bluuebunny/crossref_metadata_2025_split huggingface dataset:
Titrate to equilibrate and not exsanguinate! Characterization and validation of a novel partial resuscitative endovascular balloon occlusion of the aorta catheter in normal and hemorrhagic shock conditions
Authors: Forte Dominic M. , Do Woo S. , Weiss Jessica B. , Sheldon Rowan R. , Kuckelman John P. , Eckert Matthew J. , Martin Matthew J. 
Published: May 2019

BACKGROUND
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a significant advancement in the control of noncompressible truncal hemorrhage. However, its ischemic burden and reperfusion injury following balloon deflation limits its utilization. Partial restoration of aortic flow during REBOA has the potential to balance hemorrhage control and ischemia. This study validates the mechanics, physiology, and optimal partial flow rates using a prototype partial REBOA (pREBOA) device.

METHODS
Twenty-five swine underwent placement of aortic flow probes and zone 1 pREBOA. Experiment 1 (N = 5) animals were not injured and assessed the tested the catheters ability to titrate and control flow. Experiment 2 (N = 10) added 20% hemorrhage and either solid organ, or abdominal vascular injury to compare flow rate and rebleeding from injuries. Experiment 3 (N = 10) swine were similarly prepared, hemorrhaged, and underwent pREBOA at set partial flow rates for 2 hours followed by complete deflation for 30 minutes.

RESULTS
Balloon volume at minimum flow (mean, 0.09 L/min) was 3.5 mL to 6.0 mL. Half maximal flow was achieved with 56.5% of maximum balloon inflation. Partial REBOA allowed very fine titration of flow rates. Rebleeding occurred at 0.45 L/min to 0.83 L/min. Distal flow of 0.7 L/min had 50% survival, 0.5 had 100% survival, and 0.3 L had 50% survival with mean end lactates of 9.6, 12.6, and 13.3, respectively. There was a trend toward hyperkalemia and hypocalcemia in nonsurvivors.

CONCLUSION
The pREBOA device demonstrated a high level of titratability for restoration of aortic flow. An optimal partial flow of 0.5 L/min was effective at hemorrhage control while limiting the burden of ischemic injury, and extending the tolerable duration of zone 1 occlusion. Aggressive calcium supplementation prior to and during partial occlusion and reperfusion may be warranted to prevent hyperkalemic arrest.
A preliminary analysis of Level IV trauma centers within an organized trauma system
Authors: Vernon Tawnya M. , Cook Alan D. , Horst Michael A. , Gross Brian W. , Bradburn Eric H. , Jammula Shreya , Altenburg Juliet , Bradley David , Rogers Frederick B. 
Published: May 2019

BACKGROUND
The effect of Level IV trauma center (TC) accreditation within an existing trauma network remains understudied. This study compared preaccreditation to postaccreditation data from Level IV TCs within a mature trauma system in Pennsylvania to determine whether TC designation affected time to and/or rate of transfer to definitive care. Level IV TCs were hypothesized to have a decreased time to transfer following accreditation and improved mortality.

METHODS
The Pennsylvania Trauma Systems Foundation collects predesignation and postdesignation data from hospitals pursuing accreditation. Data from Pennsylvania Trauma Systems Foundation between 2012 and 2017 were analyzed. Variables of interest included patient demographics, injury severity, mortality, and incidence of surgical interventions precredentialingto postcredentialing. A multilevel mixed-effects logistic regression model assessed the adjusted impact of Level IV TC accreditation on transfer rate. ArcGIS Desktop was used for geospatial mapping of lives and geographic area covered by the addition of Level IV TCs in Pennsylvania.

RESULTS
Five hospitals underwent Level IV credentialing from 2012 to 2017, providing data on 5,076 cases (pre, 2,395 [47.2%]; post, 2,681 [52.8%]). No significant difference in age, admission Glasgow Coma Scale score, or shock index was observed preaccreditation to postaccreditation. A difference in transfer rate was observed after credentialing in unadjusted (62.7% vs. 63.3%; p < 0.014) and adjusted analyses (adjusted odds ratios, 1.13, p = 0.389). There was a trend toward reduced odds of mortality postcredentialing (adjusted odds ratios, 0.59, p = 0.261). Major surgical intervention decreased (Pre, 0.42%; Post, 0.04%; p = 0.004).

