bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thermal Neutron Characterization and Dose Modeling of a 239PuBe Alpha-Neutron Source
Authors: Willey Adam H. , DeVol Timothy A. , Martinez Nicole E. 
Published: September 2019

Abstract
Determination of neutron dose can be challenging and requires knowledge of neutron flux as a function of energy. The goal of this project was to characterize the thermal neutron flux of a 37 GBq 239PuBe alpha-neutron source and model the associated neutron dose using version MCNPX of the Monte-Carlo N-Particle transport codes. The 239PuBe source was placed in a neutron howitzer, and foil activation (dysprosium foils with and without cadmium covers) was used at various distances to determine thermal neutron flux, which was then used to verify the MCNPX model representing the system. The model was then adapted for dosimetric modeling to enable future neutron dose-response studies.
Measuring Self-Reported Physical Function in Individuals With TBI: Development of the TBI-QOL Mobility and Upper Extremity Item Banks and Short Forms
Authors: Capó-Lugo Carmen E. , Kisala Pamela A. , Boulton Aaron J. , Choi Seung W. , Heinemann Allen W. , Tulsky David S. 
Published: September 2019

Objectives:
To describe the development and field testing of the patient-reported outcome measures of Mobility and Upper Extremity function from the Traumatic Brain Injury Quality of Life (TBI-QOL) measurement system, and to evaluate the use of computer adaptive testing.

Setting:
Five rehabilitation facilities funded as part of the TBI Model Systems network.

Participants:
Individuals with complicated mild, moderate, or severe traumatic brain injury (n = 590).

Interventions:
Not available.

Outcome Measures:
TBI-QOL Mobility and Upper Extremity item banks.

Results:
Item response theory and factor analyses supported the unidimensionality of the Mobility and Upper Extremity banks. Descriptive statistics showed a ceiling effect for both measures. Simulated computer adaptive tests (CATs) showed that measurement precision was maintained across administration formats for both measures. The Upper Extremity CAT showed a loss of precision for individuals without impairment and that a higher number of items were required to achieve sufficiently precise measurement, compared to the Mobility CAT.

Conclusions:
The TBI-QOL Upper Extremity and Mobility item banks achieved good breadth of coverage, particularly among those individuals who have experienced some degree of functional limitation. The use of CAT administration minimizes respondent burden, while allowing for the comprehensive assessment of adults with TBI. The combined use of the TBI-QOL with performance-based measures could guide the development of targeted rehabilitation treatments.
Insight Into Illness and Defense Styles in Schizophrenia
Authors: Ogawa Yasuhiro , Fukuhara Keita , Tanaka Hiroyuki , Nagata Yuma , Ishimaru Daiki , Nishikawa Takashi 
Published: September 2019

Abstract
Although the psychological denial model argues that poor insight is a result of defense mechanisms, the direct relationship between the two remains unclear. This study aimed to examine the relationship between insight into illness and defense mechanisms while considering cognitive dysfunction in schizophrenia. A total of 38 patients with schizophrenia were evaluated for level of insight (Schedule for the Assessment of Insight), defense mechanisms (Defense Style Questionnaire), neurocognitive function (Brief Assessment of Cognition in Schizophrenia), and psychotic symptoms (Brief Psychiatric Rating Scale). Regarding level of insight, partial correlation analysis controlling neurocognitive and psychotic variables showed that “recognition of illness” was positively correlated with immature defense styles and negatively correlated with mature defense styles. Stepwise regression analyses revealed that “recognition of illness” was significantly predicted by immature defense styles. Our findings suggest that patients who tend to use immature defense styles are more likely to accept their own mental illness.
Interpersonal Problems Associated With Passive-Aggressive Personality Disorder
Authors: Laverdière Olivier , Ogrodniczuk John S. , Kealy David 
Published: September 2019

