bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Risk of Cardiac Device-Related Infection in Bacteremic Patients Is Species Specific: Results of a 12-Year Prospective Cohort
Authors: Maskarinec Stacey A , Thaden Joshua T , Cyr Derek D , Ruffin Felicia , Souli Maria , Fowler Vance G 
Published: June 2017

Abstract

Background
The species-specific risk of cardiac device-related infection (CDRI) among bacteremic patients is incompletely understood.

Methods
We conducted a prospective cohort study of hospitalized patients from October 2002 to December 2014 with a cardiac device (CD) and either Staphylococcus aureus bacteremia (SAB) or Gram-negative bacteremia (GNB). Cardiac devices were defined as either prosthetic heart valves (PHVs), including valvular support rings, permanent pacemakers (PPMs)/automatic implantable cardioverter defibrillators (AICDs), or left ventricular assist devices (LVADs).

Results
During the study period, a total of 284 patients with ≥1 CD developed either SAB (n = 152 patients) or GNB (n = 132 patients). Among the 284 patients, 150 (52.8%) had PPMs/AICDs, 72 (25.4%) had PHVs, 4 (1.4%) had LVADs, and 58 (20.4%) had &gt;1 device present. Overall, 54.6% of patients with SAB and 16.7% of patients with GNB met criteria for definite CDRI (P &lt; .0001). Multivariable logistic regression analysis revealed that 3 bacterial species were associated with an increased risk for CDRI: Staphylococcus aureus (odds ratio [OR] = 5.57; 95% confidence interval [CI], 2.16–14.36), Pseudomonas aeruginosa (OR = 50.28; 95% CI, 4.16–606.93), and Serratia marcescens (OR = 7.75; 95% CI, 1.48–40.48).

Conclusions
Risk of CDRI among patients with bacteremia varies by species. Cardiac device-related infection risk is highest in patients with bacteremia due to S aureus, P aeruginosa, or S marcescens. By contrast, it is lower in patients with bacteremia due to other species of Gram-negative bacilli. Patients with a CD who develop bacteremia due to either P aeruginosa or S marcescens should be considered for diagnostic imaging to evaluate for the presence of CDRI.
Flipped Classrooms in Graduate Medical Education: A National Survey of Residency Program Directors
Authors: Wittich Christopher M. , Agrawal Anoop , Wang Amy T. , Halvorsen Andrew J. , Mandrekar Jayawant N. , Chaudhry Saima , Dupras Denise M. , Oxentenko Amy S. , Beckman Thomas J. 
Published: June 2017

Purpose
To begin to quantify and understand the use of the flipped classroom (FC)—a progressive, effective, curricular model—in internal medicine (IM) education in relation to residency program and program director (PD) characteristics.

Method
The authors conducted a survey that included the Flipped Classroom Perception Instrument (FCPI) in 2015 regarding programs’ use and PDs’ perceptions of the FC model.

Results
Among the 368 IM residency programs, PDs at 227 (61.7%) responded to the survey and 206 (56.0%) completed the FCPI. Regarding how often programs used the FC model, 34 of the 206 PDs (16.5%) reported “never”; 44 (21.4%) reported “very rarely”; another 44 (21.4%) reported “somewhat rarely”; 59 (28.6%) reported “sometimes”; 16 (7.8%) reported “somewhat often”; and 9 (4.4%) reported “very often.” The mean FCPI score (standard deviation [SD]) for the in-class application factor (4.11 [0.68]) was higher (i.e., more favorable) than for the preclass activity factor (3.94 [0.65]) (P < .001). FC perceptions (mean [SD]) were higher among younger PDs (≤ 50 years, 4.12 [0.62]; > 50 years, 3.94 [0.61]; P = .04) and women compared with men (4.28 [0.56] vs. 3.91 [0.62]; P < .001). PDs with better perceptions of FCs had higher odds of using FCs (odds ratio, 4.768; P < .001).

Conclusions
Most IM programs use the FC model at least to some extent, and PDs prefer the interactive in-class components over the independent preclass activities. PDs who are women and younger perceived the model more favorably.
Timing of first childbirth and age-related cataract
Authors: Park Sangshin , Choi Nam-Kyong 
Published: June 2017

Abstract

Objective:
No studies investigated the effects of age at first childbirth on cataract formation. This study was performed to determine the relationships of age at first childbirth to age-related cataract in postmenopausal women.

