling text format has been shown to improve reading performance in individuals with central visual loss. Here, we sought to determine whether reading performance with scrolling text can be further improved by modulating interword spacing to reduce the effects of visual crowding, a factor known to impact negatively on reading with peripheral vision.

METHODS
The effects of interword spacing on reading performance (accuracy, memory recall, and speed) were assessed for eccentrically viewed single sentences of scrolling text. Separate experiments were used to determine whether performance measures were affected by any confound between interword spacing and text presentation rate in words per minute. Normally sighted participants were included, with a central vision loss implemented using a gaze-contingent scotoma of 8° diameter. In both experiments, participants read sentences that were presented with an interword spacing of one, two, or three characters.

RESULTS
Reading accuracy and memory recall were significantly enhanced with triple-character interword spacing (both measures, P ≤ .01). These basic findings were independent of the text presentation rate (in words per minute).

CONCLUSIONS
We attribute the improvements in reading performance with increased interword spacing to a reduction in the deleterious effects of visual crowding. We conclude that increased interword spacing may enhance reading experience and ability when using horizontally scrolling text with a central vision loss.
Case Report: A Rare Variant of Macular Serpiginous Choroiditis
Authors: Arvanitogiannis Angeliki 
Published: July 2019

SIGNIFICANCE
Serpiginous choroiditis is a rare yet visually debilitating condition. To date, there is no established consensus on treatment protocol. This article presents a case report of macular serpiginous choroiditis and reviews supporting data for immunosuppressive treatment plans.

PURPOSE
The purpose of this study was to examine a case of atypical serpiginous choroiditis with emphasis on diagnostic testing and treatment options.

CASE REPORT
A 62-year-old man presented with new, bilateral, yellow chorioretinal placoid lesions within the posterior pole. Optical coherence tomography revealed focal hyperreflective retinal pigment epithelium lesions with disruption of outer retinal layers. Fundus fluorescein angiography demonstrated stable hyperfluorescent lesions with the absence of fluid leakage. Further testing ruled out possible systemic correlation.

CONCLUSIONS
Macular serpiginous choroiditis is infrequently encountered; however, various differentials must be considered before making the diagnosis. Optical coherence tomography and fundus fluorescein angiography serve as useful tools in aiding the diagnosis. Treatment of serpiginous choroiditis must be initiated with caution given the high risk of adverse effects.
Improved Disease-free Survival After Prehabilitation for Colorectal Cancer Surgery
Authors: Trépanier Maude , Minnella Enrico M. , Paradis Tiffany , Awasthi Rashami , Kaneva Pepa , Schwartzman Kevin , Carli Franco , Fried Gerald M. , Feldman Liane S. , Lee Lawrence 
Published: July 2019

Objective:
The objective of this study was to investigate the effect of prehabilitation on survival after colorectal cancer surgery.

Summary of Background Data:
Preoperative multimodal exercise and nutritional programs (prehabilitation) improve functional capacity and recovery following colorectal surgery. Exercise may also affect cancer outcomes by mediating the systemic inflammatory response. The effect of prehabilitation on cancer outcomes is unknown.

Methods:
Pooled data from 3 prehabilitation trials (2 randomized controlled trials, 1 cohort) in patients undergoing elective, biopsy-proven, primary non-metastatic colorectal cancer surgery from 2009 to 2014 within an enhanced recovery program were analyzed. Patients were grouped into +prehab or–prehab. The primary outcomes were 5-year disease-free (DFS) and overall survival (OS). DFS and OS were analyzed using Kaplan-Meier curves and multiple Cox regression.

Results:
A total of 202 patients were included (+prehab 104, –prehab 98). Median prehabilitation duration was 29 days (interquartile range 20–40). Patient and tumor characteristics were well-balanced (33% stage III). Postoperative complications and time to adjuvant chemotherapy were similar. Mean duration of follow-up was 60.3 months (standard deviation 26.2). DFS was similar for the combined group of stage I–III patients (P = 0.244). For stage III patients, prehabilitation was associated with improved DFS (73.4% vs 50.9%, P = 0.044). There were no differences in OS (P = 0.226). Prehabilitation independently predicted improved DFS (hazard ratio 0.45; 95% confidence interval, 0.21–0.93), adjusting for stage and other confounders. Prehabilitation did not independently predict OS.

Conclusion:
In this report, prehabilitation is associated with improved 5-year DFS in stage III colorectal cancer. This finding should be confirmed in future trials.