bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reported Primary and Secondary Syphilis Cases in the United States: Implications for HIV Infection
Authors: Kidd Sarah , Torrone Elizabeth , Su John , Weinstock Hillard 
Published: February 2018

Background
Recent increases in syphilis among men who have sex with men (MSM) are especially concerning, given the biologic and epidemiologic associations between syphilis and HIV infection. We sought to better describe the current epidemiology of primary and secondary (P&S) syphilis and the prevalence of HIV infection among reported P&S syphilis cases by demographic group, including sex of sex partner, in the United States in 2016.

Methods
We reviewed national P&S syphilis case report data from 2016, including available risk factor information such as sex of sex partner and HIV status. Data were extracted from the National Electronic Telecommunications System for Surveillance, the system through which Centers for Disease Control and Prevention receives notifiable sexually transmitted disease data from all 50 states and the District of Columbia. The proportion of cases with HIV coinfection was calculated using cases with known HIV status as the denominator.

Results
Of 27,814 P&S syphilis cases reported in 2016, 58.1% were among MSM, 13.9% were among men who have sex with women only, 11.0% were among women, and 16.9% were among men without data on sex of sex partners. Similar patterns were observed across geographic regions, race/ethnicity groups, and most age groups. Overall, 38.5% of reported P&S syphilis cases with known HIV status were coinfected with HIV. The prevalence of HIV coinfection was highest among MSM (47.0%) compared with men who have sex with women only (10.7%) or women (4.1%). Among MSM with P&S syphilis, the prevalence of HIV coinfection was highest among black MSM, ranging from 33.8% among black MSM aged 15 to 19 years to 77.8% among black MSM aged 45 to 49 years.

Conclusions
These data underscore the epidemiologic linkages between syphilis and HIV, particularly among MSM. Primary and secondary syphilis may represent an opportunity to prevent HIV infection among persons who are HIV negative and identify and link to care persons living with HIV infection but not currently engaged in care.
Impact of Cognitive Demand during Sustained Near Tasks in Children and Adults
Authors: Roberts Tawna L. , Manny Ruth E. , Benoit Julia S. , Anderson Heather A. 
Published: February 2018

SIGNIFICANCE
These results demonstrate that accommodation in children is more accurate and less variable when performing a sustained near task with increased cognitive demand. In addition, children with increased uncorrected hyperopia have less stable accommodative responses, which may have visual implications during sustained near tasks.

PURPOSE
This study investigated accommodative accuracy (lag) and variability during sustained viewing for passive and active tasks in children and adults with emmetropia and uncorrected hyperopia.

METHODS
Lag and variability (root mean square [RMS] and low-frequency component) were measured in 54 children aged 3 to younger than 10 years with mean spherical equivalent of +1.31 ± 1.05 diopters (D) (range, −0.37 to +4.58 D) and 8 adults aged 22 to 32 years with mean spherical equivalent +0.65 ± 0.62 D (range, −0.13 to +1.15 D). Subjects viewed 20/50 stimuli at 33 cm during both a 10-minute passive and active task. Group 1 (<6 years or nonreaders) viewed shapes; group 2 (≥6 years and reading) and adults read passages.

RESULTS
Groups 1 and 2 had larger lags, RMS, and low-frequency component for passive versus active tasks (P < .001). Lag and RMS did not differ between tasks in adults (P > .05), but low-frequency component was larger during passive viewing (P = .04). Group 1 had significantly higher RMS and low-frequency component than group 2 and the adults in the passive condition had greater low-frequency component in the active condition. In children, hyperopia was independently associated with RMS and low-frequency component under passive (RMS 95% confidence interval [CI], 0.04 to 0.15; low-frequency component 95% CI, 0.00011 to 0.00065) and active (RMS 95% CI, 0.001 to 0.06; 95% CI, 0.000014 to 0.00023) viewing.

