bluuebunny/crossref_metadata_2025_split huggingface dataset:
Overestimation of hyperopia with autorefraction compared with retinoscopy under cycloplegia in school-age children
Authors: Hashemi Hassan , Khabazkhoob Mehdi , Asharlous Amir , Yekta Abbasali , Emamian Mohammad Hassan , Fotouhi Akbar 
Published: February 2018

AimTo compare sphere and cylinder refraction values using retinoscopy and autorefraction under cycloplegic conditions in children.MethodsThis cross-sectional study was carried out using multistage cluster sampling. The target population was children aged 6–12 years in Shahroud, a northern city in Iran. Examinations included measurements of visual acuity, subjective refraction and objective refraction. Objective refraction was measured with and without cycloplegia with a retinoscope and an autorefractometer.ResultsAfter applying the exclusion criteria, data from 5053 children were analysed. Spherical refraction results with autorefraction were significantly higher than results with retinoscopy (P<0.001). Refraction overestimation was significant in all age groups (P<0.0001). Comparison of differences in different spherical ametropia subgroups also showed a significant intermethod difference in all refractive states (P<0. 01). Overall, autorefraction tended to over plus hyperopics and under minus myopic cases compared with retinoscopy. The 95% limits of agreement for spherical values measured with the two techniques were −0.35 Diopter (D) to 0.50 D. The values of J0and J45vectors with autorefraction were significantly higher than those with retinoscopy (P<0.001). The 95% limits of agreement between the two methods for vectors J0and J45were −0.12 D to 0.15 D and −0.10 D to 0.11 D, respectively.ConclusionSince the observed differences in spherical refraction and the cylindrical components obtained through retinoscopy and autorefraction are statistically significant, but clinically insignificant, and the two methods have a strong correlation and agreement, it can be concluded that autorefraction can be a suitable substitute for retinoscopy in children under cycloplegic conditions.
Meta-analysis of self-reported health symptoms in 1990–1991 Gulf War and Gulf War-era veterans
Authors: Maule Alexis L , Janulewicz Patricia A , Sullivan Kimberly A , Krengel Maxine H , Yee Megan K , McClean Michael , White Roberta F 
Published: February 2018

ObjectivesAcross diverse groups of Gulf War (GW) veterans, reports of musculoskeletal pain, cognitive dysfunction, unexplained fatigue, chronic diarrhoea, rashes and respiratory problems are common. GW illness is a condition resulting from GW service in veterans who report a combination of these symptoms. This study integrated the GW literature using meta-analytical methods to characterise the most frequently reported symptoms occurring among veterans who deployed to the 1990–1991 GW and to better understand the magnitude of ill health among GW-deployed veterans compared with non-deployed GW-era veterans.DesignMeta-analysis.MethodsLiterature databases were searched for peer-reviewed studies published from January 1990 to May 2017 reporting health symptom frequencies in GW-deployed veterans and GW-era control veterans. Self-reported health symptom data were extracted from 21 published studies. A binomial-normal meta-analytical model was used to determine pooled prevalence of individual symptoms in GW-deployed veterans and GW-era control veterans and to calculate combined ORs of health symptoms comparing GW-deployed veterans and GW-era control veterans.ResultsGW-deployed veterans had higher odds of reporting all 56 analysed symptoms compared with GW-era controls. Odds of reporting irritability (OR 3.21, 95% CI 2.28 to 4.52), feeling detached (OR 3.59, 95% CI 1.83 to 7.03), muscle weakness (OR 3.19, 95% CI 2.73 to 3.74), diarrhoea (OR 3.24, 95% CI 2.51 to 4.17) and rash (OR 3.18, 95% CI 2.47 to 4.09) were more than three times higher among GW-deployed veterans compared with GW-era controls.ConclusionsThe higher odds of reporting mood-cognition, fatigue, musculoskeletal, gastrointestinal and dermatological symptoms among GW-deployed veterans compared with GW-era controls indicates these symptoms are important when assessing GW veteran health status.
Interprofessional Teamwork Innovation Model (ITIM) to promote communication and patient-centred, coordinated care
Authors: Li Jing , Talari Preetham , Kelly Andrew , Latham Barbara , Dotson Sherri , Manning Kim , Thornsberry Lisa , Swartz Colleen , Williams Mark V 
Published: February 2018

