bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shell properties of commercial clam Chamelea gallina are influenced by temperature and solar radiation along a wide latitudinal gradient
Authors: Gizzi Francesca , Caccia Maria Giulia , Simoncini Ginevra Allegra , Mancuso Arianna , Reggi Michela , Fermani Simona , Brizi Leonardo , Fantazzini Paola , Stagioni Marco , Falini Giuseppe , Piccinetti Corrado , Goffredo Stefano 
Published: November 2016

AbstractPhenotype can express different morphologies in response to biotic or abiotic environmental influences. Mollusks are particularly sensitive to different environmental parameters, showing macroscale shell morphology variations in response to environmental parameters. Few studies concern shell variations at the different scale levels along environmental gradients. Here, we investigate shell features at the macro, micro and nanoscale, in populations of the commercially important clamChamelea gallinaalong a latitudinal gradient (~400 km) of temperature and solar radiation in the Adriatic Sea (Italian cost). Six populations of clams with shells of the same length were analyzed. Shells from the warmest and the most irradiated population were thinner, with more oval shape, more porous and lighter, showing lower load fracture. However, no variation was observed in shell CaCO3polymorphism (100% aragonite) or in compositional and textural shell parameters, indicating no effect of the environmental parameters on the basic processes of biomineralization. Because of the importance of this species as commercial resource in the Adriatic Sea, the experimentally quantified and significant variations of mass and fracture load inC. gallinashells along the latitudinal gradient may have economic implications for fisheries producing different economical yield for fishermen and consumers along the Adriatic coastline.
Interactive effect of serum uric acid and total bilirubin for cardiovascular disease in Chinese patients with type 2 diabetes
Authors: Ren Yanfeng , Jin Nan , Hong Tianpei , Mu Yiming , Guo Lixin , Ji Qiuhe , Li Qiang , Yang Xilin , Ji Linong 
Published: November 2016

AbstractSerum uric acid (SUA) at high levels and bilirubin at low levels were potent antioxidant but it was uncertain that whether SUA and total bilirubin (TBIL) had additive interaction for the risk of CVD in type 2 diabetes mellitus (T2DM). We conducted a cross-sectional survey of 6713 inpatients with T2DM and admitted to 81 tertiary care hospitals. CVD was defined as having either prior coronary heart disease or stroke or peripheral arterial disease. Binary logistic regression was used to estimate odds ratios of SUA and TBIL for CVD. The effect size of additive interaction was estimated by three measures, i.e., relative excess risk due to interaction, attributable proportion due to interaction and synergy index. Among 6713 patients with T2DM, 561 (8.36%) suffered from CVD. Using ≥283 umol/L (median) to define high SUA and <11.5 umol/L (n = 2290 or 34.11%) to define low TBIL, copresence of both factors (n = 621 or 9.25%) was associated with 5.18-fold (95% CI, 4.00–6.72) risk of CVD with significant additive interactions in multivariable analysis as compared to absence of both risk factors. The copresence of both high SUA and low TBIL was associated with a large increased risk of CVD in high-risk Chinese patients with type 2 diabetes.
A remotely sensed pigment index reveals photosynthetic phenology in evergreen conifers
Authors: Gamon John A. , Huemmrich K. Fred , Wong Christopher Y. S. , Ensminger Ingo , Garrity Steven , Hollinger David Y. , Noormets Asko , Peñuelas Josep 
Published: November 2016

Significance
Evergreen photosynthetic activity has been difficult to determine from remote sensing, causing errors in terrestrial photosynthetic carbon uptake models. Using a reflectance chlorophyll/carotenoid index (CCI) sensitive to seasonally changing chlorophyll/carotenoid pigment ratios, we demonstrate a method of tracking photosynthetic phenology in evergreen conifers. The CCI reveals seasonally changing photosynthetic rates and detects the onset of the growing season in evergreen foliage. This method could improve our understanding of changing photosynthetic activity in a warming climate, and could improve assessment of the evergreen component of the terrestrial carbon budget, which has been elusive.
Structural basis for DNA recognition by STAT6
Authors: Li Jing , Rodriguez Jose Pindado , Niu Fengfeng , Pu Mengchen , Wang Jinan , Hung Li-Wei , Shao Qiang , Zhu Yanping , Ding Wei , Liu Yanqing , Da Yurong , Yao Zhi , Yang Jie , Zhao Yongfang , Wei Gong-Hong , Cheng Genhong , Liu Zhi-Jie , Ouyang Songying 
Published: November 2016