CONCLUSION
Level IV TC accreditation has beneficial effects on increased transfer rates and may improve mortality. It is important to continue to observe the impact of Level IV TCs on patient outcomes within a mature trauma system.

LEVEL OF EVIDENCE
Prognostic and epidemiological, level III.
Variability in international normalized ratio and activated partial thromboplastin time after injury are not explained by coagulation factor deficits
Authors: Stettler Gregory R. , Moore Ernest E. , Moore Hunter B. , Nunns Geoffrey R. , Coleman Julia R. , Colvis Arthur , Ghasabyan Arsen , Cohen Mitchell J. , Silliman Christopher C. , Banerjee Anirban , Sauaia Angela 
Published: May 2019

BACKGROUND
Conventional coagulation assays (CCAs), prothrombin time (PT)/international normalized ratio (INR) and activated partial thromboplastin time (aPTT), detect clotting factor (CF) deficiencies in hematologic disorders. However, there is controversy about how these CCAs should be used to diagnose, treat, and monitor trauma-induced coagulopathy. Study objectives were to determine whether CCA abnormalities are reflective of deficiencies of coagulation factor activity in the setting of severe injury.

METHODS
Patients without previous CF deficiency within a prospective database at an ACS-verified Level I trauma center had CF activity levels, PT/INR, aPTT, and fibrinogen levels measured upon emergency department arrival from 2014 to 2017. Linear regression assessed how CF activity explained the aPTT and PT/INR variation. Prolonged CCA values were set as INR greater than 1.3 and aPTT greater than 34 seconds. CF deficiency was defined as less than 30% activity, except for fibrinogen, defined as less than 150 mg/dL.

RESULTS
Sixty patients with a mean age of 35.8 (SD, 13.6) years and median New Injury Severity Score of 32 (interquartile range, 12–43) were included; 53.3% sustained blunt injuries, 23.3% required massive transfusion, and mortality was 11.67%. Overall, 44.6% of the PT/INR variance and 49.5% of the aPTT variance remained unexplained by CF activity. Deficiencies of CFs were: common pathway, 25%; extrinsic pathway, 1.7%; and intrinsic pathway, 6.7%. The positive predictive value for CF deficiencies were: (1) PT/INR greater than 1.3:4.4% for extrinsic pathway, 56.5% for the common pathway; (2) aPTT greater than 34 seconds:16.7% for the intrinsic pathway, 73.7% for the common pathway.

CONCLUSION
Almost half of the variances of PT/INR and aPTT were unexplained by CF activity. Prolonged PT/INR and aPTT were poor predictors of deficiencies in the intrinsic or extrinsic pathways; however, they were indicators of common pathway deficiencies.

LEVEL OF EVIDENCE
Prognostic, level III.
Relationship Turmoil and Emotional Empathy in Frontotemporal Dementia
Authors: Takeda Akitoshi , Sturm Virginia E. , Rankin Katherine P. , Ketelle Robin , Miller Bruce L. , Perry David C. 
Published: May 2019

Background:
Behavioral variant frontotemporal dementia (bvFTD) is characterized by marked deficits in empathy and social behavior; however, the effect of these symptoms on partner relationships has not been quantitatively measured.

Objective:
We aimed to determine the effect of empathy loss and behavioral symptoms on partner and familial relationship status in bvFTD. We ascertained whether patients were currently in marriage/partner relationships or were separated/divorced, the timing and duration of these relationships, and whether the patients had relationship infidelity. We investigated the relationship status of 483 patients (156 with bvFTD, 38 with nonfluent variant primary progressive aphasia, 72 with semantic variant primary progressive aphasia, 49 with corticobasal syndrome, 45 with progressive supranuclear palsy syndrome, and 123 with Alzheimer disease) over the course of follow-up, and correlated relationship status with patients’ first visit Interpersonal Reactivity Index and Neuropsychiatric Inventory.