CONCLUSIONS
Accommodation is more accurate and less variable when children are engaged in the task. Children also have more variable accommodation than adults. In addition, children with greater hyperopia have more variable accommodation during sustained near tasks.
Educational Effectiveness of an Easily Made New Simulator Model for Ultrasound-Guided Vascular Access and Foreign Body Management Procedures on Pediatric Patients
Authors: Chang Ikwan , Kwak Young Ho , Kim Do Kyun , Lee Jin Hee , Jung Jae Yun , Kwon Hyuksool , Jung Jin Hee , Lee Bongjin , Paek So Hyun 
Published: February 2018

ObjectivesThis study aimed to introduce an easily made chicken breast simulator for ultrasound (US)-guided vascular access, foreign body (FB) detection, and hydrodissection in pediatric patients and to validate the effectiveness for training using this phantom tissue model.MethodsThe authors made the tissue phantom simulator using a chicken breast and rubber tourniquet for vascular access and fragments of a tongue blade and steel clip for FB detection and hydrodissection using a very simple method. We provided training on US-guided vascular access (following the tip [FTT] method), FB detection, and hydrodissection using this model for novice physicians to learn US-guided procedures for pediatric patients. In addition, we provided a questionnaire to solicit their thoughts on their knowledge and confidence to perform these procedures before and after training and to learn their thoughts on the similarity to actual patients and usefulness of this model on a 10-point Likert scale.ResultsA total of 16 emergency residents participated in this study. We obtained US images during vascular access (FTT) and FB detection/ hydrodissection procedures using this phantom tissue model. Residents' knowledge of and confidence to perform US-guided FTT method and FB detection/hydrodissection procedures after training increased to a statistically significant degree (P< 0.001 in all items). The median Likert scores regarding the similarity to actual patients and usefulness of this model were 8.5 (interquartile range, 7.5–9) and 10 (interquartile range, 8–10), respectively.ConclusionsThe model for US-guided procedures used in this study can be constructed by simple and easy methods, presents realistic procedural images, and was useful for training novice physicians to conduct US-guided procedures on pediatric patients.
Characterization of Small Renal Tumors With Magnetic Resonance Elastography
Authors: Prezzi Davide , Neji Radhouene , Kelly-Morland Christian , Verma Hema , O'Brien Tim , Challacombe Ben , Fernando Archana , Chandra Ashish , Sinkus Ralph , Goh Vicky 
Published: February 2018

Objectives
The aim of this study was to explore the feasibility of magnetic resonance elastography (MRE) for characterizing indeterminate small renal tumors (SRTs) as part of a multiparametric magnetic resonance (MR) imaging protocol.

Materials and Methods
After institutional review board approval and informed consent were obtained, 21 prospective adults (15 men; median age, 55 years; age range, 25–72 years) with SRT were enrolled. Tumors (2–5 cm Ø) were imaged using 3-directional, gradient echo MRE. Viscoelastic parametric maps (shear wave velocity [c] and attenuation [α]) were analyzed by 2 independent radiologists. Interobserver agreement (Bland-Altman statistics and intraclass correlation coefficients) was assessed. Anatomical T2-weighted, dynamic contrast-enhanced (DCE) and diffusion sequences completed the acquisition protocol. Imaging parameters were compared between groups (Mann-Whitney U test).

Results
Quality of MRE was good in 18 cases (mean nonlinearity <50%), including 1 papillary renal cell carcinoma and 1 metanephric adenoma. A cohort of 5 oncocytomas and 11 clear-cell renal cell carcinomas (ccRCCs) was analyzed for statistical differences. The MRE viscoelastic parameters were the strongest imaging discriminators: oncocytomas displayed significantly lower shear velocity c (median, 0.77 m/s; interquartile range [IQR], 0.76–0.79) (P = 0.007) and higher shear attenuation α (median, 0.087 mm−1; IQR, 0.082–0.087) (P = 0.008) than ccRCC (medians, 0.92 m/s and 0.066 mm−1; IQR, 0.84–0.97 and 0.054–0.074, respectively). T2 signal intensity ratio (tumor/renal cortex) was lower in oncocytomas (P = 0.02). The DCE and diffusion MR parameters overlapped substantially (P ≥ 0.1). Oncocytomas displayed a consistent MRE viscoelastic profile, corresponding to data point clustering in a bidimensional scatter plot. Values for MRE intraclass correlation coefficient were 0.982 for c and 0.984 for α, indicating excellent interobserver agreement.

