bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantitative Analysis of Terrestrial Water Storage Changes Under the Grain for Green Program in the Yellow River Basin
Authors: Lv Meixia , Ma Zhuguo , Li Mingxing , Zheng Ziyan 
Published: January 2019

AbstractAfforestation‐induced changes in water resources have attracted worldwide attention. However, a clear picture of quantitative attribution of terrestrial water storage (TWS) variation from hydroclimatic and anthropogenic factors is still lacking. In this study, a quantitative analysis of TWS variation was conducted in the Yellow River basin of China under the Grain for Green project with consideration of irrigation. The results showed that the TWS has decreased (increased) more and more quickly (slowly) in the Loess Plateau (headwater region). The TWS increase corresponded to increased runoff and soil moisture in the headwaters, and the TWS depletion corresponded to decreased runoff and groundwater in the Loess Plateau and downstream regions. Regarding the TWS change (TWSC), it exhibited a negative trend across the basin. The increase in evapotranspiration (ET) dominated the basin‐averaged TWSC reduction, while the increase in ET was highly related to the increases in vegetation cover and irrigation water use. For spatial TWSC variations, the value of precipitation minus ET could account for most changes in TWSC, except for those in the headwater region and a region near the internally drained area. The increased vegetation coverage, which can affect multiple hydrological processes, played an important role in these two excluded regions. Importantly, the irrigation‐induced TWSC was considerable and varied with different irrigation water sources (i.e., surface water and groundwater). Overall, the impacts of afforestation and irrigation on TWS are sufficiently important. The research in this study can provide guidance for the water resource management during revegetation efforts.
A 10‐Year Record of Aerosol Optical Properties and Radiative Forcing Over Three Environmentally Distinct AERONET Sites in Kenya, East Africa
Authors: Boiyo Richard , Kumar K. Raghavendra , Zhao Tianliang , Guo Jianping 
Published: January 2019

AbstractIn the framework of Aerosol Robotic Network (AERONET), the aerosol optical, microphysical, and radiative properties were investigated over three sites (CRPSM_Malindi, Nairobi, and ICIPE_Mbita) in Kenya, East Africa, during 2006–2015. The annual mean (±σ) aerosol optical depth at 440 nm (AOD440) was found high at Mbita (0.27 ± 0.09) followed by Malindi (0.26 ± 0.07), and low at Nairobi (0.19 ± 0.04). Whereas the seasonal mean AOD440 noticed high (low) values during the local dry (wet) seasons. The aerosol optical properties: AOD, single scattering albedo, asymmetry parameter, and complex aerosol refractive index exhibited significant temporal and spectral heterogeneities illustrating the complexity of aerosol types with an abundance of fine‐mode aerosols during the local dry (June–July–August) season. Characterization of major aerosol types revealed the dominance of mixed‐type followed by biomass burning aerosols. The aerosol volume size distribution revealed that the coarse‐ over fine‐mode aerosols showed a significant contribution to the total volume particle concentration, especially at high (>0.3) AOD440. Further, the aerosol columnar number size distribution retrieved from the King's inversion of spectral AOD exhibited a power law distribution affirming multiplicity of aerosol sources. The direct aerosol radiative forcing values simulated in the shortwave region using the Santa Barbara DISORT Atmospheric Radiative Transfer model showed good correlation (r = >0.85) with the AERONET‐derived ones at the top‐of‐atmosphere, bottom‐of‐atmosphere, and within the atmosphere. The annual mean (±σ) top‐of‐atmosphere, bottom‐of‐atmosphere, and within the atmosphere forcing values were found in the range from −8.10 ± 3.75 to −13.23 ± 4.87, −34.54 ± 4.86 to −46.11 ± 10.27, and 26.63 ± 6.43 to 36.24 ± 7.26 W/m2, respectively, with an atmospheric heating rate of 0.74 ± 0.12–1.02 ± 0.20 K/day. The Santa Barbara DISORT Atmospheric Radiative Transfer‐derived direct aerosol radiative forcing exhibited significant temporal heterogeneity with high (low) during the local dry (wet) seasons. Results derived from the present study forms a basis for regional climate change studies and could increase the accuracy of climate models over this unexplored region of Africa.
Diagnostic Accuracy of Early Secretory Antigenic Target-6–Free Interferon-gamma Release Assay Compared to QuantiFERON-TB Gold In-tube
Authors: Nemes Elisa , Abrahams Deborah , Scriba Thomas J , Ratangee Frances , Keyser Alana , Makhethe Lebohang , Erasmus Mzwandile , Mabwe Simbarashe , Bilek Nicole , Rozot Virginie , Geldenhuys Hennie , Hatherill Mark , Lempicki Maria D , Holm Line Lindebo , Bogardus Leah , Ginsberg Ann M , Blauenfeldt Thomas , Smith Bronwyn , Ellis Ruth D , Loxton Andre G , Walzl Gerhard , Andersen Peter , Ruhwald Morten 
Published: January 2019

