bluuebunny/crossref_metadata_2025_split huggingface dataset:
A New Flea Species of the Genus Palaeopsylla (Insecta: Siphonaptera: Ctenophthalmidae) From Turkey
Authors: Keskin Adem 
Published: September 2019

AbstractA new flea (Insecta: Siphonaptera) species belonging to the Palaeopsylla minor-group, Palaeopsylla (Palaeopsylla) beaucournui n. sp. is described and illustrated. Specimens (14 males and seven females) of this new species were collected from Talpa levantis Thomas (Mammalia: Talpidae) in the deciduous mixed forest in Bursa province of Marmara Region, Turkey.
Interplay between turgor pressure and plasmodesmata during plant development
Authors: Hernández-Hernández Valeria , Benítez Mariana , Boudaoud Arezki 
Published: September 2019

AbstractPlasmodesmata traverse cell walls, generating connections between neighboring cells. They allow intercellular movement of molecules such as transcription factors, hormones, and sugars, and thus create a symplasmic continuity within a tissue. One important factor that determines plasmodesmal permeability is their aperture, which is regulated during developmental and physiological processes. Regulation of aperture has been shown to affect developmental events such as vascular differentiation in the root, initiation of lateral roots, or transition to flowering. Extensive research has unraveled molecular factors involved in the regulation of plasmodesmal permeability. Nevertheless, many plant developmental processes appear to involve feedbacks mediated by mechanical forces, raising the question of whether mechanical forces and plasmodesmal permeability affect each other. Here, we review experimental data on how one of these forces, turgor pressure, and plasmodesmal permeability may mutually influence each other during plant development, and we discuss the questions raised by these data. Addressing such questions will improve our knowledge of how cellular patterns emerge during development, shedding light on the evolution of complex multicellular plants.
Thera-SAbDab: the Therapeutic Structural Antibody Database
Authors: Raybould Matthew I J , Marks Claire , Lewis Alan P , Shi Jiye , Bujotzek Alexander , Taddese Bruck , Deane Charlotte M 
Published: September 2019

AbstractThe Therapeutic Structural Antibody Database (Thera-SAbDab; http://opig.stats.ox.ac.uk/webapps/therasabdab) tracks all antibody- and nanobody-related therapeutics recognized by the World Health Organisation (WHO), and identifies any corresponding structures in the Structural Antibody Database (SAbDab) with near-exact or exact variable domain sequence matches. Thera-SAbDab is synchronized with SAbDab to update weekly, reflecting new Protein Data Bank entries and the availability of new sequence data published by the WHO. Each therapeutic summary page lists structural coverage (with links to the appropriate SAbDab entries), alignments showing where any near-matches deviate in sequence, and accompanying metadata, such as intended target and investigated conditions. Thera-SAbDab can be queried by therapeutic name, by a combination of metadata, or by variable domain sequence - returning all therapeutics that are within a specified sequence identity over a specified region of the query. The sequences of all therapeutics listed in Thera-SAbDab (461 unique molecules, as of 5 August 2019) are downloadable as a single file with accompanying metadata.
Geriatric assessment of glioblastoma patients is feasible and may provide useful prognostic information
Authors: Lorimer Cressida F , Walsh Gill , MacKinnon Mairi , Corbett Alison , Bedborough Katie , Greenwood Kathy , Saran Frank , Chalmers Anthony J , Brock Juliet 
Published: September 2019

Abstract

Background
Glioblastoma (GBM) is the most common and most lethal primary brain tumor in adults. Clinical trials in older patients with GBM have explored the use of single and multimodality treatment regimens with modest survival benefits; however, trial criteria are commonly based on chronological age and do not reflect the heterogeneity of this cohort. Geriatric assessment (GA) techniques predict survival and treatment tolerance in other tumor sites and thus may objectively guide the decision-making process, but data are lacking in the neuro-oncology cohort.

Methods
We performed a prospective, multicenter feasibility study involving patients age 65 years or older with newly diagnosed GBM. A modified GA was undertaken in the outpatient setting prior to starting treatment. Feasibility was determined primarily by recruitment rate, alongside data completeness, impact on clinic time, and acceptability to patients and staff. Factors associated with survival were explored using Cox regression models.

