bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adherence and barriers to hyperinsufflation in children with congenital muscular dystrophy
Authors: Pascoe John E. , Sawnani Hemant , Mayer Oscar H. , McConnell Keith , McDonough Joseph M. , White Cynthia , Rutkowski Anne M. , Amin Raouf S. , Modi Avani C. 
Published: November 2016

SummaryBackgroundCongenital muscular dystrophy (CMD) is a rare, inherited neuromuscular disease characterized by progressive muscle weakness, thoracic insufficiency, and ultimately respiratory failure. Adherence to respiratory therapies in children with neuromuscular disorders is unknown. This study examined the multimodal assessment of adherence and barriers to 15 min, twice daily hyperinsufflation in children with CMD. Adherence was hypothesized to be greater than 50% and discomfort, embarrassment, and difficulty finding time were hypothesized to be barriers.MethodsParticipants included 18 children with CMD. Personalized hyperinsufflation settings were determined based on pressure–volume measurements at each study visit. Adherence was measured by a daily phone diary (DPD) and by electronic data download from the hyperinsufflation device. The DPD was conducted twice over a 48‐hr period to capture a weekend and weekday, with the goal being 60 min of hyperinsufflation over the 48 hr (100% adherence). The hyperinsufflation objective electronic data reflected daily use of hyperinsufflation for the same 48‐hr period. Data from DPD and the corresponding hyperinsufflation device data were used for analyses.ResultsAdherence to hyperinsufflation was 40% via DPD and 44% for electronic data, with strong convergence between methods (r = 0.75, P < 0.001). Surprisingly, 53% of participants reported no barriers despite low adherence. Social distractions and family obligations were identified as barriers. There were no differences in adherence between those who did and did not endorse barriers to hyperinsufflation (DPD: t(13) = 0.44, P = n.s.; hyperinsufflation device: t(13) = −0.23, P = n.s.).ConclusionAdherence to hyperinsufflation is a significant problem in children with CMD and families have difficulty identifying adherence barriers. An important next step is to encourage open dialog around adherence barriers and promote adherence behaviors via intervention. Pediatr Pulmonol. 2017; 52:939–945. © 2016 Wiley Periodicals, Inc
A computational study of substituent effects on the stability and geometry of carbazole‐pyridine complexes
Authors: Ziegler Eric W. , Baum James Clayton , Brown Alan B. , Blaustein Gail S. 
Published: November 2016

AbstractHydrogen bonding between carbazole and pyridine is known to quench fluorescence emission of carbazole. Three carbazolopyridinophanes—compounds composed of carbazole and pyridine subunits such that an intramolecular hydrogen bond may exist between them—have been pursued as reversible fluorescent sensors that detect given analytes through fluorescence restoration. However, these sensors exhibit background fluorescence believed to be related to the proportion of non‐hydrogen‐bonded conformers present. In this computational investigation, the potential energy surfaces of various hydrogen‐bonded carbazole:pyridine complexes are investigated using density functional theory with the intent of explaining the observed background fluorescence for the carbazolopyridinophanes. The results indicate carbazolopyridinophane conformers most resembling the geometry of their corresponding free carbazole:pyridine complexes exhibit the least background fluorescence.
Exploring hypergraphs with martingales
Authors: Bollobás Béla , Riordan Oliver 
Published: November 2016

ABSTRACTRecently, in [Random Struct Algorithm 41 (2012), 441–450] we adapted exploration and martingale arguments of Nachmias and Peres [ALEA Lat Am J Probab Math Stat 3 (2007), 133–142], in turn based on ideas of Martin‐Löf [J Appl Probab 23 (1986), 265–282], Karp [Random Struct Alg 1 (1990), 73–93] and Aldous [Ann Probab 25 (1997), 812–854], to prove asymptotic normality of the number L1 of vertices in the largest component of the random r‐uniform hypergraph in the supercritical regime. In this paper we take these arguments further to prove two new results: strong tail bounds on the distribution of L1, and joint asymptotic normality of L1 and the number M1 of edges of in the sparsely supercritical case. These results are used in [Combin Probab Comput 25 (2016), 21–75], where we enumerate sparsely connected hypergraphs asymptotically. © 2016 Wiley Periodicals, Inc. Random Struct. Alg., 50, 325–352, 2017
Cardiac output and blood flow redistribution in fetuses with D‐loop transposition of the great arteries and intact ventricular septum: insights into pathophysiology
Authors: Godfrey M. E. , Friedman K. G. , Drogosz M. , Rudolph A. M. , Tworetzky W. 
Published: November 2016