Abstract
With a controversial history, passive-aggressive personality disorder (PAPD) was eventually removed from the latest edition of the Diagnostic and Statistical Manual for Mental Disorders. Despite its demise from diagnostic nomenclature, clinicians continue to regard it as a clinically relevant construct, and some researchers argue for its resurrection. Toward this end, it is important to empirically demonstrate the relevance of the passive-aggressive personality construct, including demonstrating its association with impaired functioning. Consistent with contemporary emphasis on interpersonal functioning in personality pathology, the current study aims to explore interpersonal problems that are associated with PAPD in a large clinical sample. Before beginning treatment, 240 patients completed assessments of personality psychopathology and interpersonal functioning. Results showed that higher levels of PAPD were significantly associated with greater level of interpersonal distress, especially regarding interpersonal problems of a vindictive nature. The findings are consistent with clinical descriptions of the core conflictual relational issues of patients with PAPD and lend some support to further considering PAPD as a valid diagnostic construct.
Personality and the Expression of Symptomatology in Schizophrenia and Bipolar Disorder
Authors: Urošević Snežana , Halverson Tate , Sponheim Scott R. 
Published: September 2019

Abstract
Researchers and clinicians have begun using dimensions rather than categories to classify psychopathology with a reliance on personality questionnaires to tap traits that can inform dimensional characterizations. A neglected concern is whether in severe psychopathology questionnaire-based assessments of personality reflect a lifetime propensity toward a diagnosis, as some personality-psychopathology models posit, or reflect the transient effects of current symptoms, as a complication model of personality-psychopathology would suggest. Accurate characterization of psychopathology is necessary to understand etiology and prescribe clinical care. We studied 127 adults with schizophrenia, schizoaffective, or bipolar disorder who completed well-validated measures of personality, current symptomatology, and lifetime psychopathology. We found that normative personality traits were related to current symptoms but unrelated to lifetime symptomatology, whereas the schizotypal trait of cognitive-perceptual distortions predicted lifetime psychosis severity. Questionnaire-based assessments of normative personality are likely affected by current symptom states and may fail to yield a stable characterization of psychopathology.
Integration of Physical Examination, Old and New Biomarkers, and Ultrasonography by Using Neural Networks for Pediatric Appendicitis
Authors: Akgül Fatma , Er Anıl , Ulusoy Emel , Çağlar Aykut , Çitlenbik Hale , Keskinoğlu Pembe , Şişman Ali R. , Karakuş Osman Z. , Özer Erdener , Duman Murat , Yılmaz Durgül 
Published: September 2019

Objective
The objective of this study was to evaluate physical examinations, imaging, and laboratory analyses individually and combined using innovative statistical analysis methods for the accurate diagnosis of pediatric appendicitis.

Methods
Patients admitted to hospital with symptoms of abdominal pain whose pediatric appendicitis scores greater than 3 were included in the study. Clinical, radiologic, and laboratory findings and as a new biomarker calprotectin (CPT) concentrations were evaluated individually and combined using artificial neural networks (ANNs), which revealed latent relationships for a definitive diagnosis.

Results
Three hundred twenty patients were evaluated (190 appendicitis [43 perforated] vs 130 no appendicitis). The mean ± SD age was 11.3 ± 3.6 years and 63% were male. Pediatric appendicitis scores, white blood cell (WBC) count, absolute neutrophil count (ANC), C-reactive protein (CRP) level, procalcitonin (PCT) and CPT concentrations were higher in the appendicitis group; however, only WBC and ANC were higher in first 24 hours of pain. White blood cells and CRP were diagnostic markers in patients whose appendix could not be visualized using ultrasonography (US). On classic receiver operating characteristic (ROC) analysis, the areas under the curve (AUCs) were not strong enough for differential diagnosis (WBC, 0.73; ANC, 0.72; CRP, 0.65; PCT and CPT, 0.61). However, when the physical examination, US, and laboratory findings were analyzed in a multivariate model and the ROC analysis obtained from the variables with ANN, an ROC curve could be obtained with 0.91 AUC, 89.8% sensitivity, and 81.2% specificity. C-reactive protein and PCT were diagnostic for perforated appendicitis with 0.83 and 0.75 AUC on ROC.

