bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative Angiography for Free Fibula Flap Harvest: A Meta-Analysis
Authors: Alolabi Noor , Dickson Lisa , Coroneos Christopher , Farrokhyar Forough , Levis Carolyn 
Published: January 2019

Background The necessity for routine preoperative imaging for free fibula harvest is controversial. The primary objective of this meta-analysis is to determine if lower extremity angiography is necessary to detect abnormalities that may alter flap selection. The secondary objective is to determine if physical examination alone is sufficient to predict these abnormalities.
Methods A literature search was performed using Cochrane, CENTRAL, MEDLINE, CINAHL, and EMBASE. Studies were selected for inclusion if they included patients undergoing free fibula flap harvest with preoperative imaging, with or without physical examination findings. Data extraction was performed independently and in duplicate, including a change in flap selection and the level of agreement between physical examination and imaging. Pooled proportions were calculated using a random-effects model and 95% confidence intervals (CI).
Results Sixteen studies were included for analysis. Mean sample size was 42 patients (range: 5–123). Included studies were of low methodologic quality. Pooled proportion of patients who had flap selection change secondary to abnormalities identified on preoperative angiography was 20.1% (95% CI: 9.6–33.2%). A pooled proportion of 71.5% (95% CI: 5–88.7%) of cases requiring change in flap selection was missed by physical examination findings alone.
Conclusion There is low-quality evidence suggesting a necessity for routine preoperative angiography for all patients undergoing free fibula flap harvest. Physical examination alone is insufficient in detecting vascular abnormalities that may result in limb compromise or an inability to successfully harvest a free fibula. Further investigation is warranted for cost-effectiveness of preoperative imaging protocols.
Antibodies in the Treatment of Haemophilia A—A Biochemical Perspective
Authors: Ferrière Stephen , Lenting Peter 
Published: January 2019

AbstractReplacement therapy has been proven effective in the management of bleedings in haemophilia A. Nevertheless, this approach comes with several shortcomings, like the need for frequent intravenous infusions and the development of neutralizing antibodies in 20 to 30% of the patients with severe haemophilia A replacement. This has led to the development of novel strategies to expand the spectrum of treatment options, some of which are based on antibody technology. These include a bispecific antibody that bridges enzyme factor IXa and substrate factor X, monoclonal antibodies that block the function of tissue factor pathway inhibitor, and a factor VIII–nanobody fusion protein with strongly enhanced von Willebrand factor binding. In this review, functional and mechanistic considerations on the use of these antibody variants will be discussed.
ebGSEA: an improved Gene Set Enrichment Analysis method for Epigenome-Wide-Association Studies
Authors: Dong Danyue , Tian Yuan , Zheng Shijie C , Teschendorff Andrew E 
Published: January 2019

Abstract

Motivation
The biological interpretation of differentially methylated sites derived from Epigenome-Wide-Association Studies (EWAS) remains a significant challenge. Gene Set Enrichment Analysis (GSEA) is a general tool to aid biological interpretation, yet its correct and unbiased implementation in the EWAS context is difficult due to the differential probe representation of Illumina Infinium DNA methylation beadchips.

Results
We present a novel GSEA method, called ebGSEA, which ranks genes, not CpGs, according to the overall level of differential methylation, as assessed using all the probes mapping to the given gene. Applied on simulated and real EWAS data, we show how ebGSEA may exhibit higher sensitivity and specificity than the current state-of-the-art, whilst also avoiding differential probe representation bias. Thus, ebGSEA will be a useful additional tool to aid the interpretation of EWAS data.

Availability and implementation
ebGSEA is available from https://github.com/aet21/ebGSEA, and has been incorporated into the ChAMP Bioconductor package (https://www.bioconductor.org).

