bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resting-state Functional Magnetic Resonance Imaging Identifies Cerebrovascular Reactivity Impairment in Patients With Arterial Occlusive Diseases: A Pilot Study
Authors: Nishida Sei , Aso Toshihiko , Takaya Shigetoshi , Takahashi Yuki , Kikuchi Takayuki , Funaki Takeshi , Yoshida Kazumichi , Okada Tomohisa , Kunieda Takeharu , Togashi Kaori , Fukuyama Hidenao , Miyamoto Susumu 
Published: August 2018

Abstract

BACKGROUND
The development of noninvasive approaches for identifying hypoperfused brain tissue at risk is of major interest. Recently, the temporal-shift (TS) maps estimated from resting-state blood oxygenation level-dependent (BOLD) signals have been proposed for determining hemodynamic state.

OBJECTIVE
To examine the equivalency of the TS map and the cerebrovascular reactivity (CVR) map derived from acetazolamide-challenged single-photon emission computed tomography (SPECT) in identifying hemodynamic impairment in patients with arterial occlusive diseases.

METHODS
Twenty-three patients with arterial occlusive diseases who underwent SPECT were studied. With a recursive TS analysis of low-frequency fluctuation of the BOLD signal, a TS map relative to the global signal was created for each patient. The voxel-by-voxel correlation coefficient was calculated to examine the image similarity between TS and SPECT-based cerebral blood flow (CBF) or CVR maps in each patient. Furthermore, simple linear regression analyses were performed to examine the quantitative relationship between the TS of BOLD signals and CVR in each cerebrovascular territory.

RESULTS
The within-patient, voxel-by-voxel comparison revealed that the TS map was more closely correlated with SPECT-CVR map ([Z(r)] = 0.42 ± 0.18) than SPECT-CBF map ([Z(r)] = 0.058 ± 0.11; P < .001, paired t-test). The regression analysis showed a significant linear association between the TS of BOLD signals and CVR in the anterior circulation where the reduction of CVR was evident in the patient group.

CONCLUSION
BOLD TS analysis has potential as a noninvasive alternative to current methods based on CVR for identification of tissue at risk of ischemic stroke.
Two intrauterine programming mechanisms of adult hypercholesterolemia induced by prenatal nicotine exposure in male offspring rats
Authors: Zhou Jin , Zhu Chunyan , Luo Hanwen , Shen Lang , Gong Jun , Wu Yimeng , Magdalou Jacques , Chen Liaobin , Guo Yu , Wang Hui 
Published: August 2018

ABSTRACTEpidemiologic studies showed that low birth weight is associated with high cholesterol and an increased risk of cardiovascular diseases in adulthood. This study aimed to elucidate the intrauterine programming mechanisms of adult hypercholesterolemia. The results showed that prenatal nicotine exposure (PNE) caused intrauterine growth retardation and hypercholesterolemia in male adult offspring rats. Hepatic cholesterol synthesis and output were deceased in utero but increased in adults; hepatic reverse cholesterol transport (RCT) persistently deceased before and after birth. Meanwhile, PNE elevated serum corticosterone level and decreased hepatic IGF1 pathway activity in male fetuses, whereas converse changes were observed in male adults. The chronic stress model and cortisol‐treated HepG2 cells verified that excessive glucocorticoid (GC)‐induced GC‐IGF1 axis programming enhanced hepatic cholesterol synthesis and output. In addition, PNE decreased the expression of specific protein 1 and P300 enrichment and H3K27 acetylation at the promoter region of genes responsible for RCT both in fetal and adult, male livers and reduced expression of those genes, similar alterations were also confirmed in cortisol‐treated HepG2 cells, suggesting that excessive GC‐related programming induced continuous RCT reduction by epigenetic modification. Taken together, the “2‐programming” approach discussed above may ultimately contribute to the development of hypercholesterolemia in male adult offspring.—Zhou, J., Zhu, C., Luo, H., Shen, L., Gong, J., Wu, Y., Magdalou, J., Chen, L., Guo, Y., Wang, H. Two intrauterine programming mechanisms of adult hypercholesterolemia induced by prenatal nicotine exposure in male offspring rats. FASEB J. 33, 1110–1123 (2019). www.fasebj.org
Stabilization of p27Kip1/CDKN1B by UBCH7/UBE2L3 catalyzed ubiquitinylation: a new paradigm in cell‐cycle control
Authors: Whitcomb Elizabeth A. , Tsai Yien Che , Basappa Johnvesly , Liu Ke , le Feuvre Aurélie K. , Weissman Allan M. , Taylor Allen 
Published: August 2018

