bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genomic Landscape of Colorectal Mucosa and Adenomas
Authors: Borras Ester , San Lucas F. Anthony , Chang Kyle , Zhou Ruoji , Masand Gita , Fowler Jerry , Mork Maureen E. , You Y. Nancy , Taggart Melissa W. , McAllister Florencia , Jones David A. , Davies Gareth E. , Edelmann Winfried , Ehli Erik A. , Lynch Patrick M. , Hawk Ernest T. , Capella Gabriel , Scheet Paul , Vilar Eduardo 
Published: May 2016

Abstract
The molecular basis of the adenoma-to-carcinoma transition has been deduced using comparative analysis of genetic alterations observed through the sequential steps of intestinal carcinogenesis. However, comprehensive genomic analyses of adenomas and at-risk mucosa are still lacking. Therefore, our aim was to characterize the genomic landscape of colonic at-risk mucosa and adenomas. We analyzed the mutation profile and copy number changes of 25 adenomas and adjacent mucosa from 12 familial adenomatous polyposis patients using whole-exome sequencing and validated allelic imbalances (AI) in 37 adenomas using SNP arrays. We assessed for evidence of clonality and performed estimations on the proportions of driver and passenger mutations using a systems biology approach. Adenomas had lower mutational rates than did colorectal cancers and showed recurrent alterations in known cancer driver genes (APC, KRAS, FBXW7, TCF7L2) and AIs in chromosomes 5, 7, and 13. Moreover, 80% of adenomas had somatic alterations in WNT pathway genes. Adenomas displayed evidence of multiclonality similar to stage I carcinomas. Strong correlations between mutational rate and patient age were observed in at-risk mucosa and adenomas. Our data indicate that at least 23% of somatic mutations are present in at-risk mucosa prior to adenoma initiation. The genomic profiles of at-risk mucosa and adenomas illustrate the evolution from normal tissue to carcinoma via greater resolution of molecular changes at the inflection point of premalignant lesions. Furthermore, substantial genomic variation exists in at-risk mucosa before adenoma formation, and deregulation of the WNT pathway is required to foster carcinogenesis. Cancer Prev Res; 9(6); 417–27. ©2016 AACR.
Pulmonary Artery Pressure–Guided Heart Failure Management Reduces 30-Day Readmissions
Authors: Adamson Philip B. , Abraham William T. , Stevenson Lynne Warner , Desai Akshay S. , Lindenfeld JoAnn , Bourge Robert C. , Bauman Jordan 
Published: May 2016

Background—
This study examines the impact of pulmonary artery pressure–guided heart failure (HF) care on 30-day readmissions in Medicare-eligible patients.

Methods and Results—

The CardioMicroelectromechanical system (CardioMEMS) Heart Sensor Allows Monitoring of Pressures to Improve Outcomes in New York Heart Association Class III Heart Failure Patients (CHAMPION) Trial included 550 patients implanted with a permanent MEMS-based pressure sensor in the pulmonary artery. Subjects were randomized to a treatment group (uploaded pressures were made available to investigators) or a control group (uploaded pressures were not made available to investigators). This analysis focuses on the 245 Medicare-eligible subjects for whom compliance with daily transmissions was 93% compared with 88% for the overall population. Medications were changed more often in the treatment group using pressure information compared with the control group using symptoms and daily weights alone. During the 515 days follow-up after implant, the overall rate of HF hospitalizations was 49% lower in the treatment group (60 HF hospitalizations, 0.34 events/patient-year) compared with control (117 HF hospitalizations, 0.67 events/patient-year; hazard ratio 0.51, 95% confidence interval 0.37–0.70;
P
<0.0001). Of the 177 HF hospitalizations, 155 qualified as an index HF hospitalization. All-cause 30-day readmissions were 58% lower in the treatment group (0.07 events/patient-year) compared with 0.18 events/patient-year in the control group (hazard ratio 0.42, 95% confidence interval 0.22–0.80;
P
=0.0080).

Conclusions—
Pulmonary artery pressure–guided HF management in Medicare-eligible patients led to a 49% reduction in total HF hospitalizations and a 58% reduction in all-cause 30-day readmissions.

