bluuebunny/crossref_metadata_2025_split huggingface dataset:
“I Wasn't Gonna Let It Stop Me”: Exploring Women's Experiences of Getting Through Chemotherapy for Ovarian Cancer
Authors: Staneva Aleksandra A. , Beesley Vanessa L. , Niranjan Navin , Gibson Alexandra F. , Rowlands Ingrid , Webb Penelope M. 
Published: March 2018

Background
Many women with ovarian cancer experience significant chemotherapy-related adverse effects during treatment and thus cannot complete it without dose reductions and/or delays. There is some indication that chemotherapy completion is associated with improved survival, although currently little is known about what helps women get through chemotherapy.

Objective
The aim of this study was to explore women's accounts of the factors they believed were helpful during their ovarian cancer treatment.

Methods
Using a qualitative approach within a critical realist framework, we conducted interviews with 18 women who had received chemotherapy for ovarian cancer and analyzed the data thematically.

Results
We identified 3 main themes related to women's experiences of dealing with chemotherapy: “optimistic tenacity,” which illustrates a specific stoic identity that women assumed during treatment; “self-care,” which reflects the health behaviors and activities women engaged in and lifestyle adjustments they made; and “support systems,” which emphasizes the importance of social, emotional, and medical support and the specific needs shared by women undergoing treatment for ovarian cancer.

Conclusions
Our findings contribute to a deeper understanding of women's unique experiences of treatment that may influence whether they complete chemotherapy for ovarian cancer.

Implications for Practice
This study highlights the central role of women's optimistic determination within a wider self-caring and well-supported context of treatment; we aim to provide feedback and guidance to health professionals caring for women with ovarian cancer.
Emergency Medicine Providers' Knowledge and Management of Pediatric Tropical Diseases
Authors: Thomas Vanessa A. , Crouse Heather L. , Murray Kristy O. , Hsu Deborah C. , Camp Elizabeth A. , Cruz Andrea T. 
Published: March 2018

Objective
The aim of this study was to perform a needs assessment of pediatric (PEM) and general emergency medicine (EM) provider knowledge, comfort, and current practice patterns in the evaluation of pediatric tropical infectious diseases.

Methods
An online survey was developed based on educational priorities identified by an expert panel via modified Delphi methodology. The survey included assessment of providers' typical evaluation, diagnosis, and treatment of tropical diseases and was distributed to PEM and EM providers in 2 large professional organizations.

Results
A total of 333 physicians (285 PEM, 32 EM, 8 combined PEM/EM, and 8 general pediatricians in emergency department) participated. Fifty-five percent of vignettes were answered correctly. Those who trained outside the United States or Canada (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1–3.0) and PEM-trained providers (OR, 2.6; 95% CI, 1.2–5.9) were more likely to answer questions correctly. Providers answered more questions correctly about dengue (76%) and tuberculosis (77%) than typhoid (53%) and malaria (39%) (OR, 3.8; 95% CI, 3.0–4.9). Diagnostic evaluation for tropical diseases was variable with greater than 75% agreement for only 2 tests: blood smears in febrile patients from Africa (86%) and bacterial stool cultures in patients with bloody stools from Africa, Asia, or Latin America (94%). Providers had low (62%) or medium (35%) comfort level with pediatric tropical diseases, and 93% were interested in accessing emergency department–specific resources.

Conclusions
Pediatric EM and EM providers' knowledge and evaluation for pediatric tropical diseases are variable. Providers recognized their knowledge gaps and expressed interest in gaining access to resources and guidelines to standardize and improve evaluation and treatment of these diseases.
Scaphoid Fractures in Children
Authors: Porter Jonathan , Porter Robert , Chan Kevin Joseph 
Published: March 2018

Objectives
The purpose of this study is to determine the predictive value of clinical suspicion for scaphoid fracture in children aged 4 to 11 years, to look at the efficiency and practicality of current management of children presenting to the emergency department, and to help quantify the burden of the treatment strategy of immobilization for 10 to 14 days on clinical grounds despite negative or equivocal x-rays on presentation.

Methods
We performed a retrospective chart review study of a consecutive sample of all children aged 4 to 11 years old who presented to a tertiary pediatric emergency department from January 1, 2009, to December 31, 2013, within 24 hours of a wrist injury, with a clinical suspicion sufficient to order a scaphoid x-ray. Our primary outcome of interest was the positive predictive value of clinical suspicion of a scaphoid fracture.