Results
Fifty patients were recruited within a prespecified time period with a recruitment rate of 82% (target 80%). Data completeness was greater than 80% in all except one assessment. Median overall survival was 9.5 months (95% confidence interval [CI] 5.0-14.0 months). Among the GA screening factors analyzed, a baseline impaired Montreal Cognitive Assessment (hazard ratio [HR] = 2.7, 95% CI 1.128-6.530) and impairment in instrumental activities of daily living (HR = 2.9 95% CI 0.983-8.541) were associated with poorer survival.

Conclusion
In the first study of this kind among elderly GBM patients, we have shown that undertaking a neurologically focused GA screen is feasible and may provide useful prognostic information.
An attempt to identify reproducible high-density EEG markers of PTSD during sleep
Authors: Wang Chao , Ramakrishnan Sridhar , Laxminarayan Srinivas , Dovzhenok Andrey , Cashmere J David , Germain Anne , Reifman Jaques 
Published: September 2019

AbstractStudy ObjectivesWe examined electroencephalogram (EEG) spectral power to study abnormalities in regional brain activity in post-traumatic stress disorder (PTSD) during sleep. We aimed to identify sleep EEG markers of PTSD that were reproducible across nights and subsamples of our study population.MethodsSeventy-eight combat-exposed veteran men with (n = 31) and without (n = 47) PTSD completed two consecutive nights of high-density EEG recordings in a laboratory. We performed spectral-topographical EEG analyses on data from both nights. To assess reproducibility, we used the first 47 consecutive participants (18 with PTSD) for initial discovery and the remaining 31 participants (13 with PTSD) for replication.ResultsIn the discovery analysis, compared with non-PTSD participants, PTSD participants exhibited (1) reduced delta power (1–4 Hz) in the centro-parietal regions during nonrapid eye movement (NREM) sleep and (2) elevated high-frequency power, most prominent in the gamma band (30–40 Hz), in the antero-frontal regions during both NREM and rapid eye movement (REM) sleep. These findings were consistent across the two study nights, with reproducible trends in the replication analysis. We found no significant group differences in theta power (4–8 Hz) during REM sleep and sigma power (12–15 Hz) during N2 sleep.ConclusionsThe reduced centro-parietal NREM delta power, indicating reduced sleep depth, and the elevated antero-frontal NREM and REM gamma powers, indicating heightened central arousal, are potential objective sleep markers of PTSD. If independently validated, these putative EEG markers may offer new targets for the development of sleep-specific PTSD diagnostics and interventions.
Understanding Debriefing: A Qualitative Study of Event Reconstruction at an Academic Medical Center
Authors: Sweeney Rachel E. , Clapp Justin T. , Arriaga Alexander F. , Muralidharan Madhavi , Burson Randall C. , Gordon Emily K.B. , Falk Scott A. , Baranov Dimitry Y. , Fleisher Lee A. 
Published: September 2019

Purpose
This qualitative study sought to characterize the role of debriefing after real critical events among anesthesia residents at the Hospital of the University of Pennsylvania.

Method
From October 2016 to June 2017 and February to April 2018, the authors conducted 25 semistructured interviews with 24 anesthesia residents after they were involved in 25 unique critical events. Interviews focused on the experience of the event and the interactions that occurred thereafter. A codebook was generated through annotation, then used by 3 researchers in an iterative process to code interview transcripts. An explanatory model was developed using an abductive approach.

Results
In the aftermath of events, residents underwent a multistage process by which the nature of critical events and the role of residents in them were continuously reconstructed. Debriefing—if it occurred—was 1 stage in this process, which also included stages of internal dialogue, event documentation, and lessons learned. Negotiated in each stage were residents’ culpability, reputation, and the appropriateness of their affective response to events.

