bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypoalbuminemia Predicts Increased Readmission and Emergency Department Visits After Lower Extremity Bypass
Authors: Westfall John C. , Cheng Thomas W. , Farber Alik , Jones Douglas W. , Eslami Mohammad H. , Kalish Jeffrey A. , Rybin Denis , Siracuse Jeffrey J. 
Published: August 2019

Introduction: Preoperative hypoalbuminemia is associated with poor outcomes across many surgical fields. However, the effects on outcomes after lower extremity bypass (LEB), particularly over the 90-day global surgical period, are unclear. Our goal was to analyze the effect of hypoalbuminemia within 90 days after LE bypass. Methods: We performed a single-center retrospective review of all infrainguinal LEBs from 2007 to 2017. Patients were categorized into 3 preoperative albumin groups: severe hypoalbuminemia (SH; albumin ≤2.8g/dL), mild–moderate hypoalbuminemia (MH; albumin >2.8-3.5g/dL), and normal albumin (albumin >3.5g/dL). Patient and procedural details were recorded. Outcomes analyzed included wound infection, myocardial infarction (MI), pulmonary complications, early graft occlusion (≤30 days), mortality, and emergency department (ED) presentation and readmissions within 30 and 90 days. Multivariable analysis was performed. Results: We identified 313 patients undergoing LEB—45 (14.4%) with SH, 133 (42.5%) with MH, and 135 (43.1%) with normal albumin. Overall, the mean age was 65.7 years, and 63.3% were male. The SH group more frequently had tissue loss, diabetes, hypertension, end-stage renal disease, preoperative hematocrit <30%, and patients admitted preoperatively (all P < .05). There were no significant differences in wound complications, MI, pulmonary complications, early graft occlusion, 30-day or 90-day mortality, and 30-day ED presentation. Severe hypoalbuminemia compared to MH and normal albumin, respectively, had significantly higher rates of 30-day readmission (40% vs 30.8% vs 17.8%, P = .005), 90-day ED presentation (55.6% vs 33.8% vs 29.6%, P = .006), and 90-day readmission (66.7% vs 48.9% vs 35.6%, P = .001). Multivariable analysis showed that SH was independently associated with 90-day ED presentation (odds ratio [OR]: 2.8, 95% confidence interval [CI]: 1.23-6.36, P = .014) and 90-day readmission (OR: 2.63, 95% CI: 1.21-5.71, P = .015). Conclusion: Our study suggests that patients with SH undergoing LEB had similar perioperative complication rates compared to normal albumin and MH groups, and SH was independently associated with 90-day ED presentation and readmission. Further studies are needed to assess other factors associated with ED visits and readmission.
Health information technology foresight for Iran: A Delphi study of experts’ views to inform future policymaking
Authors: Hemmat Morteza , Ayatollahi Haleh , Maleki Mohammadreza , Saghafi Fatemeh 
Published: August 2019

Background: Policymakers require a systematic approach when planning for information technology needs in healthcare. Objective: The aim of this study was to obtain experts’ predictions of future health information technology (HIT) needs until 2025 for Iran in relation to the relative importance of key technologies, expected timeframe of realisation, areas that may be impacted upon and obstacles to achieving these goals. Method: This article presents results from the third phase (a Delphi study) of a larger mixed-method study. Policymakers from the Iranian Ministry of Health and faculty members from different medical universities across the country who were expert in the field of HIT were invited to participate ( n = 61). Results: Participants (39) completed the first-round questionnaire and 24 completed the second. The development of personal health records ( n = 32, 82.0%), the development of clinical decision-making systems ( n = 30, 76.9%) and the use of business intelligence for collecting and analysing clinical and financial data ( n = 32, 82.0%) were predicted to occur after 2025. The healthcare areas predicted to experience the greatest impact from most HITs were facilitating patient–provider communication and improving healthcare quality. Key barriers to achieving HITs were related to weaknesses in planning and limited financial resources for most technologies. Conclusion: By identifying the areas of impact and the barriers to achieving the HIT goals, more accurate planning is possible and resources can be allocated according to priorities.
Prevalence and Antibiotic Resistance of Stenotrophomonas maltophilia in Respiratory Tract Samples: A 10-Year Epidemiological Snapshot
Authors: Gajdács Márió , Urbán Edit 
Published: August 2019

