bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Older Age on the Perioperative Outcomes of Spinal Fusion Surgery in Patients With Lumbar Degenerative Disc Disease With Spondylolisthesis: A Propensity Score-Matched Analysis
Authors: Badhiwala Jetan H , Karmur Brij S , Hachem Laureen D , Wilson Jamie R F , Jiang Fan , Jaja Blessing , Nouri Aria , Witiw Christopher D , Nassiri Farshad , Fehlings Michael G , Wilson Jefferson R 
Published: September 2019

Abstract

BACKGROUND
Degenerative spondylolisthesis (DS) is often treated with lumbar spinal fusion (LSF). However, there is concern that the morbidity of LSF may be prohibitively high in older adults.

OBJECTIVE
To evaluate the impact of advanced age on the safety of LSF for DS.

METHODS
Patients who underwent LSF for DS were retrospectively identified from National Surgical Quality Improvement Program datasets for 2011 to 2015 using Current Procedural Terminology codes. Data on demographic characteristics, comorbidities, surgical factors, and 30-d morbidity and mortality were collected. Propensity score matching (nearest neighbor) was performed with age (<70 vs ≥70 yr) as the dependent variable and sex, type of fusion procedure, number of levels fused, diabetes, smoking, hypertension, and chronic steroid use as covariates. Outcomes were compared between age <70 and ≥70 groups.

RESULTS
The study cohort consisted of 2238 patients (n = 1119, age <70; n = 1119, age ≥70). The 2 age groups were balanced for key covariates including sex, race, diabetes, hypertension, CHF, smoking, chronic steroid use, type of fusion, and number of levels. Rates of all complications were similar between younger and older age groups, except urinary tract infection, which was more frequent among the ≥70 age group (OR 2.32, P = .009). Further, patients in the older age group were more likely to be discharged to a rehabilitation (OR 2.94, P < .001) or skilled care (OR 3.66, P < .001) facility, rather than directly home (OR 0.25, P < .001).

CONCLUSION
LSF may be performed safely in older adults with DS. Our results suggest older age alone should not exclude a patient from undergoing lumbar fusion for DS.
Is Group Ontology Morally Distracting? A Natural Law Approach to Corporate Religious Liberty
Authors: David Edward A 
Published: September 2019

Abstract
In recent years, a variety of corporate litigants, from houses of worship to for-profit enterprises, have brought religious liberty suits to the US Supreme Court. Interestingly, the metaphysical status of such litigants has been subject to intense debate by judges and commentators alike. Are these litigants corporate moral persons or mere aggregates of individuals? How, if at all, does their metaphysical status affect our assignment of corporate rights to religious freedom? While many have entertained such questions, others reject them as morally distracting. This article challenges that latter position. Drawing upon the natural law tradition, I argue that group ontology can be used in the assignment of corporate rights in a morally illuminating way. I point out the tradition’s distinctive ontology, which views groups primarily as social actions, subject to moral evaluation. I then discuss how this conception moves attention away from polarizing rights-based discourse towards measured consideration of what is morally right. Finally, I show how this ontology helps practical reasoning to discover a variety of (non-rights-based) reasons and means to protect religious freedoms as well as other moral stakes. Far from causing moral distraction, a natural law group ontology facilitates careful moral deliberation.
At the Margins of the Medical? Educational Psychology, Child Guidance and Therapy in Provincial England, c.1945–74
Authors: Burchell Andrew 
Published: September 2019

Abstract
This article mobilises archival material from local authorities in England to assess the shifting role of psychologists within local school health services from the 1930s through to the reorganisation of the National Health Service (NHS) in 1974. It argues that psychologists were increasingly positioned between therapist, diagnostician and social worker, that this was bound together with a local discourse of children’s emotional well-being and that the increasing fluidity of the psychologist’s role emerged from local policies designed to stress the ‘educational’ nature of their role. In so doing, it extends work by John Stewart on child guidance and more long-standing histories of local, ‘municipal’ medical services. It suggests ways in which the older, localised provision of public health services in Britain persisted after the creation of the NHS and argues the need for a more flexible understanding of what was ‘medical’ about the local welfare state in this period.
Initial experience with a PET/computed tomography system using silicon photomultiplier detectors
Authors: Park Sonya Youngju , Barrato Lucia , Hatami Negin , Davidzon Guido , Gambhir Sanjiv Sam , Iagaru Andrei 
Published: September 2019

Purpose
A PET/computed tomography (CT) that uses silicon photomultiplier (SiPM) technology was installed at our institution. Here, we report the initial use of the new scanner and evaluate the image quality in comparison to standard PET/CT scanners.

