bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Significance of Intraluminal Contrast Enhancement in Patients with Spontaneous Cervical Artery Dissection: A Black-Blood MRI Study
Authors: Coppenrath Eva , Lenz Olga , Sommer Nora , Lummel Nina , Linn Jennifer , Treitl Karla , Bamberg Fabian , Reiser Maximilian , Pfefferkorn Thomas , Saam Tobias 
Published: April 2017

Purpose Recent studies have suggested that intraluminal thrombi show contrast enhancement on carotid black-blood T1w MRI. The aim of this study was to evaluate the significance of intraluminal contrast enhancement (iCE) regarding symptom status in patients with spontaneous cervical artery dissection (sCAD).
Methods 33 consecutive patients (19 men) with sCAD received a brain MRI (DIFF, T2w, T2*w, FLAIR) and a multi-sequence 3T-MRI with fat-saturated high-resolution black-blood T1w-sequences pre- and post-contrast, contrast-enhanced MR angiography and TOF images of carotid and vertebral arteries. Presence/absence of iCE, vessel occlusion and vessel wall hematoma (hyperintense in T1w pre-contrast) were analysed by two radiologists in consensus decision.
Results 44 of 132 analysed vessels had a vessel wall hematoma, consistent with sCAD. In 17 of 44 dissected vessels an acute ischemic stroke was found. 16 of 17 (94.1 %) vessels ipsilateral to ischemic stroke demonstrated iCE, compared to 9 of 44 (20.4 %) dissected vessels without stroke (P< 0.001). The presence/absence of iCE resulted in a sensitivity, specificity, positive and negative predictive value and accuracy for ischemic stroke of 0.94, 0.67, 0.64, 0.95, and 0.77, respectively, and an odds ratio of 32.0.
Conclusion iCE, which is suggestive of intraluminal thrombus formation, is strongly correlated with ischemic symptoms in patients with sCAD.
Key points
Citation Format
A 3D-printed cap with sideoptics for colonoscopy: a randomized ex vivo study
Authors: Walter Benjamin , Hann Alexander , Frank Rena , Meining Alexander 
Published: April 2017

Abstract
Background Adequate polyp detection is crucial to colonoscopy; however, detection can be impaired. In particular, flat polyps located behind folds or near the colonic flexures appear to be a problem. We present a cheap and easily adjustable 3D-printed tool to enhance the view of a standard colonoscope using additional commercially available sideoptics.
Materials and methods A cap adjustable to a standard endoscope was printed by a 3 D printer and had two microcameras fixed to offer two additional views. Fourteen endoscopists performed one standard and one sideoptic-enhanced colonoscopy in a randomized order. Flat lesions were simulated in an endoscopy training model. Time for withdrawal was measured, along with the number of flat lesions detected.
Results Withdrawal time did not differ significantly between standard and sideoptic-enhanced colonoscopy (329 vs. 389 seconds). The median number of detected flat lesions per endoscopic examination was significantly higher using the sideoptic tool (8 vs. 6.5; P = 0.001).
Conclusions A 3D-printed sideoptic-enhanced cap including two microcameras may be a cheap, easy, and feasible add-on to improve adenoma detection rates in routine colonoscopy.
Bayesian posteriors for arbitrarily rare events
Authors: Fudenberg Drew , He Kevin , Imhof Lorens A. 
Published: April 2017

Significance
Many decision problems in contexts ranging from drug safety tests to game-theoretic learning models require Bayesian comparisons between the likelihoods of two events. When both events are arbitrarily rare, a large data set is needed to reach the correct decision with high probability. The best result in previous work requires the data size to grow so quickly with rarity that the expectation of the number of observations of the rare event explodes. We show for a large class of priors that it is enough that this expectation exceeds a prior-dependent constant. However, without some restrictions on the prior the result fails, and our condition on the data size is the weakest possible.
Service-like TMF tests for the life assessment of an SX GT blade
Authors: Costa A. , Guarnone P. , Poggio E. , Sanguineti A. , Vacchieri E. , Villari P. , Holdsworth S. R. 
Published: April 2017