Background: Since the 1980s, Stenotrophomonas maltophilia has emerged as an important pathogen associated with significant mortality in pneumonia and bacteremia of severely immunocompromised, hospitalized patients. The drug of choice in S maltophilia infections is sulfamethoxazole-trimethoprim (SMX/TMP); SMX/TMP resistance is a serious concern in clinical practice. The aim of this study was to assess the prevalence of S maltophilia in lower respiratory tract (LRTI) samples at a tertiary-care university hospital. Methods: This retrospective cohort study was carried out using microbiological data collected between January 2008 and December 2017. Routine antimicrobial susceptibility testing was performed for SMX/TMP and levofloxacin; in case of resistance, susceptibility testing for additional antibiotics (tigecycline, amikacin, and colistin) was also performed. Results: A total of 579 individual S maltophilia isolates were identified (2008-2012: n = 160, 2013-2017: n = 419; P = .0008). In all, 78.46% of patients were younger than 5 or older than 50 years of age and had recent trauma, surgery, or underlying conditions (malignancies, respiratory distress syndrome, congenital disorders, and cystic fibrosis). In 28.16% of samples, more than 1 pathogen was identified, and 5.35% of coisolated pathogens were multidrug resistant (MDR). In all, 12.1% of isolates were SMX/TMP-resistant (2008-2012: 6.12%, 2013-2017: 18.06%; P = .034), while 8.99% were resistant to levofloxacin (2008-2012: 7.86%, 2013-2017: 10.12%; P > .05). SMX/TMP resistance was detected more frequently in samples originating from inpatients (n = 2.50 ± 2.39 vs n = 11.50 ± 3.76; P = .0002). Conclusions: In all, 5.87% of isolates were extensively drug resistant (XDR), that is, in addition to SMX/TMP, they were resistant to levofloxacin, amikacin, colistin, and tigecycline. The results of our study correspond to the findings in the literature.
The application of FTIR microspectroscopy in a non-invasive and non-destructive way to the study and conservation of mineralised excavated textiles
Authors: Margariti Christina 
Published: August 2019

Abstract
The potential of Fourier Transform Infrared (FTIR) microspectroscopy, to inform the study and conservation of mineralised excavated textiles is discussed, highlighted by two case studies of 5th c. BCE finds. In both cases the textiles were funerary from pyre burials, used to wrap the remains of the incinerated bones of the deceased, and placed inside copper alloy urns, to be buried. FTIR spectra of the textile fibres were acquired by an FTIR microscope in reflectance mode. In regard to the two case studies, this was a non-invasive and non-destructive method, since it did not involve removal of material for sampling, as both finds were in a fragmentary condition, it did not apply any pressure, nor did it require pressing of the minute fragments used as samples. Past fibre analyses in case study A reported cultivated and wild silk, which had been used as evidence of the presence of silk in Classical Greece, while more recent studies, controversially pointed to either cellulosic or wool fibres. The unlimited application of FTIR microspectroscopy in reflectance mode due to its non-invasive/destructive nature, enhanced fibre identification but most importantly led to further analyses of specific fragments that revealed the find was suffering from active biodeterioration, subsequently treated. Case study B, where the textiles had been preserved folded, was a particularly unique find from its period, since one of the textiles present was bearing evidence of embroidery. Similarly, the extended application of FTIR microspectroscopy indicated good preservation of the organic matter within the fibres, informing thus the conservation decision-making process, which involved partial unfolding of the textiles, an action that revealed an additional decoration pattern, and minute fragments of the embroidery thread preserved.
Artificial Intelligence Treatment Decision Support For Complex Breast Cancer Among Oncologists With Varying Expertise
Authors: Xu Fengrui , Sepúlveda Martín-José , Jiang Zefei , Wang Haibo , Li Jianbin , Yin Yongmei , Liu Zhenzhen , Roebuck M. Christopher , Shortliffe Edward H. , Yan Min , Song Yuhua , Geng Cuizhi , Tang Jinhai , Rhee Kyu 
Published: August 2019