Abstract

Background
Early secretory antigenic target-6 (ESAT-6) is an immunodominant Mycobacterium tuberculosis (M.tb) antigen included in novel vaccines against tuberculosis (TB) and in interferon-gamma (IFN-γ) release assays (IGRAs). Therefore, the availability of an ESAT-6–free IGRA is essential to determine M.tb infection status following vaccination with ESAT-6–containing vaccines. We aimed to qualify a recently developed ESAT-6–free IGRA and to assess its diagnostic performance in comparison to QuantiFERON-TB Gold In-tube (QFT).

Methods
Participants with different levels of M.tb exposure and TB disease were enrolled to determine the ESAT-6–free IGRA cutoff, test assay performance in independent cohorts compared to standard QFT, and perform a technical qualification of antigen-coated blood collection tubes.

Results
ESAT-6–free IGRA antigen recognition was evaluated in QFT-positive and QFT-negative South African adolescents. The ESAT-6–free IGRA cutoff was established at 0.61 IU/mL, based on receiver operating characteristic analysis in M.tb-unexposed controls and microbiologically confirmed pulmonary TB patients. In an independent cohort of healthy adolescents, levels of IFN-γ released in QFT and ESAT-6–free IGRA were highly correlated (P < .0001, r = 0.83) and yielded comparable positivity rates, 41.5% and 43.5%, respectively, with 91% concordance between the tests (kappa = 0.82; 95% confidence interval, 0.74–0.90; McNemar test P = .48). ESAT-6–free IGRA blood collection tubes had acceptable lot-to-lot variability, precision, and stability.

Conclusions
The novel ESAT-6–free IGRA had diagnostic accuracy comparable to QFT and is suitable for use in clinical trials to assess efficacy of candidate TB vaccines to prevent established M.tb infection.
The use of intravesical cidofovir for the treatment of adenovirus-associated haemorrhagic cystitis in a kidney transplant recipient
Authors: Ho Quan Yao , Tan Chieh Suai , Thien Siew Yee , Kee Terence , Chlebicki Maciej Piotr 
Published: January 2019

Abstract
Adenovirus is an important cause of haemorrhagic cystitis in kidney transplant recipients. The optimal treatment for adenovirus-associated haemorrhagic cystitis (AAHC) is unknown. Intravenous cidofovir may be effective, but nephrotoxicity is a major concern. The use of intravesical cidofovir for viral haemorrhagic cystitis has been reported in haematopoietic stem cell transplant recipients and may be associated with a lower risk of nephrotoxicity, but its use has not been reported in kidney transplant recipients. We report the use of intravesical cidofovir for the treatment of AAHC in a kidney transplant recipients, along with a review of the literature.
Modulation of temozolomide dose differentially affects T-cell response to immune checkpoint inhibition
Authors: Karachi Aida , Yang Changlin , Dastmalchi Farhad , Sayour Elias J , Huang Jianping , Azari Hassan , Long Yu , Flores Catherine , Mitchell Duane A , Rahman Maryam 
Published: January 2019

Abstract

Background
The changes induced in host immunity and the tumor microenvironment by chemotherapy have been shown to impact immunotherapy response in both a positive and a negative fashion. Temozolomide is the most common chemotherapy used to treat glioblastoma (GBM) and has been shown to have variable effects on immune response to immunotherapy. Therefore, we aimed to determine the immune modulatory effects of temozolomide that would impact response to immune checkpoint inhibition in the treatment of experimental GBM.

Methods
Immune function and antitumor efficacy of immune checkpoint inhibition were tested after treatment with metronomic dose (MD) temozolomide (25 mg/kg × 10 days) or standard dose (SD) temozolomide (50 mg/kg × 5 days) in the GL261 and KR158 murine glioma models.

