bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Introduction of a Preoperative MRI Protocol Significantly Reduces Unplanned Return to the Operating Room in the Treatment of Pediatric Osteoarticular Infections
Authors: Griswold Branum G. , Sheppard Evan , Pitts Charlie , Gilbert Shawn R. , Khoury Joseph G. 
Published: March 2018

Background:
Pediatric osteoarticular infection can cause severe morbidity. Some infectious loci may be difficult to identify clinically, and there may be more than one. There is little agreement regarding the appropriate use of preoperative magnetic resonance imaging (MRI) in this setting. After noting an unacceptably high rate of unplanned returns to the operating room for recurrent infection, clinicians at a tertiary care children’s hospital noticed many patients had adjacent foci of infection on postoperative MRI. As a result, patients experienced prolonged treatment courses and multiple surgeries. An interdisciplinary team instituted practice guidelines whereby all patients with suspected osteoarticular infection underwent MRI for planned debridement during a reserved morning slot with a surgical suite on hold to proceed directly to surgery if indicated. Images were reviewed in real time to form the surgical plan. Young patients that required sedation for MRI were taken to surgery under the same anesthetic used for MRI without being awakened. The purpose of our retrospective study is to determine if implementing the practice guidelines for acute management of osteoarticular infection reduced unplanned returns to the operating room.

Methods:
A total of 93 patients with osteoarticular infection were included in this study. A total of 40 cases, group A, were treated before implementing practice guidelines; 53 cases, group B, were treated after implementing practice guidelines. Our primary outcomes of interest were the identification of adjacent infections prior to surgery and need for repeat surgery, either planned or unplanned.

Results:
Implementation of these guidelines reduced repeat surgery from 50% of patients to <27% (P=0.0099). Of patients requiring repeat surgery, 85% (n=17) were unplanned in group A versus 60% (n=9) in group B (P=0.0099). Adjacent infections were identified in 47.5% (n=19) of patients in group A, versus 60% (n=32) in group B. Adjacent infections were known before surgery in 32% (n=6) of patients in group A versus 72% (n=23) in group B. There were no statistically significant differences in initial patient characteristics or sites of infection.

Conclusions:
Implementing these guidelines reduced the need for repeat surgery in this population. It is difficult to predict with sufficient accuracy which patients need preoperative MRI. While resource intensive, preoperative MRI appears to offer substantial benefit in preoperative planning.
Activated Prothrombin Complex Concentrate Versus 4-Factor Prothrombin Complex Concentrate for Vitamin K-Antagonist Reversal*
Authors: Rowe A. Shaun , Dietrich Scott K. , Phillips John W. , Foster Kaci E. , Canter Joshua R. 
Published: March 2018

Objectives:
To compare the international normalized ratio normalization efficacy of activated prothrombin complex concentrates and 4-factor prothrombin complex concentrates and to evaluate the thrombotic complications in patients treated with these products for warfarin-associated hemorrhage.

Design:
Retrospective, Multicenter Cohort.

Setting:
Large, Community, Teaching Hospital.

Patients:
Patients greater than 18 years old and received either activated prothrombin complex concentrate or 4-factor prothrombin complex concentrate for the treatment of warfarin-associated hemorrhage. We excluded those patients who received either agent for an indication other than warfarin-associated hemorrhage, pregnant, had a baseline international normalized ratio of less than 2, received a massive transfusion as defined by hospital protocol, received plasma for treatment of warfarin-associated hemorrhage, or were treated for an acute warfarin ingestion.

Interventions:
Patients in the activated prothrombin complex concentrate group (enrolled from one hospital) with an international normalized ratio of less than 5 received 500 IU and those with an international normalized ratio greater than 5 received 1,000 IU. Patients in the 4-factor prothrombin complex concentrate (enrolled from a separate hospital) group received the Food and Drug Administration approved dosing algorithm.