Supplementary information
Supplementary data are available at Bioinformatics online.
Hearing Loss and Depression in Older Adults: A Systematic Review and Meta-analysis
Authors: Lawrence Blake J , Jayakody Dona M P , Bennett Rebecca J , Eikelboom Robert H , Gasson Natalie , Friedland Peter L 
Published: January 2019

AbstractBackground and ObjectivesStudies reporting an association between hearing loss and depression in older adults are conflicting and warrant a systematic review and meta-analysis of the evidence.Research Design and MethodsA search of academic databases (e.g., MEDLINE) and gray literature (e.g., OpenGrey) identified relevant articles published up to July 17, 2018. Cross-sectional or cohort designs were included. Outcome effects were computed as odds ratios (ORs) and pooled using random-effects meta-analysis (PROSPERO: CRD42018084494).ResultsA total of 147,148 participants from 35 studies met inclusion criteria. Twenty-four studies were cross-sectional and 11 were cohort designs. Overall, hearing loss was associated with statistically significantly greater odds of depression in older adults (OR = 1.47, 95% confidence interval [CI] = 1.31−1.65). When studies were stratified by design, hearing loss was associated with greater odds of depression in cross-sectional studies (OR = 1.54, 95% CI = 1.31−1.80) and cohort studies (OR = 1.39, 95% CI = 1.16 − 1.67), and there was no difference between cross-sectional or cohort effect estimates (Q = 0.64, p = .42). There was no effect of moderator variables (i.e., hearing aid use) on the association between hearing loss and depression, but these findings must be interpreted with caution. There was no presence of publication bias but certainty in the estimation of the overall effect was classified as “low.”Discussion and ImplicationsOlder adults may experience increased odds of depression associated with hearing loss, and this association may not be influenced by study or participant characteristics.
Effects of Meditation and Mind–Body Exercises on Older Adults’ Cognitive Performance: A Meta-analysis
Authors: Chan John S Y , Deng Kanfeng , Wu Jiamin , Yan Jin H 
Published: January 2019

Abstract

Background and Objectives
Meditation and mind–body exercises are suggested to delay decline or enhance cognitive capabilities in older adults. However, their effectiveness remains uncertain. This study assessed the effectiveness of meditation and mind–body exercises to improve cognition in elderly people aged 60 years or above. Moderator variables were also explored.

Research Design and Methods
A databases search (MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Library, Web of Science, CNKI, and Wangfang) was conducted from the first available date to January 10, 2018. Inclusion criteria include (a) human older adults aged 60 years or above, (b) meditation, Tai Chi, Qigong, or yoga intervention, (c) intervention should be structured, (d) inclusion of a control group, (e) at least one outcome measure of cognition was measured at baseline and post-training, and (f) peer-reviewed journal articles in English or Chinese.

Results
Forty-one studies (N = 3,551) were included in the meta-analysis. In general, meditation and mind–body exercises improve cognition in the elderly people (SMD = 0.34, 95% CI: 0.19 to 0.48), but the cognition-enhancing effects depend on the type of exercise. In addition, cognitive performance is only improved when the length of intervention is longer than 12 weeks, exercise frequency is 3–7 times/week, or duration of an exercise session is 45–60 min/session.

Discussion and Implications
This study suggests that meditation and mind–body exercises are effective to improve cognition of older adults aged 60 years or above, and exercise parameters should be considered for intervention planning.
Time-series metabarcoding analysis of zooplankton diversity of the NW Atlantic continental shelf
Authors: Bucklin Ann , Yeh Heidi D , Questel Jennifer M , Richardson David E , Reese Bo , Copley Nancy J , Wiebe Peter H 
Published: January 2019

