bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Internship Preparation Camp at the University of Maryland
Authors: Bontempo Laura J , Frayha Neda , Dittmar Philip C 
Published: May 2016

ABSTRACTBackgroundSpecialty-specific ‘boot camps’ boost the competence and confidence of medical school graduates as they prepare to enter a residency programme.ObjectiveWe sought to evaluate the efficacy of a specialty-neutral Internship Preparation Camp (IPC) that we developed and made available to senior medical students at our medical school. The primary goal of the IPC is to educate students in the cognitive and procedural skills that are applicable to postgraduate year 1 trainees in all fields of specialisation.MethodsThe curriculum was developed through input from senior medical students and faculty from multiple specialties. The course used small-group sessions and skills labs led by distinguished speakers from various professions (medicine, nursing and pharmacy) to teach senior medical students the information and skills common to the needs of all new physicians, regardless of the specialty they have chosen. The course was presented across 3 half-days and was offered just prior to graduation.ResultsOf 166 possible participants, 65 attended the course; 39 (60%) of them completed evaluations immediately following the course and 29 (45%) of participants completed a follow-up evaluation 3 months later. All respondents reported increased confidence in caring for patients in all subject areas taught. In the follow-up survey, 82% of respondents reported using information learned during the course on an hourly, daily or weekly basis in their care of patients.ConclusionsA specialty-neutral IPC is of benefit to its attendees, regardless of the medical specialty in which they train.
Patient-centred mountain medicine
Authors: Szawarski Piotr , Hillebrandt David 
Published: May 2016

AbstractVenturing into the mountains, doctors have accompanied expeditions to provide routine care to the teams, undertake research and occasionally take on a rescue role. The role of doctors practicing mountain medicine is evolving. Public health issues involving concepts of health and safety have become necessary with the coming of commercial and youth expeditions. Increasingly individuals with a disability or a medical diagnosis choose to ascend to high altitudes. Doctors become involved in assessment of risk and providing advice for such individuals. The field of mountain medicine is perhaps unique in that acceptance of risk is part of the ethos of climbing and adventure. The pursuit of mountaineering goals may represent the ultimate conquest of a disability. Knowledge of mountain environment is essential in facilitating mountain ascents for those who choose to undertake them, in spite of a disability or medical condition.
Brief history of geological and mining exploration in nineteenth century Mexico
Authors: Morelos-Rodríguez Lucero 
Published: May 2016

Abstract
In the nineteenth century, both Mexican and foreign scientific travellers, explorers, naturalists, engineers, mining entrepreneurs and enthusiasts made several scientific trips and expeditions across the whole of Mexico to prospect for its natural and mineral wealth. As they did so, they wrote records and articles and drew maps. This article discusses the state-organized geological and mining commissions and writings that promoted extraction activities in the country, offering an overview of the developments in geological and mining exploration through the scientific literature published by earth science pioneers in Mexico.
The Spectrum and Clinical Impact of Epigenetic Modifier Mutations in Myeloma
Authors: Pawlyn Charlotte , Kaiser Martin F. , Heuck Christoph , Melchor Lorenzo , Wardell Christopher P. , Murison Alex , Chavan Shweta S. , Johnson David C. , Begum Dil B. , Dahir Nasrin M. , Proszek Paula Z. , Cairns David A. , Boyle Eileen M. , Jones John R. , Cook Gordon , Drayson Mark T. , Owen Roger G. , Gregory Walter M. , Jackson Graham H. , Barlogie Bart , Davies Faith E. , Walker Brian A. , Morgan Gareth J. 
Published: May 2016

Abstract
Purpose: Epigenetic dysregulation is known to be an important contributor to myeloma pathogenesis but, unlike other B-cell malignancies, the full spectrum of somatic mutations in epigenetic modifiers has not been reported previously. We sought to address this using the results from whole-exome sequencing in the context of a large prospective clinical trial of newly diagnosed patients and targeted sequencing in a cohort of previously treated patients for comparison.
Experimental Design: Whole-exome sequencing analysis of 463 presenting myeloma cases entered in the UK NCRI Myeloma XI study and targeted sequencing analysis of 156 previously treated cases from the University of Arkansas for Medical Sciences (Little Rock, AR). We correlated the presence of mutations with clinical outcome from diagnosis and compared the mutations found at diagnosis with later stages of disease.
Results: In diagnostic myeloma patient samples, we identify significant mutations in genes encoding the histone 1 linker protein, previously identified in other B-cell malignancies. Our data suggest an adverse prognostic impact from the presence of lesions in genes encoding DNA methylation modifiers and the histone demethylase KDM6A/UTX. The frequency of mutations in epigenetic modifiers appears to increase following treatment most notably in genes encoding histone methyltransferases and DNA methylation modifiers.
Conclusions: Numerous mutations identified raise the possibility of targeted treatment strategies for patients either at diagnosis or relapse supporting the use of sequencing-based diagnostics in myeloma to help guide therapy as more epigenetic targeted agents become available. Clin Cancer Res; 22(23); 5783–94. ©2016 AACR.
Submaximal Exercise Systolic Blood Pressure and Heart Rate at 20 Years of Follow‐up: Correlates in the Framingham Heart Study
Authors: Spartano Nicole L. , Lyass Asya , Larson Martin G. , Lewis Gregory D. , Vasan Ramachandran S. 
Published: May 2016