Methods:
Study population included 7,021 postmenopausal women in the Korea National Health and Nutrition Examination Survey, 2008 to 2012. Participants were subdivided in quartiles according to the age at first childbirth as follows: 13 to 21, 22 to 23, 24 to 25, and 26 to 44 years. We used odds ratios (ORs) and 95% confidence intervals (CIs) to address the relationships between age at first childbirth and age-related cataract with adjustments for confounders.

Results:
Mean participants’ age and age at first childbirth were 64.4 and 23.6 years, respectively. The prevalence of any subtype of age-related cataract was 64.9%. Nuclear cataract prevalence was significantly higher in postmenopausal women with later age at first childbirth (24-25 and 26-44 years) compared with those with the earliest age at first childbirth (13-21 years): ORs (95% CIs) were 1.23 (1.05-1.45) and 1.24 (1.05-1.46), respectively. A significant linear trend across quintile was observed (P = 0.006). Age at first childbirth linearly 4% (OR 1.04, 95% CI 1.01-1.06) and 2% (OR 1.02, 95% CI 1.00-1.04) increased risk for nuclear and cortical cataract formation, respectively. The population-attributable fraction of nuclear cataract caused by the first childbirth at 24 years or later was 4.9% (95% CI 1.20%-8.59%, P
= 0.009).

Conclusions:
Later age of first childbirth was independently associated with higher risks of nuclear and cortical cataract in postmenopausal women. Further prospective studies are needed to elucidate the role of age at first childbirth in developing age-related cataract.
Vaginal microbiota and genitourinary menopausal symptoms: a cross-sectional analysis
Authors: Mitchell Caroline M. , Srinivasan Sujatha , Zhan Xiang , Wu Michael C. , Reed Susan D. , Guthrie Katherine A. , LaCroix Andrea Z. , Fiedler Tina , Munch Matthew , Liu Congzhou , Hoffman Noah G. , Blair Ian A. , Newton Katherine , Freeman Ellen W. , Joffe Hadine , Cohen Lee , Fredricks David N. 
Published: June 2017

Abstract

Objective:
To examine associations between the composition of the vaginal microbiota and genitourinary menopausal symptoms, serum estrogen, and vaginal glycogen.

Methods:
For this cross-sectional study, 88 women aged 40 to 62 years, enrolled in a hot flash treatment trial, provided vaginal swabs and a blood sample at enrollment. Bacterial communities were characterized using 16S rRNA PCR and deep sequencing targeting the V3-V4 region. Quantities of Lactobacillus crispatus and Lactobacillus iners were measured using qPCR. Self-reported genitourinary symptoms included: presence and severity of individual symptoms and identification of most bothersome symptom. Glycogen was measured fluorometrically in swab eluate. Serum estradiol (E2) and estrone (E1) were measured by liquid chromatography/mass spectrometry. Associations between bacteria, symptoms, glycogen, and serum estrogens were tested by linear regression or Wilcoxon signed-rank test, adjusted for multiple comparisons. Comparisons between groups used Kruskall-Wallis or Fisher's exact test.

Results:
Of the 88 women, 33 (38%) had a majority of Lactobacillus species, whereas 58 (66%) had any Lactobacillus detected. Over half (53%) reported at least one vulvovaginal symptom (most commonly dryness), but symptoms were not associated with the presence of Lactobacillus species. Women with Lactobacillus-dominant communities had higher unconjugated serum estrone, but no difference in vaginal glycogen levels, compared with those with non-Lactobacillus-dominant communities. Higher serum E2 and E1 were not associated with either higher vaginal glycogen or detection of individual genera.

Conclusions:
Presence of Lactobacillus-dominant vaginal microbiota was not associated with fewer vulvovaginal symptoms. Serum estrone was higher in women with Lactobacillus dominance, but vaginal-free glycogen was not associated with composition of the vaginal microbiota.
Missing documentation in breast cancer survivors: genitourinary syndrome of menopause
Authors: Cook Elise D. , Iglehart Elena I. , Baum George , Schover Leslie L. , Newman Lonzetta L. 
Published: June 2017

Abstract

Objective:
Breast cancer survivors often take hormonal treatments to prevent the recurrence of breast cancer, particularly aromatase inhibitors that can worsen the symptoms of genitourinary syndrome of menopause (GSM) such as dyspareunia, dysuria, and urinary incontinence, all of which may adversely affect survivors’ quality of life. Few breast cancer survivors experiencing GSM receive adequate assessment or treatment.