Significance
STAT6 is a transcription factor and plays a predominant role in IL-4/IL-13 and virus-mediated signaling pathways. Extensive studies have linked malfunctions of STAT6 to pathological features of asthma and cancer. Targeting the function of STAT6 has become an attractive therapy. Understanding the molecular mechanisms of STAT6 transcriptional regulation is still scarce. Here, we report the atomic-level structures of the phosphorylated STAT6 core fragment homodimer, both in DNA-free and complexed with N4 or N3 site DNA, uncovering both a larger dimer interface intersection angle and the unique residue H415 of STAT6 as important factors for discrimination of N4 from N3 site DNA. This study uncovers a dramatic conformational change in STAT6 dimer for recognizing and preferring N4 site DNA.
Transport efficiency of membrane-anchored kinesin-1 motors depends on motor density and diffusivity
Authors: Grover Rahul , Fischer Janine , Schwarz Friedrich W. , Walter Wilhelm J. , Schwille Petra , Diez Stefan 
Published: November 2016

Significance
Molecular motors, such as kinesin-1, are essential molecules involved in active intracellular transport. Current mechanistic insights on transport by motors are mainly based on in vitro studies where the motors are bound to rigid substrates. However, when transporting membranous cargo under physiological conditions, multiple motors are often only loosely coupled via a lipid bilayer. In this study, we investigate how the motors’ transport efficiency is affected when bound to a lipid bilayer. In our reconstituted gliding motility assays, we show that membrane-anchored motors exhibit reduced transport efficiency due to slippage in the lipid bilayer. Notably, the efficiency increases at higher motor density and reduced membrane diffusivity, providing cells with an additional means of regulating the efficiency of cargo transport.
Dynamic updating of hippocampal object representations reflects new conceptual knowledge
Authors: Mack Michael L. , Love Bradley C. , Preston Alison R. 
Published: November 2016

Significance
A cosmopolitan couple looking for a home may focus on trendy features. However, with news of a baby on the way, they must quickly learn which features make for a child-friendly home to conceptually reorganize their set of potential homes. We investigate how conceptual knowledge is updated in the brain when goals change and attention shifts to new information. By combining functional MRI with computational modeling, we find that object representations in the human hippocampus are dynamically updated with concept-relevant information during learning. We also demonstrate that when concept updating is most consequential, the hippocampus is functionally coupled with neocortex. Our findings suggest that the brain reorganizes when concepts change and provide support for a neurocomputational theory of concept formation.
Long-term survival and fate of the leg in de novo intermittent claudication
Authors: Kumakura Hisao , Kanai Hiroyoshi , Hojo Yoshiaki , Iwasaki Toshiya , Ichikawa Shuichi 
Published: November 2016

Abstract

Aims
The long-term life expectancy and fate of the leg, including progression rate to critical limb ischaemia (CLI), were analysed in de novo patients with intermittent claudication (IC).

Methods and results
A prospective cohort study was performed in 1107 patients with de novo IC. The endpoints were overall survival (OS), freedom from major adverse cardiovascular events (MACE), freedom from major adverse cardiovascular and limb events (MACLE), and fate of the leg. The 5-, 10-, 15-, and 20-year rates were 73.3, 47.8, 28.1, and 14.9% for OS, and 63.0, 35.6, 18.5, and 5.7% for freedom from MACE, respectively. In Cox multivariable analysis, body mass index, diabetes, haemodialysis, and C-reactive protein (CRP) level were correlated with OS (P &lt; 0.05). Ankle brachial pressure index, diabetes, coronary artery disease, haemodialysis, and CRP level were independently correlated with freedom from MACE and MACLE. Statins improved mortality, MACE, and MACLE (P &lt; 0.05). Revascularization did not improve mortality and MACE, and femoropopliteal revascularization increased MACLE (P &lt; 0.05). There was no deterioration of claudication in 881 patients (79.6%). Worsening claudication was noted in 211 patients (14.8% per 5 years), and 15 patients (1.1% per 5 years) worsened to CLI. Diabetes and haemodialysis were independent predictors of CLI. A history of cerebral infarction and femoropopliteal revascularization tended to increase CLI.