Conclusions
Debriefing is one of several stages of interaction that occur after a critical event; all stages play a role in shaping how the event is interpreted and remembered. Because of its dynamic role in constituting the nature of events and residents’ role in them, debriefing can be a high-stakes interaction for residents, which can contribute to their reluctance to engage in it. The function and quality of debriefing can be assessed in more insightful fashion by understanding its relation to the other stages of event reconstruction.
Mortality and Cause of Death in Patients With Vertebral Fractures
Authors: Choi Hyo Geun , Lee Joon Kyu , Sim Songyong , Kim Miyoung 
Published: September 2019

Study Design.
A retrospective study using the Korean Health Insurance Review and Assessment Service—National Sample Cohort was performed.

Objective.
To determine the rate and causes of mortality in vertebral fracture patients.

Summary of Background Data.
Vertebral fractures are associated with increased mortality in prior studies.

Methods.
Of 1,125,691 patients, we collected data of 23,026 patients of all ages who experienced thoracic or lumber vertebral fractures between 2002 and 2013. The vertebral fracture participants were matched 1:4 with control participants, accounting for age, group, sex, income, and region of residence. Finally, 21,759 vertebral fracture participants and 87,036 control participants were analyzed. The index date was the date of diagnosis of vertebral fracture; participants from the control group were followed from the same index date as their matched counterparts. The follow-up duration was the index date to the death date or the last date of study (December 31, 2013). Patients were followed until death or censoring of the data. Death was ascertained in the same period, and causes of death were grouped into 12 classifications according to the Korean Standard Classification of Disease. A stratified Cox proportional hazards model was used.

Results.
The adjusted hazard ratio (HR) for mortality of vertebral fracture was 1.28 (P < 0.001) with the higher adjusted HR in younger patients. Mortalities caused by neoplasms; neurologic, circulatory, respiratory, digestive, and muscular diseases; and trauma were higher in the vertebral fracture group (P < 0.05), with muscular disease showing the highest odds ratio for mortality.

Conclusion.
Vertebral fractures were associated with increased mortality in Korean. Disease in muscuoskeletal system and connective tissue that possibly be associated with the fractures was most responsible for elevated death rates following vertebral fracture. Our findings may help caregivers provide more effective care, ultimately decreasing the mortality rate of vertebral fracture patients.

Level of Evidence: 3
Outcomes in Critically Ill Patients With Traumatic Brain Injury: Ethnicity, Documentation, and Insurance Status
Authors: Ram Payal , Miah Fardina T. , Wyrick Jonathan M. , Kalosza Brittany A. , Coritsidis George N. 
Published: September 2019

Objectives:
Disparities in traumatic brain injury outcomes for ethnic minorities and the uninsured have previously been demonstrated; however, outcomes in undocumented immigrants have not been examined. We wanted to determine whether ethnicity, insurance, and documentation status served as risk factors for disparities in traumatic brain injury outcomes between undocumented immigrants and documented residents.

Design:
Retrospective study.

Setting:
Patients diagnosed with traumatic brain injury admitted to the surgical/trauma ICU at a level 1 trauma center serving a large immigrant population in New York City from 2009 to 2016.

Patients:
Four-hundred seventy-one traumatic brain injury patients requiring surgical/trauma ICU admission.

Interventions:
None.

Measurements and Main Results:
Undocumented immigrants constituted 29% of the population, were younger (39 vs 57 yr old, respectively; p < 0.0001), Hispanic (83%; p < 0.0001), and uninsured (87%; p < 0.0001). Falls resulted in the majority of traumatic brain injuries in the total population, however, undocumented immigrants were almost twice as likely to be assaulted (p = 0.0032). There was no difference in presence of midline shifts, Injury Severity Score, Glasgow Coma Score, hypotension, hypoxia, and pupillary reactions between undocumented immigrants and documented residents. Undocumented immigrants presented with significantly more effaced basilar cisterns (p = 0.0008). There was no difference in hospital care between undocumented immigrants and documented residents as determined by emergency department to surgical/trauma ICU transfer times (p = 0.967). Undocumented immigrants were more likely to be discharged home (53% vs 33%, respectively; p = 0.0009) and less likely to be sent to rehabilitation (25% vs 32%, respectively; p = 0.0009). After adjusting length of stay and mortality for covariates, undocumented immigrants had shorter length of stay (p < 0.05) and there was no difference in hospital mortality between undocumented immigrants and documented residents.