ABSTRACTUbiquitinylation drives many cellular processes by targeting proteins for proteasomal degradation. Ubiquitin conjugation enzymes promote ubiquitinylation and, thus, degradation of protein substrates. Ubiquitinylation is a well‐known posttranslational modification controlling cell‐cycle transitions and levels or/and activation levels of ubiquitin‐conjugating enzymes change during development and cell cycle. Progression through the cell cycle is tightly controlled by CDK inhibitors such as p27Kip1. Here we show that, in contrast to promoting its degradation, the ubiquitin‐conjugating enzyme UBCH7/UBE2L3 specifically protects p27Kip1 from degradation. Overexpression of UBCH7/UBE2L3 stabilizes p27Kip1 and delays the G1‐to‐S transition, while depletion of UBCH7/UBE2L3 increases turnover of p27Kip1. Levels of p21Cip1/Waf1, p57Kip2, cyclin A and cyclin E, all of which are also involved in regulating the G1/S transition are not affected by UBCH7/UBE2L3 depletion. The effect of UBCH7/UBE2L3 on p27Kip1 is not due to alteration of the levels of any of the ubiquitin ligases known to ubiquitinylate p27Kip1. Rather, UBCH7/UBE2L3 catalyzes the conjugation of heterotypic ubiquitin chains on p27Kip1 that are proteolytically incompetent. These data reveal new controls and concepts about the ubiquitin proteasome system in which a ubiquitin‐conjugating enzyme selectively inhibits and may even protect, rather than promote degradation of a crucial cell‐cycle regulatory molecule.—Whitcomb, E. A., Tsai, Y. C., Basappa, J., Liu, K., le Feuvre, A. K., Weissman, A.M., Taylor, A. Stabilization of p27Kip1/CDKN1B by UBCH7/UBE2L3 catalyzed ubiquitinylation: a new paradigm in cell‐cycle control. FASEB J. 33, 1235–1247 (2019). www.fasebj.org
Validation of the Dutch-Flemish PROMIS Pain Interference Item Bank in Patients With Musculoskeletal Complaints
Authors: Schuller Wouter , Terwee Caroline B. , Klausch Thomas , Roorda Leo D. , Rohrich Daphne C. , Ostelo Raymond W. , Terluin Berend , de Vet Henrica C.W. 
Published: August 2018

Study Design.
A cross-sectional study.

Objective.
The aim of this study was to validate the Dutch-Flemish PROMIS Pain Interference item bank in patients with musculoskeletal complaints.

Summary of Background Data.
PROMIS item banks have been developed and validated in the US. They need to be further validated in various patient populations and in different languages.

Methods.
One thousand six hundred seventy-seven patients answered the full item bank. A Graded Response Model (GRM) was used to study dimensionality with confirmatory factor analyses and by assessing local independency. Monotonicity was evaluated with Mokken scaling. An Item Response Theory (IRT) model was used to study item fit and to estimate slope and threshold parameters. Differential item functioning (DIF) for language, age, and gender was assessed using ordinal logistic regression analyses. DIF for language was evaluated by comparing our data with a similar US sample. Hypotheses concerning construct validity were tested by correlating item bank-scores with scores on several legacy instruments.

Results.
The GRM showed suboptimal evidence of unidimensionality in confirmatory factor analysis [Comparative Fit Index (CFI): 0.903, Tucker-Lewis Index (TLI): 0.897, Root Mean Square Error of Approximation (RMSEA): 0.144], and 99 item pairs with local dependence. A bifactor model showed good fit (CFI: 0.964, TLI: 0.961, RMSEA: 0.089), with a high Omega-H (0.97), a high explained common variance (ECV: 0.81), and no local dependence. Sufficient monotonicity was shown for all items (Mokken H(i): 0.367–0.686). The unidimensional IRT model showed good fit (only two items with S-X2 < 0.001), with slope parameters ranging from 1.00 to 4.27, and threshold parameters ranging from −1.77 to 3.66. None of the items showed DIF for age or gender. One item showed DIF for language. Correlations with legacy instruments were high (Pearson R: 0.53–0.75), supporting construct validity.

Conclusion.
The high omega-H and the high ECV indicate that the item bank could be considered essentially unidimensional. The item bank showed good item fit, good coverage of the pain interference trait, and good construct validity.