Conclusions
Life expectancy in patients with IC was poor, but the rate of IC progression to CLI was low. Statins improved mortality and morbidity, revascularization did not improve mortality and MACE, and femoropopliteal revascularization reduced freedom from MACLE with a risk of CLI.
Progress of rechargeable lithium metal batteries based on conversion reactions
Authors: Xin Sen , Chang Zhiwen , Zhang Xinbo , Guo Yu-Guo 
Published: November 2016

Abstract
In this review, we focus on the conversion reaction in newly raised rechargeable lithium batteries instanced by lithium–sulfur and lithium–oxygen batteries. A comprehensive discussion is made on the fundamental electrochemistry and recent advancements in key components of both types of the batteries. The critical problems in the Li–S and Li–O2 conversion electrochemistry are addressed along with the corresponding improvement strategies, for the purpose of shedding light on the rational design of batteries to reach optimal performance.
Use of Nucleic Acid Amplification Tests in Tuberculosis Patients in California, 2010–2013
Authors: Peralta Gianna , Barry Pennan , Pascopella Lisa 
Published: November 2016

Abstract

Background
Nucleic acid amplification tests (NAATs) have been used as a diagnostic tool for tuberculosis (TB) in the United States for many years. We sought to assess NAAT use in TB patients in California during a period of time when NAAT availability increased throughout the world.

Methods
We conducted a retrospective review of surveillance data from 6051 patients with culture-confirmed pulmonary TB who were reported to the California TB registry during 2010–2013.

Results
Only 2336 of 6051 (39%) TB patients had a NAAT for diagnosis before culture results. Although 90% (N = 2101) with NAAT had positive test results, 9% (N = 217) had falsely negative NAAT results, and 0.8% (N = 18) had indeterminate NAAT results. The median time from specimen collection to TB treatment initiation was shorter when NAAT was used (3 vs 14 days, P &lt; .0001), and patients with a positive NAAT result initiated treatment earlier than patients with a falsely negative result (1 vs 11 days from NAAT report, P &lt; .0001). We confirmed the increased sensitivity of NAAT compared with acid-fast bacilli (AFB) smear microscopy in our study population; 92 of 145 AFB smear-negative patients had positive NAATs. Median time from specimen collection to NAAT result report differed by health jurisdiction, from 1 to 11 working days.

Conclusions
Increased use of NAATs in diagnosis of pulmonary TB could decrease the time-to-treatment initiation and consequently decrease transmission. However, differential use and access to NAAT may prevent full realization of NAAT benefits in California.
Intra-abdominal Infections: The Role of Anaerobes, Enterococci, Fungi, and Multidrug-Resistant Organisms
Authors: Marcus Gil , Levy Samuel , Salhab Ghaleb , Mengesha Bethlehem , Tzuman Oran , Shur Shira , Burke Erica , Mayeda Rebecca Cruz , Cochavi Lior , Perluk Idan , Zaidenstein Ronit , Lazarovitch Tsilia , Dadon Mor , Marchaim Dror 
Published: November 2016

Abstract

Background
Intra-abdominal infections (IAI) constitute a common reason for hospitalization. However, there is lack of standardization in empiric management of (1) anaerobes, (2) enterococci, (3) fungi, and (4) multidrug-resistant organisms (MDRO). The recommendation is to institute empiric coverage for some of these organisms in “high-risk community-acquired” or in “healthcare-associated” infections (HCAI), but exact definitions are not provided.

Methods
Epidemiological study of IAI was conducted at Assaf Harofeh Medical Center (May–November 2013). Logistic and Cox regressions were used to analyze predictors and outcomes of IAI, respectively. The performances of established HCAI definitions to predict MDRO-IAI upon admission were calculated by receiver operating characteristic (ROC) curve analyses.

Results
After reviewing 8219 discharge notes, 253 consecutive patients were enrolled (43 [17%] children). There were 116 patients with appendicitis, 93 biliary infections, and 17 with diverticulitis. Cultures were obtained from 88 patients (35%), and 44 of them (50%) yielded a microbiologically confirmed IAI: 9% fungal, 11% enterococcal, 25% anaerobic, and 34% MDRO. Eighty percent of MDRO-IAIs were present upon admission, but the area under the ROC curve of predicting MDRO-IAI upon admission by the commonly used HCAI definitions were low (0.73 and 0.69). Independent predictors for MDRO-IAI were advanced age and active malignancy.