Methods:
In this descriptive study, we reviewed medical records for documented GSM and any treatments administered or referrals for treatment in 800 female patients who visited the Breast Cancer Survivorship Clinic at a comprehensive cancer center between July 1, 2010 and June 30, 2011, either at least 5 years after completion of treatment for invasive breast cancer or at least 6 months after completion of treatment for ductal carcinoma in situ.

Results:
Of the 279 patients with documented symptoms of vaginal atrophy, only 111 (39.8%) had documentation of having received any form of treatment or referral. Of the 71 patients with documented symptoms of urinary tract atrophy, only 33.8% had documentation of having received treatment or referral for treatment.

Conclusion:
Breast cancer survivors often experience GSM due to lack of estrogen. The worrisome lack of documentation of assessment or treatment for GSM in a large breast cancer survivorship practice reveals missed opportunities to improve quality of life. Dissemination of recent progress in the development of GSM assessment tools, patient handouts, and new treatments to providers who care for breast cancer survivors is needed to improve this process.
CHANGES IN CHOROIDAL THICKNESS IN CLINICALLY SIGNIFICANT PSEUDOPHAKIC CYSTOID MACULAR EDEMA
Authors: Fleissig Efrat , Cohen Shai , Iglicki Matias , Goldstein Michaella , Zur Dinah 
Published: June 2017

Purpose:
To investigate choroidal thickness in eyes with clinically significant pseudophakic cystoid macular edema (PCME) during the acute phase and following resolution of the edema, using enhanced depth imaging spectral domain optical coherence tomography (EDI-OCT).

Methods:
This is a retrospective, observational clinical study. Patients' records were reviewed for cases of clinically significant PCME after uneventful phacoemulsification surgery. Choroidal thickness was measured at time of PCME diagnosis in both eyes and after CME resolution in the affected eye using enhanced depth imaging spectral domain optical coherence tomography (Spectralis; Heidelberg Engineering). Measurements were taken subfoveal and 1.5 mm nasal, temporal, inferior, and superior from the center of the fovea. Statistical analysis was performed using paired t-test and Pearson correlation.

Results:
Mean subfoveal choroidal thickness in 34 eyes with PCME measured 258 ± 83 μm at baseline and decreased to 215 ± 79 μm after CME resolution (P < 0.001). Mean subfoveal choroidal thickness measured at baseline in fellow eyes was significantly lower (194 ± 77 μm) compared to acute PCME (P < 0.001) and after CME resolution (P = 0.011).

Conclusion:
Choroidal thickness is increased in eyes with PCME and decreases following edema resolution. These findings may strengthen the hypothesis of an inflammatory pathogenesis in PCME.
Objectively Measured Daily Physical Activity and Postural Changes as Related to Positive and Negative Affect Using Ambulatory Monitoring Assessments
Authors: Aggio Daniel , Wallace Karen , Boreham Nicola , Shankar Aparna , Steptoe Andrew , Hamer Mark 
Published: June 2017

ABSTRACT

Objective
The aim of the study was to determine whether objectively measured daily physical activity and posture of sitting, standing, and sit-to-stand transitions are associated with daily assessments of affect.

Methods
Participants (N = 51, 49% female) wore ActivPal accelerometers for 24 h/d for seven consecutive days. Time spent sitting, standing, and being physically active and sit-to-stand transitions were derived for each day. Participants also completed a mood inventory each evening. Multilevel models examined within- and between-person associations of daily physical activity with positive and negative affect, adjusting for age, sex, body mass index, education, and sleep duration.

Results
Within-person associations showed that a 1-hour increase in daily physical activity was associated with a decrease in negative affect over the same day (B = −0.11, 95% confidence interval [CI], −0.21 to −0.01). Between-person associations indicated a borderline significant association between higher average daily physical activity levels and higher positive affect (B = 1.85, 95% CI = −0.25 to 3.94). There were no between- or within-person associations between sitting, standing, and sit-to-stand transitions with affect.