Level of Evidence: N/A
Vulnerability to the Cardiovascular Effects of Ambient Heat in Six US Cities
Authors: Gronlund Carina J. , Sheppard Lianne , Adar Sara D. , O’Neill Marie S. , Auchincloss Amy , Madrigano Jaime , Kaufman Joel , Diez Roux Ana V. 
Published: August 2018

Background:With climate change, temperatures are increasing. Heat-associated health events disproportionately affect certain subpopulations. However, prior research has often lacked information on individual-level health and air conditioning and neighborhood stressors/protections.Objectives:To assess whether (1) heat (2-day mean temperature above local 75th percentiles) is associated with increased heart rate and decreased blood pressure, controlling for age, time, season, daily ozone, and daily particulate matter (PM2.5) and (2) associations differ by antihypertensive medication use, renal function, fasting glucose, emotional support, air conditioning ownership and use, normalized difference vegetation index, neighborhood safety, and residence- specific oxides of nitrogen and PM2.5.Methods:Health and behavioral characteristics were obtained repeatedly on participants of the Multi-Ethnic Study of Atherosclerosis in six US sites (2000–2010). These were linked with airport temperature, air quality, and satellite- and survey-derived neighborhood characteristics. We used a fixed-effects design, regressing health outcomes on linear temperature splines with knots at the 75th percentiles, interaction terms for each characteristic, and adjustment for month of year, age, PM2.5, and ozone.Results:Overall, heat was not associated with heart rate. However, for a 2°C increase in heat, systolic blood pressure decreased by 1.1 mmHg (95% CI = −1.6, −0.6) and diastolic blood pressure by 0.3 mmHg (95% CI = −0.6, −0.1). Among nonusers of antihypertensive medications, heat-associated decreases in SBP were 2.1 mmHg greater among individuals with central air conditioning versus those without. Confidence intervals around the remaining modifiers were wide after multiple-comparisons corrections or sensitivity analyses.Conclusions:Outdoor heat is associated with decreasing blood pressure, and cardiovascular vulnerability may vary primarily by ownership of central air conditioning.
SUPRACHOROIDAL INJECTION OF TRIAMCINOLONE ACETONIDE, CLS-TA, FOR MACULAR EDEMA DUE TO NONINFECTIOUS UVEITIS
Authors: Yeh Steven , Kurup Shree K. , Wang Robert C. , Foster C. Stephen , Noronha Glenn , Nguyen Quan Dong , Do Diana V. ,   for the DOGWOOD Study Team
Published: August 2018

Purpose:
Evaluate a single suprachoroidal injection of a proprietary triamcinolone acetonide suspension, CLS-TA, in subjects with macular edema due to noninfectious uveitis.

Methods:
Randomized, controlled, masked Phase 2 study. Safety and efficacy of a single suprachoroidal injection of CLS-TA (4.0 and 0.8 mg in a 4:1 ratio) were assessed at 1 and 2 months after injection. The primary efficacy endpoint was change in central subfield thickness from baseline to Month 2, assessed by spectral domain optical coherence tomography.

Results:
Twenty-two adults were enrolled. The primary endpoint was met in subjects who received suprachoroidal injection of CLS-TA 4.0 mg, mean central subfield thickness significantly decreased from baseline by 135 µm and 164 µm at Month 1 (P = 0.0056) and Month 2 (P = 0.0017), respectively. At Month 2, 69% of subjects who received 4.0 mg experienced ≥20% reduction in central subfield thickness, and 65% had improvement of best-corrected visual acuity of ≥5 Early Treatment Diabetic Retinopathy Study letters, with a mean improvement of 9.2 letters (P = 0.0004). Safety analyses supported acceptable safety/tolerability, with no corticosteroid-related increases in intraocular pressure.

Conclusion:
A single suprachoroidal injection of CLS-TA (4.0 mg; 0.1 mL) in subjects with macular edema due to noninfectious uveitis was well-tolerated, significantly reduced central subfield thickness from baseline at 2 months, and significantly improved visual acuity.
Tolerance of Oral Opioid Medication After Surgery for Ruptured Appendicitis in Pediatric Patients
Authors: Wilson-Kocovsky Kathleen , Sudar Kimberly 
Published: August 2018