Measurements and Main Results:
A total of 158 patients were included in the final analysis (activated prothrombin complex concentrate = 118; 4-factor prothrombin complex concentrate = 40). Those in the 4-factor prothrombin complex concentrate group had a higher pretreatment international normalized ratio (2.7 ± 1.8 vs 3.5 ± 2.9; p = 0.0164). However, the posttreatment international normalized ratio was similar between the groups. In addition, even when controlling for differences in the pretreatment international normalized ratio, there was no difference in the ability to achieve a posttreatment international normalized ratio of less than 1.4 (odds ratio, 0.753 [95% CI, 0.637–0.890]; p = 0.0009). Those in the activated prothrombin complex concentrate group did have higher odds of achieving a posttreatment international normalized ratio of less than 1.2 (odds ratio, 3.23 [95% CI, 1.34–7.81]; p = 0.0088). There was only one posttreatment thrombotic complication reported.

Conclusions:
A low, fixed dose of activated prothrombin complex concentrate was as effective as standard dose 4-factor prothrombin complex concentrate for normalization of international normalized ratio. In addition, we did not see an increase in thrombotic events.
Cutaneous T-Cell Lymphoma, a Novel Manifestation of PDGFRA-Rearranged Neoplasm
Authors: Behdad Amir , Allen Pamela , Lu Xinyan , Zhou Xiaolong Alan , Guitart Joan , Chen Qing , Pro Barbara 
Published: March 2018

Abstract:Patients withPDGFRA-rearranged hematopoietic neoplasms typically present with chronic eosinophilic leukemia and rarely with acute myeloid leukemia or T-lymphoblastic lymphoma. However, mature T-cell lymphoma has not been previously associated with PDGFRA aberrations. We report a patient who presented with simultaneous T-lymphoblastic lymphoma, focal myeloid proliferation, and cutaneous cytotoxic T-cell lymphoma refractory to chemotherapy. The presence of myeloid and lymphoid lineages prompted genetic and molecular studies. APDGFRArearrangement was identified in all compartments: cutaneous, lymph node, and bone marrow. Treatment with imatinib resulted in an excellent response in cutaneous and systemic disease. We report the first case of a mature cutaneous T-cell lymphoma withPDGFRArearrangement, expanding the spectrum of neoplasms associated with this genetic abnormality. Our case underscores the great importance of recognizingPDGFRArearrangement in unusual cases of cutaneous T-cell lymphoma, systemic lymphoid, and myeloid neoplasms. These patients may respond well to tyrosine kinase inhibitors, despite resistance to conventional chemotherapy.
Descemet Membrane Endothelial Keratoplasty Learning Curve for Graft Preparation in an Eye Bank Using 645 Donor Corneas
Authors: Parekh Mohit , Ruzza Alessandro , Romano Vito , Favaro Elisa , Baruzzo Mattia , Salvalaio Gianni , Grassetto Andrea , Ferrari Stefano , Ponzin Diego 
Published: March 2018

Purpose:
To investigate the learning curve of Descemet membrane endothelial keratoplasty (DMEK) graft preparation in an eye bank.

Methods:
Four operators prepared 645 DMEK grafts using the stripping technique between 2014 and 2017 at the Veneto Eye Bank Foundation, Italy. Endothelial cell loss (ECL) and tissue wastage were recorded retrospectively after DMEK preparation and correlated with the number of tissues prepared each year by each operator. On average, our operators performed 1 donor preparation a week over the course of this study. Only donors older than 60 years were used in this study, and approximately 10% of donors had diabetes. The Wilcoxon test for paired data and 1-way ANOVA were used for checking statistical significance with the Tukey test as post hoc analysis. P < 0.05 was considered statistically significant.

Results:
ECL did not change significantly over time from operator 1. Significant ECL drop was noted from operator 2 between years 2014–2016 (P = 0.0049) and 2017 (P = 0.0094); from operator 3 between years 2015–2016 (P = 0.0288) and 2017 (P = 0.0097); and from operator 4 between 2015–2016 (P = 0.0469) and 2017 (P = 0.0331). Operators 1 and 3 did not show a significant difference, considering every 50 grafts prepared by each operator. Operator 2 showed significant ECL drop between 1 to 50 and 51 to 100 (P = 0.0002) and 1 to 50 and 101 to 150 (P = 0.0001) grafts. Operator 4 showed significant ECL drop between 1 to 50 and 101 to 150 (P = 0.002) and 51 to 100 and 101 to 141 (P = 0.0207) grafts. No intraoperator difference was observed per 50 grafts (P > 0.05).