Conclusions
Magnetic resonance elastography is feasible for SRT characterization; MRE viscoelastic parameters were stronger discriminators between oncocytoma and ccRCC than anatomical, DCE and diffusion MR imaging parameters.
The opioid epidemic in acute care surgery—Characteristics of overprescribing following laparoscopic cholecystectomy
Authors: Hanson Kristine T. , Thiels Cornelius A. , Polites Stephanie F. , Gazelka Halena M. , Ray-Zack Mohamed D. , Zielinski Martin D. , Habermann Elizabeth B. 
Published: February 2018

BACKGROUND
Postoperative prescribing following acute care surgery must be optimized to limit excess opioids in circulation as misuse and diversion are frequently preceded by a prescription for acute pain. This study aimed to identify patient characteristics associated with higher opioid prescribing following laparoscopic cholecystectomy (LC).

METHODS
Among patients aged 18 years or older who underwent LC at a single institution in 2014 to 2016, opioids prescribed at discharge were converted to oral morphine equivalents (OME) and compared with developing state guidelines (maximum, 200 OME). Preoperative opioid use was defined as any opioid prescription 1 month to 3 months before LC or a prescription unrelated to gallbladder disease less than 1 month before LC. Univariate and multivariable methods determined characteristics associated with top quartile opioid prescriptions among opioid-naive patients.

RESULTS
Of 1,606 LC patients, 34% had emergent procedures, and 14% were preoperative opioid users. Nonemergent LC patients were more likely to use opioids preoperatively (16% vs. 11%, p = 0.006), but median OME did not differ by preoperative opioid use (225 vs. 219, p = 0.40). Among 1,376 opioid-naive patients, 96% received opioids at discharge. Median OME was 225 (interquartile range, 150–300), and 52% were prescribed greater than 200 OME. Top quartile prescriptions (≥300 OME) were associated with gallstone pancreatitis diagnosis, younger age, higher pain scores, and longer length of stay (all p < 0.05). While median OME did not differ by emergent status (median, 225; interquartile range, 150–300 for both, p = 0.15), emergent had more top quartile prescriptions (32% vs. 25%, p = 0.005). After adjusting for diagnosis, age, and sex, emergent status showed evidence of being associated with top quartile prescription (odds ratio, 1.3; 95% confidence interval, 1.0–1.8). Thirty-day refill rate was 5%.

CONCLUSION
Over half of opioid-naive patients undergoing LC were prescribed opioids exceeding draft state guidelines. Variation in prescribing patterns was not fully explained by patient factors. Acute care surgeons have an opportunity to optimize prescribing practices with the ultimate goal of reducing opioid misuse.

LEVEL OF EVIDENCE
Therapeutic study, level IV; Epidemiologic study, level III.
Vascular surgery during U.S. combat operations from 2002 to 2016: Analysis of vascular procedures performed to inform military training
Authors: Turner Caryn A. , Stockinger Zsolt T. , Gurney Jennifer M. 
Published: February 2018

BACKGROUND
Vascular surgery constitutes approximately 6.5% of surgical procedures performed for combat injuries, yet general surgeons are increasingly unfamiliar with vascular surgery. This study examines the frequency and type of vascular surgical procedures performed during recent US Military operations from 2002 to 2016.

METHODS
A retrospective analysis of the Department of Defense Trauma Registry was performed for all Role (R)2 and R3 medical treatment facilities (MTFs), from January 2002 to May 2016. A total of 106 International Classification of Diseases—9th Rev.—Clinical Modification (ICD-9-CM) procedure codes were categorized as vascular and were included in the present analysis. Procedure codes were separated by anatomic location and procedure type. Ligation as part of an amputation was excluded. Grafts were further subdivided by type: synthetic, autologous, and unknown. Procedure grouping and categorization were determined by subject matter experts. Data analysis used Stata Version 14 (College Station, TX).

RESULTS
A total of 25,816 vascular surgical procedures were identified at R2 and R3 MTFs. Role 3 MTFs reported more than four times the number of procedures compared to R2 MTFs. The most common anatomic locations documented were extremity (64.96%) and not otherwise specified (28.1%). The most common procedures overall were amputation (33.36%) and fasciotomy (18.83%). The most common graft type was autologous (68.87%), and the least common was synthetic (5.69%).