Procedures
Seventy-two patients were scanned first using standard PET/CT followed immediately by the new PET/CT system. Images from the new PET/CT system were reconstructed using a conventional [non time-of-flight (TOF)] algorithm, TOF alone and TOF in combination with BSREM. Images from standard PET/CT were reconstructed using clinical standard-of-care settings. Three blinded readers randomly reviewed four datasets (standard, non-TOF, TOF alone, TOF+BSREM) per patient for image quality using a five-point Likert scale. SUV measurements for the single most avid lesion on each dataset were also recorded.

Results
Datasets from the new scanner had higher image quality (P < 0.001) and SUV measurements (P < 0.001) compared with the standard scanners, and scores further improved when TOF and BSREM algorithms were added (mean scores for standard, non-TOF, TOF alone and TOF+BSREM were 3.1, 3.9, 4.3 and 5.0, respectively; mean SUVmax for hottest lesion were 8.8, 10.3, 10.7 and 13.3, respectively).

Conclusion
The SiPM-based PET/CT system outperforms two standard Bismuth germanium oxide- and Lutetium-yttrium oxyorthosilicate-based scanners in terms of image quality, with further benefits added using TOF and BSREM. This may be beneficial for detecting small lesions and more accurate disease staging.
Integrative Approaches to Stress Management
Authors: Carlson Linda E. , Toivonen Kirsti , Subnis Utkarsh 
Published: September 2019

AbstractThis narrative review provides an overview of the scope of psychosocial distress and stress in cancer patients and survivors and the potential negative consequences of untreated symptoms. Evidence-based interventions to treat these symptoms are reviewed, beginning with a summary of published clinical practice guidelines, followed by more detailed reviews of the specific integrative interventions with the largest empirical support: cognitive-behavioral stress management, yoga, mindfulness-based interventions, and massage. We also comment on use of natural health products because of their popularity. Finally, we conclude with recommendations to improve the quality of research in integrative interventions for stress management.
Integrative Approaches for Sleep Health in Cancer Survivors
Authors: Garland Sheila N. , Mahon Kaitlyn , Irwin Michael R. 
Published: September 2019

Abstract
Sleep disturbance and insomnia are prevalent problems for the more than 15 million cancer survivors in the United States. If not addressed, poor-quality sleep can negatively impact physical and psychological recovery from cancer diagnosis and treatment. Cancer survivors are increasingly turning to integrative therapies to improve sleep and optimize their health. The purpose of this article is to review the evidence for the use of nonpharmacological integrative therapies to improve sleep health in cancer patients. Therapies are grouped into the following categories: cognitive-behavioral, meditative (e.g., mindfulness-based interventions, yoga, qigong/tai chi), and body based (e.g., acupuncture, acupressure, massage, reflexology). Cognitive-behavioral therapy for insomnia, mindfulness-based therapies, qigong/tai chi, and acupuncture have the most evidence for improving sleep and insomnia, whereas yoga, acupressure, massage, and reflexology are still being investigated or building their evidence base. Several areas of strength are identified, gaps in the literature are highlighted, and recommendations for improving future research are provided.
Patient-Reported Outcomes in Integrative Oncology
Authors: Lopez Gabriel , Lacey Judith , Christie Aimee J. , Powers-James Catherine , Narayanan Santhosshi , Liu Wenli , Cohen Lorenzo 
Published: September 2019

Abstract
There is growing interest in the value of routine collection and monitoring of patient-reported outcomes as part of high-quality, patient-centered, oncology care. Integrative oncology, with its focus on providing symptom and lifestyle support for patients throughout the cancer care continuum, serves a diverse patient population with a complex, changing symptom burden. Monitoring of patient-reported outcomes can contribute significantly to the successful comprehensive evaluation and management of patients receiving integrative oncology care. Data collected as part of an integrative oncology evaluation can also support real-world clinical research efforts to help learn more about the effects of integrative oncology interventions on patient symptoms, quality of life, and treatment outcomes.
Maternal and Paternal Well-Being During Nasoalveolar Molding and Primary Surgery Periods
Authors: Nur Yilmaz R. Burcu , Germeç Çakan Derya , Türkyilmaz Uyar Ece 
Published: September 2019

Aim:
The aim was to evaluate the anxiety and depression of both the father and mother of an infant with cleft lip and palate (CLP) before, during and after nasoalveolar molding (NAM) therapy and before and after the lip surgery.

