bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pliocene–Pleistocene palaeoclimate reconstruction from Ashalim Cave speleothems, Negev Desert, Israel
Authors: Vaks Anton , Bar-Matthews Miryam , Ayalon Avner , Matthews Alan , Frumkin Amos 
Published: December 2017

Abstract

Speleothems from Ashalim Cave, located in the arid central Negev Desert, Israel, were used in a reconstruction of the palaeoclimate of the northern Saharan–Arabian desert margin. The sequence of speleothems is composed of three stratigraphic members: the yellow Pliocene Basal Member, the brown Early Pleistocene Intermediate Member and the thin Middle–Late Pleistocene Young Member. The age of the Basal Member is
c.
3.1 Ma and the base of the Intermediate Member is 1.272 ± 0.018 Ma. Two last deposition periods of the Young Member occurred at 221–190 ka (Negev Humid Period (NHP) 2) and 134–114 ka (NHP-1), associated with interglacial marine isotopic stages 7.3–7.1 and 5.5, respectively. NHP-1 and -2 occurred when the African monsoon index was highest in the last 221 ka. The δ
18
O values of the speleothems range between −6.9 and −11.2‰, 2–4‰ less than in the speleothems of central and northern Israel. This may indicate a remote southern tropical source of precipitation, although during NHP-1 and -2 the thickness of the Negev Desert speleothems decreases from north to south, showing a stronger northern Mediterranean source of moisture. The δ
13
C values of the speleothems (3.5 to −8.5‰) show steppe to semi-desert C4 type vegetation. The
87
Sr/
86
Sr ratios of the speleothems increased from
c.
0.7078 in the Pliocene to 0.7082–0.7085 in the Pleistocene, indicating an increasing supply of desert dust and a decrease in host rock weathering.
Accelerating Discovery of Functional Mutant Alleles in Cancer
Authors: Chang Matthew T. , Bhattarai Tripti Shrestha , Schram Alison M. , Bielski Craig M. , Donoghue Mark T.A. , Jonsson Philip , Chakravarty Debyani , Phillips Sarah , Kandoth Cyriac , Penson Alexander , Gorelick Alexander , Shamu Tambudzai , Patel Swati , Harris Christopher , Gao JianJiong , Sumer Selcuk Onur , Kundra Ritika , Razavi Pedram , Li Bob T. , Reales Dalicia N. , Socci Nicholas D. , Jayakumaran Gowtham , Zehir Ahmet , Benayed Ryma , Arcila Maria E. , Chandarlapaty Sarat , Ladanyi Marc , Schultz Nikolaus , Baselga José , Berger Michael F. , Rosen Neal , Solit David B. , Hyman David M. , Taylor Barry S. 
Published: December 2017

AbstractMost mutations in cancer are rare, which complicates the identification of therapeutically significant mutations and thus limits the clinical impact of genomic profiling in patients with cancer. Here, we analyzed 24,592 cancers including 10,336 prospectively sequenced patients with advanced disease to identify mutant residues arising more frequently than expected in the absence of selection. We identified 1,165 statistically significant hotspot mutations of which 80% arose in 1 in 1,000 or fewer patients. Of 55 recurrent in-frame indels, we validated that novel AKT1 duplications induced pathway hyperactivation and conferred AKT inhibitor sensitivity. Cancer genes exhibit different rates of hotspot discovery with increasing sample size, with few approaching saturation. Consequently, 26% of all hotspots in therapeutically actionable oncogenes were novel. Upon matching a subset of affected patients directly to molecularly targeted therapy, we observed radiographic and clinical responses. Population-scale mutant allele discovery illustrates how the identification of driver mutations in cancer is far from complete.Significance: Our systematic computational, experimental, and clinical analysis of hotspot mutations in approximately 25,000 human cancers demonstrates that the long right tail of biologically and therapeutically significant mutant alleles is still incompletely characterized. Sharing prospective genomic data will accelerate hotspot identification, thereby expanding the reach of precision oncology in patients with cancer. Cancer Discov; 8(2); 174–83. ©2017 AACR.This article is highlighted in the In This Issue feature, p. 127
Time-to-Effect–Based Dosing Strategy for Cryoballoon Ablation in Patients With Paroxysmal Atrial Fibrillation
Authors: Ferrero-de-Loma-Osorio Ángel , García-Fernández Amaya , Castillo-Castillo Jesús , Izquierdo-de-Francisco Maite , Ibáñez-Críado Alicia , Moreno-Arribas Jose , Martínez Angel , Bertomeu-González Vicente , López-Mases Patricia , Ajo-Ferrer María , Núñez Carlos , Bondanza-Saavedra Lourdes , Sánchez-Gómez Juan Miguel , Martínez-Martínez Juan Gabriel , Chorro-Gascó Francisco Javier , Ruiz-Granell Ricardo 
Published: December 2017

Background
The optimal dosage of cryotherapy during cryoballoon ablation of pulmonary veins is still unclear. This trial tested the noninferiority of a novel, individualized, cryotherapy-dosing strategy for each vein.