Results:
Relationship dissolution and infidelity were significantly more frequent among patients with bvFTD than in the other groups. Across all patients, empathy loss was associated with relationship dissolution. In the bvFTD group, patients who experienced relationship dissolution or infidelity had significantly lower empathy than those who did not.

Conclusions:
Changes in relationship status differed across dementia groups and were associated with empathy decline.
The atypical social brain network in autism: advances in structural and functional MRI studies
Authors: Sato Wataru , Uono Shota 
Published: May 2019

Purpose of review
To review advances in structural and functional MRI studies regarding the neural underpinnings of social atypicalities in autism spectrum disorder (ASD).

Recent findings
According to the hypothesis that the social brain network, which includes brain regions, such as the amygdala and superior temporal sulcus, may be atypical in ASD, recent structural MRI studies have identified regional gray matter volume abnormalities in the social brain regions in ASD groups compared with the typically developing groups. Studies evaluating gray matter volume covariance and white matter volume/integrity suggested network-level abnormalities associated with the social brain regions. Recent functional MRI studies assessing resting-state neural activity showed reduced functional connectivity among the social brain regions in individuals with ASD compared with typically developing groups. Similarly, task-based functional MRI studies recently revealed a reduction in regional activity and intraregional functional coupling in the social brain regions during the processing of social stimuli in individuals with ASD.

Summary
These structural and functional MRI studies provide supportive evidence for the hypothesis that an atypical social brain network underlies behavioral social problems in ASD.
Sex differences in neurodevelopmental disorders
Authors: May Tamara , Adesina Ife , McGillivray Jane , Rinehart Nicole J. 
Published: May 2019

Purpose of review
There continues to be more males than females diagnosed with neurodevelopmental disorders, which may provide clues about their cause. This review will focus on the two most common neurodevelopmental disorders – autism spectrum disorder (autism) and attention deficit hyperactivity disorder (ADHD), and explore recent research to understand recent developments in the field.

Recent findings
Biological mechanisms including genetics, hormones and their interaction with other risk factors, such as stress and lead exposure, point to complex causal pathways for neurodevelopmental disorders. Over recent years, the research focus on sex differences in symptom profiles in autism has continued; however, a meta-analysis of existing studies indicated minimal sex differences in core autism symptoms. In ADHD, changes in the sex ratio from disparity in childhood to parity in adulthood may relate to the onset and trajectory of hyperactivity symptoms in females. Research into medical and psychiatric comorbidities, such as polycystic ovary syndrome and gender dysphoria, is also providing insights into the role of early androgen exposure as a potential causal factor for neurodevelopmental disorders.

Summary
The factors, which contribute to an increased number of males with neurodevelopmental disorders in most cases are complex involving interactions between genetics, hormones and environmental factors.
Memantine Rescues Neurosyphilis-Related Schizophrenic-like Features and Cognitive Deficit
Authors: Chen Wen-Chien , Wang Hui-Yi , Chen Po-An , Chen I-Chia , Chen Yi-Chyan 
Published: May 2019

Objectives
Neurosyphilis, an infectious neuroinflammatory disorder, could cause diverse neuropsychiatric symptoms mimicking disorders of schizophrenia and dementia; hence, it is known as the “chameleon of psychiatry.” Here, we present a subject with neurosyphilis with schizophrenic features and share the treatment outcome.

Methods
A 42-year-old single man had schizophrenic-like features and cognitive dysfunction for 1 year. Neurosyphilis was confirmed by a cerebral spinal fluid study. The brain image revealed multiple punctuated white matter gliosis in the bilateral frontal lobes and old lacunar infarctions in the bilateral basal hippocampus. The neuropsychiatric functions were declined until adjunctive memantine therapy.