Subjects and Method:
Forty mothers (age range: 18–36; mean ± SD: 23.6 ± 4.51) and 40 fathers (age range: 19–40; mean ± SD: 26.9 ± 4.69) of infants with CLP were asked to answer the 21-item Beck Depression as well as Anxiety Inventory (BDI and BAI) at 1 week after birth and before any intervention (T1), after impression taking (T2), after 2 months of NAM (T3), immediate before primary surgery (T4) and approximately 1 month of recovery after surgery (T5).

Results:
Maternal and paternal depression levels between T1, T2, T3, T4, and T5 showed significant differences (P < 0.05). The BDI scores decrease from T2 to T3 and T4 to T5. The increases of scores from T3 to T4 were significant (P < 0.05). The maternal depression and anxiety levels were higher than the paternal ones in all time periods. The BDI and BAI levels were lesser in mothers and fathers of babies with unilateral than bilateral CLP (P < 0.05).

Conclusion:
Hence realizing of recovery, being in contact with the cleft team and other families, and having an active role in the therapy, the maternal and parental well-being increase with NAM therapy. However, depression and anxiety levels significantly increase before the lip surgery. It may be recommended that the cleft team deliver information and psychological support especially at birth and before the surgical approaches.
Utilizing a Hospital-based Setting to Increase Organ Donor Registrations
Authors: Sutherland Michael , Moloney Gail , Norton Maddison , Bowling Alison , Walker Iain 
Published: September 2019

Background.
Shortages of organs for transplantation are a concern for many countries. In Australia’s “opt-in” system, people register their donation decision on the Australian Organ Donor Register (AODR) in their own time, yet <30% of the population have done so. Consent registrations are honored by the next-of-kin in 90% of cases, so increasing registrations will increase donated organs for transplantation. This study investigated the efficacy of offering an immediate registration opportunity in 2 hospitals, and the role that beliefs about organ donation play in registration behavior.

Methods.
An immediate registration opportunity was offered at a public and a private hospital in New South Wales, Australia. Participants (N = 168) categorized as medical/healthcare (eg, doctor and nurse) and nonhealthcare (eg, teacher and chef) completed a measure of beliefs about organ donation, were encouraged to discuss their fears and concerns about organ donation, and given an immediate opportunity to register on the AODR.

Results.
A total of 81.5% of medical/healthcare participants who were eligible registered, and 71.5% of all eligible participants registered on the spot. Beliefs about the negative consequences of donation and concerns over the medical care given to potential donors predicted (non)registration. Medical/healthcare participants reported lower levels of fears and concerns than nonhealthcare participants. Although both groups reported strong positive beliefs about donation, these did not predict registration.

Conclusions.
Offering an immediate registration opportunity in 2 hospitals notably increased the number of registrations on the AODR, suggesting this is a strategy that could potentially increase registrations in opt-in donation systems.
Association of Clinical Rejection Versus Rejection on Protocol Biopsy With Cardiac Allograft Vasculopathy in Pediatric Heart Transplant Recipients
Authors: Asimacopoulos Eleni P. , Garbern Jessica C. , Gauvreau Kimberlee , Blume Elizabeth D. , Daly Kevin P. , Singh Tajinder P. 
Published: September 2019

Background.
Two or more early rejections (<1 y) or any late acute rejection (>1 y) have been associated with coronary artery vasculopathy (CAV) in pediatric heart transplant (HT) recipients. We hypothesized that clinical rejection defined by concurrent new-onset heart failure or left ventricular systolic dysfunction is more strongly associated with future CAV than rejection diagnosed on protocol biopsy.