Background

Beyond their resting values, exercise responses in blood pressure (
BP
) and heart rate (
HR
) may add prognostic information for cardiovascular disease (
CVD
). In cross‐sectional studies, exercise
BP
and
HR
responses correlate with
CVD
risk factors; however, it is unclear which factors influence longitudinal changes in exercise responses over time, which is important for our understanding of the development of
CVD
.

Methods and Results

We assessed
BP
and
HR
responses to low‐level exercise tests (6‐minute Bruce protocol) in 1231 Framingham Offspring participants (55% women) who underwent a routine treadmill test in 1979–1983 (baseline; mean age 39±8 years) that was repeated in 1998–2001 (follow‐up; mean age 58±8 years). Adjusting for baseline exercise responses, we related the follow‐up exercise responses to baseline
CVD
risk factors and to their changes between examinations. Compared with men, women had greater rise in exercise systolic (S)
BP
and
HR
at 20‐year follow‐up (both
P
<0.005). Baseline blood lipid levels, resting
SBP
and
HR
, and smoking status were associated with greater exercise
SBP
at follow‐up (all
P
<0.05). Weight gain across examinations was associated with higher exercise
SBP
and
HR
at follow‐up (both
P
<0.0001). Smoking cessation was associated with a 53% reduced risk of attaining the highest quartile of exercise
SBP
(≥180 mm Hg) at follow‐up (
P
<0.05).

Conclusion

An adverse
CVD
risk factor profile in young adults and its worsening over time were associated with higher
SBP
and
HR
responses to low‐level exercise in midlife. Maintaining or adopting a healthy risk factor profile may favorably impact the exercise responses over time.
Excessively High Hydration Volume May Not Be Associated With Decreased Risk of Contrast‐Induced Acute Kidney Injury After Percutaneous Coronary Intervention in Patients With Renal Insufficiency
Authors: Liu Yong , Li Hualong , Chen Shiqun , Chen Jiyan , Tan Ning , Zhou Yingling , Liu Yuanhui , Ye Piao , Ran Peng , Duan Chongyang , Chen Pingyan 
Published: May 2016

Background

No well‐defined protocols currently exist regarding the optimal rate and duration of normal saline administration to prevent contrast‐induced acute kidney injury (
CI
‐
AKI
) in patients with renal insufficiency.

Methods and Results

Hydration volume ratios (hydration volume/weight;
HV
/W) were calculated in 1406 patients with renal insufficiency (estimated glomerular filtration rate [
eGFR
], <90 mL/min per 1.73 m
2
) undergoing percutaneous coronary intervention (
PCI
) with routine speed hydration (1 or 0.5 mL/kg per hour). We investigated the relationship between hydration volume, risk of
CI
‐
AKI
(increase in serum creatinine ≥0.5 mg/dL or 25% within 48–72 hours), and prognosis. Mean follow‐up duration was 2.85±0.88 years. Individuals with higher
HV
/W were more likely to develop
CI
‐
AKI
(quartiles: Q1, Q2, Q3, and Q4: 4.3%, 6.6%, 10.9%, and 15.0%, respectively;
P
<0.001). After adjusting 12 confounders, including age, sex,
eGFR
, anemia, emergent
PCI
, diabetes mellitus, chronic heart failure, diuretics, contrast volume, lesions, smoking status, and number of stents, multivariate analysis showed that a higher
HV
/W ratio was not associated with a decreased
CI
‐
AKI
risk (Q2 vs Q1: adjusted odds ratio [
OR
], 1.13; Q3 vs Q1: adjusted
OR
, 1.51; Q4 vs Q1: adjusted
OR
, 1.87; all
P
>0.05) and even increased
CI
‐
AKI
risk (
HV
/W >25 mL/kg: adjusted
OR
, 2.11; 95%
CI
, 1.24–3.59;
P
=0.006). Additionally, higher
HV
/W was significantly associated with an increased risk of death (Q4 vs Q1: adjusted hazard ratio, 3.44; 95%
CI
, 1.20–9.88;
P
=0.022).