Thermo-mechanical fatigue (TMF) is the main source of failure of gas turbine (GT) components, owing to thermal gradients and complex geometry. A GT-component life assessment procedure has to consider TMF and the effect of metallic coatings. A single crystal (SX) blade is analysed by FE simulation to identify the critical locations and their thermo-mechanical conditions during a ‘cold’ startup/shutdown transient. The defined TMF cycle is applied to SX superalloy specimens with two different coatings. The results highlight a significant life reduction for specimens with the coating having the highest Re content due to its microstructure. The experimental results are confirmed by field feedback from operated blades. This paper is part of a thematic issue on the 9th International Charles Parsons Turbine and Generator Conference. All papers have been revised and extended before publication in Materials Science and Technology.
Last but not least
Authors: Harris Tristen A. , Butler Kenneth R. 
Published: April 2017

ABSTRACT
This article describes the history of physician assistants (PAs) in Mississippi, the last state to pass legislation allowing for PA practice. A small group of PAs in the state began pursuing a PA practice act in the early 1990s with little political advocacy experience, and in 1994, the American Academy of PAs actively joined “The Battle for Mississippi.” In April 2000, after years of PA advocacy, Mississippi passed the bill that would authorize PA practice in the state.
Does low-dose methotrexate deserve more respect from clinicians?
Authors: Luu Brent , Rodway George W. 
Published: April 2017

ABSTRACT
Medical errors associated with low-dose methotrexate may be life-threatening. Prescribers should be cognizant of the medication's toxicities and the persistent challenges in preventing adverse events. This article reviews the properties of methotrexate and its common drug-drug interactions. Best practices from the Institute for Safe Medication Practices, aimed at reducing methotrexate errors, are highlighted.
Changes in Personal Relationships During Residency and Their Effects on Resident Wellness: A Qualitative Study
Authors: Law Marcus , Lam Michelle , Wu Diana , Veinot Paula , Mylopoulos Maria 
Published: April 2017

Purpose
Residency poses challenges for residents’ personal relationships. Research suggests residents rely on family and friends for support during their training. The authors explored the impact of residency demands on residents’ personal relationships and the effects changes in those relationships could have on their wellness.

Method
The authors used a constructivist grounded theory approach. In 2012–2014, they conducted semistructured interviews with a purposive and theoretical sample of 16 Canadian residents from various specialties and training levels. Data analysis occurred concurrently with data collection, allowing authors to use a constant comparative approach to explore emergent themes. Transcripts were coded; codes were organized into categories and then themes to develop a substantive theory.

Results
Residents perceived their relationships to be influenced by their evolving professional identity: Although personal relationships were important, being a doctor superseded them. Participants suggested they were forced to adapt their personal relationships, which resulted in the evolution of a hierarchy of relationships that was reinforced by the work–life imbalance imposed by their training. This poor work–life balance seemed to result in relationship issues and diminish residents’ wellness. Participants applied coping mechanisms to manage the conflict arising from the adaptation and protect their relationships. To minimize the effects of identity dissonance, some gravitated toward relationships with others who shared their professional identity or sought social comparison as affirmation.

Conclusions
Erosion of personal relationships could affect resident wellness and lead to burnout. Educators must consider how educational programs impact relationships and the subsequent effects on resident wellness.
Plasma Concentration of Itraconazole in Patients With Hematologic Malignancies Treated With Itraconazole Oral Solution
Authors: Marumo Atsushi , Miyawaki Shuichi , Dan Naoaki , Ishiyama Ken 
Published: April 2017

Background:
The prophylactic administration of itraconazole (ITCZ) is effective for preventing mycotic infections during chemotherapy in patients with hematologic malignancies. However, fungal infections can occur when the ITCZ does not reach an effective concentration.

Methods:
We conducted a prospective study to monitor the plasma concentration of ITCZ and hydroxyl-ITCZ (OH-ITCZ) weekly and to verify whether the day 3 plasma concentration of ITCZ could predict the subsequent acquisition of an effective plasma concentration.