PURPOSE The aim of the current study was to assess treatment concordance and adherence to National Comprehensive Cancer Network breast cancer treatment guidelines between oncologists and an artificial intelligence advisory tool. PATIENTS AND METHODS Study cases of patients (N = 1,977) who were at high risk for recurrence or who had metastatic disease and cell types for which the advisory tool was trained were obtained from the Chinese Society for Clinical Oncology cancer database (2012 to 2017). A cross-sectional observational study was performed to examine treatment concordance and guideline adherence among an artificial intelligence advisory tool and 10 oncologists with varying expertise—three fellows, four attending physicians, and three chief physicians. In a blinded fashion, each oncologist provided treatment advice on an average of 198 cases and the advisory tool on all cases (N = 1,977). Results are reported as rates and logistic regression odds ratios. RESULTS Concordance for the recommended treatment was 0.56 for all physicians and higher for fellows compared with chief and attending physicians (0.68 v 0.54; 0.49; P = .001). Concordance differed by hormone receptor subtype–TNM stage, with the lowest for hormone receptor–positive human epidermal growth factor receptor 2/neu-positive cancers (0.48) and highest for triple-negative breast cancers (0.71) across most TNM stages. Adherence to National Comprehensive Cancer Network guidelines was higher for oncologists compared with the advisory tool (0.96 v 0.82; P < .003) and lower for fellows compared with attending physicians (0.93 v 0.98; 0.96; P = .04). CONCLUSION Study findings reflect a complex breast cancer case mix, the limits of medical knowledge regarding optimum treatment, clinician practice patterns, and use of a tool that reflects expertise from one cancer center. Additional research in different practice settings is needed to understand the tool’s scalability and its impact on treatment decisions and clinical and health services outcomes.
Validation of a Semiautomated Natural Language Processing–Based Procedure for Meta-Analysis of Cancer Susceptibility Gene Penetrance
Authors: Deng Zhengyi , Yin Kanhua , Bao Yujia , Armengol Victor Diego , Wang Cathy , Tiwari Ankur , Barzilay Regina , Parmigiani Giovanni , Braun Danielle , Hughes Kevin S. 
Published: August 2019

PURPOSE Quantifying the risk of cancer associated with pathogenic mutations in germline cancer susceptibility genes—that is, penetrance—enables the personalization of preventive management strategies. Conducting a meta-analysis is the best way to obtain robust risk estimates. We have previously developed a natural language processing (NLP) –based abstract classifier which classifies abstracts as relevant to penetrance, prevalence of mutations, both, or neither. In this work, we evaluate the performance of this NLP-based procedure. MATERIALS AND METHODS We compared the semiautomated NLP-based procedure, which involves automated abstract classification and text mining, followed by human review of identified studies, with the traditional procedure that requires human review of all studies. Ten high-quality gene–cancer penetrance meta-analyses spanning 16 gene–cancer associations were used as the gold standard by which to evaluate the performance of our procedure. For each meta-analysis, we evaluated the number of abstracts that required human review (workload) and the ability to identify the studies that were included by the authors in their quantitative analysis (coverage). RESULTS Compared with the traditional procedure, the semiautomated NLP-based procedure led to a lower workload across all 10 meta-analyses, with an overall 84% reduction (2,774 abstracts v 16,941 abstracts) in the amount of human review required. Overall coverage was 93%—we are able to identify 132 of 142 studies—before reviewing references of identified studies. Reasons for the 10 missed studies included blank and poorly written abstracts. After reviewing references, nine of the previously missed studies were identified and coverage improved to 99% (141 of 142 studies). CONCLUSION We demonstrated that an NLP-based procedure can significantly reduce the review workload without compromising the ability to identify relevant studies. NLP algorithms have promising potential for reducing human efforts in the literature review process.
Tissue/Site-Agnostic Study of Ribociclib for Tumors With Cyclin D–CDK4/6 Pathway Genomic Alterations: A Phase II, Open-Label, Single-Arm Basket Study
Authors: Peguero Julio , Sohal Davendra P. S. , O’Neil Bert H. , Safran Howard , Kelly Karen , Grilley-Olson Juneko E. , Subbiah Vivek , Nadauld Lincoln , Purkayastha Das , Stealey Erica , Ricart Alejandro D. , Kang Barinder P. , Eder Joseph Paul 
Published: August 2019

PURPOSE
As part of the Novartis Signature Program, this study evaluated the efficacy of ribociclib (selective cyclin-dependent kinase 4/6 [CDK4/6] inhibitor) in patients with cyclin D–CDK4/6 pathway–aberrant tumors.

