bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations between estimated foetal weight discordance and clinical characteristics within dichorionic twins: The NICHD Fetal Growth Studies
Authors: Amyx Melissa M. , Albert Paul S. , Bever Alaina M. , Hinkle Stefanie N. , Owen John , Grobman William A. , Newman Roger B. , Chien Edward K. , Gore‐Langton Robert E. , Buck Louis Germaine M. , Grantz Katherine L. 
Published: September 2019

AbstractBackgroundBirthweight discordance is well studied, with less known about longitudinal inter‐twin differences in foetal growth.ObjectiveTo examine inter‐twin per cent differences in EFW (EFW%), head (HC%) and abdominal circumference (AC%), and femur length (FL%) across gestation in dichorionic twin gestations and explore associated characteristics.MethodsFoetal biometrics were assessed by ultrasound and EFW calculated at ≤6 study visits among women with dichorionic twin pregnancies enrolled in the NICHD Fetal Growth Studies cohort (US, 2012‐2013). Inter‐twin per cent difference was defined: ([Sizelarger twin − Sizesmaller twin]/Sizelarger twin × 100). Linear mixed models evaluated per cent differences in foetal biometrics at 15 weeks and their change per week overall and by maternal/neonatal characteristics in unadjusted and adjusted models.ResultsIn 140 pregnancies, inter‐twin per cent differences increased across gestation for EFW (0.18%/week, 95% confidence interval [CI] 0.10, 0.27), HC (0.03%/week, 95% CI 0.00, 0.06), and AC (0.03%/week, 95%CI −0.01, 0.08) but decreased for FL (−0.03%/week, 95% CI −0.09, 0.02). After adjustment, change in EFW% difference across gestation differed by pre‐pregnancy body mass index (BMI [kg/m2]; underweight [<18.5]; normal weight [18.5‐24.9]; overweight [25.0‐29.9]; obese [≥30.0]; Pinteraction = .022); and conception method (in vitro fertilisation [IVF], intrauterine insemination, ovulation induction medication, donor egg/embryo, none; Pinteraction = .060). While EFW% difference increased with normal pre‐pregnancy BMI (0.24%/week, 95% CI 0.12, 0.37), little change was noted with pre‐pregnancy obesity (0.01%/week, 95% CI −0.15, 0.17). EFW% difference increased in conceptions without fertility treatments (0.23%/week, 95% CI 0.11, 0.34) but not IVF conceptions (−0.00%/week, 95% CI −0.16, 0.16). Similar patterns of differences across gestation were noted for HC% by conception method (Pinteraction = .026) and AC% by pre‐pregnancy BMI (Pinteraction = .071); changes in HC% differed by parity (nulliparous, multiparous; Pinteraction = .004).ConclusionsEFW% difference increased across gestation in dichorionic twins, but remained stable with pre‐pregnancy obesity or IVF conception, patterns mirrored for HC and AC. Research is needed to understand pathologic versus physiologic differential twin growth trajectories.
Implementation of Nurse‐Driven HIV Screening Targeting Key Populations in Emergency Departments: A Multilevel Analysis From the DICI‐VIH Trial
Authors: Leblanc Judith , Côté José , Pagé M. Gabrielle , Piquet Hélène , Simon Tabassome , Crémieux Anne‐Claude ,   the DICI‐VIH (Dépistage Infirmier CIblé du VIH) Group
Published: September 2019