Conclusions
Multidrug-resistant organism-IAIs are common, and empiric broad-spectrum coverage is important among elderly patients with active malignancy, even if the infection onset was outside the hospital setting, regardless of current HCAI definitions. Outcomes analyses suggest that empiric regimens should routinely contain antianaerobes (except for biliary IAI); however, empiric antienterococcal or antifungals regimens are seldom needed.
Virologic Failure and Human Immunodeficiency Virus Drug Resistance in Rural Cameroon With Regard to the UNAIDS 90-90-90 Treatment Targets
Authors: Boullé Charlotte , Guichet Emilande , Kouanfack Charles , Aghokeng Avelin , Onambany Benjamin , Ikaka Catherine Massama , Ngock Emile , Tsoumsta Landry , Msellati Philippe , Mpoudi-Ngolé Eitel , Peeters Martine , Delaporte Eric , Laurent Christian 
Published: November 2016

AbstractBackgroundIn rural Africa, data on virologic effectiveness of antiretroviral treatment (ART) are not sufficient to assess the gap with the UNAIDS 90-90-90 treatment targets. We investigated the prevalences of unsuppressed viral load and antiretroviral drug resistance and the profile of genotypic resistance mutations among patients routinely treated in rural Cameroon.MethodsA cross-sectional study was performed in 2013–2014 among patients ≥15 years and on first-line ART for ≥6 months in a district hospital. Patients were offered free access to human immunodeficiency virus viral load testing. Genotypic drug resistance testing was done when the viral load was &gt;1000 copies/mL. Multivariate logistic regression models were used to assess the relationship of unsuppressed viral load or antiretroviral drug resistance with sociodemographic and medical characteristics.ResultsOf 407 patients (women 74.9%, median age 41.8 years, median time on ART 29.2 months), 96 (23.6%; 95% confidence interval [CI], 19.5–28.0) had unsuppressed viral load and 74 (18.2%; 95% CI, 14.6–22.3) had antiretroviral drug resistance. The prevalences of unsuppressed viral load and resistance increased with time on ART, from 12.0% and 8.0% in the 6- to 12-month group to 31.3% and 27.1% in the &gt;72-month group, respectively. All 74 patients with antiretroviral drug resistance were resistant to nonnucleoside reverse-transcriptase inhibitors, and 57 of them were also resistant to nucleoside reverse-transcriptase inhibitors.ConclusionsOur estimations were among the highest observed in the west and central African region. The proportion of patients with virologic failure should be divided at least by 2 to reach the UNAIDS 90-90-90 treatment targets.
Improving Learner Handovers in Medical Education
Authors: Warm Eric J. , Englander Robert , Pereira Anne , Barach Paul 
Published: November 2016

Multiple studies have demonstrated that the information included in the Medical Student Performance Evaluation fails to reliably predict medical students’ future performance. This faulty transfer of information can lead to harm when poorly prepared students fail out of residency or, worse, are shuttled through the medical education system without an honest accounting of their performance. Such poor learner handovers likely arise from two root causes: (1) the absence of agreed-on outcomes of training and/or accepted assessments of those outcomes, and (2) the lack of standardized ways to communicate the results of those assessments. To improve the current learner handover situation, an authentic, shared mental model of competency is needed; high-quality tools to assess that competency must be developed and tested; and transparent, reliable, and safe ways to communicate this information must be created.
To achieve these goals, the authors propose using a learner handover process modeled after a patient handover process. The CLASS model includes a description of the learner’s Competency attainment, a summary of the Learner’s performance, an Action list and statement of Situational awareness, and Synthesis by the receiving program. This model also includes coaching oriented towards improvement along the continuum of education and care. Just as studies have evaluated patient handover models using metrics that matter most to patients, studies must evaluate this learner handover model using metrics that matter most to providers, patients, and learners.
Creating a Cadre of Fellowship-Trained Medical Educators, Part II: A Formal Needs Assessment to Structure Postgraduate Fellowships in Medical Education Scholarship and Leadership
Authors: Jordan Jaime , Yarris Lalena M. , Santen Sally A. , Guth Todd A. , Rougas Steven , Runde Daniel P. , Coates Wendy C. 
Published: November 2016

Purpose
Education leaders at the 2012 Academic Emergency Medicine Consensus Conference on education research proposed that dedicated postgraduate education scholarship fellowships (ESFs) might provide an effective model for developing future faculty as scholars. A formal needs assessment was performed to understand the training gap and inform the development of ESFs.