Methods and Results

This prospective, randomized, multicenter, noninferiority study included 140 patients with paroxysmal atrial fibrillation, which was refractory to antiarrhythmic drugs. Patients were randomly assigned to a conventional strategy of 180-second cryoballoon applications per vein with a bonus freeze (control group, n=70) or to a shorter-time application protocol, with 1 application that lasted the time required for electric block time to effect plus 60- and a 120-second freeze bonus (study group, n=70). Patients were followed with a long-term monitoring system of 30 days. At 1-year follow-up, no difference was observed in terms of free atrial fibrillation-recurrence rates: 79.4% in control versus 78.3% in study group (Δ=1.15%; 90% confidence interval, −10.33% to 12.63%;
P
=0.869). Time to effect was detected in 72.1% of veins. The control and study groups had similar mean number of applications per patient (9.6±2 versus 9.9±2.4;
P
=0.76). Compared with controls, the study group had a significantly shorter cryotherapy time (28.3±7 versus 19.4±4.3 minutes;
P
<0.001), left atrium time (104±25 versus 92±23 minutes;
P
<0.01), and total procedure time (135±35 versus 119±31 minutes;
P
<0.01). No differences were observed in complications or acute reconnections.

Conclusions
The new time-to-effect–based cryotherapy dosage protocol led to shorter cryotherapy and procedure times, with equal safety, and similar acute and 1-year follow-up results, compared with the conventional approach.

Clinical Trial Registration

URL:
https://clinicaltrials.gov
. Unique identifier: NCT02789358.
Trends in the Use of Inotropes to List Adult Heart Transplant Candidates at Status 1A
Authors: Parker William F. , Garrity Edward R. , Fedson Savitri , Churpek Matthew M. 
Published: December 2017

Background
The number of adult heart transplant candidates waiting at the most urgent status 1A has increased over time despite the expansion of geographic sharing of hearts in 2006. We aimed to determine whether candidates listed with inotropes contribute to the excess status 1A candidates.

Methods and Results

The initial registrations of all adult heart-only candidates listed from 2000 to 2015 were analyzed using the Scientific Registry of Transplant Recipients data set. Trends in listing status, justifications, and candidate factors were measured. Adjusted trends in listing status pre- and post–geographic sharing were estimated using multilevel logistic regression. Competing risks models provided trends in transplant-free waitlist survival. There were 46 853 adult heart-alone listings during 2000 to 2015. Pre-sharing, status 1A listing was unchanged over time (adjusted odds ratio, 0.98; 95% confidence interval, 0.78–1.23). Post-sharing, the adjusted odds of status 1A listing increased 117% over 9 years (adjusted odds ratio 2.17, 95% confidence interval, 1.82–2.58). The number of candidates listed as status 1A with inotropes increased by 193 a year, whereas the dobutamine, dopamine, and milrinone doses used decreased 49%, 55%, and 29% (
P
<0.001). The risk of waitlist death or deterioration of status 1A inotrope candidates relative to status 2 candidates decreased 62% for 2006 to 2010 and 70% for 2011 to 2015 compared with that for 2003 to 2006.

Conclusions
After the wider geographic sharing of hearts in 2006, transplant programs used multiple inotropes to list candidates at status 1A more frequently with progressively lower doses. Concurrently, the status 1A inotrope candidate waitlist outcomes improved substantially. These trends suggest that overtreatment with multiple inotropes contributes to the current critical excess of status 1A candidates.
Radial Versus Femoral Access for Rotational Atherectomy
Authors: Watt Jonathan , Austin David , Mackay Daniel , Nolan James , Oldroyd Keith G. 
Published: December 2017

Background—
Rotational atherectomy (RA) is an important interventional tool for heavily calcified coronary lesions. We compared the early clinical outcomes in patients undergoing RA using radial or femoral access.