Results
With the add-on therapy of memantine 10 mg daily, the psychotic and dementic symptoms markedly improved, and the patient recovered to the premorbid state in the 2-year follow-up course.

Conclusions
Memantine has an adjunctive effect on neurosyphilis-related neuropsychiatric disorder via modulation of the glutamatergic neurotransmission and microglia-induced neuroinflammation.
Grades, motivation, and resilience: the role cognitive and non-cognitive traits play in the undergraduate research student selection process
Authors: Suart Celeste , Heirwegh Meagan , Vulcu Felicia 
Published: May 2019

AbstractThe academic research experience is extremely rewarding but is also froth with many challenges, setbacks, and frustrations. The publish-or-perish mentality of a research-intensive academic environment demands a certain skill set in its trainees. This selection criterion begins with the undergraduate research selection process, but what is the ideal skill set of an incoming student entering the research experience? The current landscape on this topic is bleak, with little examination of how students are chosen for these positions. We therefore conducted an analysis examining student selection methods, non-cognitive traits, emphasis on grades and medical school future ambitions. Our findings suggest that the top five student traits valued by principal investigators are: motivation, resilience, hard work, inquisitiveness and honesty. Surprisingly, emphasis on grades as a screening tool decreased as age of laboratory and frequency of publication increased. Additionally, we identified an inverse correlation between student interest in medical school and research supervisor interest in selecting the student for an undergraduate research experience. Taken together, our study culminates in a defined set of skills beneficial for an incoming student at the beginning of their research experience. We feel our findings will greatly facilitate the overall undergraduate student selection process in any academic environment.
Galaxy External Display Applications: Closing a dataflow interoperability loop
Authors: Blankenberg Daniel , Chilton John , Coraor Nate 
Published: May 2019

AbstractInteroperability of datasets, tools, and resources is essential to modern scientific investigation and analysis. The necessity to gather disparate datasets together, perform analysis with a collection of discrete tools, and visualize the results remains a standard approach for exploring and making sense across scientific research domains. Here, we describe the Galaxy External Display Application (GEDA) framework which provides researchers with the ability to facilitate the interoperability of Galaxy user data and external resources, while promoting findability, accessibility, and reuse. The only requirement on the external resource for GEDA accessibility is that it is able to accept a parameter value that contains a URL pointing to user data.
Relationship between footshock intensity, post-training corticosterone release and contextual fear memory specificity over time
Authors: dos Santos Corrêa Moisés , dos Santos Vaz Barbara , Grisanti Gabriel David Vieira , de Paiva Joselisa Péres Queiroz , Tiba Paula Ayako , Fornari Raquel Vecchio 
Published: May 2019

ABSTRACTOvergeneralized fear has long been implicated in generalized anxiety and post-traumatic stress disorder, however, time-dependent mechanisms underlying memory retrieval are still not completely understood. Previous studies have revealed that stronger fear conditioning training protocols are associated with both increased post-training corticosterone (CORT) levels and fear responses at later retrieval tests. Here we used discriminative contextual fear conditioning (CFC) to investigate the relationship between post-training CORT levels and memory specificity in different retrieval timepoints. Wistar rats were exposed to CFC training with increasing footshock intensities (0.3, 0.6 or 1.0mA) and had their blood collected 30 min afterwards to measure post-training plasma CORT. After 2, 14 or 28 days, rats were tested for memory specificity either in the training or in the novel context. Regression analysis was used to verify linear and non-linear interactions between CORT levels and freezing. Higher footshock intensities increased post-training CORT levels and freezing times during tests in all timepoints. Moreover, stronger trainings elicited faster memory generalization, which was associated with higher CORT levels during memory consolidation. The 0.3mA training maintained memory specificity up to 28 days. Additionally, linear regressions suggest that the shift from specific to generalized memories is underway at 14 days after training. These results are consistent with the hypotheses that stronger training protocols elicit a faster generalization rate, and that this process is associated with increased post-training CORT release.HIGHLIGHTSStronger contextual fear conditioning (CFC) elicits higher plasma corticosterone (CORT).Strong CFC and high CORT levels increase the rate of memory generalization.Weak CFC and low CORT levels retain memory specificity up to 28 days.Post-training plasma CORT is linearly associated with remote generalized fear.
Retinal stabilization reveals limited influence of extraretinal signals on heading tuning in the medial superior temporal area
Authors: Manning Tyler S , Britten Kenneth H 
Published: May 2019