Results
There were 142 patients (144 wrists) included in the study. Of these, 110 had a normal initial x-ray. Initial x-rays showed evidence of nonscaphoid fractures in 30 wrists and equivocal scaphoid fractures in 4 wrists. Of the 110 wrists with normal initial x-rays, 69 were immobilized and 52 of those had a follow-up x-ray (47 normal, 1 scaphoid fracture, 1 nonscaphoid fracture, and 3 equivocal evidence of a scaphoid fracture). The positive predictive value was found to be 2.1% to 12.5%.

Conclusions
This study suggests that children aged 4 to 11 years with clinical suspicion for scaphoid fractures do not necessarily need to be x-rayed or immobilized. A larger multicentered prospective clinical trial would confirm this.
Barriers and Facilitators to Central Venous Catheter Insertion: A Qualitative Study
Authors: Cameron Kenzie A. , Cohen Elaine R. , Hertz Joelle R. , Wayne Diane B. , Mitra Debi , Barsuk Jeffrey H. 
Published: March 2018

Objectives
The aims of the study were to identify perceived barriers and facilitators to central venous catheter (CVC) insertion among healthcare providers and to understand the extent to which an existing Simulation-Based Mastery Learning (SBML) program may address barriers and leverage facilitators.

Methods
Providers participating in a CVC insertion SBML train-the-trainer program, in addition to intensive care unit nurse managers, were purposively sampled from Veterans Administration Medical Centers located in geographically diverse areas. We conducted semistructured interviews to assess perceptions of barriers and facilitators to CVC insertion. Deidentified transcripts were analyzed using a grounded theory approach and the constant comparative method. We subsequently mapped identified barriers and facilitators to our SBML curriculum to determine whether or not the curriculum addresses these factors.

Results
We interviewed 28 providers at six Veterans Administration Medical Centers, identifying the following five overarching factors of perceived barriers to CVC insertion: (1) equipment, (2) personnel/staff, (3) setting or organizational context, (4) patient or provider, and (5) time-related barriers. Three overarching factors of facilitators emerged: (1) equipment, (2) personnel, and (3) setting or organizational context facilitators. The SBML curriculum seems to address most identified barriers, while leveraging many facilitators; building on the commonly identified facilitator of nursing staff contribution by expanding the curriculum to explicitly include nurse involvement could improve team efficiency and organizational culture of safety.

Conclusions
Many identified facilitators (e.g., ability to use ultrasound, personnel confidence/competence) were also identified as barriers. Evidence-based SBML programs have the potential to amplify these facilitators while addressing the barriers by providing an opportunity to practice and master CVC insertion skills.
The Scintigraphic Drooping Lily Sign
Authors: Sahakyan Karine , Spevak Melissa R. , Ziessman Harvey A. , Gorin Michael A. , Rowe Steven P. 
Published: March 2018

Abstract
The “drooping lily” sign is identified on intravenous urography or voiding cystourethrography in patients with a duplicated renal collecting system and refers to inferolateral displacement of a functioning lower pole moiety by an obstructed upper pole collecting system. In this case, a 2-month-old girl with a prenatal diagnosis of hydronephrosis was found to have a “scintigraphic drooping lily” sign on 99mTc-dimercaptosuccinic acid renal scan. Evaluation with ultrasound and voiding cystourethrography confirmed a duplicated collecting system and obstructed upper pole moiety. Correlation with anatomic imaging can help avoid mistaking the scintigraphic “drooped” lower pole for an inferiorly positioned normal kidney.
Synchronous Detection of Male Breast Cancer and Prostatic Cancer in a Patient With Suspected Prostatic Carcinoma on 68Ga-PSMA PET/CT Imaging
Authors: Kumar Rajender , Mittal Bhagwant Rai , Bhattacharya Anish , Singh Harmandeep , Singh Shrawan Kumar 
Published: March 2018

Abstract
The male breast cancer is very less common as compared with the female breast cancer. We report a case of 64-year-old man who presented with the history of lower urinary tract symptoms. The digital rectal examination revealed hard and nodular prostate, and serum prostate-specific antigen level was 23.4 ng/mL. 68Ga-labeled prostate-specific membrane antigen PET/CT revealed prostate-specific membrane antigen–expressing lesions in the prostate, axillary tail of the right breast, and axillary lymph nodes. Histology from prostate revealed prostate carcinoma, whereas fine-needle aspiration from the breast revealed invasive ductal carcinoma of the breast.
Transplantation of Autogenous Bone Block With an Osseointegrated Implant: Seedling Technique With Twelve-Month Follow-Up
Authors: Kutlu Huseyin Burak , Goyushov Samir , Calisan Bünyamin , Tözüm Tolga F. 
Published: March 2018