CONCLUSION
While amputation, fasciotomy, and ligation were the most common vascular procedures performed for combat trauma, the need for definitive repair including grafting is common at both R2 and R3 MTFs. Vascular surgery therefore remains a necessary skill set for the deployed US Military surgeon; military general surgeons need to train and sustain their vascular skills, including proficiency at amputation and fasciotomy.

LEVEL OF EVIDENCE
Epidemiologic study, level III.
Nonocclusive mesenteric ischemia in patients with methamphetamine use
Authors: Anderson Jamie E. , Brown Ian E. , Olson Kristin A. , Iverson Katherine , Cocanour Christine S. , Galante Joseph M. 
Published: February 2018

BACKGROUND
Data suggest that methamphetamine may increase the risk of nonocclusive mesenteric ischemia (NOMI). We describe patterns of presentation and outcomes of patients with methamphetamine use who present with NOMI to a single institution.

METHODS
This is an observational study of patients from January 2015 to September 2017 with methamphetamine use who presented with NOMI at an academic medical center in Northern California. We summarize patient comorbidities, clinical presentation, operative findings, pathologic findings, hospital course, and survival.

RESULTS
Ten patients with methamphetamine use and severe NOMI were identified. One patient was readmitted with a perforated duodenal ulcer, for a total of 11 encounters. Most presented with acute (n = 3) or acute-on-chronic (n = 4) abdominal pain. Distribution of ischemia ranged from perforated duodenal ulcer (n = 3), ischemia of the distal ileum (n = 1), ischemia of entire small bowel (n = 2), and patchy necrosis of entire small bowel and colon (n = 5). Six patients died, three within 1 week of admission and three between 3 months and 8 months.

CONCLUSION
Methamphetamine use may be associated with significant microvascular compromise, increasing the risk of mesenteric ischemia. Providers in areas with high prevalence of methamphetamine use should have a high index of suspicion for intestinal ischemia in this patient population. Patients with methamphetamine use admitted for trauma or other pathology may be at particular risk of ischemia and septic shock, especially in the setting of dehydration. Use of vasoconstrictors in this patient population may also exacerbate intestinal ischemia.

LEVEL OF EVIDENCE
Therapeutic Case series study, level V.
Emergent management of primary headache: a review of current literature
Authors: Naeem Farnia , Schramm Chris , Friedman Benjamin W. 
Published: February 2018

Purpose of review
The current article reviews recent data on treatment of acute headache patients in the acute care setting.

Recent findings
Intravenous fluid hydration, a common component of emergency department (ED) migraine therapy, does not improve pain outcomes and leads to longer ED lengths of stay. Therefore, intravenous fluids should be administered only to migraine patients with clinical evidence of dehydration. Similarly, intravenous ketamine has garnered interest as a treatment for acute pain but does not provide substantial relief to migraine patients. New studies on the serotonin (5-HT3; 5-hydroxytryptamine-3) antagonist granisetron, intranasal lidocaine, and high-flow oxygen have reported conflicting results for migraine patients. Finally, although experts recommend avoiding opioids in migraine treatment, opioid administration remains prevalent in the ED. A new study has demonstrated that patients who receive intravenous hydromorphone in the ED are much less likely to attain acute headache relief. Standardized headache protocols may decrease opioid use and provide significant pain relief for patients.

Summary
Recent data have clarified the role of opioids and ketamine in the ED (do not use!). The role of treatment protocols and intravenous fluids is still ill-defined. Subpopulations of migraine patients may benefit from high-flow oxygen and intranasal lidocaine.
Medical consequences of pathogenic CNVs in adults: Analysis of the UK Biobank
Authors: Crawford Karen , Bracher-Smith Matthew , Kendall Kimberley M , Rees Elliott , Pardiñas Antonio F , Einon Mark , Escott-Price Valentina , Walters James TR , O’Donovan Michael C , Owen Michael J , Kirov George 
Published: February 2018