AbstractHeading perception in primates depends heavily on visual optic-flow cues. Yet during self-motion, heading percepts remain stable even though smooth-pursuit eye movements often distort optic flow. Electrophysiological studies have identified visual areas in monkey cortex, including the dorsal medial superior temporal area (MSTd), that signal the true heading direction during pursuit. According to theoretical work, self-motion can be represented accurately by compensating for these distortions in two ways: via retinal mechanisms or via extraretinal efference-copy signals, which predict the sensory consequences of movement. Psychophysical evidence strongly supports the efference-copy hypothesis, but physiological evidence remains inconclusive. Neurons that signal the true heading direction during pursuit are found in visual areas of monkey cortex, including the dorsal medial superior temporal area (MSTd). Here we measured heading tuning in MSTd using a novel stimulus paradigm, in which we stabilize the optic-flow stimulus on the retina during pursuit. This approach isolates the effects on neuronal heading preferences of extraretinal signals, which remain active while the retinal stimulus is prevented from changing. Our results demonstrate a significant but small influence of extraretinal signals on the preferred heading directions of MSTd neurons. Under our stimulus conditions, which are rich in retinal cues, we find that retinal mechanisms dominate physiological corrections for pursuit eye movements, suggesting that extraretinal cues, such as predictive efference-copy mechanisms, have a limited role under naturalistic conditions.Significance StatementSensory systems discount stimulation caused by the animal’s own behavior. For example, eye movements cause irrelevant retinal signals that could interfere with motion perception. The visual system compensates for such self-generated motion, but how this happens is unclear. Two theoretical possibilities are a purely visual calculation or one using an internal signal of eye movements to compensate for their effects. Such a signal can be isolated by experimentally stabilizing the image on a moving retina, but this approach has never been adopted to study motion physiology. Using this method, we find that eye-movement signals have little influence on neural activity in visual cortex, while feed-forward visual calculation has a strong effect and is likely important under real-world conditions.
Dissociating proprioceptive deficits in Autism Spectrum Disorders: Intact acuity but impaired sensory integration in postural control
Authors: Doumas Michail , Knox Rebekah , O’Brien Cara , Craig Chesney E. 
Published: May 2019

AbstractWe investigated the presence of proprioceptive deficits in adults with Autism Spectrum Disorder (ASD), by assessing peripheral proprioceptive information (or proprioceptive acuity) as well as integration of proprioceptive information in the context of postural control. We hypothesized that proprioceptive acuity would be intact but that integration during a postural control task would be impaired. Sixteen adults with ASD and sixteen Neurotypical (NT) adults were screened using an IQ test and the adolescent-adult sensory profile. Proprioceptive acuity was assessed using an ankle Joint Position Sense (JPS) task and integration of proprioceptive information was assessed using a postural adaptation task. This task comprised standing upright, without vision in three phases: standing on a fixed surface for 2 minutes (baseline), followed by standing on a surface tilting in proportion to participants’ body sway, or support-surface sway reference for 3 minutes (adaptation) and finally standing on the restored fixed surface for 3 minutes (reintegration). Results showed no group differences in proprioceptive acuity and in the baseline phase, but greater postural sway during adaptation in individuals with ASD compared with NT controls. Specifically, group differences were not present in the first 30s of adaptation, but emerged after the second window suggesting a deficit in sensory integration of proprioception in adults with ASD. Our results suggest that peripheral proprioceptive information is intact in ASD but neural sensory integration of proprioception is impaired in this group.