ABSTRACTObjectivesAlthough the postnatal physiology of D‐loop transposition of the great arteries with intact ventricular septum (D‐TGA/IVS) is well established, little is known about fetal D‐TGA/IVS. In the normal fetus, the pulmonary valve (PV) is larger than the aortic valve (AoV), there is exclusive right‐to‐left flow at the foramen ovale (FO) and ductus arteriosus (DA), and the left ventricle (LV) ejects 40% of combined ventricular output (CVO) through the aorta, primarily to the brain. In D‐TGA/IVS, the LV ejects oxygen‐rich blood to the pulmonary artery, theoretically leading to pulmonary vasodilation, increased branch pulmonary artery flow and reduced DA flow. In this study, we tested the hypothesis that D‐TGA/IVS anatomy results in altered cardiac valve sizes, ventricular contribution to CVO, and FO and DA flow direction.MethodsSeventy‐four fetuses with D‐TGA/IVS that underwent fetal echocardiography at our institution between 2004 and 2015 were included in the study. AoV, PV, mitral valve and tricuspid valve sizes were measured and Z‐scores indexed to gestational age were generated. Ventricular output was calculated using Doppler‐derived velocity‐time integral, and direction of flow at the FO and DA shunts was recorded in each fetus using both color Doppler and flap direction. Measurements in the D‐TGA/IVS fetuses were compared with data of 222 controls, matched for gestational‐age range, from our institutional normal fetal database.ResultsThe LV component of CVO was higher in D‐TGA/IVS fetuses than in controls (50.7% vs 40.2%; P < 0.0001), with no difference in the total CVO. Flow was bidirectional at the FO in 56 (75.7%) and at the DA in 24 (32.4%) D‐TGA/IVS fetuses. Only 21.6% fetuses had normal right‐to‐left flow at both shunts. Bidirectional shunting was more common in third‐trimester fetuses than in second‐trimester ones (P < 0.03). AoV and PV diameters were nearly identical in D‐TGA/IVS in contrast to control fetuses, hence AoV Z‐score was higher than PV Z‐score (1.13 vs –0.65, P < 0.0001) in D‐TGA/IVS.ConclusionsIn fetuses with D‐TGA/IVS there is loss of the normal right‐sided dominance, as each ventricle provides half of the CVO, with a relatively large AoV diameter and a small PV diameter, and high incidence of bidirectional FO and DA flow. This may support the theory that high pulmonary artery oxygen content reduces pulmonary vascular resistance, thereby increasing branch pulmonary artery flow and venous return, which results in increased LV preload and output. Pulmonary sensitivity to oxygen is thought to increase later in gestation, which may explain the higher incidence of bidirectional shunting. Consequences of these flow alterations include increased aortic and, most likely, brain flow, perhaps in an attempt to compensate for the substrate deficiency observed in D‐TGA/IVS. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
Performance analysis of two‐way MAC layer network coding under finite relay buffer and non‐negligible signalling overhead
Authors: Shi Shijie , Ni Wei , Liu Ren Ping , Li Shiyin 
Published: November 2016

AbstractTwo‐way exclusive OR (XOR) relay can enable hidden nodes to exchange data with low delays and high data rate, while keeping signal processing simple. In this paper, we analyse practical two‐way XOR relaying systems, where finite relay buffer, non‐negligible signalling overhead, and lossy wireless channels are all captured. A two‐layer model is developed to characterise such practical two‐way relay systems, which is then reformulated into a Markov process after we project and combine inter‐layer state transitions of the two‐layer model. Using Markov techniques, we evaluate the steady state probabilities of the Markov process and, in turn, the key performance measures of two‐way XOR relaying, such as throughput, delay, and packet loss. The accuracy of our model is validated by simulations. Our model can also be used as an online tool to configure the buffer resources, adapting to wireless channel conditions and signalling requirements. Copyright © 2016 John Wiley & Sons, Ltd.
Perfect timing: splicing and transcription rates in living cells
Authors: Alpert Tara , Herzel Lydia , Neugebauer Karla M. 
Published: November 2016