Conclusions
Although none of the biomarkers were sufficient for an accurate diagnosis of appendicitis individually, a combination of physical examination and laboratory and US was a good diagnostic tool for pediatric appendicitis.
Hopkins Syndrome
Authors: Gateau Kameelah L. , David Henry , Lowe Calvin G. 
Published: September 2019

Abstract
We report a rare case of a 22-month-old who developed flaccid paralysis of her right arm shortly after she was hospitalized for an asthma exacerbation. There are many etiologies of acute flaccid paralysis; however, because of the uncommon presentation of a focalized finding, establishing the diagnosis of this patient was difficult in the emergency department setting. Associated with asthma exacerbations, Hopkins syndrome is a paralytic illness that resembles poliomyelitis. This case highlights the challenges of evaluating a child with monoparesis and establishing an association with asthma amyotrophy.
Orbital Decompression for Treatment of Acute Visual Loss After Facial Trauma
Authors: Ruiz Samuel , Lim Rizal 
Published: September 2019

Abstract
Injury to the orbital region represents a significant proportion of emergency department attendances and it is a common injury in patients with multisystem trauma. To date, trauma remains a leading cause of monocular blindness.
Traumatic optic neuropathy may be caused by direct trauma to the optic nerve and from compression caused by foreign bodies and bone fragments. Indirect trauma can lead to visual loss from transmitted force to the optic canal by blunt facial trauma without associated fractures. Occasionally traumatic optic neuropathy is due to reversible changes, such as edema or contusion.
High-dose intravenous steroids and surgical decompression of the optic canal have been advocated for the management of acute traumatic optic neuropathy, but the efficacy and safety of these treatments have been questioned.
The authors present 3 patients with traumatic optic nerve injury, 1 due to a gunshot wound to the face and 2 caused by blunt facial trauma, where fragments of bone intrude into the orbit leading to compression of its content. These injuries where successfully treated with both preoperative intravenous steroids followed by acute surgical decompression of the orbit with return of visual function.
Comprehensive Learning Curve of Robotic Surgery
Authors: Kim Min Seo , Kim Won Jun , Hyung Woo Jin , Kim Hyoung-Il , Han Sang-Uk , Kim Young-Woo , Ryu Keun Won , Park Sungsoo 
Published: September 2019

Objective:
To evaluate the complication-based learning curve and identify learning-associated complications of robotic gastrectomy.

Summary Background Data:
With the increased popularity of robotic surgery, a sound understanding of the learning curve in the surgical outcome of robotic surgery has taken on great importance. However, a multicenter prospective study analyzing learning-associated morbidity has never been conducted in robotic gastrectomy.

Methods:
Data on 502 robotic gastrectomy cases were prospectively collected from 5 surgeons. Risk-adjusted cumulative sum analysis was applied to visualize the learning curve of robotic gastrectomy on operation time and complications.

Results:
Twenty-five cases, on average, were needed to overcome complications and operation time-learning curve sufficiently to gain proficiency in 3 surgeons. An additional 23 cases were needed to cross the transitional phase to progress from proficiency to mastery. The moderate complication rate (CD ≥ grade II) was 20% in phase 1 (cases 1–25), 10% in phase 2 (cases 26–65), 26.1% in phase 3 (cases 66–88), and 6.4% in phase 4 (cases 89–125) (P < 0.001). Among diverse complications, CD ≥ grade II intra-abdominal bleeding (P < 0.001) and abdominal pain (P = 0.01) were identified as major learning-associated morbidities of robotic gastrectomy. Previous experience on laparoscopic surgery and mode of training influenced progression in the learning curve.

Conclusions:
This is the first study suggesting that technical immaturity substantially affects the surgical outcomes of robotic gastrectomy and that robotic gastrectomy is a complex procedure with a significant learning curve that has implications for physician training and credentialing.
Systematic Review and Meta-Analysis of the Associations Between Body Mass Index, Prostate Cancer, Advanced Prostate Cancer and Prostate Specific Antigen
Authors: Harrison Sean , Tilling Kate , Turner Emma L. , Martin Richard M. , Lennon Rosie , Lane J. Athene , Donovan Jenny L. , Hamdy Freddie C. , Neal David E. , Bosch J.L.H. Ruud , Jones Hayley E. 
Published: September 2019