Results:
A total of 39 patients who underwent 66 courses of chemotherapy were assessed in this study. An effective plasma concentration was achieved on day 7 in 34 of 63 patients (54%) and on day 14 in 35 of 59 patients (59%). A univariate analysis revealed that age, type of chemotherapy, and the body surface area were significantly associated with a high plasma concentration of ITCZ + OH-ITCZ. A linear regression analysis extracted the body surface area and the type of chemotherapy as significant factors. An receiver operating characteristic curve analysis revealed a day 3 plasma ITCZ + OH-ITCZ concentration of >656 ng/mL led to a plasma concentration that exceeded the minimum effective level on day 7; the sensitivity and specificity were 62% and 93%, respectively.

Conclusions:
This study showed that the measurement of the day 3 plasma concentration could lead to a better outcome in patients receiving chemotherapy for hematologic malignancies.
Establishing Content Validity of the CLEFT-Q: A New Patient-reported Outcome Instrument for Cleft Lip/Palate
Authors: Tsangaris Elena , Wong Riff Karen W.Y. , Goodacre Tim , Forrest Christopher R. , Dreise Marieke , Sykes Jonathan , de Chalain Tristan , Harman Karen , O’Mahony Aisling , Pusic Andrea L. , Thabane Lehana , Thoma Achilleas , Klassen Anne F. 
Published: April 2017

Background:The CLEFT-Q is a new patient-reported outcome instrument designed to measure outcomes that matter to patients. The aim of this qualitative study was to establish content validity of the CLEFT-Q in patients who differ by age and culture.Methods:Patients aged between 6 and 29 years were recruited from plastic surgery clinics in Canada, India, Ireland, the Philippines, the Netherlands and the United States. Healthcare providers and other experts participated in a focus group or provided individual feedback. Input was sought on all aspects of the CLEFT-Q (item wording, instructions, and response options), and to identify missing content. Patient interviews and expert feedback took place between September 2013 and September 2014.Results:Sixty-nine patients and 44 experts participated. The first draft of the CLEFT-Q consisted of 163 items measuring 12 constructs. The first round of feedback identified 92 items that required revision. In total, 3 rounds of interviews, and the involvement of an artist to create pictures for 17 items, were needed to establish content validity. At the conclusion of cognitive interviews, the CLEFT-Q consisted of 13 scales (total 171 items) that measure appearance, health-related quality of life, and facial function. The mean Flesch-Kincaid readability statistic for items was 1.4 (0 to 5.2).Conclusion:Cognitive interviews and expert review allowed us to identify items that required re-wording, re-conceptualizing, or to be removed, as well as any missing items. This process was useful for refining the CLEFT-Q scales for further testing.
Serum Neutrophil Gelatinase–Associated Lipocalin: A Diagnostic Marker in Pediatric Sepsis
Authors: Saleh Nagwan Yossery , Abo El Fotoh Wafaa Moustafa M. , El-Hawy Mahmoud A. 
Published: April 2017

Objectives:
Sepsis is a life-threatening condition that arises when the response of the body to infection injures its own tissues and organs. The early prediction of sepsis by current clinical and laboratory methods remains inadequate. Serum neutrophil gelatinase–associated lipocalin level is increased in sepsis irrespective of renal dysfunction. Therefore, we aimed to correlate the serum neutrophil gelatinase–associated lipocalin value determined at admission with clinical progression and severity of disease in critically ill children and to declare its role as a potential diagnostic and prognostic marker for sepsis in critically ill children in the emergency department.

Design:
A prospective cohort study.

Setting:
The study carried out at the PICU of Menoufia University Hospital.

Patients:
We serially enrolled 120 critically ill children admitted to the PICU at 2 fixed days per week in addition to 40 healthy children served as controls.

Interventions:
Clinical examination was performed including calculation of the Pediatric Risk of Mortality and Pediatric Index of Mortality 2. Serum neutrophil gelatinase–associated lipocalin measurement was performed for patients at admission and for the controls. Patients were followed up for 30 days. The discriminatory power of neutrophil gelatinase– associated lipocalin was determined using the receiver-operating characteristic and other predictive likelihood values.