Conclusions:
There is a learning curve for DMEK graft preparation. ECL and tissue wastage can be reduced with practice and skills. However, each operator may be limited to his or her own learning capability.
Association of Postoperative Topical Prostaglandin Analog or Beta-Blocker Use and Incidence of Pseudophakic Cystoid Macular Edema
Authors: Wendel Colten , Zakrzewski Helena , Carleton Bruce , Etminan Mahyar , Mikelberg Frederick S. 
Published: March 2018

Purpose:
The purpose of this article is to determine the association of postoperative topical prostaglandin analog (PGA) or topical beta-blocker use and the incidence of pseudophakic cystoid macular edema (CME).

Methods:
This was a nested case-control study. All adult patients who underwent cataract surgery between January 1, 2006 and December 31, 2016 and who were enrolled in the PharMetrics Plus database were eligible for inclusion. The association between postoperative topical PGAs (bimatoprost, latanoprost, and travoprost/travoprost-z) or beta-blocker (betaxolol, levobunolol, and timolol) use and the incidence of pseudophakic CME was assessed by conditional logistic regression.

Results:
Five hundred eight cases and 5080 controls were included in the analyses. Incidence of pseudophakic CME was found to be statistically significantly associated with the current postoperative use of both topical PGAs [relative risk (RR), 1.86; 95% confidence interval (CI), 1.04-3.32] and topical beta-blockers (RR, 2.64; 95% CI, 1.08-6.49). Postoperative use of each of bimatoprost (RR, 2.73; 95% CI, 1.35%-5.53%) and travoprost/travoprost-z (RR, 3.16; 95% CI, 1.42-7.03) in the year before diagnosis was demonstrated to be statistically significantly associated with the incidence of pseudophakic CME. This association was not observed to be statistically significant with the postoperative use of latanoprost (RR, 1.55; 95% CI, 0.84-2.88).

Conclusions:
To the best of our knowledge this is the largest study that has investigated the association between postoperative topical PGA or topical beta-blocker use and the incidence of pseudophakic CME. Postoperative use of both topical PGAs and topical beta-blockers was found to be associated with the incidence of pseudophakic CME.
Surgical Outcomes of a New Low-Cost Nonvalved Glaucoma Drainage Device in Refractory Glaucoma: Results at 1 Year
Authors: Pathak Ray Vanita , Rao Divya P. 
Published: March 2018

Purpose:
The purpose of this study was to report the early outcomes in terms of efficacy and safety of a new, indigenously manufactured, low-cost nonvalved drainage device [AADI (Aurolab Aqueous Drainage Implant)] in the management of refractory glaucoma in the Indian population.

Methods:
Retrospective review of consecutive patients older than 12 years, who underwent glaucoma drainage device surgery (GDD) using AADI, by a single fellowship-trained surgeon, between January 2014 and December 2016, who had at least 3 months of documented post-op follow-up.

Outcome measures:
Primary—intraocular pressure (IOP).
Secondary—number of antiglaucoma medication (AGM), LogMAR best corrected visual acuity (BCVA), and complications.
Complete success was defined as IOP ≥5 mm Hg and ≤21 mm Hg or reduction of IOP by ≥20% from baseline without AGM; qualified success with use of AGM. Failure was defined as inability to meet IOP criteria, loss of perception of light, explantation or any additional glaucoma surgery.

Results:
A total of 54 eyes of 51 patients were included. Mean follow up was 12.1±6.3 months. The IOP and number of AGM required was significantly lower at every visit postoperatively (P<0.001). Median LogMAR BCVA remained unchanged (P=0.5). Complications occurred in 22 patients (40.7%). Complete success was seen in 66.6%; overall success was 92.6%.