BackgroundDespite recommendations and the need to accelerate redesign of delivery models to be team-based and patient-centred, professional silos and cultural and structural barriers that inhibit working together and communicating effectively still predominate in the hospital setting. Aiming to improve team-based rounding, we developed, implemented and evaluated the Interprofessional Teamwork Innovation Model (ITIM).MethodsThis quality improvement (QI) study was conducted at an academic medical centre. We followed the system’s QI framework, FOCUS-PDSA, with Lean as guiding principles. Primary outcomes included 30-day all-cause same-hospital readmissions and 30-day emergency department (ED) visits. The intervention group consisted of patients receiving care on two hospitalist ITIM teams, and patients receiving care from other hospitalist teams were matched with a control group. Outcomes were assessed using difference-in-difference analysis.ResultsTeam members reported enhanced communication and overall time savings. In multivariate modelling, patients discharged from hospitalist teams using the ITIM approach were associated with reduced 30-day same-hospital readmissions with an estimated point OR of 0.56 (95% CI 0.34 to 0.92), but there was no impact on 30-day same-hospital ED visits. Difference-in-difference analysis showed that ITIM was not associated with changes in average total direct costs nor average cost per patient day, after adjusting for all other covariates in the models, despite the addition of staff resources in the ITIM model.ConclusionThe ITIM approach facilitates a collaborative environment in which patients and their family caregivers, physicians, nurses, pharmacists, case managers and others work and share in the process of care.
Ambulatory blood pressure and long-term risk for atrial fibrillation
Authors: Tikhonoff Valérie , Kuznetsova Tatiana , Thijs Lutgarde , Cauwenberghs Nicholas , Stolarz-Skrzypek Katarzyna , Seidlerová Jitka , Malyutina Sofia , Gilis-Malinowska Natasza , Swierblewska Ewa , Kawecka-Jaszcz Kalina , Filipovský Jan , Narkiewicz Krzysztof , Lip Gregory Y H , Casiglia Edoardo , Staessen Jan A 
Published: February 2018

ObjectiveData on the contribution of ambulatory blood pressure (ABP) components to the risk of developing atrial fibrillation (AF) are limited. We prospectively tested the hypothesis that ABP may represent a potentially modifiable risk factor for the development of AF in a European population study.MethodsWe recorded daytime blood pressure (BP) in 3956 subjects randomly recruited from the general population in five European countries. Of these participants, 2776 (70.2%) underwent complete 24-hour ABP monitoring. Median follow-up was 14 years. We defined daytime systolic BP load as the percentage BP readings above 135 mm Hg. The incidence of AF was assessed from ECGs obtained at baseline and follow-up and from records held by general practitioners and/or hospitals.ResultsOverall, during 58 810 person-years of follow-up, 143 participants experienced new-onset AF. In adjusted Cox models, each SD increase in baseline 24 hours, daytime and night-time systolic BP was associated with a 27% (P=0.0056), 22% (P=0.023) and 20% (P=0.029) increase in the risk for incident AF, respectively. Conventional systolic BP was borderline associated with the risk of AF (18%; P=0.06). As compared with the average population risk, participants in the lower quartile of daytime systolic BP load (<3%) had a 51% (P=0.0038) lower hazard for incident AF, whereas in the upper quartile (>38%), the risk was 46% higher (P=0.0094).ConclusionsSystolic ABP is a significant predictor of incident AF in a population-based cohort. We also observed that participants with a daytime systolic BP load >38% had significantly increased risk of incident AF.
Interobserver variation in the diagnosis of fibroepithelial lesions of the breast: a multicentre audit by digital pathology
Authors: Dessauvagie Benjamin F , Lee Andrew H S , Meehan Katie , Nijhawan Anju , Tan Puay Hoon , Thomas Jeremy , Tie Bibiana , Treanor Darren , Umar Seemeen , Hanby Andrew M , Millican-Slater Rebecca 
Published: February 2018