Conclusions

Excessively high hydration volume at routine speed might be associated with increased risk of
CI
‐
AKI
and death post‐
PCI
in patients with renal insufficiency.
Assessment of arterial stiffness in patients with venous thromboembolism: Separate or continuous circuits?
Authors: Aykan Ahmet Çağrı , Hatem Engin , Kalaycıoğlu Ezgi , Gökdeniz Tayyar , Karabay Can Yucel 
Published: May 2016

Objectives The aim of this study is to evaluate the association of venous thromboembolism with arterial stiffness by cardio-ankle vascular index method. Method We included 52 patients with a documented lower extremity venous thromboembolism within the last six months and 52 healthy subjects to this cross sectional observational study. Results Cardio-ankle vascular index (8.58 ± 1.60 versus 7.05 ± 1.44, p < 0.001, respectively) and systolic blood pressure (128.02 ± 7.13 mmHg versus 123.94 ± 8.12 mmHg, p = 0.008, respectively) were significantly higher among patients with venous thromboembolism than controls. Cardio-ankle vascular index was an independent predictor of venous thromboembolism in multivariate logistic regression analysis (p < 0.001, odds ratio = 1.864, 95% confidence interval = 1.370–2.536). Cardio-ankle vascular index value > 7.8 had a sensitivity of 82.7% and a specificity of 80.8% for predicting venous thromboembolism (area under curve = 0.789, 95% confidence interval = 0.698–0.863, p < 0.001) in receiver operating characteristic curve analysis. Conclusion We found that arterial stiffness was increased in patients with venous thromboembolism which highlights the fact that arterial and venous circulation is in continuum and an insult may affect both of these circuits.
Functional and morphological alterations associated with working memory dysfunction in patients with generalized anxiety disorder
Authors: Moon Chung-Man , Jeong Gwang-Woo 
Published: May 2016

Background Generalized anxiety disorder (GAD) has been related to functional brain activities and structural brain abnormalities. Purpose To investigate the neural mechanism on working memory dysfunction in patients with GAD in terms of the combined functional and morphological brain abnormalities. Material and Methods Patients with GAD and healthy controls matched for age, sex, and education level underwent high-resolution T1-weighted (T1W) magnetic resonance imaging (MRI) and functional MRI (fMRI). In this study, fMRI and voxel-based morphometry (VBM) were used for assessing the differential brain activation patterns, as well as for comparing the morphological alterations between the two groups. Results In response to the neutral distractors, the patients showed significantly lower activities in the regions of the fusiform gyrus (FuG), superior parietal gyrus (SPG), precuneus (PCu), superior occipital gyrus (SOG), lingual gyrus (LiG), cuneus (Cun), calcarine cortex (CaC), parahippocampal gyrus (PHG) and cerebellar cortex (Cb) compared to the controls. In response to the anxiety-inducing distractors, the patients showed significantly higher activity in the hippocampus and lower activities in the regions of the dorsolateral prefrontal cortex (DLPFC), FuG, SPG, PCu, SOG, and Cb. Also, the patients showed a significant reduction of the white matter volumes in the DLPFC, anterior limb of the internal capsule (ALIC) and midbrain. Conclusion This study provides the first evidence for the association between the morphometric alterations and functional deficit in the working memory processing with the neutral and anxiety-inducing distractors in GAD patients. These findings would be helpful to understand the neural mechanisms on working memory impairment in connection with GAD symptoms.
Correlation of CT imaging features and tumor size with Fuhrman grade of clear cell renal cell carcinoma
Authors: Oh Saelin , Sung Deuk Jae , Yang Kyung Sook , Sim Ki Choon , Han Na Yeon , Park Beom Jin , Kim Min Ju , Cho Sung Bum 
Published: May 2016