Conclusions:
New nonvalved GDD (AADI) surgery is effective in reducing IOP and need for AGM with a safety profile similar to published reports of prevailing GDDs. It thus has the ability to breach the cost barrier in low-to-middle income countries; further follow-up is required to determine sustainability over time.
Linking the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) to the International Classification of Function
Authors: Thompson Sharon V. , Cech Donna J. , Cahill Susan M. , Krzak Joseph J. 
Published: March 2018

Purpose:
The purpose of the current study was to examine how comprehensively the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) addresses Activity and Participation components of the International Classification of Functioning, Disability, and Health (ICF).

Methods:
Two raters individually linked the 276 items of the PEDI-CAT to the ICF using ICF linking rules, the PEDI-CAT manual, and the ICF browser. Agreement between reviewers was evaluated, and reliability of the linking process was assessed using Cohen's κ.

Results:
All 9 chapters of Activity and Participation were represented within the PEDI-CAT. The highest frequency of representation was in Mobility (43%) and Self-care (20%) chapters. Agreement between the 2 raters was strong (κ = 0.84). Two items were not definable in the ICF, and 3 linked to Body Function codes.

Conclusions:
The PEDI-CAT was strongly representative of the Activities and Participation component of the ICF. The linking process had substantial reliability.
Short-Term Recovery of Balance Control: Association With Chemotherapy-Induced Peripheral Neuropathy in Pediatric Oncology
Authors: Gilchrist Laura S. , Tanner Lynn R. 
Published: March 2018

Purpose:
To describe the incidence and short-term recovery of balance control in children and adolescents receiving neurotoxic treatment for noncentral nervous system cancers and to investigate the association of chemotherapy-induced peripheral neuropathy and balance control.

Methods:
Sixty-five children and adolescents diagnosed with leukemia, lymphoma, or other solid tumors were tested 3 to 6 months into treatment and 3 and 6 months following treatment using the Bruininks-Oseretsky Balance Subscale and Pediatric Modified Total Neuropathy Scale scores of chemotherapy-induced peripheral neuropathy (CIPN).

Results:
Seventy-eight percent of the participants scored 1 standard deviation or more below population means on the balance subscale while on treatment, and this improved to 53% by 6 months posttreatment, with the leukemia group performing worse at both time points. On-treatment balance scores were moderately associated with motor CIPN, while at 6 months posttreatment they were more closely associated with sensory CIPN.

Conclusions:
Mild to moderate balance impairments improve but can persist, even when CIPN has improved, 6 months after treatment for childhood cancer.
Increased Single-Fiber Jitter Level Is Associated With Reduction in Motor Function With Aging
Authors: Chung Tae , Tian Yanli , Walston Jeremy , Hoke Ahmet 
Published: March 2018

Objective
Age-associated skeletal muscle weakness is a major contributing factor to an increased late life mortality and morbidity, but its neurobiology is poorly understood. Previously, we provided histological evidence of dying-back axonal degeneration of motor neurons and denervation of neuromuscular junctions in age-associated muscle weakness. Given this, we aimed to evaluate the relation between impaired neuromuscular transmission and various aspects of age-associated muscle weakness.

Design
We compared two electrophysiological measures, single-fiber jitter and compound motor action potential in mice of different age groups, and correlated them with various physical performance measures, such as grip strength, standing and walking time, and treadmill performance.

Results
Consistent with our previous histological data, single-fiber jitter, a measure of neuromuscular junction transmission, was significantly increased in older animals, whereas compound motor action potential shows no difference between young and old age groups. Neither jitter nor compound motor action potential correlated with any of physical performance measures, except for jitter and standing activity.

Conclusions
Impaired neuromuscular transmission—represented as increase in single-fiber electromyography jitter level—reflects decline in motor function with aging.
Comparative Analysis of Linear and Nonlinear Dimension Reduction Techniques on Mass Cytometry Data
Authors: Konstorum Anna , Jekel Nathan , Vidal Emily , Laubenbacher Reinhard 
Published: March 2018