Methods.
We identified all subjects <21 years old who received first HT at Boston Children’s Hospital during 1986–2015 with at least 1 post-HT coronary angiogram. CAV was diagnosed using 2010 International Society for Heart and Lung Transplantation guidelines. Time to CAV diagnosis was assessed using a Cox model with occurrence of clinical rejection analyzed as a time-varying covariate.

Results.
Of 228 study subjects, 106 remained rejection-free, 77 had rejection diagnosed only on protocol biopsy (≥2R cellular or antibody-mediated), and 45 had a clinical rejection. Subjects with rejection diagnosed only on protocol biopsy were not at higher risk of CAV (hazard ratio [HR] 1.09, 95% confidence interval [CI]: 0.54-2.09). In contrast, clinical rejection was significantly associated with risk of CAV (HR 4.84, 95% CI: 2.99-7.83). Late rejection was associated with a higher risk of CAV (HR 4.27, 95% CI: 2.42-7.51) if it was clinical rejection but not if it was diagnosed on protocol biopsy (HR 0.83, 95% CI: 0.51-1.37).

Conclusions.
Clinical rejection poses a far greater risk for future CAV than rejection on protocol biopsy in pediatric HT recipients. Preventing CAV should therefore become the focus of medical management after initial treatment and resolution of clinical rejection.
Psychiatric comorbid disorders of cognition: A machine learning approach using 1,175 UK Biobank participants
Authors: Li Chenlu , Gheorghe Delia A. , Gallacher John E.J. , Bauermeister Sarah 
Published: September 2019

AbstractBackgroundConceptualising comorbidity is complex and the term is used variously. Here, it is the coexistence of two or more diagnoses which might be defined as ‘chronic’ and, although they may be pathologically related, they may also act independently1. Of interest here is the comorbidity of common psychiatric disorders and impaired cognition.ObjectivesTo examine whether anxiety and/or depression are important longitudinal predictors of cognitive change.MethodsUK Biobank participants used at three time points (n= 502,664): baseline, 1st follow-up (n= 20,257) and 1st imaging study (n=40,199). Participants with no missing data were 1,175 participants aged 40 to 70 years, 41% female. Machine learning (ML) was applied and the main outcome measure of reaction time intraindividual variability (cognition) was used.FindingsUsing the area under the Receiver Operating Characteristic (ROC) curve, the anxiety model achieves the best performance with an Area Under the Curve (AUC) of 0.68, followed by the depression model with an AUC of 0.63. The cardiovascular and diabetes model, and the covariates model have weaker performance in predicting cognition, with an AUC of 0.60 and 0.56, respectively.ConclusionsOutcomes suggest psychiatric disorders are more important comorbidities of long-term cognitive change than diabetes and cardiovascular disease, and demographic factors. Findings suggest that psychiatric disorders (anxiety and depression) may have a deleterious effect on long-term cognition and should be considered as an important comorbid disorder of cognitive decline.Clinical implicationsImportant predictive effects of poor mental health on longitudinal cognitive decline should be considered in secondary and also primary care.Summary BoxWhat is already known about this subject? 3-4 bullet pointsPoor mental health is associated with cognitive deficits.One in four older adults experience a decline in affective state with increasing age.ML approaches have certain advantages in identifying patterns of information useful for the prediction of an outcome.What are the new findings? 3-4 bullet pointsPsychiatric disorders are important comorbid disorders of long-term cognitive change.Machine-learning methods such as sequence learning based methods are able to offer non-parametric joint modelling, allow for multiplicity of factors and provide prediction models that are more robust and accurate for longitudinal dataThe outcome of the RNN analysis found that anxiety and depression were stronger predictors of change IIV over time than either cardiovascular disease and diabetes or the covariate variables.How might it impact on clinical practice in the foreseeable future?The important predictive effect of mental health on longitudinal cognition should be noted and, its comorbidity relationship with other conditions such as cardiovascular disease likewise to be considered in primary care and other clinical settings
Photo-Disassembly of Membrane Microdomains Revives Conventional Antibiotics against MRSA
Authors: Hui Jie , Dong Pu-Ting , Liang Lijia , Mandal Taraknath , Li Junjie , Ulloa Erilinda R. , Zhan Yuewei , Jusuf Sebastian , Zong Cheng , Seleem Mohamed N. , Liu George Y. , Cui Qiang , Cheng Ji-Xin 
Published: September 2019