AbstractBiodiversity of zooplankton is central to the functioning of ocean ecosystems, yet morphological taxonomic analysis requires teams of experts and detailed examination of many samples. Metabarcoding (DNA sequencing of short amplified regions of one or a few genes from environmental samples) is a powerful tool for analysis of the composition and diversity of natural communities. The 18S rRNA V9 hypervariable region was sequenced for 26 zooplankton samples collected from the Gulf of Maine, Georges Bank, and Mid-Atlantic Bight during ecosystem monitoring surveys by the U.S. Northeast Fisheries Science Center during 2002–2012. A total of 7 648 033 sequences and 22 072 operational taxonomic units (OTUs) were identified and classified into 28 taxonomic groups of plankton. Comparative analysis of molecular (V9 sequence numbers) and morphological (abundance counts) focused on seven taxonomic groups and revealed similar patterns of variation among years and regions. Sequence numbers and abundance counts showed positive correlation for all groups, with significant correlations (p &lt; 0.05) for Calanoida, Gastropoda, and Chaetognatha. Shannon diversity index values calculated using sequence numbers and abundance counts showed highly significant correlation (r = 0.625; p &lt; 0.001) across all regions during 2002–2012. This study demonstrates the potential of metabarcoding for time-series analysis of zooplankton biodiversity, ocean ecosystem assessment, and fisheries management.
Morphine induces dysfunction of PINK1/Parkin-mediated mitophagy in spinal cord neurons implying involvement in antinociceptive tolerance
Authors: Kong Hong , Jiang Chun-Yi , Hu Liang , Teng Peng , Zhang Yan , Pan Xiu-Xiu , Sun Xiao-Di , Liu Wen-Tao 
Published: January 2019

Abstract
The development of opioid-induced analgesic tolerance is a clinical challenge in long-term use for managing chronic pain. The mechanisms of morphine tolerance are poorly understood. Mitochondria-derived reactive oxygen species (ROS) is a crucial signal inducing analgesic tolerance and pain. Chronic administration of morphine leads to robust ROS production and accumulation of damaged mitochondria, which are immediately removed by mitophagy. Here, we show that morphine inhibits mitochondria damage-induced accumulation of PTEN-induced putative kinase 1 (PINK1) in neurons. It interrupts the recruitment of Parkin to the impaired mitochondria and inhibits the ubiquitination of mitochondrial proteins catalyzed by Parkin. Consequently, morphine suppresses the recognition of autophagosomes to the damaged mitochondria mediated by LC3 and sequestosome-1 (SQSTM1/p62). Thus, morphine inhibits autophagy flux and leads to the accumulation of SQSTM1/p62. Finally, the impaired mitochondria cannot be delivered to lysosomes for degradation and ultimately induces robust ROS production and morphine tolerance. Our findings suggest that the dysfunction of mitophagy is involved in morphine tolerance. The deficiency of PINK1/Parkin-mediated clearance of damaged mitochondria is crucial for the generation of excessive ROS and important to the development of analgesic tolerance. These findings suggest that the compounds capable of stabilizing PINK1 or restoring mitophagy may be utilized to prevent or reduce opioid tolerance during chronic pain management.
Defining the Role of Novel β-Lactam Agents That Target Carbapenem-Resistant Gram-Negative Organisms
Authors: Tamma Pranita D , Hsu Alice J 
Published: January 2019

AbstractWith the current carbapenem-resistant organism crisis, conventional approaches to optimizing pharmacokinetic-pharmacodynamic parameters are frequently inadequate, and traditional salvage agents (eg, colistin, tigecycline, etc) confer high toxicity and/or have low efficacy. However, several β-lactam agents with activity against carbapenem-resistant organisms were approved recently by the US Food and Drug Administration, and more are anticipated to be approved in the near future. The primary goal of this review is to assist infectious disease practitioners with preferentially selecting 1 agent over another when treating patients infected with a carbapenem-resistant organism. However, resistance to some of these antibiotics has already developed. Antibiotic stewardship programs can ensure that they are reserved for situations in which other options are lacking and are paramount for the survival of these agents.
Pediatric Sedation
Authors: Lowrie Lia H. 
Published: January 2019