Results
SD temozolomide treatment resulted in an upregulation of markers of T-cell exhaustion such as LAG-3 and TIM-3 in lymphocytes which was not seen with MD temozolomide. When temozolomide treatment was combined with programmed cell death 1 (PD-1) antibody therapy, the MD temozolomide/PD-1 antibody group demonstrated a decrease in exhaustion markers in tumor infiltrating lymphocytes that was not observed in the SD temozolomide/PD-1 antibody group. Also, the survival advantage of PD-1 antibody therapy in a murine syngeneic intracranial glioma model was abrogated by adding SD temozolomide to treatment. However, when MD temozolomide was added to PD-1 inhibition, it preserved the survival benefit that was seen by PD-1 antibody therapy alone.

Conclusion
The peripheral and intratumoral immune microenvironments are distinctively affected by dose modulation of temozolomide.
Top-Down Suppression of Sensory Cortex in an NMDAR Hypofunction Model of Psychosis
Authors: Ranson Adam , Broom Eluned , Powell Anna , Chen Fangli , Major Guy , Hall Jeremy 
Published: January 2019

Abstract
Conceptual and computational models have been advanced that propose that perceptual disturbances in psychosis, such as hallucinations, may arise due to a disruption in the balance between bottom-up (ie sensory) and top-down (ie from higher brain areas) information streams in sensory cortex. However, the neural activity underlying this hypothesized alteration remains largely unexplored. Pharmacological N-methyl-d-aspartate receptor (NMDAR) antagonism presents an attractive model to examine potential changes as it acutely recapitulates many of the symptoms of schizophrenia including hallucinations, and NMDAR hypofunction is strongly implicated in the pathogenesis of schizophrenia as evidenced by large-scale genetic studies. Here we use in vivo 2-photon imaging to measure frontal top-down signals from the anterior cingulate cortex (ACC) and their influence on activity of the primary visual cortex (V1) in mice during pharmacologically induced NMDAR hypofunction. We find that global NMDAR hypofunction causes a significant increase in activation of top-down ACC axons, and that surprisingly this is associated with an ACC-dependent net suppression of spontaneous activity in V1 as well as a reduction in V1 sensory-evoked activity. These findings are consistent with a model in which perceptual disturbances in psychosis are caused in part by aberrant top-down frontal cortex activity that suppresses the transmission of sensory signals through early sensory areas.
Diagnosis of occupational hypersensitivity pneumonitis
Authors: Morell Ferran , Ojanguren Iñigo , Cruz María-Jesús 
Published: January 2019

Purpose of review
To discuss the diagnostic methods currently used in the study of patients with hypersensitivity pneumonitis, with special emphasis on the most recent contributions published in the medical literature regarding the diagnosis of occupational hypersensitivity pneumonitis (OHP). This review presents an update of the use of these diagnostic tests, a controversial issue among experts.

Recent findings
In spite of the multiple attempts at systematization and the publication of expert consensus statements, standardizing and diagnostic methods and criteria remain particularly difficult. As a result, centers tend to rely on their own experience and establish diagnosis by consensus among their multidisciplinary teams. Though recommendable in many ways, this method presents significant limitations.

Summary
Diagnosis of OHP should be made with a thorough clinical history of the symptoms and clinical signs as well as a meticulous review, if possible by an expert, of possible exposures in the working environment; a meticulous physical examination; high-resolution computed tomography of the thorax; serum determination of specific immunoglobuline Gs; bronchoalveolar lavage and possibly cryobiopsy; fungal culture; and, when appropriate, a specific inhalation challenge test with the suspected antigen.
The North Carolina Community Preceptor Experience: Third Study of Trends Over 12 Years
Authors: Latessa Robyn , Keen Susan , Byerley Julie , Foley Kathleen A. , Payne Lauren E. , Conner Kirstie T. , Tarantino Heather , Peyser Bruce , Steiner Beat D. 
Published: January 2019

Purpose
To measure community-based preceptors’ overall satisfaction and motivations, the influence of students on preceptors’ practices, and compare with 2005 and 2011 studies.

Method
North Carolina primary care preceptors across disciplines (physicians, pharmacists, advanced practice nurses, physician assistants) received survey invitations via e-mail, fax, postcard, and/or full paper survey. Most questions in 2017 were the same as questions used in prior years, including satisfaction with precepting, likelihood to continue precepting, perceived influence of teaching students in their practice, and incentives for precepting. A brief survey or phone interview was conducted with 62 nonresponders. Chi-square tests were used to examine differences across discipline groups and to compare group responses over time.