Objective:
Loss of teeth frequently results in compound horizontal and vertical alveolar bone defects. An appropriate bone structure is the key for implant placement and bony support of soft tissues. Advanced bone augmentation techniques are required for the reconstruction of these defects. This report will present a new bone block grafting technique with 12-month follow-up.

Method:
The seedling technique was used to augment the alveolar bone 3-dimensionally with autologous bone block and an osseointegrated implant in a 2-stage procedure. Horizontal and vertical bone loss is revealed after cone beam radiographic examination in the right maxillary lateral incisor area. Initially, the implant was placed at the right maxillary tuber area, where the bone was abundant. After 2-months healing phase, the osseointegrated implant was harvested with the surrounding bone and transplanted to the anterior region of maxilla to augment the horizontal and the vertical components of the recipient site. Transplanted implant inserted into autogenous bone block was fixed with mini plate to the adjacent native bone. Prosthetic restoration was applied 4 months after the transplantation.

Results:
Seven months after the first surgery, treatment of anterior bone deficiency was accomplished. The patient was fully satisfied with the function and the esthetics of the restoration. The radiological and clinical examinations at 1-year follow-up evaluation showed successful outcome of transplanted autogenous bone block without any resorption.

Conclusion:
This clinical report demonstrated that anterior maxillary single-tooth replacement, according to seedling concept of autogenous bone block with osseointegrated implant, is a successful and predictable treatment modality.
Proximal penetrating extremity injuries—An opportunity to decrease overtriage?
Authors: Martin Grace E. , He Heng , Makley Amy T. , Pritts Timothy A. , Elterman Joel B. , Johannigman Jay A. , Goodman Michael D. 
Published: March 2018

BACKGROUNDPenetrating injuries to the extremity proximal to the elbow or knee are anatomic criteria for full trauma team activation (FFTA) by the American College of Surgeon’s Committee on Trauma standards. This criterion lacks objective evidence-based support. Overtriage of trauma team activation may result in excessive costs and resource burden at trauma centers. We hypothesized that FFTA for penetrating injuries to the proximal extremities by anatomic criteria alone may lead to significant overtriage.METHODSA 3-year retrospective review (2013–2015) was completed of all patients evaluated at an urban Level I trauma center with isolated penetrating extremity injuries. Data included the number of full and limited trauma team activations as well as criterion met, Injury Severity Score (ISS), injury, limb characteristics, and disposition. Overtriage was defined as FFTA for an ISS of 15 or less, with a goal rate less than 50%.RESULTSWe identified 6,335 total trauma team activations with 795 isolated penetrating extremity injuries. Of these injuries, 413 (51.9%) were injuries proximal to the joint. Within this subgroup, 71.2% of patients were discharged from the emergency department with a median ISS of 1 and no additional intervention. Only 5.3% of patients that did not meet additional FFTA criteria underwent immediate operative intervention. By comparison, 21% of FFTAs and 5.8% of limited trauma team activations underwent immediate operative intervention during the 3-year period. Of the 413 isolated penetrating proximal-extremity injuries, only one had an ISS of 15 or greater, resulting in a 99.7% overtriage rate.CONCLUSIONPenetrating injuries to the extremities are common in urban trauma centers. Full trauma team activation based on anatomic, rather than physiologic, criteria may lead to a significant overtriage rate. Further distinction in the level of trauma team activation may be made based on hard signs of neurovascular injury.LEVEL OF EVIDENCEEpidemiological study, level III; Care Management, level IV.
Reviewing the effects of food provisioning on wildlife immunity
Authors: Strandin Tomas , Babayan Simon A. , Forbes Kristian M. 
Published: March 2018