Abstract
The processes of care involved in providing sedation and analgesia for children undergoing diagnostic and therapeutic procedures have evolved from an afterthought necessary to accomplish a procedure humanely to almost a medical discipline of its own centering around patient physical and psychological comfort and safety. Many of the tests and procedures common to modern medical care are easily accomplished for a competent adult who is able to understand the advantages of holding still, the timeframe of brief painful injections, and the future benefits represented by accomplishing the unpleasant test. Infants and children developmentally cannot project such abstract thinking to rationalize an unpleasant experience and may experience potentially long-lasting psychological consequences unless healthcare professionals provide supportive and preventive care. In this sense, procedural sedation is a uniquely pediatric field. This chapter should serve to place the rapidly emerging arena of pediatric procedural sedation into an appropriate historical context from which the reader may better understand the current state of the art of pediatric sedation and recognize the gaps in understanding of best practice in the complex care required.
The Sedation Continuum
Authors: van der Jagt Élise W. 
Published: January 2019

Abstract
When patients undergo procedural sedation/analgesia, they enter into a sedation continuum. Several levels have been formally defined along this continuum: minimal sedation/anxiolysis, moderate sedation, deep sedation, and at the deepest level, general anesthesia. An additional and somewhat separate level in the sedation continuum is dissociative sedation, which has its own unique characteristics. Given the dynamic nature of the sedation process, a patient will move in and out of these defined levels (as well as intermediate ones) depending on the agents and dosing used, the procedures being performed, and a patient’s own unique characteristics and physiologic responses. At all times, the provider of procedural sedation/analgesia must be able to recognize the sedation levels attained by the patient and be ready to manage any potential adverse events.
Risk Assessment
Authors: Buckmaster Mark A. 
Published: January 2019

Abstract
Evaluation of patient risk is a critical aspect of the presedation phase of care. For scheduled procedures and tests, information obtained during the prescreening process is incorporated into the formal assessment of the patient at the time of the procedure. If the prescreening process has been sufficiently rigorous, the patient is likely to be appropriately prepared for sedation and the day-of-procedure evaluation (procedure screen) should be able to be done quickly, efficiently, and safely. The presedation evaluation represents the final step prior to the initiation of sedation. This is where all interval information and findings are fused to develop the overall sedation plan. Appropriate integration of a rigorous prescreening process with a careful presedation review allows for the most comprehensive and safe approach to pediatric procedural sedation. Specific patient conditions that pose additional significant risk during procedural sedation are further discussed.
Ventilation—Observation, Capnography, and Precordial Stethoscope
Authors: Couloures Kevin G. 
Published: January 2019

Abstract
A variety of monitoring techniques can be used to ensure adequate ventilation during sedation. Three of the methods are direct observation, precordial/pretracheal stethoscope, and end-tidal CO2 monitoring. Direct observation is simple and effective but may miss subtle changes and is difficult when the room is darkened or the patient is covered. Precordial stethoscopes are frequently utilized during dental procedures and can help detect changes in respiration or the need for suctioning. MRI-compatible versions are available, but the practitioner needs to be within 4 feet of the patient. End-tidal CO2 monitoring gives the most information about the adequacy of ventilation but requires costly equipment and placement of a specialized nasal cannula or mask on the child’s face. The benefit of utilizing any of these modalities is that changes in ventilation will precede changes in oxygenation. Hence, early recognition of change can help prevent respiratory compromise.
Cardiology
Authors: Phelps Janey 
Published: January 2019

Abstract
Congenital heart disease is the most common type of birth defect and is estimated to affect nearly 1% of all births per year in the United States. Echocardiograms are necessary to fully evaluate these defects, and depending on the age of the child, sedation may be required to ensure optimal imaging. This chapter discusses the sedation/anesthesia options for transthoracic echocardiography, transesophageal echocardiography, and cardioversion. For all of these procedures high-risk patients should be triaged to a pediatric anesthesia provider and in some cases, a pediatric cardiac anesthesiologist. Transthoracic echocardiograms can be completed with distraction and/or minimal sedation with oral or intranasal midazolam. If moderate sedation is required due to patient characteristics or previous history of failure with minimal sedation, intranasal dexmedetomidine is a good option. Transesophageal echocardiography is an invasive procedure; patients &lt;2 years of age should be intubated and those &gt;2 years of age can maintain a native airway with deep sedation with propofol. The need for cardioversion is infrequent in pediatrics but when needed, propofol is a good choice.
Child Life Specialists and Nonpharmacologic Interventions
Authors: Mitchell Laura , Tatem Christine 
Published: January 2019