AbstractMass cytometry, also known as CyTOF, is a newly developed technology for quantification and classification of immune cells that can allow for analysis of over three dozen protein markers per cell. The high dimensional data that is generated requires innovative methods for analysis and visualization. We conducted a comparative analysis of four dimension reduction techniques – principal component analysis (PCA), isometric feature mapping (Isomap), t-distributed stochastic neighbor embedding (t-SNE), and Diffusion Maps by implementing them on benchmark mass cytometry data sets. We compare the results of these reductions using computation time, residual variance, a newly developed comparison metric we term neighborhood proportion error (NPE), and two-dimensional visualizations. We find that t-SNE and Diffusion Maps are the two most effective methods for preserving relationships of interest among cells and providing informative visualizations. In low dimensional embeddings, t-SNE exhibits well-defined phenotypic clustering. Additionally, Diffusion Maps can represent cell differentiation pathways with long projections along each diffusion component. We thus recommend a complementary approach using t-SNE and Diffusion Maps in order to extract diverse and informative cell relationship information in a two-dimensional setting from CyTOF data.
The Medical Genome Reference Bank: a whole-genome data resource of 4,000 healthy elderly individuals. Rationale and cohort design
Authors: Lacaze Paul , Pinese Mark , Kaplan Warren , Stone Andrew , Brion Marie-Jo , Woods Robyn L , McNamara Martin , McNeil John J , Dinger Marcel E , Thomas David M 
Published: March 2018

AbstractAllele frequency data from human reference populations is of increasing value for filtering and assignment of pathogenicity to genetic variants. Aged and healthy populations are more likely to be selectively depleted of pathogenic alleles, and therefore particularly suitable as a reference populations for the major diseases of clinical and public health importance. However, reference studies of the healthy elderly have remained under-represented in human genetics. We have developed the Medical Genome Reference Bank (MGRB), a large-scale comprehensive whole-genome dataset of confirmed healthy elderly individuals, to provide a publicly accessible resource for health-related research, and for clinical genetics. It also represents a useful resource for studying the genetics of healthy aging. The MGRB comprises 4,000 healthy, older individuals with no reported history of cancer, cardiovascular disease or dementia, recruited from two Australian community-based cohorts. DNA derived from blood samples will be subject to whole genome sequencing. The MGRB will measure genome-wide genetic variation in 4,000 individuals, mostly of European decent, aged 60-95 years (mean age ≥ 75 years). The MGRB has committed to a policy of data sharing, employing a hierarchical data management system to maintain participant privacy and confidentiality, whilst maximizing research and clinical usage of the database. The MGRB will represent a dataset of international significance, broadly accessible to the clinical and genetic research community.
Sex- and Context-dependent Effects of Oxytocin on Social Reward Processing
Authors: Ma Xiaole , Zhao Weihua , Luo Ruixue , Zhou Feng , Geng Yayuan , Xu Lei , Gao Zhao , Zheng Xiaoxiao , Becker Benjamin , Kendrick Keith M 
Published: March 2018

AbstractWe interact socially and form bonds with others because such experiences are rewarding. However, an insecure attachment style or social anxiety can reduce these rewarding effects. The neuropeptide oxytocin (OXT) may facilitate social interactions either by increasing their rewarding experience or by attenuating anxiety, although effects can be sex- and attachment-style dependent. In this study, 64 pairs of same-sex friends completed a social sharing paradigm in a double-blind, placebo-controlled, between-subject design with one friend inside an MRI scanner and the other in a remote behavioral testing room. In this way we could examine whether intranasal-OXT differentially modulated the emotional impact of social sharing and associated neural processing. Additionally, we investigated if OXT effects were modulated by sex and attachment style. Results showed that in women, but not men, OXT increased ratings for sharing stimuli with their friend but not with a stranger, particularly in the friend in the scanner. Corresponding neuroimaging results showed that OXT decreased both amygdala and insula activity as well as their functional connectivity in women when they shared with friends but had the opposite effect in men. On the other hand, OXT did not enhance responses in brain reward circuitry. In the PLC treated group amygdala responses in women when they shared pictures with their friend were positively associated with attachment anxiety and OXT uncoupled this. Our findings demonstrate that OXT facilitates the impact of sharing positive experiences with others in women, but not men, and that this is associated with differential effects on the amygdala and insula and their functional connections. Furthermore, OXT particularly reduced increased amygdala responses during sharing in individuals with higher attachment anxiety. Thus, OXT effects in this context may be due more to reduced anxiety when sharing with a friend than to enhanced social reward.