AbstractBackgroundIn countries with concentrated HIV epidemics, optimizing screening to reach individuals with undiagnosed infection is essential. The DICI‐VIH study, a cluster‐randomized crossover trial conducted in eight French emergency departments (EDs), found that a strategy combining nurse‐driven targeted HIV screening with routine diagnostic testing was effective.AimThe aim was to investigate factors associated with the implementation of HIV screening targeting key populations in EDs.MethodsA self‐administered questionnaire was distributed at registration to patients aged 18–64 years and able to give consent during the DICI‐VIH intervention. Based on their responses, those belonging to key populations were offered a rapid test by triage nurses. Two key stages of the process were evaluated: questionnaire distribution by providers and test acceptance by patients. Patient information, daily workload, and ED characteristics were collected. The associations between these variables and (a) the proportion of questionnaires distributed and (b) the proportion of tests accepted were evaluated using multilevel modeling in order to examine differences in screening implementation between EDs.ResultsQuestionnaire distribution proportions varied from 23% to 48% across EDs. They were higher on weekdays than weekends (odds ratio, OR: 3.77; 95% CI: 3.57–3.99) and when research staff participated (OR: 1.31; 95% CI: 1.26–1.37). They decreased over time (OR: 0.76; 95% CI: 0.71–0.82; 4th [Q3] vs. 1st quartile [Q0] of intervention days) and with increased patient flow (OR: 0.61; 95% CI: 0.56–0.67; Q3 vs. Q0 of eligible patients). Test acceptance varied from 64% to 77% across EDs, increased with research staff participation (OR 1.20; 95% CI: 1.03–1.40), and decreased over time (OR: 0.75; 95% CI: 0.60–0.92; Q3 vs. Q0). Patients who accepted were more likely to be younger (OR: 0.76; 95% CI: 0.61–0.96; 50–64‐year‐old vs. 30–39‐year‐old patients).Linking Evidence to ActionPatient flow, intervention duration, weekdays, and research staff participation were important determinants of targeted screening implementation. These findings could help guide future implementation in similar settings.
Trajectory Measurement of Radial Jet Drilling Wells: Improved Tool and Data Processing
Authors: Huang Zhe , Huang Zhongwei , Wu Long , Su Yinao , Hong Chunyang 
Published: September 2019

Abstract
Drilling by high-pressure liquid jet, radial jet drilling (RJD) is a cost-effective technology to restimulate the production of old wells and the development of unconventional reservoirs. However, due to the unique process of 90 deg turning in the casing, hardly any traditional tool can be applied in the RJD trajectory measurement. Even minitools have been developed in the last few years; the increasing cost and unpredictable failure risk of lateral re-entrance are still non-negligible as the current design, much less than the huge measuring errors. In this paper, a new tool was proposed. Based on a special-shaped circuit board and separation of the supporting section, a fluid passageway was reserved in the measuring section to realize the measurement while or after the jet drilling without extra trips. It reduces the cost and failure risk of lateral re-entrance. Ample space in the supporting section was also provided, which meets the long-time operation requirements and establishes the base for real-time communication and trajectory control. Based on noise analyses, random walk is the main source of system noise in short-time measurements, and the effective measuring frequency is mostly in the range of 0–5 Hz. Therefore, autoregressive moving average (ARMA) models, Kalman filter, and low-pass filter were established for denoising. It allows us to analyze the data feature in more detail and extract the valid measuring data with improved accuracy. Considering performance tests result, the average errors of reckoned parameters were improved to less than 15%.
Impact of aging on the immune response to traumatic brain injury (AIm:TBI) study protocol
Authors: Thompson Hilaire J , Rivara Frederick , Becker Kyra J , Maier Ronald , Temkin Nancy 
Published: September 2019

BackgroundTraumatic brain injury (TBI) in older adults leads to considerable morbidity and mortality. Outcomes among older adults with TBI are disparately worse than in younger adults. Differences in immunological response to injury may account for at least some of this disparity. Understanding how ageing differentially affects the immune response to TBI and how older age and these immunological changes affect the natural history of recovery following TBI are the goals of this study.Design/methodsA prospective multiple cohort design is being used to assess the effects of ageing and TBI on immune makers and to test predictors of impairment and disability in older adults following mild TBI. Older adults (>55 years) with mild TBI are enrolled with three comparison groups: younger adults (21–54 years) with mild TBI, non-injured older adults (>55 years) and non-injured young adults (21–54 years). For the primary analysis, we will assess the association between immune markers and Glasgow Outcome Scale-Extended at 6 months, using logistic regression. Predictors of interest will be inflammatory biomarkers. Multivariate linear regression will be used to evaluate associations between biomarkers and other outcomes (symptoms, function and quality of life) at 3 and 6 months. Exploratory analyses will investigate the utility of biomarkers to predict outcome using receiver-operating characteristic curves.DiscussionA better understanding of the recovery trajectory and biological rationale for disparate outcomes following TBI in older adults could allow for development of specific interventions aimed at reducing or eliminating symptoms. Such interventions could reduce impairment and healthcare costs.
ATMIN Is a Tumor Suppressor Gene in Lung Adenocarcinoma
Authors: Foster Hanna , Ruiz E. Josue , Moore Christopher , Stamp Gordon W. H. , Nye Emma L. , Li Ningning , Pan Yihang , He Yulong , Downward Julian , Behrens Axel 
Published: September 2019