An important step toward understanding gene regulation is the elucidation of the time necessary for the completion of individual steps. Measurement of reaction rates can reveal potential nodes for regulation. For example, measurements of in vivo transcription elongation rates reveal regulation by DNA sequence, gene architecture, and chromatin. Pre‐mRNA splicing is regulated by transcription elongation rates and vice versa, yet the rates of RNA processing reactions remain largely elusive. Since the 1980s, numerous model systems and approaches have been used to determine the precise timing of splicing in vivo. Because splicing can be co‐transcriptional, the position of Pol II when splicing is detected has been used as a proxy for time by some investigators. In addition to these ‘distance‐based’ measurements, ‘time‐based’ measurements have been possible through live cell imaging, metabolic labeling of RNA, and gene induction. Yet splicing rates can be convolved by the time it takes for transcription, spliceosome assembly and spliceosome disassembly. The variety of assays and systems used has, perhaps not surprisingly, led to reports of widely differing splicing rates in vivo. Recently, single molecule RNA‐seq has indicated that splicing occurs more quickly than previously deduced. Here we comprehensively review these findings and discuss evidence that splicing and transcription rates are closely coordinated, facilitating the efficiency of gene expression. On the other hand, introduction of splicing delays through as yet unknown mechanisms provide opportunity for regulation. More work is needed to understand how cells optimize the rates of gene expression for a range of biological conditions. WIREs RNA 2017, 8:e1401. doi: 10.1002/wrna.1401This article is categorized under:

RNA-Based Catalysis > RNA Catalysis in Splicing and Translation
RNA Interactions with Proteins and Other Molecules > RNA–Protein Complexes
RNA Processing > Splicing Mechanisms
C‐Reactive Protein Indicates Early Stage of Postoperative Infectious Complications in Patients Following Minimally Invasive Esophagectomy
Authors: Miki Yuichiro , Toyokawa Takahiro , Kubo Naoshi , Tamura Tatsuro , Sakurai Katsunobu , Tanaka Hiroaki , Muguruma Kazuya , Yashiro Masakazu , Hirakawa Kosei , Ohira Masaichi 
Published: November 2016

AbstractBackgroundEsophagectomy for patients with esophageal cancer is associated with high rate of postoperative infectious complications (PICs). Although minimally invasive esophagectomy (MIE) could reduce the rate of PICs, its incidence cannot be ignored. Early detection of PICs may be beneficial in clinical settings. We investigated whether systemic inflammation markers, such as C‐reactive protein (CRP) and white blood cell count (WBC), are useful for the early detection of PICs.MethodWe reviewed 158 patients who underwent MIE from 2000 to 2015 and assessed PIC incidence and severity. The value of CRP and WBC in the early detection of PICs was evaluated by receiver operating characteristics analyses. Univariate and multivariate analyses were performed to identify severe PICs risk factors (Clavien–Dindo classification, grade IIIa or higher).ResultsThirty patients developed PICs: grades III, IV, and V in 19 (12.0%), 9 (5.7%), and 2 (1.3%) patients, respectively. CRP on 4POD showed the highest value for detection of PICs (AUC = 072). Cutoff value of CRP on 4POD was determined as 11.1 (mg/dL), in which the sensitivity and specificity were the maximum value. The univariate analysis revealed that sex (male), operation time (≥597 min), and CRP on 4POD (≥11.1 mg/dL) were significant factors for detecting PICs. Multivariate analyses showed that operation time (≥597) and CRP on 4POD (≥11.1 mg/dL) were independent significant factors for detecting PICs.ConclusionsCRP on 4POD ≥11.1 mg/dL was an independent PICs risk factor in patients who underwent MIE. It will be beneficial for the early detection of PICs following MIE.
Perioperative Risks of Dietary and Herbal Supplements
Authors: Levy Ilana , Attias Samuel , Ben‐Arye Eran , Goldstein Lee , Matter Ibrahim , Somri Mostafa , Schiff Elad 
Published: November 2016