AbstractPurposeThe relationship between body-mass index (BMI) and prostate cancer remains unclear. However, there is an inverse association between BMI and prostate-specific antigen (PSA), used for prostate cancer screening. We conducted this review to estimate the associations between BMI and (1) prostate cancer, (2) advanced prostate cancer, and (3) PSA.MethodsWe searched PubMed and Embase for studies until 02 October 2017 and obtained individual participant data from four studies. In total, 78 studies were identified for the association between BMI and prostate cancer, 21 for BMI and advanced prostate cancer, and 35 for BMI and PSA. We performed random-effects meta-analysis of linear associations of log PSA and prostate cancer with BMI and, to examine potential non-linearity, of associations between categories of BMI and each outcome.ResultsIn the meta-analyses with continuous BMI, a 5 kg/m2 increase in BMI was associated with a percentage change in PSA of −5.88% (95% CI −6.87% to −4.87%). Using BMI categories, compared to normal weight men the PSA levels of overweight men were 3.43% lower (95% CI −5.57% to −1.23%), and obese men were 12.9% lower (95% CI −15.2% to −10.7%). Prostate cancer and advanced prostate cancer analyses showed little or no evidence associations.ConclusionThere is little or no evidence of an association between BMI and risk of prostate cancer or advanced prostate cancer, and strong evidence of an inverse and non-linear association between BMI and PSA. The association between BMI and prostate cancer is likely biased if missed diagnoses are not considered.
Influenza-associated mortality for different causes of death during the 2010-2011 through the 2014-2015 influenza seasons in Russia
Authors: Goldstein Edward 
Published: September 2019

AbstractBackgroundThere is limited information on the volume of influenza-associated mortality in Russia.MethodsUsing previously developed methodology (Goldstein et al., Epidemiology 2012), we regressed the monthly rates of mortality for respiratory causes, circulatory causes, and for certain infectious and parasitic diseases (available from the Russian Federal State Statistics Service (Rosstat)) linearly against the monthly proxies for the incidence of influenza A/H3N2, A/H1N1 and B (obtained using data from the Smorodintsev Research Institute of Influenza (RII) on levels of ILI/ARI consultations and the percent of respiratory specimens testing positive for influenza A/H3N2, A/H1N1 and B), adjusting for the baseline rates of mortality not associated with influenza circulation and temporal trends.ResultsFor the 2010/11 through the 2014/15 seasons, influenza circulation was associated with an average annual 11106 (95% CI (4321,17892)) deaths for circulatory causes, 4552 (3744,5360) deaths for respiratory causes, and 343 (63,624) deaths for certain infectious and parasitic diseases, with influenza A/H3N2 being responsible for the majority of influenza-associated respiratory deaths and influenza B making a substantial contribution to influenza-associated mortality for circulatory causes.ConclusionsInfluenza circulation is associated with a substantial mortality burden in Russia, particularly for circulatory deaths. Those results support the potential utility of influenza vaccination (with the role played by influenza B in circulatory mortality pointing to the benefit of quadrivalent influenza vaccines), as well as of administration of antiviral drugs for high-risk individuals during periods of active influenza circulation.
The purine pathway in liver tissue biopsies from donors for transplantation is associated to immediate graft function and survival
Authors: Xu Jin , Hassan-Ally Mohammad , Casas-Ferreira Ana María , Suvitaival Tommi , Ma Yun , Vilca-Melendez Hector , Rela Mohamed , Heaton Nigel , Jassem Wayel , Legido-Quigley Cristina 
Published: September 2019

AbstractBackground & AimsThe current shortage of livers for transplantation has increased the use of organs sourced from donation after circulatory death (DCD). These organs are prone to higher incidence of graft failure, but the underlying mechanisms are largely unknown. Here we aimed to find biomarkers of liver function before transplantation to better inform clinical evaluation.MethodsMatched pre- and post-transplant liver biopsies from DCD (n=24) and donation after brain death (DBD, n=70) were collected. Liver biopsies were analysed using mass spectroscopy molecular phenotyping. First, a discrimination analysis DCD vs DBD was used to parse metabolites associated to DCD. Then a data-driven approach was used to predict Immediate Graft Function (IGF). The metabolites were tested in models to predict survival.ResultsFive metabolites in the purine pathway were selected and investigated. The ratios of: adenine monophosphate (AMP), adenine, adenosine and hypoxanthine to urate, differed between DBD and DCD biopsies at pre-transplantation stage (q<0.05). The ratios of AMP and adenine to urate also differed in biopsies from recipients undergoing IGF (q<0.05). Using random forest a panel composed by alanine aminotransferase (ALT) and AMP, adenine, hypoxanthine ratio to urate predicted IGF with AUC 0.84 (95% CI [0.71, 0.97]). In comparison AUC 0.71 (95%CI [0.52, 0.90]) was achieved by clinical measures. Survival analysis revealed that the metabolite classifier could stratify 6-year survival outcomes (p = 0.0073) while clinical data and donor class could not.ConclusionsAt liver pre-transplantation stage, a panel composed of purine metabolites and ALT in tissue could improve prediction of IGF and survival.Lay summaryNew liver function biomarkers could help clinicians assess livers before transplantation. Purines are small molecules that are found in healthy livers, and in this work we found that their levels changed critically in livers from cardiac death donors. Measuring them before transplantation improved the prediction of the liver’s immediate graft function.Graphic abstractHighlightsThe ratios of purine metabolites to urate differ between DCD and DBD in liver tissue at pre-transplantation.The ratios of purine metabolites to urate and ALT pre-transplantation can improve prediction of IGF after transplantation.Purine metabolites ratios to urate stratified 6-year survival outcome better than clinical data and donor class.
Associations between reasons for vaping and current vaping and smoking status: Evidence from a UK based cohort
Authors: Khouja Jasmine N. , Taylor Amy E. , Munafò Marcus R. 
Published: September 2019