Abstract
This chapter discusses the role of the child life specialist in the multidisciplinary pediatric sedation team and the various nonpharmacologic techniques that may be used to attenuate the fear, anxiety, and pain responses of children undergoing procedural care. Child life specialists are an integral component of the sedation team. Their assessments can help the team develop a plan of care, and they offer insight into how to provide developmentally appropriate education as well as psychosocial and emotional support to pediatric patients and their families. Nonpharmacologic techniques that have been shown to be effective in reducing pain and anxiety for children undergoing medical procedure include setting up the environment, parental presence, positioning for comfort, and distraction. Considerations for infants are also discussed. The chapter includes a table of appropriate language to use with children and another with a summary of age-appropriate distraction techniques. The ONE VOICE© model is included as a reference for practitioners to use in daily practice.
War-Related PTSD in Black, Hispanic, and Majority White Vietnam Veterans
Authors: Dohrenwend Bruce P. , Turner J. Blake , Turse Nick , Lewis-Fernández Roberto , Yager Thomas J. 
Published: January 2019

Abstract
This chapter investigates elevated prevalence of chronic PTSD for black and Hispanic Vietnam veterans. Previous research relied on retrospective reports of war-zone stress and on PTSD assessments that failed to distinguish between prevalence and incidence. This chapter addresses these limitations using record-based exposure measures and clinical diagnoses on a subsample of NVVRS veterans. Compared with majority white, it explains the black elevation by blacks’ greater exposure to combat and the Hispanic elevation by Hispanics’ greater exposure, younger age, lesser education, and lower Armed Forces Qualification Test (AFQT) scores. Hispanics’ younger age mainly accounts for the PTSD elevation in Hispanics versus blacks. The main reason for the group differences in severity of exposure appears to be racial-ethnic contrasts in the military branches in which the veterans served.
Families of Veterans
Authors: Yager Thomas J. , Gerszberg Nicole , Dohrenwend Bruce P. 
Published: January 2019

Abstract
This chapter focuses on wives or partners and offspring of a subsample of 115 clinically diagnosed male Vietnam veterans who had one or more children aged 6–16 at the time of the NVVRS. It defines veteran traumatization as meeting criteria for lifetime war-related PTSD. Secondary traumatization is operationalized by elevated scores on children’s internalizing or externalizing behavior problems and on wives’ demoralization. This chapter reports evidence of secondary traumatization in the veterans’ sons. Current PTSD in the veterans is associated with demoralization in their wives or partners, which in turn is associated with behavior problems in their daughters. Demoralization of the wife or partner is also associated with current alcoholism in the veterans. Even with the degree of secondary traumatization present, the veterans’ children appear at least as healthy as their counterparts in the general population.
Veterans’ Appraisals of the Impact of the War on Their Lives 10-Plus Years After the War Ended
Authors: Dohrenwend Bruce P. , Yager Thomas J. , Neria Yuval , Turner J. Blake , Turse Nick , Marshall Randall , Lewis-Fernández Roberto , Koenen Karestan C. 
Published: January 2019

Abstract
This chapter presents findings that the large majority (between 61.8% and 70.9%) of U.S. male veterans in the NVVRS sample appraised the impact of Vietnam service on their personal lives as mainly positive, and that negative appraisals, especially those with high salience (i.e., importance), are strongly associated with PTSD onset and current PTSD. A substantial minority (41.7%) judged the effects to be highly salient in their present lives. It investigates the valence and salience of these appraisals in relation to PTSD and other indicators of wartime and post-war functioning. The results are consistent with the hypothesis that mainly positive appraisals are affirmations of successful wartime and post-war adaptation rather than defensive denials related to maladaptive outcomes. It discusses the possibility that mainly positive appraisals, especially those with low salience, also contribute to successful post-war adaptation.