AbstractConfronted with the rapid evolution and dissemination of antibiotic resistance, there is an urgent need to develop alternative treatment strategies for drug-resistant pathogens. Here, we present an unconventional approach to restore the susceptibility of methicillin-resistantS. aureus(MRSA) to a broad spectrum of conventional antibiotics via photo-disassembly of functional membrane microdomains. The photo-disassembly of microdomains is based on effective photolysis of staphyloxanthin, the golden carotenoid pigment that gives its name. Upon pulsed laser treatment, cell membranes are found severely disorganized and malfunctioned to defense antibiotics, as unveiled by membrane permeabilization, membrane fluidification, and detachment of membrane protein, PBP2a. Consequently, our photolysis approach increases susceptibility and inhibits development of resistance to a broad spectrum of antibiotics including penicillins, quinolones, tetracyclines, aminoglycosides, lipopeptides, and oxazolidinones.One Sentence SummaryUsing photons to crashS. aureuscell membrane and its formidable defense against a broad spectrum of antibiotics.
Bitter taste receptors stimulate phagocytosis in human macrophages through calcium, nitric oxide, and cyclic-GMP signaling
Authors: Gopallawa Indiwari , Freund Jenna R. , Lee Robert J. 
Published: September 2019

AbstractBitter taste receptors (T2Rs) are GPCRs involved in detection of bitter compounds by type 2 taste cells of the tongue, but are also expressed in other tissues throughout the body, including the airways, gastrointestinal tract, and brain. These T2Rs can be activated by several bacterial products and regulate innate immune responses in several cell types. Expression of T2Rs has been demonstrated in immune cells like neutrophils; however, the molecular details of their signaling are unknown. We examined mechanisms of T2R signaling in primary human monocyte-derived unprimed (M0) macrophages (MΦs) using live cell imaging techniques. Known bitter compounds and bacterial T2R agonists activated low-level calcium signals through a pertussis toxin (PTX)-sensitive, phospholipase C-dependent, and inositol trisphosphate receptor-dependent calcium release pathway. These calcium signals activated low-level nitric oxide (NO) production via endothelial and neuronal NO synthase (NOS) isoforms. NO production increased cellular cGMP and enhanced acute phagocytosis ∼3-fold over 30-60 min via protein kinase G. In parallel with calcium elevation, T2R activation lowered cAMP, also through a PTX-sensitive pathway. The cAMP decrease also contributed to enhanced phagocytosis. Moreover, a co-culture model with airway epithelial cells demonstrated that NO produced by epithelial cells can also acutely enhance MΦ phagocytosis. Together, these data define MΦ T2R signal transduction and support an immune recognition role for T2Rs in MΦ cell physiology.
Structure-based identification and characterisation of novel inhibitors of KNa1.1 potassium channels, a stratified target for KCNT1-related epilepsy
Authors: Cole Bethan A. , Johnson Rachel M. , Dejakaisaya Hattapark , Pilati Nadia , Fishwick Colin W.G. , Muench Stephen P. , Lippiat Jonathan D. 
Published: September 2019

AbstractSeveral types of drug-resistant epileptic encephalopathies of infancy have been associated with mutations in the KCNT1 gene, which encodes the sodium-activated potassium channel subunit KNa1.1. These mutations are commonly gain-of-function, increasing channel activity, therefore inhibition by drugs is proposed as a stratified approach to treat disorders. To date, quinidine therapy has been trialled with several patients, but mostly with unsuccessful outcomes, which has been linked to its low potency and lack of specificity. Here we describe the use of a cryo-electron microscopy-derived KNa1.1 structure and mutational analysis to identify the quinidine biding site and identified novel inhibitors that target this site using computational methods. We describe six compounds that inhibit KNa1.1 channels with low- and sub-micromolar potencies, likely through binding in the intracellular pore vestibule. In preliminary hERG inhibition and cytotoxicity assays, two compounds showed little effect. These compounds may provide starting points for the development of novel pharmacophores for KNa1.1 inhibition, with the view to treating KCNT1-associated epilepsy and, with their potencies higher than quinidine, could become key tool compounds to further study this channel. Furthermore, this study illustrates the potential for utilising cryo-electron microscopy in ion channel drug discovery.