Methods and Results—

We identified all patients in England and Wales who underwent RA between January 1, 2005, and March 31, 2014. Eight thousand six hundred twenty-two RA cases (3069 radial and 5553 femoral) were included in the analysis. The study primary outcome was 30-day mortality. Propensity scores were calculated to determine the factors associated with treatment assignment to radial or femoral access. Multivariable logistic regression analysis, using the calculated propensity scores, was performed. Thirty-day mortality was 2.2% in the radial and 2.3% in the femoral group (
P
=0.76). Radial access was associated with equivalent 30-day mortality (adjusted odds ratio [OR], 1.06; 95% confidence interval [CI], 0.77–1.46;
P
=0.71), procedural success (OR, 1.04; 95% CI, 0.84–1.29;
P
=0.73), major adverse cardiac and cerebrovascular events (OR, 1.05; 95% CI, 0.80–1.38;
P
=0.72), and net adverse clinical events (OR, 0.90; 95% CI, 0.71–1.15;
P
=0.41), but lower rates of in-hospital major bleeding (OR, 0.62; 95% CI, 0.40–0.98;
P
=0.04) and major access site complications (OR, 0.05; 95% CI, 0.01–0.38;
P
=0.004), compared with femoral access.

Conclusions—
In this large real-world study of patients undergoing RA, radial access was associated with equivalent 30-day mortality and procedural success, but reduced major bleeding and access site complications, compared with femoral access.
Causes and Consequences of Missing Health-Related Quality of Life Assessments in Patients Who Undergo Mechanical Circulatory Support Implantation
Authors: Grady Kathleen L. , Jones Philip G. , Cristian-Andrei Adin , Naftel David C. , Myers Susan , Dew Mary Amanda , Idrissi Katharine , Weidner Gerdi , Wissman Sherri A. , Kirklin James K. , Spertus John A. 
Published: December 2017

Background—
Missing health-related quality of life (HRQOL) data in longitudinal studies can reduce precision and power and bias results. Using INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support), we sought to identify factors associated with missing HRQOL data, examine the impact of these factors on estimated HRQOL assuming missing at random missingness, and perform sensitivity analyses to examine missing not at random (MNAR) missingness because of illness severity.

Methods and Results—

INTERMACS patients (n=3248) with a preimplantation profile of 1 (critical cardiogenic shock) or 2 (progressive decline) were assessed with the EQ-5D-3L visual analog scale and Kansas City Cardiomyopathy Questionnaire-12 summary scores pre-implantation and 3 months postoperatively. Mean and median observed and missing at random–imputed HRQOL scores were calculated, followed by sensitivity analyses. Independent factors associated with HRQOL scores and missing HRQOL assessments were determined using multivariable regression. Independent factors associated with preimplantation and 3-month HRQOL scores, and with the likelihood of missing HRQOL assessments, revealed few correlates of HRQOL and missing assessments (
R
2
range, 4.7%–11.9%). For patients with INTERMACS profiles 1 and 2 and INTERMACS profile 1 alone, missing at random–imputed mean and median HRQOL scores were similar to observed scores, before and 3 months after implantation, whereas MNAR-imputed mean scores were lower (≥5 points) at baseline but not at 3 months.

Conclusions—
We recommend use of sensitivity analyses using an MNAR imputation strategy for longitudinal studies when missingness is attributable to illness severity. Conduct of MNAR sensitivity analyses may be less critical after mechanical circulatory support implant, when there are likely fewer MNAR data.
Court Advocacy for Police Officers
Authors: Walker Cyril H. 
Published: December 2017

Police officers often find themselves as prosecuting advocates in courts of summary jurisdiction. Despite calls from the Law Society and others for all prosecuting to be carried out by solicitors, there is little doubt much court work will continue to be done by police officers — in fact with recent economy cuts, we have seen some police authorities cutting the number of solicitors employed by them and not employing solicitors in areas where there is a real need. Also more forces are setting up process units to carry out their accident and process enquiries and where Sergeants and above are acting as prosecutors. I hope that the information contained in the following pages will be of some help to police officers charged with the important task of representing their police force in court.
Hypercalcemia-Induced Pancreatitis in Pregnancy Following Calcium Carbonate Ingestion
Authors: Trezevant May S. , Winton John C. , Holmes Ashley K. 
Published: December 2017