Background Identification of clinical features to determine the aggressive potential of tumors is highly warranted to stratify patients for adequate treatment. Computed tomography (CT) imaging features of clear cell renal cell carcinoma (ccRCC) may contribute to personalized risk assessment. Purpose To assess the correlation between CT imaging features and Fuhrman grade of ccRCC, and to identify the predictors of high Fuhrman grade in conjunction with tumor size. Material and Methods CT scans of 169 patients with 173 pathologically proven ccRCCs were retrospectively reviewed in consensus by two radiologists for the presence of intratumoral necrosis and intratumoral cyst and tumor size. Histologic grade was classified as either low (Fuhrman grade I or II) or high (Fuhrman grade III or IV). Statistical significance was evaluated by using univariate, multivariate regression, receiver operating characteristic (ROC) curve, and Spearman correlation analyses. Results On CT, 20 of the 173 tumors had intratumoral cysts, 60 had intratumoral necrosis, and 93 showed entirely solid tumors. The odds of high grade were higher with intratumoral necrosis and entirely solid tumor than with intratumoral cyst ( P < 0.03). Intratumoral necrosis showed a significantly high odds ratio of 25.73 for high Fuhrman grade. The ROC curve showed a threshold tumor size of 36 mm to predict high Fuhrman grade for overall tumors (area under the ROC curve, 0.70). In ccRCCs with intratumoral necrosis or cyst, tumor size did not significantly correlate with Fuhrman grade. Conclusion Intratumoral necrosis on CT was a strong and independent predictor of biologically aggressive ccRCCs, irrespective of tumor size.
Effects of nodule characteristics on sampling number and duration of thyroid fine-needle aspiration biopsy: size does not matter, but cystic degeneration ratio does
Authors: Cengic Ismet , Tureli Derya , Altas Hilal , Ozden Ferhat , Bugdayci Onur , Aribal Erkin 
Published: May 2016

Background Ultrasound-guided fine needle aspiration biopsy (FNAB) of thyroid nodules, though the most accurate method to rule out malignancy, still has an inherent risk of yielding non-diagnostic specimens despite immediate assessment of specimen adequacy by an on-site cytopathologist. Purpose To evaluate the effects of nodule volume and extent of cystic degeneration on total biopsy time and number of aspirations required for obtaining an adequate specimen. Material and Methods A total of 510 patients underwent FNAB by a single radiologist accompanied by a cytopathologist who immediately assessed each sample for specimen adequacy. All sampled nodules were single and had one maximum diameter > 10 mm. Nodule volumes and cystic degeneration ratios were calculated prior to the intervention. Aspirations were repeated until the cytological material was deemed adequate by the cytopathologist; the number of aspirations and total biopsy time were then recorded. Results Nodule volumes did not have significant effect on neither number of aspirations necessary for achieving specimen adequacy ( P > 0.05) nor total biopsy time (r = −0.148 with P = 0.001). Predominantly cystic nodules, compared to predominantly solid nodules, required more sampling per nodule (4.58 ± 1.11 vs. 3.44 ± 1.19 aspirations, P = 0.001) and longer total biopsy time (16.40 ± 6.19 vs. 11.15 ± 6.18 min, P = 0.001). Conclusion Predominantly cystic nodules require allocation of more time for biopsy. To ensure specimen adequacy when immediate specimen evaluation by an on-site cytopathologist is not possible, four samples from predominantly solid nodules and five passes through predominantly cystic nodules are required.
Influence of fractional anisotropy thresholds on diffusion tensor imaging tractography of the periprostatic neurovascular bundle and selected pelvic tissues: do visualized tracts really represent nerves?
Authors: Baur Alexander DJ , Daqqaq Tareef , Collettini Federico , Denecke Timm , Hamm Bernd , Durmus Tahir , Scheel Michael 
Published: May 2016

Background Diffusion tensor imaging (DTI) tractography has recently been shown to successfully visualize periprostatic tracts allegedly representing the neurovascular bundle. Purpose To examine the impact of different fractional anisotropy (FA) thresholds on the results of DTI tractography in the male pelvis as well as to evaluate the resulting specificity for nerve tracts. Material and Methods Ten healthy male volunteers were examined at 3 Tesla. DTI tractography was performed based on seed points placed circularly around the prostate, in the rectoprostatic angle, the peripheral zone of the prostate, the sciatic nerve, and in addition the urinary bladder using FA thresholds of 0.20, 0.05, and 0.01. DTI tract number and DTI tract length measured with different FA thresholds were compared. ANOVA with repeated measures was used for statistics. Results DTI tract number and tract length were significantly dependent on FA thresholds. While a FA threshold of 0.20 visualized the typical distribution of DTI tracts in the sciatic nerve, a FA threshold of ≤0.05 was necessary to yield results visually mimicking the distribution of nerve tracts in the NVB. However, with such low FA thresholds even in the filled urinary bladder DTI tracts could be visualized. With FA thresholds of 0.20, the number and length of periprostatic DTI tracts did not differ from those measured within the prostate. Conclusion DTI tractography can be used to visualize DTI tracts periprostatically. However, one may doubt that these DTI tracts represent nerve tracts and that the periprostatic neurovascular bundle can be evaluated in a meaningful way with the current methods available.
Pedicle screw placement in patients with variant atlas pedicle
Authors: Zhang Qiang-Hua , Li Hai-Dong , Min Ji-Kang 
Published: May 2016