METHODS

This was a phase II, single-arm, signal-seeking study in patients with advanced malignancies that had progressed on or after standard treatment. Prior identification of tumor
CDK4/6
mutation or amplification,
CCND1
/3 amplification, or
CDKN2A
mutation or loss was required. Clinical benefit (defined as the proportion of patients with response or stable disease at ≥ 16 weeks) was the primary end point.

RESULTS
From 61 centers in the United States, 106 patients (median age, 62.5 years) were enrolled across multiple malignancies. The patient population was heavily pretreated (median number of prior therapies, three; range, 0 to 19). Median progression-free survival was 1.8 months (95% CI, 1.8 to 1.9). In patients with solid tumors, the clinical benefit rate was 18.1% (n = 19 of 105) and the overall response rate was 2.9% (n = 3 of 105); three partial responses occurred in patients with adenocarcinoma (unknown primary), soft tissue sarcoma, and urothelial carcinoma. No tumor cohort met the prespecified criteria for success. The most common adverse events suspected to be related to treatment were neutropenia (30.2%; decreased neutrophils, 15.1%), fatigue (31.1%), and nausea (29.2%). Fatigue and nausea were typically mild. Only one incident of febrile neutropenia was experienced (grade 3).

CONCLUSION

No new or unexpected safety signals were observed in this heavily pretreated patient population. Although responses were seen in tumors with
CCND1
–
CDK4/6
amplifications, the primary end point was not met, suggesting additional evaluation of ribociclib, possibly as combination therapy, is needed.
The Romantic Work of Genius: Author, Nature, Nation, and the “Genial Criticism” of Samuel Taylor Coleridge
Authors: Hess Scott 
Published: August 2019

AbstractThis essay explores how genius in the nineteenth century simultaneously constituted both individual and collective national identity, helping to produce new forms of liberal democratic nationalist culture. It offers a Latourian interpretation of genius in terms of the kind of social work and connections that the term enabled. Genius became associated in the late eighteenth and early nineteenth centuries with author, nature, and nation in ways that grounded new models of literature and identity in the supposedly transcendental truth of nature and in specific landscapes as “sites of memory.” This discourse of genius played a keystone role in Samuel Taylor Coleridge’s aesthetic and social criticism, or “genial criticism,” which exerted a deep influence on Anglophone culture. The essay concludes by assessing the overall cultural politics of genius in relation to various categories of identity, especially gender, and by suggesting how the “romantic work of genius” continues to operate and hold power in our (post)modern societies today.
C9ORF72-related cellular pathology in skeletal myocytes derived from ALS-patient induced pluripotent stem cells
Authors: Lynch Eileen , Semrad Theran , Belsito Vincent S. , FitzGibbons Claire , Reilly Megan , Hayakawa Koji , Suzuki Masatoshi 
Published: August 2019

ABSTRACT
Amyotrophic lateral sclerosis (ALS) is a late-onset neuromuscular disease with no cure and limited treatment options. Patients experience a gradual paralysis leading to death from respiratory complications on average only 2-5 years after diagnosis. There is increasing evidence that skeletal muscle is affected early in the disease process, yet the pathological processes occurring in the skeletal muscle of ALS patients are still mostly unknown. Specifically, the most common genetic cause of ALS, a hexanucleotide repeat expansion in the C9ORF72 gene, has yet to be fully characterized in the context of skeletal muscle. In this study, we used the protocol previously developed in our lab to differentiate skeletal myocytes from induced pluripotent stem cells (iPSCs) of C9ORF72 ALS (C9-ALS) patients in order to create an in vitro disease model of C9-ALS skeletal muscle pathology. Of the three C9ORF72 mutation hallmarks, we did not see any evidence of haploinsufficiency, but we did detect RNA foci and dipeptide repeat (DPR) proteins. Additional abnormalities included changes in the expression of mitochondrial genes and a susceptibility to oxidative stress, indicating that mitochondrial dysfunction may be a critical feature of C9-ALS skeletal muscle pathology. Finally, the C9-ALS myocytes had increased expression and aggregation of TDP-43. Together, these data show that skeletal muscle cells experience pathological changes due to the C9ORF72 mutation. Our in vitro model could facilitate further study of cellular and molecular pathology in ALS skeletal muscle in order to discover new therapeutic targets against this devastating disease.
This article has an associated First Person interview with the first author of the paper.
Acute and sub-acute toxicity study of the root extracts of Fagaropsis hildebrandtii in mice and evaluation of their antimicrobial effects
Authors: Muia Beatrice Mwende , Mbaria James Mucunu , Kanja Laetitia Wakonyu , Gitahi Nduhiu , Okumu Paul Onyango , Okumu Mitchel Otieno 
Published: August 2019