Abstract

Tumor cells proliferate rapidly and thus are frequently subjected to replication stress and the risk of incomplete duplication of the genome. Fragile sites are replicated late, making them more vulnerable to damage when DNA replication fails to complete. Therefore, genomic alterations at fragile sites are commonly observed in tumors. FRA16D is one of the most common fragile sites in lung cancer, however, the nature of the tumor suppressor genes affected by FRA16D alterations has been controversial. Here, we show that the ATMIN gene, which encodes a cofactor required for activation of ATM kinase by replication stress, is located close to FRA16D and is commonly lost in lung adenocarcinoma. Low ATMIN expression was frequently observed in human lung adenocarcinoma tumors and was associated with reduced patient survival, suggesting that ATMIN functions as a tumor suppressor in lung adenocarcinoma. Heterozygous Atmin deletion significantly increased tumor cell proliferation, tumor burden, and tumor grade in the LSL-KRasG12D; Trp53 F/F (KP) mouse model of lung adenocarcinoma, identifying ATMIN as a haploinsufficient tumor suppressor. ATMIN-deficient KP lung tumor cells showed increased survival in response to replication stress and consequently accumulated DNA damage. Thus, our data identify ATMIN as a key gene affected by genomic deletions at FRA16D in lung adenocarcinoma.

Significance:
These findings identify ATMIN as a tumor suppressor in LUAD; fragility at chr16q23 correlates with loss of ATMIN in human LUAD and deletion of Atmin increases tumor burden in a LUAD mouse model.
Syndecan-Mediated Ligation of ECM Proteins Triggers Proliferative Arrest of Disseminated Tumor Cells
Authors: Shibue Tsukasa , Reinhardt Ferenc , Weinberg Robert A. 
Published: September 2019

Abstract

Systemic dissemination of tumor cells often begins long before the development of overt metastases, revealing the inefficient nature of the metastatic process. Thus, already at the time of initial clinical presentation, many patients with cancer harbor a myriad disseminated tumor cells (DTC) throughout the body, most of which are found as mitotically quiescent solitary cells. This indicates that the majority of DTCs fail, for still unknown reasons, to initiate rapid proliferation after entering foreign tissue, which likely contributes significantly to the inefficiency of metastasis formation. Here, we showed that extracellular matrix (ECM) components of the host parenchyma prevented proliferation of DTCs that had recently infiltrated foreign tissue by binding to syndecan receptors expressed on the surface of these cells. This led to the recruitment of the Par-3:Par-6:atypical PKC protein complex, a critical regulator of cell polarity, to the plasma membrane and release of Par-1 kinase into the cytosol. Cytosolic Par-1 bound, phosphorylated, and inactivated KSR scaffolding proteins ultimately inhibited Ras/ERK signaling and, in turn, cell proliferation. Inhibition of the syndecan-mediated signaling restored the proliferation of otherwise dormant DTCs, enabling these cells to efficiently colonize foreign tissues. Intriguingly, naturally aggressive cancer cells overcame the antiproliferative effect of syndecan-mediated signaling either by shutting down this signaling pathway or by activating a proproliferative signaling pathway that works independent of syndecan-mediated signaling. Collectively, these observations indicate that the proliferative arrest of DTCs is attributable, in part, to the syndecan-mediated ligation of ECM proteins.

Significance:
This study identifies a novel signaling pathway that regulates the proliferative dormancy of individual disseminated tumor cells.
DUBbing Down Translation: The Functional Interaction of Deubiquitinases with the Translational Machinery
Authors: Kapadia Bandish B. , Gartenhaus Ronald B. 
Published: September 2019