Measurements and Main Results:
Serum neutrophil gelatinase–associated lipocalin level was significantly higher among the total patient cohort and those with sepsis than among the controls (p < 0.001), also in patients with systemic inflammatory response syndrome without sepsis and patients without systemic inflammatory response syndrome (p = 0.04 and <0.001). Furthermore, plasma level of neutrophil gelatinase–associated lipocalin was significantly elevated in nonsurvivors compared with survivors (p < 0. 001). Receiver-operating characteristic curve analysis exhibited an area under the curve of 0.84 for neutrophil gelatinase–associated lipocalin for diagnosis of sepsis, whereas C-reactive protein had an area under the curve of 0.79. Regarding the prognosis, neutrophil gelatinase–associated lipocalin had an area under the curve of 0.74 for prediction of mortality, whereas the area under the curve for Pediatric Risk of Mortality, Pediatric Index of Mortality 2, and C-reactive protein were 0.59, 0.58, and 0.62, respectively.

Conclusion:
Overall, the data support the view that measurement at admission, serum neutrophil gelatinase–associated lipocalin results in substantial added value for early diagnosis and prognostication of sepsis in critically sick children.
Perceived Discrimination and Longitudinal Change in Kidney Function Among Urban Adults
Authors: Beydoun May A. , Poggi-Burke Angedith , Zonderman Alan B. , Rostant Ola S. , Evans Michele K. , Crews Deidra C. 
Published: April 2017

ABSTRACT

Objective
Perceived discrimination has been associated with psychosocial distress and adverse health outcomes. We examined associations of perceived discrimination measures with changes in kidney function in a prospective cohort study, the Healthy Aging in Neighborhoods of Diversity across the Life Span.

Methods
Our study included 1620 participants with preserved baseline kidney function (estimated glomerular filtration rate [eGFR] ≥ 60 mL/min/1.73 m2) (662 whites and 958 African Americans, aged 30–64 years). Self-reported perceived racial discrimination and perceived gender discrimination (PGD) and a general measure of experience of discrimination (EOD) (“medium versus low,” “high versus low”) were examined in relation to baseline, follow-up, and annual rate of change in eGFR using multiple mixed-effects regression (γbase, γrate) and ordinary least square models (γfollow).

Results
Perceived gender discrimination “high versus low PGD” was associated with a lower baseline eGFR in all models (γbase = −3.51 (1.34), p = .009 for total sample). Among white women, high EOD was associated with lower baseline eGFR, an effect that was strengthened in the full model (γbase = −5.86 [2.52], p = .020). Overall, “high versus low” PGD was associated with lower follow-up eGFR (γfollow = −3.03 [1.45], p = .036). Among African American women, both perceived racial discrimination and PGD were linked to lower follow-up kidney function, an effect that was attenuated with covariate adjustment, indicating mediation through health-related, psychosocial, and lifestyle factors. In contrast, EOD was not linked to follow-up eGFR in any of the sex by race groups.

Conclusions
Perceived racial and gender discrimination are associated with lower kidney function assessed by glomerular filtration rate and the strength of associations differ by sex and race groups. Perceived discrimination deserves further investigation as a psychosocial risk factors for kidney disease.
Intelligence and Interleukin-6 in Older Adults: The Role of Repetitive Thought
Authors: Segerstrom Suzanne C. , Reed Rebecca G. , Scott April B. 
Published: April 2017

ABSTRACT

Objective
Higher intelligence quotient (IQ) correlates with lower systemic inflammation, consistent with an association between lower IQ and disease risk. The present study examined the role of repetitive thought (RT) in the relationship between IQ and interleukin (IL)-6. RT is thinking attentively, repeatedly, and frequently about oneself and one's world and is characterized by valence (positive-negative), purpose (searching-solving), and total quantity (much-little).

Methods
Estimated IQ and RT dimension scores were assessed at baseline in a sample of older adults (N = 120, mean age = 74 years), who thereafter had blood drawn up to 10 times semiannually (n = 799). Models were adjusted for body mass index, chronological age, and statin medication.

Results
Higher IQ was associated with lower IL-6 (γ = −0.225, SE = 0.111, p = .045). Of the RT dimensions, only more total RT predicted lower IL-6 (γ = −0.037, SE = 0.011, p = .001), an effect that was not moderated by valence or purpose. More total RT accounted for part of the effect of IQ on IL-6 (indirect effect = −0.06 [confidence interval = −0.14 to −0.002]). There was also a significant interaction between IQ and total RT (F(1,119) = 6.97, p = .009), in which more total RT was more strongly associated with lower IL-6 for people with lower IQ.