AimFibroepithelial lesions (FELs) of the breast span a morphological continuum including lesions where distinction between cellular fibroadenoma (FA) and benign phyllodes tumour (PT) is difficult. The distinction is clinically important with FAs managed conservatively while equivocal lesions and PTs are managed with surgery. We sought to audit core biopsy diagnoses of equivocal FELs by digital pathology and to investigate whether digital point counting is useful in clarifying FEL diagnoses.MethodScanned slide images from cores and subsequent excisions of 69 equivocal FELs were examined in a multicentre audit by eight pathologists to determine the agreement and accuracy of core needle biopsy (CNB) diagnoses and by digital point counting of stromal cellularity and expansion to determine if classification could be improved.ResultsInterobserver variation was high on CNB with a unanimous diagnosis from all pathologists in only eight cases of FA, diagnoses of both FA and PT on the same CNB in 15 and a ‘weak’ mean kappa agreement between pathologists (k=0.36). ‘Moderate’ agreement was observed on CNBs among breast specialists (k=0.44) and on excision samples (k=0.49). Up to 23% of lesions confidently diagnosed as FA on CNB were PT on excision and up to 30% of lesions confidently diagnosed as PT on CNB were FA on excision. Digital point counting did not aid in the classification of FELs.ConclusionAccurate and reproducible diagnosis of equivocal FELs is difficult, particularly on CNB, resulting in poor interobserver agreement and suboptimal accuracy. Given the diagnostic difficulty, and surgical implications, equivocal FELs should be reported in consultation with experienced breast pathologists as a small number of benign FAs can be selected out from equivocal lesions.
A multi-decade joinpoint analysis of firearm injury severity
Authors: Kalesan Bindu , Zuo Yi , Xuan Ziming , Siegel Michael B , Fagan Jeffrey , Branas Charles , Galea Sandro 
Published: February 2018

BackgroundNon-fatal firearm injuries constitute approximately 70% of all firearm trauma injuries in the United States. Patterns of severity of these injuries are poorly understood. We analyzed the overall, age-, sex- and intent-specific temporal trends in the injury severity of firearm hospitalizations from 1993 to 2014.MethodsWe assessed temporal trends in the severity of patients hospitalized for firearm using Nationwide Inpatient Sample (NIS) data over a 22 year period. Firearm hospitalization was identified using assault (E965x), unintentional (E922x), intentional self-harm (E955x), legal (E970) and undetermined (E985x) International Classification of Diseases, Ninth Revision, Clinical Modification (ICD9) codes. Injury severity was measured using the computed New Injury Severity Score (NISS). We used survey weighted means, SD and annual percent change (APC), and joinpoint regression to analyze temporal trends.ResultsA weighted total of 648 662 inpatient admissions for firearm injury were analyzed. Firearm injury severity demonstrated a significant annual increase of 1.4% (95% CI=1.3 to 1.6), and was driven by annual increases among young adults (APC=1.4%, 95% CI=1.3 to 1.5), older adults (APC=1.5%, 95% CI=1.3 to 1.6), female (APC=1.5%, 95% CI=1.3 to 1.6) and male (APC=1.4%, 95% CI=1.3 to 1.6) hospitalizations. The annual increase among assault/legal injuries was 1.4% (95% CI=1.3 to 1.5), similar to unintentional (APC=1.4%, 95% CI=1.3 to 1.6), intentional self-harm (APC=1.5%, 95% CI=1.4 to 1.6) and undetermined (APC=1.4%, 95% CI=1.3 to 1.6).ConclusionsThe severity of hospitalized firearm injuries increased significantly from 1993 to 2014. This annual increase reflects a move towards hospitalization of more serious injuries, and outpatient management of less serious injuries across the board, suggesting a mounting burden on the US healthcare system.Level of evidenceLevel IV.
Elementary equivalence in Artin groups of finite type
Authors: Kabiraj Arpan , Prathamesh T. V. H. , Vyas Rishi 
Published: February 2018

Irreducible Artin groups of finite type can be parametrized via their associated Coxeter diagrams into six sporadic examples and four infinite families, each of which is further parametrized by the natural numbers. Within each of these four infinite families, we investigate the relationship between elementary equivalence and isomorphism. For three out of the four families, we show that two groups in the same family are equivalent if and only if they are isomorphic; a positive, but weaker, result is also attained for the fourth family. In particular, we show that two braid groups are elementarily equivalent if and only if they are isomorphic. The [Formula: see text] fragment suffices to distinguish the elementary theories of the groups in question. As a consequence of our work, we prove that there are infinitely many elementary equivalence classes of irreducible Artin groups of finite type. We also show that mapping class groups of closed surfaces — a geometric analogue of braid groups — are elementarily equivalent if and only if they are isomorphic.
Icariin promotes osteoblastic differentiation in OVX mice via MAPK signaling pathway revealed by profiling
Authors: Bian Qin , Liu Shufen , Zhao Yongjian , Huang Jianhua , Shen Ziyin 
Published: February 2018