Clinical Trial Registration—

http://www.clinicaltrials.gov
. Unique identifier: NCT00531661.
Early Rivaroxaban Use After Cardioembolic Stroke May Not Result in Hemorrhagic Transformation
Authors: Gioia Laura C. , Kate Mahesh , Sivakumar Leka , Hussain Dulara , Kalashyan Hayrapet , Buck Brian , Bussiere Miguel , Jeerakathil Thomas , Shuaib Ashfaq , Emery Derek , Butcher Ken 
Published: May 2016

Background and Purpose—
Early anticoagulation after cardioembolic stroke remains controversial because of the potential for hemorrhagic transformation (HT). We tested the safety and feasibility of initiating rivaroxaban ≤14 days after cardioembolic stroke/transient ischemic attack.

Methods—
A prospective, open-label study of patients with atrial fibrillation treated with rivaroxaban ≤14 days of transient ischemic attack or ischemic stroke (National Institute of Health Stroke Scale <9). All patients underwent magnetic resonance imaging <24 hours of rivaroxaban initiation and day 7. The primary end point was symptomatic HT at day 7.

Results—
Sixty patients (mean±SD age 71±19 years, 82% stroke/18% transient ischemic attack) were enrolled. Median (interquartile range) time from onset to rivaroxaban was 3 (5) days. At treatment initiation, median National Institute of Health Stroke Scale was 2 (4), and median diffusion-weighted imaging volume was 7.9 (13.7) mL. At baseline, HT was present in 25 (42%) patients (hemorrhagic infarct [HI]1=19, HI2=6). On follow-up magnetic resonance imaging, no patients developed symptomatic HT. New asymptomatic HI1 developed in 3 patients, and asymptomatic progression from HI1 to HI2 occurred in 5 patients; otherwise, HT remained unchanged at day 7.

Conclusions—
These data support the safety of rivaroxaban initiation ≤14 days of mild–moderate cardioembolic stroke/transient ischemic attack. Magnetic resonance imaging evidence of petechial HT, which is common, does not appear to increase the risk of symptomatic HT.
Constructing Spirituality
Authors: Sheldrake Philip 
Published: May 2016

How we define “spirituality” and also distinguish and describe different traditions of spirituality is not a simple matter of objective observation. All definitions and descriptions are a matter of interpretation which, in turn, involves preferences, assumptions and choices. In that sense, our approaches to spirituality may often be effectively “political” in that they express values and commitments. Sometimes our historical narratives also reflect the interests of dominant groups – whether in a religious institutional, theological or socio-cultural sense. This process may sometimes be conscious but is more often unconscious and uncritical. This essay first of all explores some of the issues surrounding the question of definition in the study and presentation of Christian spirituality in particular. Second, the essay examines how the history of Christian spirituality has been shaped by certain underlying “narratives”. However, following the thought of Paul Ricoeur, narrative and story are not to be rejected in favour of a quest for history as a form of pure factual “truth”. Rather, what is needed is a more conscious understanding of the power of narrative, its importance and the potential released by identifying forgotten or repressed human stories. Third, the essay then asks whether our approaches to, and descriptions of, particular spiritual traditions have masked prior assumptions about their autonomy, purity and their radical discontinuity (or “rupture”) from what went before or what lies alongside them. Two examples are briefly outlined: the supposed Catholic-Protestant spiritual divide and the often unacknowledged impact of another faith (for example, Sufi Islam) on certain Christian spiritual or mystical traditions. Fourth, the regular geographical-cultural biases in the study of Christian spirituality are noted and one response to this among Spanish-speaking Christians of the Americas, known as “traditioning”, is outlined. Finally, the importance of critical self-awareness in how we employ interpretative frameworks is underlined.
Description of a new species of the genus Hyalessa China (Hemiptera: Cicadidae: Sonatini) from Yunnan, China, with a key to the species of Hyalessa and a calling song analysis for two Hyalessa species
Authors: PUISSANT STÉPHANE , LEE YOUNG JUNE 
Published: May 2016

A new species, Hyalessa scutata sp. nov., is described from Yunnan, China. This species is similar to Hyalessa fuscata (Distant, 1905) but is distinguished by the larger male opercula and the evenly narrow uncal lobe. Hyalessa ella (Lei & Chou, 1997) syn. nov. is synonymized with Hyalessa stratoria (Distant, 1905). A detailed sound analysis of the calling songs of Hyalessa fuscata (Distant, 1905) and Hyalessa maculaticollis (De Motschulsky, 1866) is provided. A key to the species of Hyalessa China, 1925 is also provided. A discussion is conducted for the first time about the presence of potential hybrids between H. maculaticollis and H. fuscata within Tsushima Island situated in the Korea Strait.
Building Memory
Authors: Wilson Kristi M. 
Published: May 2016