Conclusions
Although some forms of RT such as worry may have negative health correlates for older adults, engaging in RT per se can be healthy insofar as it also encompasses planning, processing, and coping. Older adults with higher IQ were more likely to engage in RT, but those with average IQ benefitted the most with regard to a marker of systemic inflammation.
Acceleration of Nucleotide Semi-Global Alignment with Adaptive Banded Dynamic Programming
Authors: Suzuki Hajime , Kasahara Masahiro 
Published: April 2017

AbstractMotivationPairwise alignment of nucleotide sequences has previously been carried out using the seed- and-extend strategy, where we enumerate seeds (shared patterns) between sequences and then extend the seeds by Smith-Waterman-like semi-global dynamic programming to obtain full pairwise alignments. With the advent of massively parallel short read sequencers, algorithms and data structures for efficiently finding seeds have been extensively explored. However, recent advances in single-molecule sequencing technologies have enabled us to obtain millions of reads, each of which is orders of magnitude longer than those output by the short-read sequencers, demanding a faster algorithm for the extension step that accounts for most of the computation time required for pairwise local alignment. Our goal is to design a faster extension algorithm suitable for single-molecule sequencers with high sequencing error rates (e.g., 10-15%) and with more frequent insertions and deletions than substitutions.ResultsWe propose an adaptive banded dynamic programming algorithm for calculating pairwise semi-global alignment of nucleotide sequences that allows a relatively high insertion or deletion rate while keeping band width relatively low (e.g., 32 or 64 cells) regardless of sequence lengths. Our new algorithm eliminated mutual dependences between elements in a vector, allowing an efficient Single-Instruction-Multiple-Data parallelization. We experimentally demonstrate that our algorithm runs approximately 5× faster than the extension alignment algorithm in NCBI BLAST+ while retaining similar sensitivity (recall).We also show that our extension algorithm is more sensitive than the extension alignment routine in DALIGNER, while the computation time is comparable.AvailabilityThe implementation of the algorithm and the benchmarking scripts are available athttps://github.com/ocxtal/adaptivebandbench.Contactmkasa@edu.k.u-tokyo.ac.jp
The yeast Mig1 transcriptional repressor is dephosphorylated by glucose-dependent and independent mechanisms
Authors: Shashkova Sviatlana , Wollman Adam J.M. , Leake Mark C. , Hohmann Stefan 
Published: April 2017

AbstractSaccharomyces cerevisiaeAMPK/Snf1 regulates glucose derepression of genes required for utilization of alternative carbon sources through the transcriptional repressor Mig1. It has been suggested that the Glc7-Reg1 phosphatase dephosphorylates Mig1. Here we report that Mig1 is dephosphorylated by Glc7-Reg1 in an apparently glucose-dependent mechanism but also by a mechanism independent of glucose and Glc7-Reg1. In addition to serine/threonine phosphatases another process including tyrosine phosphorylation seems crucial for Mig1 regulation. Taken together, Mig1 dephosphorylation appears to be controlled in a complex manner, in line with the importance for rapid and sensitive regulation upon altered glucose concentrations in the growth medium.
Leveraging population-based clinical quantitative phenotyping for drug repositioning
Authors: Brown Adam S , Rasooly Danielle , Patel Chirag J 
Published: April 2017

ABSTRACTComputational drug repositioning methods can scalably nominate approved drugs for new diseases, with reduced risk of unforeseen side effects. The majority of methods eschew individual-level phenotypes despite the promise of biomarker-driven repositioning. In this study, we propose a framework for discovering serendipitous interactions between drugs and routine clinical phenotypes in cross-sectional observational studies. Key to our strategy is the use of a healthy and non-diabetic population derived from the National Health and Nutrition Examination Survey, mitigating risk for confounding by indication. We combine complementary diagnostic phenotypes (fasting glucose and glucose response) and associate them with prescription drug usage. We then sought confirmation of phenotype-drug associations in un-identifiable member claims data from Aetna using a retrospective self-controlled case analysis approach. We identify bupropion hydrochloride as a plausible antidiabetic agent, suggesting that surveying otherwise healthy individuals cross-sectional studies can discover new drug repositioning hypotheses that have applicability to longitudinal clinical practice.