Objective: Icariin (ICA), an extract from epimedium, has been reported to be effective in promoting bone formation. The objective of the study is to search for the molecular targets of ICA in bone mesenchymal stem cells (bMSCs) from the mice with ovariectomy (OVX)-induced osteoporosis. Methods: Six-month-old Imprinting Control Region (ICR) mice that underwent OVX were treated with ICA. After three months, bone mass was evaluated by microcomputed tomography, morphometry and immunohistological detection. bMSCs were isolated from the femur and tibia to observe the self-renewal and differentiation capacities using colony-forming unit fibroblastic (CFU-F), colony-forming unit adipocyte (CFU-Adipo) and alkaline phosphatase (ALP) staining. In addition, microarray of bMSCs ex vivo was measured two weeks after ICA treatment and analyzed by heatmap and pathway analysis. The signaling pathway was further explored by western blot assay and inhibitors of p38 and ERK: SB203508 and PD98059. Results: [Formula: see text]CT displayed a decrease in bone mass for three months after OVX. ICA treatment increased the trabecular thickness (Tb.Th), osteoblast number while decreased osteoclast number, elevating osteocalcin (OC) protein levels in vivo and facilitating the self-renewal and osteoblastic differentiation of bMSCs ex vivo. Microarray data indicated ICA rescued several gene expressions that were dysregulated by OVX. Pathway analysis revealed that the core genes acted by ICA were highly involved in MAPK signaling pathway. Further study demonstrated ICA suppressed ERK while stimulated p38 phosphorylation to promote osteoblastic differentiation in vitro. Conclusion: ICA promotes osteoblastic differentiation of bMSCs in OVX mice. MAPK signaling pathway might be involved in the process.
A DNA-Interacting Payload Designed to Eliminate Cross-Linking Improves the Therapeutic Index of Antibody–Drug Conjugates (ADCs)
Authors: Miller Michael L. , Shizuka Manami , Wilhelm Alan , Salomon Paulin , Reid Emily E. , Lanieri Leanne , Sikka Surina , Maloney Erin K. , Harvey Lauren , Qiu Qifeng , Archer Katie E. , Bai Chen , Vitharana Dilrukshi , Harris Luke , Singh Rajeeva , Ponte Jose F. , Yoder Nicholas C. , Kovtun Yelena , Lai Katharine C. , Ab Olga , Pinkas Jan , Keating Thomas A. , Chari Ravi V.J. 
Published: February 2018

Abstract
Tumor-selective delivery of cytotoxic agents in the form of antibody–drug conjugates (ADCs) is now a clinically validated approach for cancer treatment. In an attempt to improve the clinical success rate of ADCs, emphasis has been recently placed on the use of DNA–cross-linking pyrrolobenzodiazepine compounds as the payload. Despite promising early clinical results with this class of ADCs, doses achievable have been low due to systemic toxicity. Here, we describe the development of a new class of potent DNA-interacting agents wherein changing the mechanism of action from a cross-linker to a DNA alkylator improves the tolerability of the ADC. ADCs containing the DNA alkylator displayed similar in vitro potency, but improved bystander killing and in vivo efficacy, compared with those of the cross-linker. Thus, the improved in vivo tolerability and antitumor activity achieved in rodent models with ADCs of the novel DNA alkylator could provide an efficacious, yet safer option for cancer treatment. Mol Cancer Ther; 17(3); 650–60. ©2018 AACR.
Trajectories of Long‐Term Normal Fasting Plasma Glucose and Risk of Coronary Heart Disease: A Prospective Cohort Study
Authors: Yuan Zhongshang , Yang Yang , Wang Chunxia , Liu Jing , Sun Xiubin , Liu Yi , Li Shengxu , Xue Fuzhong 
Published: February 2018

Background

Fasting plasma glucose (
FPG
) levels can vary over time and its longitudinal changing patterns may predict cardiometabolic risk. We aim to identify different trajectories of
FPG
in those who remained normoglycemic and investigate the association between trajectory groups and coronary heart disease risk in a large prospective cohort study.

Methods and Results

A total of 20 514 subjects between ages 20 and 80 years were included at baseline. All participants had maintained normal
FPG
throughout an average follow‐up period of 5.8 years. We identified 3 distinct trajectories using a group‐based trajectory model, labeled by initial value and changing pattern: low‐increasing (n=12 694), high‐increasing‐decreasing (n=5330), and high‐decreasing‐increasing (n=2490). The coronary heart disease incidence density among these 3 groups (3.00, 4.05, and 3.26 per 1000 person‐years, respectively) was significantly different (
P
=0.038). The high‐increasing‐decreasing group was characterized by a starting
FPG
of 4.80 mmol/L, and increased up to 5.42 mmol/L at age 55, then decreased thereafter. Treating the low‐increasing group as the reference, the age‐ and sex‐adjusted hazard ratio was 1.58 (95% confidence interval, 1.23–2.02) for the high‐increasing‐decreasing group by Cox proportional hazard regression. After adjustment for other potential confounding factors, the hazard ratio is 1.40 (95% confidence interval, 1.08–1.81). The association persisted after adjustment for baseline
FPG
, mean, or SD of
FPG
.