Conclusions:
Undocumented immigrants with traumatic brain injuries were more likely to be younger, have shorter length of stay, and experience similar mortality rates to documented residents. Social economic status may play a role in events prior to hospitalization and likely does in disposition outcomes.
Role of Potassium-Sparing Diuretics in the Management of Hypokalemia in Peritoneal Dialysis
Authors: Nguyen Timothy , Ren Steven , Hussain Jaweria , Balaoro Jessica J. 
Published: September 2019

Background:
Patients with kidney disease are at a higher risk of experiencing potassium imbalance. The kidney plays an important role in maintaining potassium homeostasis. A common dyskalemia that peritoneal dialysis (PD) patients experience is hypokalemia.

Areas of Uncertainty:
Potassium-sparing diuretics such as spironolactone causes increased amounts of sodium and water to be excreted, while potassium is retained. Owing to its potassium-sparing effects, it may correct hypokalemia that PD patients experience. The proper usage of potassium-sparing diuretics in PD patients and data on the efficacy and safety are being explored.

Data Sources:
Four relevant trials were identified. One randomized double-blind placebo-controlled cross-over study (n = 20), one interventional study without the control group (n = 20), one retrospective single-center chart review (n = 53), and one cross-sectional review (n = 75) trial. The randomized controlled trial did not note a statistically significant change in K levels (P > 0.05); the other 3 trials observed an increase in potassium levels in the potassium-sparing diuretics groups, but trials contained small participants and inadequate statistic rigor.

Therapeutic Opinions:
The role of potassium-sparing diuretics use for hypokalemia management in PD patients remains unclear.
Risk stratification for multidrug-resistant Gram-negative infections in ICU patients
Authors: Burillo Almudena , Muñoz Patricia , Bouza Emilio 
Published: September 2019

Purpose of review
Antimicrobial resistance among Gram-negative microorganisms has alarmingly increased in the past 10 years worldwide. Infections caused by these microorganisms are difficult to treat, especially in critically ill patients.
The present review examines how to accurately predict which patients carry a greater risk of colonization or infection on which to base the timely choice of an effective empirical antibiotic treatment regimen and avoid antibiotic overuse.

Recent findings
There are many risk factors for acquiring one of many multidrug-resistant Gram-negative microorganisms (MDR-GN); however, scores anticipating colonization, infection among those colonized, or mortality among those infected have a variable accuracy. Accuracy of scores anticipating colonization is low. Scores predicting infections among colonized patients are, in general, better, and ICU patients infected with MDR-GN have a worse prognosis than those infected by non-resistant microorganisms. Scores are, in general, better at excluding patients.

Summary
Despite these limitations, scores continue to gain popularity including those by Giannella, Tumbarello, Johnson, or the scores INCREMENT carbapenem-producing Enterobacteriaceae score, Cano, Tartof, or CarbaSCORE.
Neisseria meningitidis and meningococcal disease: recent discoveries and innovations
Authors: Read Robert C. 
Published: September 2019

Purpose of review
Meningococcal disease is a severe consequence of infection with Neisseria meningitidis, a pathobiont of the pharynx. This organism is panmitic so virulent clones transformed with new genetic material can emerge and cause severe outbreaks. The key to sustainable prevention is to restrict carriage of disease-causing strains and thus reduce the chances of transmission between human hosts.

Recent findings
Meningococcal population biology has changed recently with emergence of virulent strains linked to a number of sublineages of clonal complex 11. These strains have variously expressed the capsular material of serogroups C and W and caused severe disease in various countries. Glycoconjugate vaccines including quadrivalent (ACWY) and now pentavalent (ACWYX) vaccines are highly immunogenic and prevent disease and carriage due to their respective serogroups. For NmB, new vaccines (4CMenB and MenB-FHbp) containing conserved outer membranes proteins have been deployed and are immunogenic and protective at population level, but clones exist which do not express cognate antigens. In contrast to glycoconjugate vaccines they may not have potent carriage-reducing activity. Mass chemoprophylaxis is gaining credence as an alternative strategy is effective, but has significant shortcomings in sustainability.