Objective To investigate how the anatomy of variant atlas vertebra impacts on the strategy used to place pedicle screws used to treat atlantoaxial instability. Methods The study enrolled patients with cervical instability who had a posterior arch pedicle height <3.5 mm at the anchor point, a vertebral artery groove height <3.5 mm, or both. Pedicle screws were fitted according to the anatomy of the variant atlas vertebra. Patients were followed-up to evaluate accuracy of the screw placement and maintenance of cervical stability. Results A total of 28 patients were enrolled. The mean height of the atlas pedicle proximal section was >5.0 mm. For the vertebral artery groove, the height of the lateral region was significantly greater than that of the medial region. Approximately 60% of atlas vertebrae had lateral heights >3.5 mm (34 of 56). The majority of the posterior arch heights were <3.0 mm. There were no perioperative or postoperative complications observed. Conclusions Pedicle screw placement in the lateral pedicle region is the safest and most reliable strategy to treat variant atlas pedicles.
Incidence and age and gender profiles of hyperplasia in individual cervical vertebrae
Authors: Li Min , Liu Shuyong , Kong Qingkui , Sun Haitao , Zhang Xia , Wang Guangbin 
Published: May 2016

Objective To analyze the incidence and age and gender profiles of hyperplasia in individual cervical vertebrae. Methods In this retrospective study, computed tomography three-dimensional reconstruction images of cervical vertebrae from patients with neck discomfort were analyzed for the presence of hyperplasia and compared with age and gender data. Results Scans from a total of 580 patients (352 males, 228 females) were analyzed. The highest incidence of hyperplasia was seen in C2 (25%), followed by C1 (23%), C6 (16%), C5 (15%), C7 (9%), C4 (8%) and C3 (4%). Patients with C2 hyperplasia were the youngest and those with C1 hyperplasia were the second youngest, while patients with C7 hyperplasia were the oldest. Of those with C2, C1 and C7 hyperplasia, males were significantly younger than females, whereas of those with C3, C4, C5 and C6 hyperplasia, females were significantly younger than males. Conclusions Hyperplasia of the cervical spine shows different age and gender profiles among the seven vertebrae. These findings may be helpful for the early recognition of cervical hyperplasia and highlight the importance of protecting the atlanto-axial joint in daily life.
Accuracy of Depression Screening Tools to Detect Major Depression in Children and Adolescents: A Systematic Review
Authors: Roseman Michelle , Kloda Lorie A. , Saadat Nazanin , Riehm Kira E. , Ickowicz Abel , Baltzer Franziska , Katz Laurence Y. , Patten Scott B. , Rousseau Cécile , Thombs Brett D. 
Published: May 2016

Objective: Depression screening among children and adolescents is controversial, and no clinical trials have evaluated benefits and harms of screening programs. A requirement for effective screening is a screening tool with demonstrated high accuracy. The objective of this systematic review was to evaluate the accuracy of depression screening instruments to detect major depressive disorder (MDD) in children and adolescents. Method: Data sources included the MEDLINE, MEDLINE In-Process, EMBASE, PsycINFO, HaPI, and LILACS databases from 2006 to September 30, 2015. Eligible studies compared a depression screening tool to a validated diagnostic interview for MDD and reported accuracy data for children and adolescents aged 6 to 18 years. Risk of bias was assessed with QUADAS-2. Results: We identified 17 studies with data on 20 depression screening tools. Few studies examined the accuracy of the same screening tools. Cut-off scores identified as optimal were inconsistent across studies. Width of 95% confidence intervals (CIs) for sensitivity ranged from 9% to 55% (median 32%), and only 1 study had a lower bound 95% CI ≥80%. For specificity, 95% CI width ranged from 2% to 27% (median 9%), and 3 studies had a lower bound ≥90%. Methodological limitations included small sample sizes, exploratory data analyses to identify optimal cut-offs, and the failure to exclude children and adolescents already diagnosed or treated for depression. Conclusions: There is insufficient evidence that any depression screening tool and cut-off accurately screens for MDD in children and adolescents. Screening could lead to overdiagnosis and the consumption of scarce health care resources.