Conclusions
Promoting physical activity may be a potential intervention strategy to acutely suppress negative affective states.
Palliative oxygen for chronic breathlessness: what new evidence?
Authors: Ahmadi Zainab , Currow David C. , Ekström Magnus 
Published: June 2017

Purpose of review
Supplemental oxygen improves survival in patients with chronic obstructive pulmonary disease (COPD) and severe hypoxaemia, but the effect of oxygen therapy in mild or moderate hypoxaemia to reduce symptomatic chronic breathlessness remains unclear. This review provides an overview of recent evidence about the role of oxygen therapy for the relief of chronic breathlessness in advanced illness.

Recent findings
In COPD, a recent Cochrane review strengthens earlier findings regarding the positive effect of supplemental oxygen compared with air during exercise test in the training setting. The novel analysis of effect of oxygen therapy on quality of life (QoL) showed no clear effect. Short-burst oxygen therapy given before exercise had no effect and should not be used.

Summary
Supplemental oxygen during exercise has been shown to reduce breathlessness in patients with COPD who have no or mild hypoxaemia, but it is not clear whether the reduction in breathlessness shown in the laboratory setting translates into a clinically important benefit. Further studies are needed to establish this.
Increased ParB level affects expression of stress response, adaptation and virulence operons and potentiates repression of promoters adjacent to the high affinity binding sitesparS3andparS4inPseudomonas aeruginosa
Authors: Kawałek Adam , Głąbski Krzysztof , Bartosik Aneta Agnieszka , Fogtman Anna , Jagura-Burdzy Grażyna 
Published: June 2017

AbstractSimilarly to its homologs in other bacteria,Pseudomonas aeruginosapartitioning protein ParB facilitates segregation of newly replicated chromosomes. Lack of ParB is not lethal but results in increased frequency of anucleate cells production, longer division time, cell elongation, altered colony morphology and defective swarming and swimming motility. Unlike in other bacteria, inactivation ofparBleads to major changes of the transcriptome, suggesting that, directly or indirectly, ParB plays a role in regulation of gene expression in this organism.ParB overproduction affects growth rate, cell division and motility in a similar way as ParB deficiency. To identify primary ParB targets, here we analysed the impact of a slight increase in ParB level onP. aeruginosatranscriptome. ParB excess, which does not cause changes in growth rate and chromosome segregation, significantly alters the expression of 176 loci. Most notably, the mRNA level of genes adjacent to high affinity ParB binding sitesparS1-4close tooriCis reduced. Conversely, in cells lacking eitherparBor functionalparSsequences the orfs adjacent toparS3andparS4are upregulated, indicating that direct ParB-parS3/parS4interactions repress the transcription in this region. In addition, increased ParB level brings about repression or activation of numerous genes including several transcriptional regulators involved in SOS response, virulence and adaptation. Overall, our data support the role of partitioning protein ParB as a transcriptional regulator inPseudomonas aeruginosa.
Comparative analyses of toxin-associated gene homologs from an Old World viper,Daboia russelii
Authors: Krishnan Neeraja M. , Panda Binay 
Published: June 2017

AbstractAvailability of snake genome sequences has opened up exciting areas of research on comparative genomics and gene diversity. One of the challenges in studying snake genomes is the acquisition of biological material from live animals, especially from the venomous ones. Additionally, in certain countries, Government permission is required to handle live snakes, making the process cumbersome and time-consuming. Here, we report comparative sequence analyses of toxin gene homologs from Russells viper (Daboia russelii) using whole-genome sequencing data obtained from the shed skin. When compared with the major venom proteins in Russells viper studied previously, we found 45-100% sequence similarity between the venom proteins and their skin homologs. Additionally, comparative analyses of 20 toxin gene family homologs provided evidence of unique sequence motifs in nerve growth factor (NGF), platelet derived growth factor (PDGF), Kunitz/Bovine pancreatic trypsin inhibitor (Kunitz BPTI), cysteine-rich secretory proteins, antigen 5, and pathogenesis-related 1 proteins (CAP) and cysteine-rich secretory protein (CRISP). We identified V11 and T35 in the NGF domain; F23 and A29 in the PDGF domain; N69, K2 and A5 in the CAP domain; and Q17 in the CRISP domain to be responsible for differences in the largest pockets across the protein domain structures in crotalines, viperines and elapids from the in silico structure-based analysis. Similarly, residues F10, Y11 and E20 appear to play an important role in the protein structures across the kunitz protein domain of viperids and elapids. Our study sheds light on the usefulness of studying venom protein homologs from skin, their unique features and evolution in vipers. Data deposition: Russells viper sequence data is deposited in the NCBI SRA database under the accession number SRR5506741 and sequences for the individual venom-associated gene homologs to GenBank (accession numbers in Table S1).
Allele specific expression analysis identifies regulatory variation associated with stress-related genes in the Mexican highland maize landrace Palomero Toluqueño
Authors: Aguilar-Rangel M. Rocío , Chávez Montes Ricardo A. , Gonzalez-Segovia Eric , Ross-Ibarra Jeffrey , Simpson June K. , Sawers Ruairidh J. H. 
Published: June 2017