Method
A mixed-methods needs assessment was conducted of four emergency medicine national stakeholder groups in 2013: department chairs; faculty education/research leaders; existing education fellowship directors; and current education fellows/graduates. Descriptive statistics were reported for quantitative data. Qualitative data from semistructured interviews and free-text responses were analyzed using a thematic approach.

Results
Participants were 11/15 (73%) education fellowship directors, 13/20 (65%) fellows/graduates, 106/239 (44%) faculty education/research leaders, and a convenience sample of 26 department chairs. Department chairs expected new education faculty to design didactics (85%) and teach clinically (96%). Faculty education/research leaders thought new faculty were inadequately prepared for job tasks (83.7%) and that ESFs would improve the overall quality of education research (91.1%). Fellowship directors noted that ESFs provide skills, mentorship, and protected time for graduates to become productive academicians. Current fellows/graduates reported pursing an ESF to develop skills in teaching and research methodology.

Conclusions
Stakeholder groups uniformly perceived a need for training in education theory, clinical teaching, and education research. These findings support dedicated, deliberate training in these areas. Establishment of a structure for scholarly pursuits prior to assuming a full-time position will effectively prepare new faculty. These findings may inform the development, implementation, and curricula of ESFs.
Seven Dirty Words: Hot-Button Language That Undermines Interprofessional Education and Practice
Authors: Cahn Peter S. 
Published: November 2016

An increasingly common goal of health professions education is preparing learners to collaborate with the full range of members on a health care team. While curriculum developers have identified many logistical and conceptual barriers to interprofessional education, one overlooked factor threatens to undermine interprofessional education and practice: language. Language reveals the mental metaphors governing thoughts and actions. The words that faculty members and health care providers use send messages that can—consciously or not—undermine explicit lessons about valuing each member of the care team. Too often, word choices make visible hierarchies in health care that may contradict overt messages about collaboration.
In this Perspective, the author draws on his experience as an outsider coming to academic medicine, noticing that certain words triggered negative responses in colleagues from different professions. He reflects on some of the most charged (or hot-button) words commonly heard in health care and educational settings and suggests possible alternatives that have similar denotations but that also have more collaborative connotations. By exploring seven of these dirty words, the author intends to raise awareness about the unintended effects of word choices. Changing exclusionary language may help promote the adoption of new metaphors for professional relationships that will more easily facilitate interprofessional collaboration and reinforce the formal messages about collaborative practice aimed at learners.
Type I Cutaneous Meningioma (Rudimentary Meningocele) With Intradural Attachment to the Phylum Terminale
Authors: Mazloom Sean E. , Holliday Alex C. , Coman Garrett C. , Chavan Rahul N. , Kolodney Michael S. , Grider Douglas J. 
Published: November 2016

Abstract:
Cutaneous meningiomas (CM) are a small subset of meningiomas, further classified into three subtypes. The authors present a 15-year-old male with a symptomatic congenital type I CM and describe the histopathological and immunohistochemical findings. To the authors' knowledge, this is the first report of an extraspinal lumbar type I CM with intradural attachment to the phylum terminale.
Update on abortion policy
Authors: Conti Jennifer A. , Brant Ashley R. , Shumaker Heather D. , Reeves Matthew F. 
Published: November 2016

Purpose of review
To review the status of antiabortion restrictions enacted over the last 5 years in the United States and their impact on abortion services.

Recent findings
In recent years, there has been an alarming rise in the number of antiabortion laws enacted across the United States. In total, various states in the union enacted 334 abortion restrictions from 2011 to July 2016, accounting for 30% of all abortion restrictions since the legalization of abortion in 1973. Data confirm, however, that more liberal abortion laws do not increase the number of abortions, but instead greatly decrease the number of abortion-related deaths. Several countries including Romania, South Africa and Nepal have seen dramatic decreases in maternal mortality after liberalization of abortion laws, without an increase in the total number of abortions. In the United States, abortions are incredibly safe with very low rates of complications and a mortality rate of 0.7 per 100 000 women. With increasing abortion restrictions, maternal mortality in the United States can be expected to rise over the coming years, as has been observed in Texas recently.

Summary
Liberalization of abortion laws saves women's lives. The rising number of antiabortion restrictions will ultimately harm women and their families.