Results
Of the 2,786 preceptors contacted, 893 (32.1%) completed questionnaires. Satisfaction (816/890; 91.7%) and likelihood of continuing to precept (778/890; 87.4%) remained unchanged from 2005 and 2011. However, more preceptors reported a negative influence for patient flow (422/888; 47.5%) in 2017 than in 2011 (452/1,266; 35.7%) and 2005 (496/1,379; 36.0%) (P < .0001), and work hours (392/889; 44.1%) in 2017 than in 2011 (416/1,268; 32.8%) and 2005 (463/1,392; 33.3%) (P < .0001). Importance of receiving payment for teaching increased from 32.2% (371/1,152) in 2011 to 46.4% (366/789) in 2017 (P < .0001).

Conclusions
This 2017 survey suggests preceptor satisfaction and likelihood to continue precepting have remained unchanged from prior years. However, increased reporting of negative influence of students on practice and growing value of receiving payment highlight growing concerns about preceptors’ time and finances and present a call to action.
Addressing Race, Culture, and Structural Inequality in Medical Education: A Guide for Revising Teaching Cases
Authors: Krishnan Aparna , Rabinowitz Molly , Ziminsky Ariana , Scott Stephen M. , Chretien Katherine C. 
Published: January 2019

Problem
Sociodemographic identities, including race, culture, ethnicity, gender, and sexual orientation (race and culture), are recognized as important determinants of health, with significant impacts on patients’ health outcomes, but teaching medical students about this is challenging. The authors sought to identify areas for improvement in delivery of critical content about race, culture, structural inequalities, and health disparities within a set of virtual patient cases used by U.S. medical schools and develop revision guidelines.

Approach
A workgroup (medical students and faculty) conducted a literature review in 2017 to identify challenges and best practices for teaching and learning about race and culture in medicine. Using an analytic framework informed by this review, they analyzed 63 Aquifer virtual patient teaching cases for effectiveness of the presentation of race and culture, resulting in six main themes describing common mistakes or pitfalls. They then developed an evidence-based guide for systematic case revision.

Outcomes
The authors present a novel, practical guide for medical educators to use to revise existing teaching cases and improve the delivery of critical concepts surrounding race and culture. This guide includes fundamental definitions and six sections to guide structured case revision based on the main themes. It includes examples of language, suggested edits, and the rationale and evidence for recommendations.

Next Steps
Feedback from faculty and students regarding implementation of the guide and delivery of revised content in Aquifer cases will be critical in determining the guide’s effectiveness. This structured guide may be adapted to a variety of teaching modalities in medicine.
Pelvic Tilt Changes After Hamstring Lengthening in Children With Cerebral Palsy
Authors: Wijesekera Maheshi P.C. , Wilson Nichola C. , Trinca Daniele , Holmes Gillian , Bass Alfie , Wright David M. , Walton Roger 
Published: January 2019

Background:
Flexion deformity of the knee is a common presentation in children with cerebral palsy with hamstring surgery as an option for addressing this. However, concerns with regard to increased pelvic tilt have been raised. The purpose of this study was to compare preoperative and postoperative pelvic tilt after isolated hamstring lengthening versus combined hamstring lengthening and the influence of Gross Motor Function Classification System (GMFCS) levels on pelvic tilt.

Methods:
This retrospective study included 46 ambulatory children with cerebral palsy who had had open medial hamstring lengthening (mean age at surgery, 11 y 11 mo; SD, 2 y 11 mo; GMFCS I, 16; GMFCS II 20; GMFCS III 10). Twelve children underwent isolated surgery and 34 children underwent combined surgery. The isolated hamstring procedures could be combined with foot and/or ankle-level surgery, as only the hamstring procedure would affect the pelvic tilt. Combined surgery was defined as hamstring lengthening with other procedures performed at the knee or more proximally. The preoperative and postoperative 3-dimensional gait analysis data were evaluated in this study.

Results:
Both the isolated and combined hamstring lengthening groups showed no significant change in pelvic tilt (∆1.28, P=0.203; ∆1.47, P=0.113, respectively). A significant change in pelvic tilt was seen in children functioning at GMFCS III (∆4.66, P=0.009) but not GMFCS I and II (∆0.37, P=0.718; ∆0.48, P=0.697). Significant postoperative decreases in the knee flexion angle at initial contact were seen for both isolated (∆5.72, P=0.010) and combined hamstring lengthening (∆10.95, P<0.001).

Conclusions:
Hamstring lengthening, for the majority of patients, did not lead to a clinically significant change in mean pelvic tilt and improved knee flexion angle at initial contact. Children who functioned at GMFCS level III had an increase in anterior pelvic tilt and caution should be exercised in this group.