AbstractBackgroundPatients undergoing surgery often use Dietary and Herbal Supplements (DHS). We explored the risk of DHS–drug interactions in the perioperative setting.MethodsIn this cross‐sectional prospective study, participants hospitalized for surgery completed a questionnaire regarding DHS use. We used pharmacological databases to assess DHS–drug interactions. We then applied univariate and multivariate logistic regression analyses to characterize patients at risk for DHS–drug interactions.ResultsOf 526 interviewees, 230 (44%) patients reported DHS use, with 16.5% reporting using DHS that could potentially interact with anesthesia. Twenty‐four (10%) patients used DHS that could potentially interact with antithrombotic drugs taken perioperatively. The medical files of three patients included reports of intraoperative bleeding. The patient files of only 11% of DHS users documented DHS use.ConclusionsDHS use poses a significant health risk due to potential interactions. Guidelines should emphasize perioperative management of DHS use.
Does MRI of the Thoracolumbar Spine Change Management in Blunt Trauma Patients with Stable Thoracolumbar Spinal Injuries Without Neurologic Deficits?
Authors: Deramo Paul , Agrawal Vaidehi , Amos Joseph , Patel Nimesh , Jefferson Henry 
Published: November 2016

AbstractBackgroundIn blunt trauma patients with computed tomography (CT) findings of stable thoracolumbar (TL) spinal injury without neurologic deficits, magnetic resonance imaging (MRI) studies are commonly obtained, though the impact on overall management remains unclear. The indication for MRI in patients with TL injury without neurologic deficits continues to remain unclear. Here, we evaluate the role of MRI on clinical management of patients presenting with this diagnosis.MethodsAfter IRB approval, all registry patients from December 2005 to December 2015 with all blunt TL injuries without defects were extracted. General demographics, injury parameters, hospital and ICU length of stay (ILOS/HLOS), CT/MRI findings, and intervention were collected. Impact of variant ISS in the four groups was corrected by dividing HLOS and ILOS by ISS. The Student’s t test was conducted for statistical analysis.ResultsOf 613 patients, 236 met the inclusion criteria with average age of 52 ± 23 y, ISS (7 ± 4), HLOS (5 ± 3 days), and ILOS (1 ± 2 days). One hundred and thirty‐three patients underwent MRI, and 103 patients underwent CT only. Patients who underwent MRI were no more likely to attain intervention (p < 0.06) but had longer length of stay relative to ISS (p < 0.006).ConclusionsMRI did not affect rate of intervention though increased HLOS accounting for ISS. CT findings of stability were concordant with MRI findings. Our results suggest that MRI may not affect intervention decisions in blunt trauma patients with CT findings of stable thoracolumbar spinal injury without neurological deficits.
Hospital for Special Surgery ACL Registry: 2-Year Outcomes Suggest Low Revision and Return to OR Rates
Authors: McCarthy Moira , Mallett Katherine , Abola Matthew , Vassallo Sherrie , Nguyen Joseph 
Published: November 2016

Background Anterior cruciate ligament (ACL) injuries are among the most common knee injuries. Patient outcomes, rate of subsequent operations, and rate of subsequent ACL reconstruction following primary ACL reconstruction need to be evaluated. Questions/Purposes This study was designed to answer the following questions: (1) What is the return to surgery (OR) rate following primary ACL reconstruction and (2) what is the revision ACL reconstruction rate? Methods Data was drawn from the Hospital for Special Surgery (HSS) ACL Registry. International Knee Documentation Committee (IKDC) Subjective Knee Evaluation, Lysholm-Tegner Scales, Marx Activity Scale, and SF12 were completed by patients at baseline, 1-, and 2-year follow-up. Clinical data and intraoperative data were registered by surgeons on an intraoperative form. Subsequent surgery rates were determined by evaluating the medical records for subsequent surgery, laterality, surgeon, procedure description, and type of anesthesia. Results The majority of the ACL reconstructions performed were autograft (76.6%) with the most common graft being bone-patellar tendon-bone (BTB) autograft (47.2%), hamstring autograft (21.9%), and Achilles allograft (18.2%). Average IKDC score improved from 51.9 (SD 16.1) at baseline to 83.5 (SD 14.2) at 2-year follow-up. Females had a 2.5-point lower IKDC and 1.4-point Marx scores compared to males. Of the enrolled patients, 7.3% had revision ACL surgery with 70.4% being ipsilateral ACL surgery. Of the enrolled patients, 10.3% had subsequent knee surgery with 72.3% being ipsilateral knee surgery. Multivariable logistic regression analysis showed that patients less than 18 years of age at the time of their index surgery were over three times more likely to undergo a revision ACL reconstruction compared to older patients and were at four times higher risk than older patients for any subsequent knee surgery. Conclusion Understanding ACL surgery, patient outcomes, and risk factors for revision ACL surgery and subsequent knee surgery after primary ACL reconstruction is essential. Patients less than 18 years of age have a higher risk of subsequent knee surgery and subsequent ACL surgery than older patients.
Multimodal Pain Management for Enhanced Recovery: Reinforcing the Shift From Traditional Pathways Through Nurse‐Led Interventions
Authors: Montgomery Robert , McNamara Sharon A. 
Published: November 2016