AbstractCancer cells revamp the regulatory processes that control translation to induce tumor-specific translational programs that can adapt to a hostile microenvironment as well as withstand anticancer therapeutics. Translational initiation has been established as a common downstream effector of numerous deregulated signaling pathways that together culminate in prooncogenic expression. Other mechanisms, including ribosomal stalling and stress granule assembly, also appear to be rewired in the malignant phenotype. Therefore, better understanding of the underlying perturbations driving oncogenic translation in the transformed state will provide innovative therapeutic opportunities. This review highlights deubiquitinating enzymes that are activated/dysregulated in hematologic malignancies, thereby altering the translational output and contributing to tumorigenesis.
A Randomized Trial of a 1-Hour Troponin T Protocol in Suspected Acute Coronary Syndromes
Authors: Chew Derek P. , Lambrakis Kristina , Blyth Andrew , Seshadri Anil , Edmonds Michael J.R. , Briffa Tom , Cullen Louise A. , Quinn Stephen , Karnon Jonathan , Chuang Anthony , Nelson Adam J. , Wright Deborah , Horsfall Matthew , Morton Erin , French John K. , Papendick Cynthia 
Published: September 2019

Background:
High-sensitivity troponin assays promise earlier discrimination of myocardial infarction. Yet, the benefits and harms of this improved discriminatory performance when incorporated within rapid testing protocols, with respect to subsequent testing and clinical events, has not been evaluated in an in-practice patient-level randomized study. This multicenter study evaluated the noninferiority of a 0/1-hour high-sensitivity cardiac troponin T (hs-cTnT) protocol in comparison with a 0/3-hour masked hs-cTnT protocol in patients with suspected acute coronary syndrome presenting to the emergency department (ED).

Methods:
Patients were randomly assigned to either a 0/1-hour hs-cTnT protocol (reported to the limit of detection [<5 ng/L]) or masked hs-cTnT reported to ≤29 ng/L evaluated at 0/3-hours (standard arm). The 30-day primary end point was all-cause death and myocardial infarction. Noninferiority was defined as an absolute margin of 0.5% determined by Poisson regression.

Results:

In total, 3378 participants with an emergency presentation were randomly assigned between August 2015 and April 2019. Ninety participants were deemed ineligible or withdrew consent. The remaining participants received care guided either by the 0/1-hour hs-cTnT protocol (n=1646) or the 0/3-hour standard masked hs-cTnT protocol (n=1642) and were followed for 30 days. Median age was 59 (49–70) years, and 47% were female. Participants in the 0/1-hour arm were more likely to be discharged from the ED (0/1-hour arm: 45.1% versus standard arm: 32.3%,
P
<0.001) and median ED length of stay was shorter (0/1-hour arm: 4.6 [interquartile range, 3.4–6.4] hours versus standard arm: 5.6 (interquartile range, 4.0–7.1) hours,
P
<0.001). Those randomly assigned to the 0/1-hour protocol were less likely to undergo functional cardiac testing (0/1-hour arm: 7.5% versus standard arm: 11.0%,
P
<0.001). The 0/1-hour hs-cTnT protocol was not inferior to standard care (0/1-hour arm: 18/1646 [1.1%] versus 16/1642 [1.0%]; incidence rate ratio, 1.06 [ 0.53–2.11], noninferiority
P
value=0.001, superiority
P
value=0.744), although an increase in myocardial injury was observed. Among patients discharged from ED, the 0/1-hour protocol had a negative predictive value of 99.6% (95% CI, 99.0–99.9%) for 30-day death or myocardial infarction.

Conclusions:
This in-practice evaluation of a 0/1-hour hs-cTnT protocol embedded in ED care enabled more rapid discharge of patients with suspected acute coronary syndrome. Improving short-term outcomes among patients with newly recognized troponin T elevation will require an evolution in management strategies for these patients.

Clinical Trial Registration:

URL:
https://www.anzctr.org.au
. Unique identifier: ACTRN12615001379505.
A Tale of Two Positivities and the N400: Distinct Neural Signatures Are Evoked by Confirmed and Violated Predictions at Different Levels of Representation
Authors: Kuperberg Gina R. , Brothers Trevor , Wlotko Edward W. 
Published: September 2019