Summary
Meningococcal disease is well defined genomically for epidemiological purposes. There is potential for unpredictable emergence of clones that may have reduced susceptibility even to modern vaccines, and continued surveillance and vigilance is necessary. However, tremendous strides have been made in recent years.
The Impact of Service Quality on Patient Satisfaction and Revisiting Intentions: The Case of Public Emergency Departments
Authors: Amarantou Vasiliki , Chatzoudes Dimitrios , Kechagia Vasiliki , Chatzoglou Prodromos D. 
Published: September 2019

Background and Objectives:
This study attempts to (a) identify the main quality indicators that affect “service quality” and (b) examine the effect of “patient satisfaction” on patient “revisiting intentions.”

Methods:
The sample includes patients of 2 hospitals, 1 urban and 1 provincial. The comparative analysis of 2 emergency departments (EDs) with different characteristics aims at understanding their diverse problems and their specific needs from a patient point of view. Empirical data were collected in the fall of 2015. Three hundred questionnaires were distributed in person. A total of 169 valid questionnaires, 80 from hospital A and 89 from hospital B, were returned, with a response rate of 56.3%.

Results:
The Structural Equation Modeling technique revealed that overall satisfaction is strongly influenced by “perceived service quality” (β = .79), while it positively affects patient “behavioral intentions” (β = .39). Also, “perceived waiting time” proved to have a more intense impact on “perceived service quality” (β = −.59), rather than on “perceived technical and functional quality” (β = .18). Moreover, it was determined that patients visiting the urban ED pay more attention in waiting times, while patients visiting the provincial ED care about receiving both quality and timely health care services. Overall, the study provides insight about the main factors affecting “perceived service quality” and “overall satisfaction.” These factors fall into 2 distinct categories: “perceived technical and functional quality” and “perceived waiting time.”

Conclusions:
The study concludes that “overall satisfaction” acts as a mediator between “perceived service quality” and patient “behavioral intentions,” while “perceived waiting time” is the most significant indicator of service quality and the most crucial predictor of ED patient satisfaction. Moreover, it offers empirical evidence concerning the differences in the way patients rate the services offered by a hospital, based on the hospital size and the region it is located (urban or provincial).
Extended Molecular Profiling Improves Stratification and Prediction of Survival After Resection of Colorectal Liver Metastases
Authors: Lang Hauke , Baumgart Janine , Heinrich Stefan , Tripke Verena , Passalaqua Monia , Maderer Annett , Galle Peter R. , Roth Wilfried , Kloth Michael , Moehler Markus 
Published: September 2019

Objective:
The aim of this study was to assess the effect of cancer-related genes and their mutations analyzed by next-generation sequencing (NGS) on the oncological outcome after resection of colorectal liver metastases (CRLM).

Background:
Traditional prognostic scores include clinical and pathological parameters of primary tumor and metastases. The modified clinical risk score (m-CS), based on size of metastases, primary tumor nodal status, and RAS mutation status outperformed traditional scores. We hypothesized to further improve the scoring system based on the results of NGS.

Methods:
Cancer tissues of 139 patients with CRLM were used for NGS. The work-up included the analysis of recurrent somatic mutations and copy number changes of 720 genes. Clinical data were extracted from a prospectively collected institutional liver database.

Results:
Depending on significance, the following cancer-related genes and their alterations (%) were further investigated: APC (86%), TP53 (78%), KRAS (29%), SMAD4 (15%), PIK3CA (14%), BRAF (8%), ERBB2 (6%), SMAD3 (5%), SMAD2 (4%), and NRAS (4%). The most predictive parameters for poor oncological outcome were alterations in the SMAD family (P = 0.0186) and RAS-RAF pathway (P = 0.032). Refining the m-CS by replacing RAS with RAS-RAF pathway and adding SMAD family resulted in an extended clinical risk score which is highly predictive for oncological outcome (P < 0.0001).

Conclusion:
In conclusion, mutations of the SMAD family revealed a strong prognostic effect after surgery for CRLM. Integration of alterations of the SMAD family as well as the RAS/RAF pathway resulted in a new, still simple but highly prognostic score.