While urban expansion increasingly encroaches on natural habitats, many wildlife species capitalize on anthropogenic food resources, which have the potential to both positively and negatively influence their responses to infection. Here we examine how food availability and key nutrients have been reported to shape innate and adaptive immunity in wildlife by drawing from field-based studies, as well as captive and food restriction studies with wildlife species. Examples of food provisioning and key nutrients enhancing immune function were seen across the three study type distinctions, as were cases of trace metals and pharmaceuticals impairing the immunity of wildlife species. More generally, food provisioning in field studies tended to increase innate and adaptive responses to certain immune challenges, whereas patterns were less clear in captive studies. Mild food restriction often enhanced, whereas severe food restriction frequently impaired immunity. However, to enable stronger conclusions we stress a need for further research, especially field studies, and highlight the importance of integrating nutritional manipulation, immune challenge, and functional outcomes. Despite current gaps in research on this topic, modern high throughput molecular approaches are increasingly feasible for wildlife studies and offer great opportunities to better understand human influences on wildlife health.
This article is part of the theme issue ‘Anthropogenic resource subsidies and host–parasite dynamics in wildlife’.
Coupling between cerebral blood flow and cerebral blood volume: Contributions of different vascular compartments
Authors: Wesolowski Roman , Blockley Nicholas P. , Driver Ian D. , Francis Susan T. , Gowland Penny A. 
Published: March 2018

AbstractA better understanding of the coupling between changes in cerebral blood flow (CBF) and cerebral blood volume (CBV) is vital for furthering our understanding of the BOLD response. The aim of this study was to measure CBF-CBV coupling in different vascular compartments during neural activation. Three haemodynamic parameters were measured during a visual stimulus. Look-Locker Flow-sensitive Alternating Inversion Recovery (LL-FAIR) was used to measure changes in CBF and arterial CBV (CBVa) using sequence parameters optimised for each contrast. Changes in total CBV (CBVtot) were measured using a Gadolinium based contrast agent technique. Haemodynamic changes were extracted from a region of interest based on voxels that were activated in the CBF experiments. The CBF-CBVtot coupling constant αtot was measured as 0.16±0.14 and the CBF-CBVa coupling constant αa was measured as 0.65±0.24. Using a two compartment model of the vasculature (arterial and venous), the change in venous CBV (CBVv) was predicted for an assumed value of baseline arterial and venous blood volume. These results will enhance the accuracy and reliability of applications that rely on models of the BOLD response, such as calibrated BOLD.
Efficient CRISPR/Cas9-based genome editing and its application to conditional genetic analysis in Marchantia polymorpha
Authors: Sugano Shigeo S. , Nishihama Ryuichi , Shirakawa Makoto , Takagi Junpei , Matsuda Yoriko , Ishida Sakiko , Shimada Tomoo , Hara-Nishimura Ikuko , Osakabe Keishi , Kohchi Takayuki 
Published: March 2018

AbstractMarchantia polymorpha is one of the model species of basal land plants. Although CRISPR/Cas9-based genome editing has already been demonstrated for this plant, the efficiency was too low to apply to functional analysis. In this study, we show the establishment of CRISPR/Cas9 genome editing vectors with high efficiency for both construction and genome editing. Codon optimization of Cas9 to Arabidopsis achieved over 70% genome editing efficiency at two loci tested. Systematic assessment revealed that guide sequences of 17 nt or shorter dramatically decreased this efficiency. We also demonstrated that a combinatorial use of this system and a floxed complementation construct enabled conditional analysis of a nearly essential gene. This study reports that simple, rapid, and efficient genome editing is feasible with the series of developed vectors.
Arsenite exposure inhibits histone acetyltransferase p300 for attenuating H3K27ac at enhancers in low-dose exposed mouse embryonic fibroblast cells
Authors: Zhu Yan , Li Yanqiang , Lou Dan , Gao Yang , Yu Jing , Kong Dehui , Zhang Qiang , Jia Yankai , Zhang Haimou , Wang Zhibin 
Published: March 2018