AbstractBackgroundGenomic copy number variants (CNVs) increase risk for early-onset neurodevelopmental disorders but their impact on medical outcomes in later life is poorly understood. The UK Biobank, with half a million well-phenotyped adults, presents an opportunity to study the medical consequences of CNV in middle and old age.MethodsWe called 54 CNVs associated with clinical phenotypes or genomic disorders, including their reciprocal deletions or duplications, in all Biobank participants. We used logistic regression analysis to test CNVs for associations with 58 common medical phenotypes.FindingsCNV carriers had an increased risk of developing 37 of the 58 phenotypes at nominal levels of statistical significance, with 19 associations surviving Bonferroni correction (p<8·6×10−4). Tests of each of the 54 CNVs for association with each of the 58 phenotypes identified 18 associations that survived Bonferroni correction (p<1·6×10−5) and a further 57 that were associated at a false discovery rate (FDR) threshold of 0·1. Thirteen CNVs had three or more significant associations at FDR=0·1, with the largest number of phenotypes (N=15) found for deletions at 16p11·2. The most common CNVs (frequency 0·5-0·7%) have no or minimal impact on medical outcomes in adults.InterpretationSome of the 54 tested CNVs have profound effects on physical health, even in people who have largely escaped early neurodevelopmental outcomes. Our work provides clinicians with a morbidity map of potential outcomes among carriers of these CNVs.FundingMRC UK, Wellcome Trust UK
Building a local community of practice in scientific programming for Life Scientists
Authors: Stevens Sarah L. R. , Kuzak Mateusz , Martinez Carlos , Moser Aurelia , Bleeker Petra , Galland Marc 
Published: February 2018

AbstractIn this paper, we describe why and how to build a local community of practice in scientific programming for life scientists that use computers and programming in their research. A community of practice is a small group of scientists that meet regularly to help each other and promote good practices in scientific programming. While most life scientists are well-trained in the laboratory to conduct experiments, good practices with (big) datasets and their analysis are often missing. We propose a model on how to build such a community of practice at a local academic institution, present two real-life examples and introduce challenges and implemented solutions. We believe that the current data deluge that life scientists face can benefit from the implementation of these small communities. Good practices spread among experimental scientists will foster open, transparent and sound scientific results beneficial to society.
CRISPR-based editing reveals edge-specific effects in biological networks
Authors: Li Yi , Nowak Chance M. , Withers Daniel , Pertsemlidis Alexander , Bleris Leonidas 
Published: February 2018

AbstractUnraveling the properties of biological networks is central to understanding normal and disease cellular phenotypes. Networks consist of functional elements (nodes) that form a variety of diverse connections (edges) with each node being a hub for multiple edges. Herein, in contrast to node-centric network perturbation and analysis approaches, we present a high-throughput CRISPR-based methodology for delineating the role of network edges. Ablation of network edges using a library targeting 93 miRNA target sites in 71 genes reveals numerous edges that control, with variable importance, cellular survival under stress. To compare the impact of removing nodes versus edges in a biological network, we dissect a specific p53-microRNA pathway. In summary, we demonstrate that network edges are critical to the function and stability of biological networks. Our results introduce a novel genetic screening opportunity via edge ablation and highlight a new dimension in biological network analysis.
Yellow Fever, Dengue Fever and West Nile Viruses Co-Circulation in Ogbomoso
Authors: Oladipo E.K. , Awoyelu E.H. , Oloke J.K. 
Published: February 2018

AbstractArboviruses are an emerging threat of significant impact on human health and well-being. With increasing proportion of the world living in urban environments, inadvertently, there is the creation of better habitats for vector species. This study is aimed at establishing the occurrence of arboviruses within Ogbomoso, with a view to providing baseline data for further study. Ninety-three plasma samples from consenting individuals in the age range 1-75 years were collected and screened for IgM to dengue fever (DENV), West Nile (WNV) and yellow fever (YFV) viruses using third generation Enzyme Linked Immuno-Sorbent Assay (WKEA Med Supplies Corp, China) kits. An overall prevalence of 52.7% (49/93) were recorded from the recruited individuals. IgM antibodies to Dengue, Yellow fever and West Nile viruses were found in 16/49 (17.2%), 16/49 (17.2%) and 17/49 (18.3%), respectively. High prevalence were recorded in the age groups 16-30, 31-45 and 61-75 years. Gender analysis of the positive samples showed higher prevalence among females than males. The result also showed high prevalence in urban settings than rural settings for DENV and WNV, however, for YNF, higher prevalence was found in the rural area. The prevalence of dual and trio arboviral infection showed 17.2% and 11.8% respectively. This study confirms the circulation of Dengue fever, Yellow fever and West Nile viruses in Ogbomoso and therefore suggest the need for public awareness on vector control.