AbstractDespite recent advances in perioperative patient care, postsurgical pain continues to be undermanaged. There is increasing acceptance of the concept that effective postsurgical pain management is best achieved through combined use of more than one analgesic agent or technique, and overreliance on opioids produces unwanted side effects limiting their utility. Accordingly, a balanced, multimodal approach to pain management within the larger framework of an Enhanced Recovery After Surgery (ERAS) pathway has become standard at many institutions for perioperative care, to control postsurgical pain, reduce opioid‐related adverse events, hasten postsurgical recovery, and shorten length of hospital stay. The success of ERAS is dependent on nurses and the multidisciplinary team to execute its standardized processes across the care continuum, including patient education, perioperative care, and postsurgical evaluation. Here, we review current concepts related to multimodal analgesia and ERAS regarding care of adult surgical patients and discuss the perioperative nurse's role within this paradigm.
Circadian alterations during early stages of Alzheimer's disease are associated with aberrant cycles of DNA methylation in BMAL1
Authors: Cronin Peter , McCarthy Michael J. , Lim Andrew S.P. , Salmon David P. , Galasko Douglas , Masliah Eliezer , De Jager Philip L. , Bennett David A. , Desplats Paula 
Published: November 2016

AbstractIntroductionCircadian alterations are prevalent in Alzheimer's disease (AD) and may contribute to cognitive impairment, behavioral symptoms, and neurodegeneration. Epigenetic mechanisms regulate the circadian clock, and changes in DNA methylation have been reported in AD brains, but the pathways that mediate circadian deregulation in AD are incompletely understood. We hypothesized that aberrant DNA methylation may affect circadian rhythms in AD.MethodsWe investigated DNA methylation, transcription, and expression of BMAL1, a positive regulator of the circadian clock, in cultured fibroblasts and brain samples from two independent cohorts of aging and AD.ResultsDNA methylation modulated rhythmic expression of clock genes in cultured fibroblasts. Moreover, rhythmic methylation of BMAL1 was altered in AD brains and fibroblasts and correlated with transcription cycles.DiscussionOur results indicate that cycles of DNA methylation contribute to the regulation of BMAL1 rhythms in the brain. Hence, aberrant epigenetic patterns may be linked to circadian alterations in AD.
The risk of pain syndrome affecting a previously non-painful limb following trauma or surgery in patients with a history of complex regional pain syndrome
Authors: Satteson Ellen S. , Harbour Patrick W. , Koman L. Andrew , Smith Beth P. , Li Zhongyu 
Published: November 2016

Abstract

Background and purpose
Complex regional pain syndrome (CRPS) is a challenging complication after surgery or trauma. This study sought to determine the incidence of CRPS after a second inciting event in a previously unaffected extremity in patients with a history of an ongoing CRPS diagnosis in another extremity.

Methods
A retrospective review identified patients with CRPS seen in clinic over a 20-month period. The incidence of CRPS after subsequent surgery or injury in a previous unaffected extremity was determined and compared to an average incidence reported in the literature.

Results
Ninety-three patients had a diagnosis of primary CRPS. Nineteen (20.4%) developed CRPS in one or more additional extremity compared to the incidence of 23.4 per 100,000 (0.0234%) in the literature (odds ratio 1069.6, p < 0.0001,95% CI 562.0–2035.7). Twenty patients had a documented secondary injury or surgery in a second extremity. Fifteen (75%) developed secondary CRPS compared to a CRPS incidence rate of 6.4% following distal radius fracture, as determined by literature review (odds ratio 11.7, p < 0.001, 95% CI 5.9–23.2).

Conclusions
These result suggest that patients with a history of CRPS are more likely to develop secondary CRPS compared to the rates reported in the literature among the general population.

Implications
Patients with a history of CRPS should be counselled that they may be at risk for developing secondary CRPS if they undergo surgery or sustain trauma to another extremity.