Study Design:
Level IV evidence—case series.
Reflectance Confocal Microscopy Features of Plaque Psoriasis Overlap With Horizontal Histopathological Sections: A Case Series
Authors: Verzì Anna Elisa , Lacarrubba Francesco , Caltabiano Rosario , Broggi Giuseppe , Musumeci Maria Letizia , Micali Giuseppe 
Published: January 2019

Abstract:
Reflectance confocal microscopy (RCM) displays horizontal, en face tissue sections of the epidermis and upper dermis, and interpretation of its features is classically based on the comparison with vertical conventional histopathological sections that, as known, do not reflect the same plane of observation. In 10 patients affected by psoriasis, we correlated RCM images with horizontal histopathological sections from skin biopsies, observing in all cases marked overlaps between the 2 techniques. Although vertical section examination remains the gold standard for the diagnosis of psoriasis, this novel comparative approach may contribute to a more precise definition of RCM findings and could represent the drive for further research as well as an innovative tool for educational purposes.
Exploring Patient Experience of Facial Nerve Palsy to Inform the Development of a PROM
Authors: Norris Jonathan H. , Longmire Natasha M. , Kilcoyne Sarah , Johnson David , Fitzpatrick Ray , Klassen Anne F. 
Published: January 2019

Background:
There is currently a mandate globally to incorporate patient’s perceptions of their illness into outcome measures, in order to provide a deeper insight into medical practice. Facial nerve palsy (FNP) is a devastating condition that can significantly impact quality of life. However, no measure currently exists that comprehensively assesses outcome in FNP using patient perception. The aim of this study is to explore patients’ experiences of FNP with the aim of informing the development of a patient-reported outcome measure.

Methods:
Presented is a qualitative study, using in-depth semi-structured interviews with FNP patients. An interview guide was developed using expert opinion and a literature review. Interpretative description was used as the qualitative approach. Interviews were audio-recorded, transcribed, and coded line-by-line. Codes were refined using the constant comparison approach. Interviews continued until data saturation was reached. The data were used to develop a conceptual framework of patient perceived issues relating to FNP.

Results:
The sample included 5 men and 9 women aged 57.7 years (range, 36–78) with a range of causes of FNP, including Bell’s palsy (n = 5), acoustic neuroma (n = 3), trauma (n = 2), meningioma (n = 1), muscular dystrophy (n = 1), congenital (n = 1), and Ramsay Hunt syndrome (n = 1). Analysis of the 14 participant interviews led to identification of 5 major domains including “facial function concerns,” “appearance concerns,” “psychological function,” “social function,” and “experience of care.”

Conclusion:
This study provides a conceptual framework covering outcomes that matter to patients with FNP, which can be used to inform the development of a new comprehensive FNP-specific patient-reported outcome measure.
Immediate Dental Implantation in Oncologic Jaw Reconstruction: Workflow Optimization to Decrease Time to Full Dental Rehabilitation
Authors: Allen Robert J. , Shenaq Deana S. , Rosen Evan B. , Patel Snehal G. , Ganly Ian , Boyle Jay O. , Nelson Jonas A. , Matros Evan 
Published: January 2019

Summary:
Full dental rehabilitation following segmental mandibulectomy or maxillectomy for oncologic tumor ablation should be the goal for every patient. But despite advances in technology and reconstructive techniques, many patients do not achieve timely or complete oral rehabilitation. Recognizing this fault, we recently adopted an innovative workflow to increase the number of patients undergoing dental restoration, irrespective of tumor pathology or need for adjuvant radiotherapy. Preoperatively, every osseous jaw reconstruction undergoes virtual surgical planning to incorporate the placement of endosseous implants into the fibula osteocutaneous free flap. The dental implants are then placed intraoperatively at the time of tumor ablation and reconstruction. Four-to-six weeks following the initial surgery, the patient returns to the operating room for vestibuloplasty and exposure of the dental implants. Within 3 days of the vestibuloplasty, a temporary dental prosthesis is placed in the dental clinic, and the patient can then begin radiation therapy if needed. Following adjuvant radiation therapy, the temporary prosthesis can be replaced with a permanent one. At our institution, this innovative workflow has allowed for earlier aesthetic restoration of the jaw and greatly expanded the number of patients able to achieve oral rehabilitation. Herein, we describe this innovative workflow and provide technical pearls for successful execution.