The U.S.-backed Latin American military dictatorships of the 1970s and 1980s resulted in a lack of documentary evidence about the lives of thousands of political activists, intellectuals, union leaders, and everyday people who were tortured and disappeared by their own governments. In Argentina, people have attempted to come to terms with such horrific past events in a variety of ways that are neither static nor univocal. The dynamic process of memory building is influenced by ongoing political debates, shifting power dynamics, global markets, social movements, and a host of other factors such as justice policies. Spaces of memory and museums created in former clandestine centers of torture and disappearance bring to light a politics of truth that works against and reframes a history of silence through impunity. Parte del legado de las dictaduras militares latinoamericanas de los años 70 y 80 apo-yadas por los Estados Unidos es la carencia de pruebas documentales acerca de las vidas de miles de militantes políticos, intelectuales, líderes sindicales y gente común que fueron torturados y desaparecidos por sus propios gobiernos. En la Argentina, la gente ha tratado de lidiar con estos horribles hechos del pasado por medio de una variedad de formas que no son ni estáticas ni unívocas. El proceso dinámico de construir la memoria está influenciado por los debates políticos en curso, las cambiantes dinámicas de poder, los mercados globales, los movimientos sociales y una gama de otros factores tales como las políticas judiciales. Los espacios de la memoria y los museos creados en antiguos centros de tortura y desapariciones clandestinos como el ESMA y el Olimpo ponen de manifiesto una política de la verdad que de forma visual actúa en contra de una historia del silencio guiada por la impunidad y la redefine.
Anterolateral Advancement Pharyngoplasty
Authors: Emara Tarek Abdelzaher , Hassan Mostafa Hasan , Mohamad Abdelraoof Saeed , Anany Ahmad Mohamad , Ebrahem Ahmad Elsayed 
Published: May 2016

ObjectiveTo investigate the efficacy of anterolateral advancement pharyngoplasty to enlarge pharyngeal airspace and to decrease palatal and lateral pharyngeal wall collapse in the treatment of obstructive sleep apnea (OSA).Study DesignProspective study.SettingUniversity medical hospital.Subjects and MethodForty‐one patients underwent an anterolateral advancement pharyngoplasty procedure according to the following criteria: body mass index <30 kg/m2, Friedman stage II or III, type I Fujita, nocturnal polysomnography diagnostic of OSA, retropalatal and lateral pharyngeal collapse, and diagnosis with flexible nasoendoscopy during a Müller’s maneuver based on a 5‐point scale. Patients with retroglossal airway collapse were excluded from the study. The principle of this technique is to advance and fix the palatopharyngeus muscle with the superior pharyngeus constrictor muscle without transecting any of their fascicules anterolateral to the pterygomandibular raphe and anterosuperior to the levator veli palatine muscle.ResultsPre‐ and postoperative polysomnography findings (mean ± SD) showed significant statistical differences: apnea hypopnea index (AHI) decreased from 42.1 ± 16.34 to 16.3 ± 10.3 (P ≤. 001); percentage of time with oxyhemoglobin saturation <90% decreased from 18.5% ± 4.2% to 10.1% ± 1.3% (P ≤. 001); and lowest oxygen saturation level increased from 79.9% ± 14.8% to 89.3% ± 11.1% (P ≤. 05). The mean time for patients to return to a normal diet was 12.2 days. There was no postoperative bleeding, velopharyngeal insufficiency, speech alternations, or taste loss. Based on a threshold of a 50% reduction in AHI and AHI <20, surgical success was 86.8%.ConclusionAnterolateral advancement pharyngoplasty appears to be an effective technique with a high surgical success rate in the treatment of OSA patients with lateral pharyngeal wall collapse.
Systematic Review and Meta‐analysis of Surgical Complications following Cochlear Implantation in Canal Wall Down Mastoid Cavities
Authors: Hunter Jacob B. , O’Connell Brendan P. , Wanna George B. 
Published: May 2016