Background:Among the Kamba community of Kenya, roots ofFagaropsis hildebrandtii(FH) are boiled and used in managing cough, fertility problems, and microbial infections. The safety of this plant in oral administration and the validity of the ethnomedical claims is unverified. This study evaluated the toxicity of the aqueous and hexane root extracts of FH in mice and antimicrobial effects againstStaphylococcus aureus,Salmonella typhimuriumandCandida albicans.Methods: Doses (300 and 2000mg/kg) of the extracts were administered orally to mice for 14 days. The weight, feed, and water consumption, organ weight of mice and gross macroscopy of the liver were used in evaluating acute toxicity. Mice were additionally treated with 250, 500, and 1000mg/kg body weight doses of the extracts for 28 days and haematological, biochemical, and histological parameters noted. The minimum inhibitory and minimum bactericidal/fungicidal concentrations (MIC; MBC/MFC) of the extracts against the aforementioned pathogens were determined by broth dilution.Results:Acute oral toxicity of the extracts was >2000mg/kg, there were dose dependent changes in haematological and biochemical parameters, all female mice died when treated with doses of 1000mg/kg and doses ≥500mg/kg caused tubular degeneration and haemorrhage of the kidney, cloudy swelling of hepatocytes, and multifocal necrosis and pyknosis in the liver. The MBC/MIC ratio of each of the extracts againstStaph. aureusandS. typhimuriumwas 2, whileC. albicanswas not sensitive to any of the extracts.Conclusions:Long term use of root extracts of FH was associated with dose-dependent changes in the kidney and liver of mice and changes in biochemical and haematological parameters. Root extracts of FH are bactericidal againstStaph. aureusandS. typhimuriumbut have no effect onC. albicans. Future work should aim at identifying the metabolites responsible for the observed toxic and bactericidal effects of the roots of FH.
Testing the role of SOX15 in human primordial germ cell fate
Authors: Pierson Smela Merrick , Sybirna Anastasiya , Wong Frederick C.K. , Surani M. Azim 
Published: August 2019

Background: Potentially novel regulators of early human germline development have been identified recently, including SOX15 and SOX17, both of which show specific expression in human primordial germ cells. SOX17 is now known to be a critical specifier of human germ cell identity. There have been suggestions, as yet without evidence, that SOX15 might also play a prominent role. The early human germline is inaccessible for direct study, but an in vitro model of human primordial germ cell-like cell (hPGCLC) specification from human embryonic stem cells (hESCs) has been developed. This enables mechanistic study of human germ cell specification using genetic tools to manipulate the levels of SOX15 and SOX17 proteins to explore their roles in hPGCLC specification. Methods: SOX15 and SOX17 proteins were depleted during hPGCLC specification from hESCs using the auxin-inducible degron system, combined with a fluorescent reporter for tracking protein levels. Additionally, SOX15 protein was overexpressed using the ProteoTuner system. Protein-level expression changes were confirmed by immunofluorescence. The impact on hPGCLC specification efficiency was determined by flow cytometry at various time points. qPCR experiments were performed to determine some transcriptional effects of SOX15 perturbations. Results: We observed specific SOX15 expression in hPGCLCs by using immunofluorescence and flow cytometry analysis. Depletion of SOX15 had no significant effect on hPGCLC specification efficiency on day 4 after induction, but there was a significant and progressive decrease in hPGCLCs on days 6 and 8. By contrast, depletion of SOX17 completely abrogated hPGCLC specification. Furthermore, SOX15 overexpression resulted in a significant increase in hPGCLC fraction on day 8. qPCR analysis revealed a possible role for the germ cell and pluripotency regulator PRDM14 in compensating for changes to SOX15 protein levels. Conclusions: SOX17 is essential for hPGCLC specification, yet SOX15 is dispensable. However, SOX15 may have a role in maintaining germ cell identity.