Conclusions

Distinct trajectories of long‐term normal
FPG
are associated with the development of coronary heart disease, which is independent of other metabolic factors including
FPG
levels. These findings have implications for intervention and prevention of coronary heart disease among individuals who are normoglycemic.
National Practice Patterns of Obtaining Informed Consent for Stroke Thrombolysis
Authors: Mendelson Scott J. , Courtney D. Mark , Gordon Elisa J. , Thomas Leena F. , Holl Jane L. , Prabhakaran Shyam 
Published: February 2018

Background and Purpose—
No standard approach to obtaining informed consent for stroke thrombolysis with tPA (tissue-type plasminogen activator) currently exists. We aimed to assess current nationwide practice patterns of obtaining informed consent for tPA.

Methods—
An online survey was developed and distributed by e-mail to clinicians involved in acute stroke care. Multivariable logistic regression analyses were performed to determine independent factors contributing to always obtaining informed consent for tPA.

Results—
Among 268 respondents, 36.7% reported always obtaining informed consent and 51.8% reported the informed consent process caused treatment delays. Being an emergency medicine physician (odds ratio, 5.8; 95% confidence interval, 2.9–11.5) and practicing at a nonacademic medical center (odds ratio, 2.1; 95% confidence interval, 1.0–4.3) were independently associated with always requiring informed consent. The most commonly cited cause of delay was waiting for a patient’s family to reach consensus about treatment.

Conclusions—
Most clinicians always or often require informed consent for stroke thrombolysis. Future research should focus on standardizing content and delivery of tPA information to reduce delays.
Die arithmetische Feinstruktur im Traktat De oratione des Evagrios Pontikos
Authors: Joest Christoph 
Published: February 2018

Abstract
In the introduction to his tractate De oratione Evagrios Pontikos speaks of figures that are “triangles”, “squares”, and even “spheres”. These remarks are less cryptic if one regards the numerical systems used in late antiquity. However, they may hint at a hidden structure within De oratione. Selecting all chapters whose numbers are “triangles”, or “squares” respectively, etc., we find chains of sayings which follow certain themes woven into the “fabric” of the tractate. This discovery reveals again Evagrios as the master of literary composition.
Assessing the Impact of Targeting CEACAM1 in Head and Neck Squamous Cell Carcinoma
Authors: Tam Kenric , Schoppy David W. , Shin June Ho , Tay Joshua K. , Moreno‐Nieves Uriel , Mundy David C. , Sunwoo John B. 
Published: February 2018

ObjectiveIn conjunction with advances made in cytotoxic chemotherapy, radiation, and surgery, immunotherapy has emerged as a fourth modality of treatment for head and neck squamous cell carcinoma (HNSCC). Understanding the mechanisms by which HNSCC evades immune‐mediated control will aid in the development of new therapies to augment an antitumor immune response. Carcinoembryonic antigen–related cell adhesion molecule 1 (CEACAM1) is a cell surface receptor that is expressed on malignant cells and lymphocytes such as natural killer (NK) cells. We sought to determine whether tumor‐derived CEACAM1 inhibits NK cell cytotoxicity and whether blockade of CEACAM1 restores antitumor immunity.Study DesignIn vitro HNSCC cell line study.SettingResearch laboratory.Subject and MethodsWe utilized a real‐time cell analyzer to assess NK cell cytotoxicity against an oral squamous cell carcinoma cell line after modulating CEACAM1 expression by cytokines and shRNA knockdown of CEACAM1 expression.ResultsNK cells and HNSCC cells both demonstrated cytokine‐inducible expression of CEACAM1. Coincubation of NK cells and HNSCC cells resulted in the upregulation of CEACAM1 on the tumor cells. When compared with CEACAM1‐ cells, CEACAM1+ tumor cells exhibited increased cell growth and increased size and number of organoids in 3‐dimensional culture. Notably, CEACAM1+ HNSCC cells were more resistant to NK cell–mediated killing, but the inhibited expression of CEACAM1 by an shRNA construct restored NK cell cytotoxicity.ConclusionTogether, these data indicate that CEACAM1 acts as an inducible checkpoint molecule, and they support the idea that targeting CEACAM1 could serve as a novel immunotherapy approach in HNSCC.