ABSTRACTBackgroundGene regulatory variation has been proposed to play an important role in the adaptation of plants to environmental stress. In the central highlands of Mexico, farmer selection has generated a unique group of maize landraces adapted the challenges of the highland niche. In this study, gene expression in Mexican highland maize and a reference maize breeding line were compared to identify evidence of regulatory variation in stress-related genes. It was hypothesised that local adaptation in Mexican highland maize would be associated with a transcriptional signature observable even under benign conditions.MethodsAllele specific expression analysis was performed using the seedling-leaf transcriptome of an F1 individual generated from the cross between the highland adapted Mexican landrace Palomero Toluqueño and the reference line B73, grown under benign conditions. Results were compared with a published dataset describing the transcriptional response of B73 seedlings to cold, heat, salt and UV treatments.ResultsA total of 2386 genes were identified to show allele specific expression. Of these, 277 showed an expression difference between Palomero Toluqueño and B73 alleles that mirrored the response of B73 cold, heat, salt and/or UV treatments, and, as such, were considered to display a constitutive stress response. Constitutive stress response candidates included genes associated with plant hormone signaling and a number of transcription factors. Construction of a gene co-expression network revealed further signaling and stress-related genes to be among the potential targets of the transcription factors candidates.DiscussionConstitutive activation of responses may represent the best strategy when stresses are severe but predictable. Expression differences observed here between PT and B73 alleles indicate the presence ofcis-acting regulatory variation linked to stress-related genes in PT. Considered alongside gene annotation and population data, allele specific expression analysis of plants grown under benign conditions provides an attractive strategy to identify functional variation potentially linked to local adaptation.
Genetic and Environmental Influences on Pubertal Hormones in Human Hair across Development
Authors: Grotzinger Andrew D. , Briley Daniel A. , Engelhardt Laura E. , Mann Frank D. , Patterson Megan W. , Tackett Jennifer L. , Tucker-Drob Elliot M. , Harden K. Paige 
Published: June 2017

AbstractBackground:Puberty is a complex biopsychosocial process that is linked to an array of psychiatric and medical disorders that emerge in adolescence and persist across the lifespan. Although the pubertal process is driven by neuroendocrine changes, few quantitative genetic studies have directly measured puberty-relevant hormones. Hair samples can now be assayed for accumulation of hormones over several months. In contrast to more conventional salivary measures, hair measures are not confounded by diurnal variation or hormonal reactivity.Methods:In an ethnically and socioeconomically diverse sample of 1,286 child and adolescent twins and multiples from 672 unique families, we estimated genetic and environmental influences on concentrations of testosterone, DHEA, and progesterone in hair across the period of 8 to 18 years of age.Results:We identified sex-specific developmental windows of maximal heritability in each hormone. Peak heritability for DHEA occurred at age 9.8 years for males and 10.0 years for females. Peak heritability for testosterone occurred at age 12.5 and 15.2 years for males and females, respectively. Peak heritability for male progesterone occurred at 11.2 years, while the heritability of female progesterone remained uniformly low.Conclusion:This is the first study of genetic influences on pubertal hormone concentrations in human hair and is the largest of the heritability of pubertal hormones in any form. The identification of specific developmental windows when genetic signals for hormones are maximized has critical implications for well-informed models of hormone-behavior associations in childhood and adolescence.