Background: Calcium carbonate is often used to relieve Gastroesophageal Reflux Disease (GERD) in pregnant patients. This report describes a potentially serious complication. Case: A pregnant female presented at 34 weeks gestation with abdominal pain, nausea, and vomiting. Home medications included an unquantifiable amount of calcium carbonate 500 mg due to constant consumption for GERD. Laboratory findings included elevated calcium, amylase, lipase, and triglyceride level. Pancreatitis was diagnosed and abdominal ultrasound excluded gallstones. Despite hydration, lipase rose and emergency cesarean section was performed. Hypercalcemia was managed by intravenous fluid administration. After delivery, pancreatitis resolved. Conclusion: Pancreatitis developed in pregnant patient with hypercalcemia due to excessive calcium carbonate ingestion and resolved after delivery of the fetus, fluid resuscitation, and return of calcium level to normal.
A spoonful of care ethics: The challenges of enriching medical education
Authors: van Reenen Eva , van Nistelrooij Inge 
Published: December 2017

Background: Nursing Ethics has featured several discussions on what good care comprises and how to achieve good care practices. We should “nurse” ethics by continuously reflecting on the way we “do” ethics, which is what care ethicists have been doing over the past few decades and continue to do so. Ethics is not limited to nursing but extends to all caring professions. In 2011, Elin Martinsen argued in this journal that care should be included as a core concept in medical ethical terminology because of “the harm to which patients may be exposed owing to a lack of care in the clinical encounter,” specifically between doctors and patients. However, Martinsen leaves the didactical challenges arising from such a venture open for further enquiry. Objectives: In this article, we explore the challenges arising from implementing care-ethical insights into medical education. Research design: Medical education in the Netherlands is investigated through a “care-ethical lens”. This means exploring the possibility of enriching medical education with care-ethical insights, while at the same time discovering possible challenges emerging from such an undertaking. Participants and research context: This paper has been written from the academic context of a master in care ethics and policy. Ethical considerations We have tried to be fair and respectful to the authors discussed and take a neutral stance towards the findings portrayed. Findings: Several challenges are identified, which we narrow down to two types: didactical and non-didactical. Discussion and conclusion: In order to overcome these challenges, we must not underestimate the possible resistance to a paradigm shift. Our efforts should mainly target the learning that takes place in the clinical phases of medical training and should be accompanied by the creation of awareness in healthcare practice.
Complete genome sequence analysis of Archaeoglobus fulgidus strain 7324 (DSM 8774), a hyperthermophilic archaeal sulfate reducer from a North Sea oil field
Authors: Birkeland Nils-Kåre , Schönheit Peter , Poghosyan Lianna , Fiebig Anne , Klenk Hans-Peter 
Published: December 2017

AbstractArchaeoglobus fulgidus is the type species of genus Archaeoglobus Stetter 1998, a hyperthermophilic sulfate reducing group within the Archaeoglobi class of the euryarchaeota phylum. Members of this genus grow heterotrophically or chemolithoautotrophically with sulfate or thiosulfate as electron acceptors. Except for A. fulgidus strain 7324 and the candidate species “Archaeoglobus lithotrophicus”, which both originate from deep oil-fields, the other members of this genus have been recovered from marine hydrothermal systems. Here we describe the features of the A. fulgidus strain 7324 genome as compared to the A. fulgidus VC16 type strain. The 2.3 Mbp genome sequence of strain 7324 shares about 93.5% sequence identity with that of strain VC16T but is about 138 Kbp longer, which is mostly due to two large ‘insertions’ carrying one extra cdc6 (cell-cycle control protein 6) gene, extra CRISPR elements and mobile genetic elements, a high-GC ncRNA gene (hgcC) and a large number of hypothetical gene functions. A comparison with four other Archaeoglobus spp. genomes identified 1001 core Archaeoglobus genes and more than 2900 pan-genome orthologous genes.
Analysis of the opinions of adolescents on the risk factors of suicide
Authors: Kielan Aleksandra , Cieślak Ilona , Skonieczna Joanna , Olejniczak Dominik , Jabłkowska-Górecka Karolina , Panczyk Mariusz , Gotlib Joanna , Walewska-Zielecka Bożena 
Published: December 2017