Introduction: Each year, numerous children undergo surgery and require oral opioids during their postoperative recovery. Little is known about when children who have been on a nothing-by-mouth diet after surgery can tolerate oral opioids. Although oral opioids offer advantages over the intravenous route, healthcare professionals have differing opinions regarding how much oral intake (liquids or solids) a patient needs to tolerate before starting oral opioids. This could lead to inconsistencies in practice, which could impact patients' comfort, length of stay, and, ultimately, healthcare costs. The primary purpose of this study was to identify current practice regarding initiation of oral opioids in pediatric patients recovering from an appendectomy for ruptured appendicitis. On the basis of this data, our team aimed to provide a best practice recommendation for this population. Methods: A retrospective chart review was conducted from a sample of 43 children recovering from an appendectomy secondary to ruptured appendicitis. Data included time from surgery to ingestion of clear liquids, administration of oral opioids, and occurrence of emesis in relation to either of these administrations. Results: Children received from 30 ml to an average of 354 ml of clear liquids before taking oral opioids, and no patients had emesis documented regardless of the volume of clear liquids they ingested before administration of oral opioids. Discussion: Results suggest that pediatric patients may be able to tolerate oral opioids regardless of the amount of clear liquids they tolerate beforehand. Although more studies are needed to support these results, such results could mean earlier transition from intravenous to oral opioids, which could decrease healthcare costs and potentially decrease length of stay.
Incidence of Combat Sport-Related Mild Traumatic Brain Injuries Presenting to the Emergency Department From 2012 to 2016
Authors: Lemme Nicholas J. , Johnston Benjamin , DeFroda Steven F. , Owens Brett D. , Kriz Peter K. 
Published: August 2018

Objectives:We sought to investigate the incidence and characteristics of traumatic brain injuries [mild traumatic brain injury (MTBI)] presenting to the emergency department as a result of boxing, wrestling, and martial arts (MA).Design:Retrospective cross-sectional study of MTBI in combat sport athletes who were evaluated in emergency departments in the United States.Setting:Patient data were taken from the National Electronic Injury Surveillance System.Participants:All patients with MTBI from 2012 to 2016, which occurred during participation in boxing, MA, or wrestling.Interventions:None.Main Outcome Measures:The incidence of combat sport-related MTBI presenting to emergency departments in the United States.Results:The mean annual incidence of MTBI due to wrestling was significantly larger (269.3 per 100 000 person-years) than boxing (85.6 per 100 000 person-years) and MA (61.0 per 100 000 person-years) (P< 0.01). The average age at injury was significantly lower for wrestling compared with boxing and MA (15.0 years [SD ± 3.9] vs 21.7 years [SD ± 8.2] vs 19.9 years [SD ± 10.5];P< 0.01). A significantly larger proportion of MTBIs (95.3%;P< 0.01) in patients younger than 20 years were related to wrestling, compared with boxing (55.8%) and MA (54.1%). Most patients with combat sport-related MTBIs were treated and discharged (96.3%), with only 1.7% of patients being admitted and 0.6% of patients being held for observation.Conclusion:Combat sports athletes are at high risk of sustaining an MTBI. Such athletes presenting to the emergency department for combat sport-related MTBI were more likely to be male and younger than 20 years. Of these athletes, wrestlers experience the highest incidence of MTBI-related emergency department visits.
Evaluation of Muscle Injuries in Professional Football Players: Does Coach Replacement Affect the Injury Rate?
Authors: Dönmez Gürhan , Kudaş Savaş , Yörübulut Mehmet , Yıldırım Murat , Babayeva Naila , Torgutalp Şerife Şeyma 
Published: August 2018

Objectives:
To assess the incidence and characteristics of muscle injuries in professional football players and to assess if coach dismissal may be related with muscle injuries within 1-month period from the dismissal.

Design:
Prospective cohort study during 3 consecutive seasons.

Setting:
Turkish Super League football teams.

Participants:
One hundred eighteen male football players.

Main Outcome Measures:
Data on time-loss muscle injuries confirmed using magnetic resonance imaging were recorded, including type, body part, duration, and lay-off time, and training session and match exposure times. The muscle injury rate was evaluated at 2 weeks and 30 days after coach dismissal.

Results:
In total, 124 muscle injuries were recorded, with injury incidences of 2.3 muscle injuries per 1000 hours of exposure overall, 1.2 in training sessions, and 13.6 in matches. Injury time loss ranged from 3 to 67 days (median, 13 days). Eighteen percent of the injuries (n = 23) were recurrent; no association was found between recurrence rate and the player's age or position (P = 0.15, P = 0.27, respectively). Recurrent injuries caused more severe injuries (26.1%, P = 0.02) and longer median lay-off time (P = 0.01). During the study, teams A and B replaced 7 and 3 coaches, respectively. The injury incidence increased to 5.3 per 1000 hours of exposure in the 2 weeks after the coach dismissal, and decreased to 4.5 within 1 month of coach dismissal.