ObjectiveWe sought to assess the complication rates following cochlear implantation in canal wall down mastoid cavities in adults and children.Data SourcesA systematic review of English articles from PubMed, Web of Science, EMBASE, and the Cochrane Library. Additional studies were identified by reviewing the reference lists of the originally identified studies.Review MethodsStudies were included that reported on surgical outcomes following cochlear implantation in canal wall down mastoid cavities. Two authors, using predefined data fields, independently reviewed all articles while tabulating study quality indicators. A meta‐analysis of proportions was conducted on select cohorts to determine weighted complication rates.ResultsForty‐two articles were included that accounted for 424 patients and described surgical outcomes following cochlear implantation in canal wall down mastoid cavities. In a comparison of the postoperative complication rates, overclosing the external auditory meatus had significantly fewer global complications than did maintaining a canal wall down mastoid cavity (P =. 027). In a comparison of the complication rates (1) between staging the cochlear implantation and performing external auditory meatus overclosure simultaneously with cochlear implantation and (2) between pediatric and adult cochlear implantation recipients with external auditory meatus overclosure, there were no significant differences (P =. 085 and P =. 92, respectively).ConclusionOverclosing the external auditory meatus at the same time of cochlear implantation leads to significantly fewer complications when compared with maintaining a canal wall down mastoid cavity with soft tissue coverage of the electrode array.
Incidence and Risk Factors for Prolonged Hospitalization and Readmission after Transsphenoidal Pituitary Surgery
Authors: Bur Andrés M. , Brant Jason A. , Newman Jason G. , Hatten Kyle M. , Cannady Steven B. , Fischer John P. , Lee John Y. K. , Adappa Nithin D. 
Published: May 2016

ObjectiveTo evaluate the incidence and factors associated with 30‐day readmission and to analyze risk factors for prolonged hospital length of stay following transsphenoidal pituitary surgery.Study DesignRetrospective longitudinal claims analysis.SettingAmerican College of Surgeons National Surgical Quality Improvement Program.Subjects and MethodsThe database of the American College of Surgeons National Surgical Quality Improvement Program was queried for patients who underwent transsphenoidal pituitary surgery (Current Procedural Terminology code 61548 or 62165) between 2005 and 2014. Patient demographic information, indications for surgery, and incidence of hospital readmission and length of stay were reviewed. Risk factors for readmission and prolonged length of stay, defined as >75th percentile for the cohort, were identified through logistic regression modeling.ResultsA total of 1006 patients were included for analysis. Mean hospital length of stay after surgery was 4.1 ± 0.2 days. Predictors of prolonged length of stay were operative time (P <. 001, odds ratio [OR] = 1.7, 95% confidence interval [95% CI] = 1.5‐2.0), bleeding disorder (P =. 049, OR = 3.1, 95% CI = 1.0‐9.5), insulin‐dependent diabetes (P =. 007, OR = 2.4, 95% CI = 1.3‐4.4), and reoperation (P <. 001, OR = 10.3, 95% CI = 4.7‐23.9). In a subset analysis of 529 patients who had surgery between 2012 and 2014, 7.2% (n = 38) required hospital readmission. History of congestive heart failure (CHF) was a predictor of hospital readmission (P = 0.03, OR = 12.7, 95% CI = 1.1‐144.0).ConclusionThis review of a large validated surgical database demonstrates that CHF is an independent predictor of hospital readmission after transsphenoidal surgery. Although CHF is a known risk factor for postoperative complications, it poses unique challenges to patients with potential postoperative pituitary dysfunction.
Does the Press Ganey Survey Correlate to Online Health Grades for a Major Academic Otolaryngology Department?
Authors: Ryan Timothy , Specht Jessica , Smith Sarah , DelGaudio John M. 
Published: May 2016

ObjectivesAnalyze the correlation between online‐based review websites and the Press Ganey Patient Satisfaction Survey (PGPSS) in an academic otolaryngology department.Study DesignRetrospective cross sectional.SettingTertiary academic institution.MethodsAll available data were collected for Vitals.com and Healthgrades.com, along with PGPSS data for 16 otolaryngology attending physicians from 2012 to 2014. A mean rating was calculated for each topic category for online websites and compared with 7 PGPSS content questions using zero‐order correlations. A paired t test was used to analyze the difference between the PGPSS and online scores.ResultsThere were no statistically significant correlations between time spent with the patient (r = 0.391, P =. 208) and overall provider scores (r = 0.193, P =. 508) when compared between Vitals.com and the PGPSS. The correlations were not statistically significant when Healthgrades.com was compared with the PGPSS in the items “probability of recommending the provider” (r = −0.122, P =. 666) and “trust in provider” (r = −0.025, P =. 929). The most important factors in a patient recommending the provider were as follows, per resource: time spent with the patient for Vitals.com (r = 0.685, P =. 014), listening for Healthgrades.com (r = 0.981, P ≤. 001), and trust in the provider for the PGPSS (r = 0.971, P ≤. 001).ConclusionThis study suggests that online‐based reviews do not have statistically significant correlations with the widely used PGPSS and may not be an accurate source of information for patients. Patients should have access to the most reliable and least biased surveys available to the public to allow for better‐informed decisions regarding their health care.
The impact of tabalumab on the kidney in systemic lupus erythematosus: results from two phase 3 randomized, clinical trials
Authors: Rovin B H , Dooley M A , Radhakrishnan J , Ginzler E M , Forrester T D , Anderson P W 
Published: May 2016