Cel pracyCelem niniejszej pracy jest poznanie opinii młodzieży w wieku 16-19 lat, uczęszczającej do warszawskich publicznych liceów ogólnokształcących, na temat czynników ryzyka samobójstw.MetodaPopulacja badana objęła młodzież, która w roku 2015 była w wieku 16-19 lat (M = 17,29; SD = 0,94). Respondenci uczęszczali do ośmiu warszawskich publicznych liceów ogólnokształcących z ośmiu różnych dzielnic. Badanie było reprezentatywne. W badaniu uczestniczyło 1439 respondentów – 821 dziewcząt (57,1%) i 592 chłopców (41,1%). Badanie przeprowadzono metodą PAPI. Kwestionariusz zawierał 34 pytania podzielone na trzy bloki- dotycząc epidemiologii, czynników ryzyka i profilaktyki zachowań samobójczych.WynikiWedług 37,0% badanych głównym problemem występującym w rodzinie, który może stać się czynnikiem ryzyka popełnienia samobójstwa jest brak zrozumienia przez rodziców. Badani uważali, że konflikty z rówieśnikami stanowią sytuacje związane ze szkołą, które mogą stać się przyczyną powstania myśli samobójczych (48,6%). Ponad połowa badanych (59,1%) uważała, że odrzucenie przez osoby bliskie i ważne stanowi główny czynnik związany z poczuciem osamotnienia, mogący być przyczyną aktu samobójczego.Wnioski1. Istotnym elementem w prewencji zachowań autodestrukcyjnych młodych osób powinien być trening rodzicielski w zakresie okazywania zrozumienia i akceptacji swoim dzieciom.
2. Wskazane jest prowadzenie zajęć, doskonalących umiejętności psychospołeczne młodzieży, w szczególności zdolności rozwiązywania problemów interpersonalnych, w celu zmniejszenia liczby konfliktów z rówieśnikami, występujących w środowisku szkolnym.
Correlates of employment interest among adults with schizophrenia
Authors: Westcott Cassandra , Waghorn Geoffrey , McLean Duncan , Statham Dixie , Mowry Bryan 
Published: December 2017

Background/Aims: Role functioning is an important part of recovery and psychiatric rehabilitation for people with schizophrenia. However, little is known about why some people and not others return to socially valued roles such as employment. While the demographic and clinical correlates of employment have been extensively studied, little is known about how employment interest forms and develops into actual employment activity. The aim was to compare demographic and clinical correlates of employment interest to correlates of actual employment participation. Methods: A community sample of 255 working-age adults with schizophrenia or schizoaffective disorder were interviewed about their current employment status and current employment interest. Univariate logistic regression was used to examine the demographic and clinical correlates of both employment interest and participation. Findings: Age, employment history and severity of current hallucinations were associated with both employment interest and participation, while illness severity pattern, illness course, severity of disability, and severity of avolition were associated only with employment participation. Conclusions: Resilience of employment interest to the clinical symptoms of schizophrenia is a promising finding. Those with more severe illness patterns and more impaired functioning can remain good candidates for vocational rehabilitation, because interest and motivation for employment may be unaffected.
Analysis and comparison of the psychometric properties of two balance scales for elderly adults
Authors: Lee Young-jung , Yi Chung-hwi , Kim Gyoung-mo 
Published: December 2017

Background/Aims: The aim of this research was to verify psychometric properties of the Berg Balance Scale and the Fullerton Advanced Balance Scale, and compare the item difficulty between the two scales. Methods: A total of 97 community-dwelling older adults participated in this study. All participants were assessed on their degree of balance ability by the Berg Balance Scale and the Fullerton Advanced Balance Scale, respectively. We identified the psychometric properties and compared the item difficulty of the two scales using the Rasch analysis. Findings: Among the items on the Berg Balance Scale, the Standing to sitting and Transfers items showed misfit statistics. The most difficult item was Standing on one foot, whereas the easiest item was Sitting unsupported. In the case of the Fullerton Advanced Balance Scale, the Standing with feet together and eyes closed, Stand on foam, eyes closed and Walk with head turns items showed misfit statistics. Also, the most difficult item was Stand on one leg (logit value, 2.93), whereas the easiest item was Turn in full circle. Among the 24 items of the combined Berg Balance Scale and Fullerton Advanced Balance Scale, 13 items (nine items for the Fullerton Advanced Balance Scale and four items on the Berg Balance Scale) had positive logit values, and 11 items (one item on the FAB and 10 on the Berg Balance Scale) had negative logit values. Conclusions: Both the Berg Balance Scale and the Fullerton Advanced Balance appear to be reliable and valid tools to assess balance function in older adults. However, the Berg Balance Scale is suitable for assessing balance ability in a group of lower functioning older adults, whereas, the Fullerton Advanced Balance is suitable for assessing balance ability in a group of higher functioning older adults.