AbstractEpidemiological investigations have validated the positive relationships between arsenic in drinking water and several cancers, including skin, liver and lung cancers. Besides genotoxicity, arsenic exposure-related pathogenesis of disease is widely considered through epigenetic mechanisms; however, the underlying mechanistic insight remains elusive. Herein we explore the initial epigenetic changes via acute low-dose arsenite exposures of mouse embryonic fibroblast (MEF) cells and Dot1L knockout MEF (Dot1L-/- for abbreviation) cells. Our RNA-seq and Western blot data demonstrated that, in both cell lines, acute low-dose arsenite exposure abolished histone acetyltransferase p300 at the RNA level and subsequent protein level. Consequently, p300-specific main target histone H3K27ac, a marker separating active from poised enhancers, decreased dramatically as validated by both Western blot and ChIP-seq analyses. Concomitantly, H3K4me1 as another well-known marker for enhancers also showed significant decreases, suggesting an underappreciated crosstalk between H3K4me1 and H3K27ac involved in arsenite exposure. Significantly, arsenite exposure-reduced H3K27ac and H3K4me1 inhibit the expression of genes includingEP300itself andKruppel Like Factor 4(Klf4), a tumor suppressor gene. Collectively, our investigations identify p300 as an internal bridging factor within cells to sense external environmental arsenite exposure to alter chromatin, thereby changing gene transcription for disease pathogenesis.
Mercury-methylating bacteria are associated with zooplankton: a proof-of-principle survey in the Baltic Sea
Authors: Gorokhova Elena , Soerensen Anne L. , Motwani Nisha H. 
Published: March 2018

AbstractMethylmercury (MeHg) is a potent neurotoxin that biomagnifies in marine food-webs. Inorganic mercury (Hg) methylation is generally considered to be conducted by bacteria associated with sediment or detritus, but endogenous methylation by the gut microbiome of animals in the lower food webs is another possible source. We examined the occurrence of the bacterial gene (hgcA), required for Hg methylation, in the guts of dominant Baltic zooplankters. A qPCR assay targeting thehgcAsequence in three main clades (Deltaproteobacteria, FirmicutesandArchaea) was used in the field-collected specimens of copepods (Acartia bifilosa, Eurytemora affinis, Pseudocalanus acuspesandLimnocalanus macrurus) and cladocerans (Bosmina coregoni maritimaandCercopagis pengoi). All copepods were found to carryhgcAgenes in their gut microbiome, whereas no positive amplification was recorded in the cladocerans. In the copepods,hgcAgenes belonging to onlyDeltaproteobacteriaandFirmicuteswere detected. These findings suggest that endogenous Hg methylation can occur in zooplankton and may contribute to seasonal, spatial and vertical MeHg variability in water column and food webs. Additional molecular and metagenomics studies are needed to identify bacteria carryinghgcAgenes and improve their quantification in microbiota.
Breast cancer susceptibility: an integrative analysis of genomic data
Authors: Mocellin Simone , Valpione Sara , Rossi Carlo Riccardo , Pooley Karen 
Published: March 2018

AbstractBackgroundGenome wide association studies (GWAS) are greatly accelerating the pace of discovery of germline variants underlying the genetic architecture of sporadic breast cancer predisposition. We have built the first knowledge-base dedicated to this field and used it to generate hypotheses on the molecular pathways involved in disease susceptibility.MethodsWe gathered data on the common single nucleotide polymorphisms (SNPs) discovered by breast cancer risk GWAS. Information on SNP functional effect (including data on linkage disequilibrium, expression quantitative trait locus, and SNP relationship with regulatory motifs or promoter/enhancer histone marks) was utilized to select putative breast cancer predisposition genes (BCPGs). Ultimately, BCPGs were subject to pathway (gene set enrichment) analysis and network (protein-protein interaction) analysis.ResultsData from 38 studies (28 original case-control GWAS enrolling 383,260 patients with breast cancer; and 10 GWAS meta-analyses) were retrieved. Overall, 281 SNPs were associated with the risk of breast cancer with a P-value <10E-06 and a minor allele frequency >1%. Based on functional information, we identified 296 putative BCPGs. Primary analysis showed that germline perturbation of classical cancer-related pathways (e.g., apoptosis, cell cycle, signal transduction including estrogen receptor signaling) play a significant role in breast carcinogenesis. Other less established pathways (such as ribosome and peroxisome machineries) were also highlighted. In the main subgroup analysis, we considered the BCPGs encoding transcription factors (n=36), which in turn target 252 genes. Interestingly, pathway and network analysis of these genes yielded results resembling those of primary analyses, suggesting that most of the effect of genetic variation on disease risk hinges upon transcriptional regulons.ConclusionsThis knowledge-base, which is freely available and will be annually updated, can inform future studies dedicated to breast cancer molecular epidemiology as well as genetic susceptibility and development.AbbreviationsGWASgenome-wide association studySNPsingle nucleotide polymorphismBCPGbreast cancer predisposition geneLDlinkage disequilibrium