ABSTRACTBackgroundThis study aimed to discover which young adults vape, the reasons given for vaping, and which reasons for vaping are associated with continued vaping/smoking.MethodsIn a UK cohort of 3,994 young adults, we explored the association of retrospectively-recalled reasons for vaping by 23 years with vaping/smoking status at 24 years. Using logistic regression, we assessed the association with vaping behaviour among ever vapers who had ever smoked (n=668), and with smoking behaviour among individuals who regularly smoked prior to vaping (n=412).ResultsVaping to quit smoking was associated with higher likelihood of vaping (odds ratio [OR] = 3.51, 95% confidence interval [95%CI] = 2.29 to 5.38), but lower likelihood of smoking at 24 years (OR = 0.50, 95%CI = 0.32 to 0.78). Vaping to cut down smoking was associated with higher likelihood of vaping (OR = 2.90, 95%CI = 1.87 to 4.50) and smoking at 24 years (OR = 1.62, 95%CI = 1.02 to 2.58). Vaping out of curiosity was associated with lower likelihood of vaping at 24 years (OR = 0.41, 95%CI = 0.26 to 0.63) but higher likelihood of smoking at 24 years (OR = 1.66, 95%CI = 1.04 to 2.65).ConclusionsIntention to quit smoking appears important for young adults to stop smoking using e-cigarettes; vaping to cut down is associated with continued smoking, but smoking to quit is associated with discontinued smoking. Vaping out of curiosity is less likely to lead to a change in smoking/vaping behaviour (i.e., current smokers continue to smoke).
Analysis of corneal real astigmatism changes and high order aberration after lower eyelid epiblepharon repair surgery
Authors: Lee Dong Cheol 
Published: September 2019

ABSTRACTObjectiveTo investigate changes in corneal low and high order aberrations (LOA and HOA), which cause visual disturbances after lower eyelid epiblepharon repair surgery.Methods and analysisThis was a retrospective, cross-sectional study, which included 108 eyes from 54 patients. Wavefront analyses for calibrated LOAs and HOAs (root mean square, coma, three-piece aberrations [Trefoil], secondary astigmatisms, and spherical aberrations [SA]) were performed via a Galilei G4 Dual Scheimpflug Analyzer preoperatively, at the first and second follow-ups (f/u), and at G1, G2, and G3 (<45 days, 45–75 days, and >75 days post-surgery). Several risk factors (age, sex, body mass index, and corneal keratitis presence) were assessed.ResultsIn LOAs, flat keratometer (K) and axis values decreased significantly from baseline at the first f/u. At the second f/u, mean K and axis decreased. In HOAs, coma and trefoil increased from baseline at the first f/u and normalized by the second f/u. SA decreased at the second f/u and in G3. The various risk factors did not affect postoperative outcomes, axis, and secondary astigmatisms. After correcting for risk factors, at the first f/u, cylinder, coma, trefoil, and SA increased significantly from the baseline, while axis and flat K decreased. At the second f/u, cylinder increased, while axis and mean K decreased significantly from the baseline.ConclusionEpiblepharon repair surgery may impact axis changes. Flat K, coma, and trefoil may be affected by mechanical force changes immediately following surgery. Mean K and SA may change with cornea state changes during healing.