Abstract
It has been proposed that hierarchical prediction is a fundamental computational principle underlying neurocognitive processing. Here, we ask whether the brain engages distinct neurocognitive mechanisms in response to inputs that fulfill versus violate strong predictions at different levels of representation during language comprehension. Participants read three-sentence scenarios in which the third sentence constrained for a broad event structure, for example, {Agent caution animate–Patient}. High constraint contexts additionally constrained for a specific event/lexical item, for example, a two-sentence context about a beach, lifeguards, and sharks constrained for the event, {Lifeguards cautioned Swimmers}, and the specific lexical item swimmers. Low constraint contexts did not constrain for any specific event/lexical item. We measured ERPs on critical nouns that fulfilled and/or violated each of these constraints. We found clear, dissociable effects to fulfilled semantic predictions (a reduced N400), to event/lexical prediction violations (an increased late frontal positivity), and to event structure/animacy prediction violations (an increased late posterior positivity/P600). We argue that the late frontal positivity reflects a large change in activity associated with successfully updating the comprehender's current situation model with new unpredicted information. We suggest that the late posterior positivity/P600 is triggered when the comprehender detects a conflict between the input and her model of the communicator and communicative environment. This leads to an initial failure to incorporate the unpredicted input into the situation model, which may be followed by second-pass attempts to make sense of the discourse through reanalysis, repair, or reinterpretation. Together, these findings provide strong evidence that confirmed and violated predictions at different levels of representation manifest as distinct spatiotemporal neural signatures.
Reversal of Severe Multiorgan Failure Associated With Sickle Cell Crisis Using Plasma Exchange: A Case Series
Authors: Zaidi Gulrukh Z. , Rosentsveyg Juliana A. , Fomani Katayoun F. , Louie James P. , Koenig Seth J. 
Published: September 2019

Objective: Red blood cell exchange (RBCE) is the standard of care for patients with sickle cell disease (SCD) who present with severe vaso-occlusive crisis (VOC). However, subsets of these critically ill patients have progressive multiorgan failure (MOF) despite RBCE therapy. The purpose of this case series is to describe the use of plasma exchange (PLEX) for the treatment of SCD-related MOF that is refractory to RBCE. Methods: A retrospective case review of patients with severe MOF from sickle cell crisis unresponsive to RBCE who underwent PLEX in a 14-bed adult medical intensive care unit (ICU) at a tertiary care university hospital over a 4-year time period. Key laboratory data including complete blood count, indices of hemolysis, and markers of organ failure were recorded before and after both RBCE and PLEX. Results: Our primary objective is to evaluate the effectiveness of PLEX, in addition to RBCE, on organ dysfunction, laboratory indices, and mortality. Of the 7 patients, 6 survived. Of the patients who survived, all remained hemodynamically stable during PLEX sessions and showed both clinical and laboratory evidences of improvement in hemolysis and organ function. Average time from completion of first PLEX treatment to initial laboratory signs of organ failure reversal for patients who survived was 15.6 hours, the average length of stay in the ICU was 5.6 days, and the average total length of stay in the hospital was 14 days. Conclusions: Plasma exchange, in addition to RBCE, may be a novel synergistic treatment option to decrease risk of mortality in patients with refractory VOC and MOF.
Characterizing the Financial Value of In-Home Palliative Care for Patients, Payers, and Hospitals
Authors: Akhtar Saad , Srinivasan Vamshek , Weisse Carol , DiSorbo Phil 
Published: September 2019

Background: The holistic and multidisciplinary approach of in-home palliative care (IHPC) is known to offer high-quality and cost-effective care for patients at the end of life. However, the financial benefits of upstream IHPC programs to hospitals, patients, and payers have not been fully characterized for patients with comorbid chronic conditions. Aim: To characterize the financial benefits that upstream IHPC offers to patients with multiple chronic conditions. Methods: A structured retrospective patient record review was conducted on the number of emergency department (ED) visits, number of inpatient hospitalizations, hospital length of stay (LOS), and payments made to the hospital for all patients (N = 71) enrolled in an IHPC program between January 1, 2016, and June 30, 2016. Discharge history from each patient’s medical record was also assessed. Comparisons were drawn between patients’ LOS on IHPC and an equivalent time period prior to enrollment in IHPC. Results: After patients enrolled in IHPC, average ED and inpatient utilization declined significantly by 41% ( P = .01) and 71% ( P < .001), respectively. The payers for health-care services realized a significant decline of US$2,201 ( P < .001) in hospital payments per patient per month. Inpatient LOS was also significantly lower than expected once patients enrolled in the program ( P = .01). Conclusions: As the need for chronic disease management continues to grow, managers of health systems, managed care organizations, and home health agencies should be cognizant of the financial value that IHPC has to offer.