Introduction Tabalumab is a monoclonal antibody that neutralizes membrane and soluble B-cell activating factor. Two 52-week, randomized, double-blind, placebo controlled phase 3 trials evaluated the safety and efficacy of tabalumab in systemic lupus erythematosus. Methods Patients with moderate to severe active systemic lupus erythematosus (without severe active lupus nephritis) were randomly assigned 1:1:1 to receive tabalumab (120 mg subcutaneously every 2 or 4 weeks) or placebo for 52 weeks. Serum creatinine concentration, estimated glomerular filtration rate, urine protein/creatinine ratio, renal flares and renal adverse events were determined monthly. Data were analyzed for the intent-to-treat population and for intent-to-treat patients with baseline urine protein/creatinine ratio >20 mg/mmol (intent-to-treat plus urine protein/creatinine ratio). Results The trials enrolled 2262 patients. At baseline, demographics, systemic lupus erythematosus disease activity, serum creatinine concentration, estimated glomerular filtration rate and urine protein/creatinine ratio were similar among the treatment arms (with the exception of disease duration). In the intent-to-treat and intent-to-treat plus urine protein/creatinine ratio populations, there were no differences between the arms in the baseline-to-endpoint change in serum creatinine concentration, glomerular filtration rate, urine protein/creatinine ratio, or renal flare rates. Tabalumab resulted in a significant B-cell reduction and decreased immunoglobulin G levels at both doses. Conclusions Compared to placebo, tabalumab did not significantly affect the serum creatinine concentration, glomerular filtration rate, urine protein/creatinine ratio, or renal flare rates over 1 year in intent-to-treat or intent-to-treat plus urine protein/creatinine ratio patients. There were no significant renal safety signals. ClinicalTrials.gov identifiers: NCT01205438 and NCT01196091 Lupus (2016) 25, 1597–1601.
Nurses’ narratives of moral identity: Making a difference and reciprocal holding
Authors: Peter Elizabeth , Simmonds Anne , Liaschenko Joan 
Published: May 2016

Background: Explicating nurses’ moral identities is important given the powerful influence moral identity has on the capacity to exercise moral agency. Research objectives: The purpose of this study was to explore how nurses narrate their moral identity through their understanding of their work. An additional purpose was to understand how these moral identities are held in the social space that nurses occupy. Research design: The Registered Nurse Journal, a bimonthly publication of the Registered Nurses’ Association of Ontario, Canada, features a regular column entitled, ‘In the End … What Nursing Means to Me …’ These short narratives generally include a story of an important moment in the careers of the authors that defined their identities as nurses. All 29 narratives published before June 2015 were analysed using a critical narrative approach, informed by the work of Margaret Urban Walker and Hilde Lindemann, to identify a typology of moral identity. Ethical considerations: Ethics approval was not required because the narratives are publicly available. Findings: Two narrative types were identified that represent the moral identities of nurses as expressed through their work: (1) making a difference in the lives of individuals and communities and (2) holding the identities of vulnerable individuals. Discussion: Nurses’ moral identities became evident when they could see improvement in the health of patients or communities or when they could maintain the identity of their patients despite the disruptive forces of illness and hospitalization. In reciprocal fashion, the responses of their patients, including expressions of gratitude, served to hold the moral identities of these nurses. Conclusion: Ultimately, the sustainability of nurses’ moral identities may be dependent on the recognition of their own needs for professional satisfaction and care in ways that go beyond the kind of acknowledgement that patients can offer.
Psychiatry and the ‘Gay Holocaust’ – the lessons of Jill Soloway’s Transparent
Authors: Robertson Michael D , Light Edwina , Walter Garry , Lipworth Wendy 
Published: May 2016

Objective: We aim to consider issues relevant to psychiatry raised by the television series, Transparent. Conclusions: Psychiatry’s disturbing history regarding the lesbian, gay, bisexual, transgender and intersex (LGBTI) community shares many aspects with the group’s persecution by the National Socialist regime in Germany. The medicalised ‘otherness’ conferred on LGBTI patients, latent homophobia and transphobia, and lack of culturally sensitive clinical services for these people represent a major ethical challenge for modern Australasian psychiatry.