Conclusion:
Given the link between coach dismissal and increased rates of muscle strain injuries, increased attentiveness to preventing muscle injuries during coaching transitions and to the impact of new training regimens is required by trainers and medical teams.
The impact of interprofessional education on family nurse practitioner students' and family medicine residents' knowledge and confidence in screening for breast and cervical cancer
Authors: Weston Cindy , Akinlotan Marvellous , Lichorad Anna , McClellan David , Helduser Janet , Ojinnaka Chinedum , Holland Benny , Bolin Jane N. 
Published: August 2018

Background and Purpose:
This study determined the impact of an interprofessional education (IPE) simulation on family nurse practitioner (FNP) students' and family medicine residents' (FMRs) self-reported confidence in counseling women reluctant to engage in cancer screening or evaluation and assessed knowledge of breast and cervical cancer risk factors.

Method:
A multi-item knowledge survey on breast and cervical cancer risk factors was administered to 76 FNP students and FMRs followed by an IPE simulation with a pre-/postsurvey of self-reported confidence in counseling a woman reluctant to have breast and cervical cancer screening and evaluation.

Discussion:
Data demonstrated knowledge deficits in breast and cervical cancer risk factors in both disciplines with the average risk factor knowledge score of 8.5/12 for breast cancer and 7.8/12 for cervical cancer. Following IPE simulation, confidence in counseling women reluctant to have breast or cervical cancer screening improved across both disciplines (p < .05) and debrief feedback findings suggest improved attitudes toward collegiality, communication, and understanding of other interprofessional roles among both disciplines.

Conclusion:
Knowledge gaps exist among both FNP students and FMRs in breast and cervical cancer risk factors. This study suggests IPE simulation is effective in building individual provider confidence and team collegiality.
Nurse practitioners' time on nonbillable activities
Authors: Kippenbrock Thomas , Lo Wen-Juo , Emory Jan , Buron Bill , Odell Ellen , Reimers Jennifer 
Published: August 2018

ABSTRACT

Background and purpose:
During the provision of patient care delivery, all providers, including nurse practitioners (NPs), spend some time in activities that are not reimbursable. Understanding these nonbillable activities is crucial to the economic viability and success of existing and projected practice models. This study explored and compared seven nonbillable activities occurring in the practices of NPs in various settings.

Methods:
Using a nonexperimental, descriptive design, 509 NPs were surveyed about nonbillable activities encountered in daily practice. Binomial regression analyses and incidence rate ratios were used to interpret relationships between each variable and nonbillable time.

Conclusions:
Although not every variable had significance, there were significant differences found in the amount of time spent in certain nonbillable activities depending on workplace setting, number of support staff, and primary care provider role.

Implications for practice:
The uncertainty of health care reform, including reimbursement, provider shortage, and the expanding roles of NPs, requires a closer look at both billable and nonbillable care activities. Understanding how nonbillable time affects work efficiency, costs, and the value of NPs will allow NPs to influence future health care reimbursement policies and delivery care models.
Acute Otitis Media and Associated Complications in United States Emergency Departments
Authors: Ren Yin , Sethi Rosh K. V. , Stankovic Konstantina M. 
Published: August 2018

Objective:
Complications due to acute otitis media (AOM), while rare, are associated with significant morbidity and are not well characterized from an epidemiological perspective. We analyze the pattern of presentation and emergency department (ED) utilization in patients with AOM and associated complications.

Study Design:
Retrospective analysis of the Nationwide Emergency Department Sample (NEDS) from 2009 to 2011.

Setting:
Emergency Department.

Patients:
Patients who presented with a primary diagnosis of AOM or acute mastoiditis.

Intervention:
Diagnostic.

Main Outcome Measures:
NEDS was queried for patient encounters with a diagnosis of AOM or acute mastoiditis based on ICD-9 codes. Complications of severe infection, including petrositis, Gradenigo's syndrome, facial paresis, labyrinthitis, meningitis, intracranial abscess, venous sinus thrombosis, and cerebrospinal fluid leak, were assessed. Weighted estimates for demographics, types of complications, socioeconomic status, and trends over time were extracted.

Results:
A weighted total of 5,811,127 ED visits were identified. The majority of patients were less than 18 years old (79.9%) with an average age of 10.1 years. Most were discharged (99.4%). There were 15,243 (0.26%) patients who presented with a complication. The most common complications were acute mastoiditis (0.16%), labyrinthitis (0.06%), and facial paresis (0.03%). Compared with patients with uncomplicated AOM, patients with complicated AOM were older (37 vs. 10-yr old), insured by Medicare (18% vs. 2.1%), and more likely to be admitted (43.6% vs. 0.4%) (p < 0.0001, for all comparisons).

Conclusions:
ED visits related to AOM or mastoiditis are common and complications are rare. An in-depth analysis on a national level is useful for assessing healthcare utilization trends.