bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pathological and Molecular Aspects to Improve Endoscopic Ultrasonography–Guided Fine-Needle Aspiration From Solid Pancreatic Lesions
Authors: Matsubayashi Hiroyuki , Sasaki Keiko , Ono Sachiyo , Abe Masato , Ishiwatari Hirotoshi , Fukutomi Akira , Uesaka Katsuhiko , Ono Hiroyuki 
Published: January 2018

Abstract
Endoscopic ultrasonography–guided fine-needle aspiration (EUS-FNA) has been applied to pancreatic lesions since the 1990s, and its use is now widespread. Improvements in endoscopic devices and sampling techniques have resulted in excellent diagnostic ability for solid pancreatic lesions. However, clinical improvements alone are not responsible for it; pathological aspects have also played important roles. Rapid on-site evaluation minimizes endoscopic procedures, although its value at improving the diagnostic ratio is still debated. Diagnostic efficacy differs by sample preparations (direct smear, cytospin, liquid-based cytology, cell block, and biopsy) and by staining methods (Papanicoloau, Diff-Quik, hematoxylin-eosin, and Giemsa). Several immunocytochemistry protocols aid in diagnosing epithelial components with cytological atypia and in differentiating various tumor types. One cytopathology diagnostic system is telecytology, which uses transmitted digital images and enables real-time diagnosis of EUS-FNA samples by expert cytologists at remote locations. However, EUS-FNA samples are useful for more than just diagnoses, as molecular analysis of these samples allows the identification of prognostic markers, such as genetic alterations in K-ras and EGFR. Expression of drug-metabolizing enzymes, human equilibrative nucleoside transporter 1, correlates with the response to gemcitabine-based chemotherapy. These pathology efforts have enhanced the diagnostic efficacy of EUS-FNA, thereby leading to better outcomes for patients with pancreatic diseases.
Self-Esteem and Anger in Borderline Patients With Self-Injury Behavior
Authors: Almeida Carla Maria , Horta Maria Purificação 
Published: January 2018

Abstract
Anger and low self-esteem characterize borderline individuals, yet little is known about their role and impact in the presence or absence of self-injury behavior. The present study aimed to investigate the impact of anger and self-esteem in borderline patients and whether these variables distinguish these patients with and without self-injury. Patients were recruited from a psychiatric service and were evaluated for self-esteem and anger. Additionally, impulsivity and symptoms were assessed. Two groups were compared, one with self-injurious behavior (n = 18) and another one without it (n = 23). Those who injure themselves seem to have a lower self-esteem (p < 0.001), yet the strengthening of self-esteem seems to have different outcomes, according to the presence or absence of self-injury. Anger and self-esteem seem to influence the severity of diagnosis, but only in patients who self-injure. Anger and self-esteem may influence borderline patients differently according to the presence or absence of self-injury.
Chronic Hematoma of the Neck
Authors: Angster Kristen H. , Da Costa Victor 
Published: January 2018

Abstract
Chronic hematomas are defined as hematomas with slow, progressive growth over many weeks. They are an extremely rare cause of acute neck swelling in the pediatric population. They consist of an organized central mass of blood with granulation tissue and fibrotic changes peripherally. The presence of a capsule prevents resorption but allows for intracapsular bleeding with subsequent expansion. We describe a case of a 6-year-old girl who presented to the emergency department with a spontaneously occurring left neck mass in the supraclavicular region. A possible neoplasm was suggested on imaging. The patient was referred to a head and neck surgeon, she underwent a thorough workup, and the mass was ultimately surgically excised. Histologically, the mass was confirmed to be a chronic hematoma. The patient recovered uneventfully, and there has been no recurrence.
Association Between Altered Hip Extension and Kinetic Gait Variables
Authors: Wonsetler Elizabeth C. , Miller Ellie L. , Huey Katherine L. , Frye Sarah E. , Bowden Mark G. 
Published: January 2018

Abstract
Kinematic and kinetic outcome measures are tightly linked in walking. Although altering motor output is a major goal of gait rehabilitation, little is understood regarding the relationship between altering a single kinematic variable and kinetic outcome changes. We designed a strategy to isolate hip extension alterations during walking on a treadmill to assess the change in kinetic outcomes. Ten healthy individuals walked on an instrumented split-belt treadmill with motion capture to calculate hip extension and kinetic outcomes at the following five different randomized cadences: self-selected cadence, self-selected ± 10%, and self-selected ± 20%. The treadmill speed was held constant at the individual's self-selected walking speed, forcing cadence changes to result in successful alterations to hip extension, varying 8.3 degrees from the self-selected −20% to +20% cadence conditions. Kinetic outcomes demonstrated similar alterations. Hip extension changes at each cadence significantly correlated with kinetic changes in propulsive impulse (r = 0.852, P < 0.001), peak ankle power (r = 0.473, P = 0.002), and ankle plantarflexion work (r = 0.762, P < 0.001). These results demonstrate that kinetic outcomes are highly alterable in response to a kinematic gait change. This clinically relevant finding highlights the potential to improve motor output in individuals during rehabilitation by altering gait patterns to achieve more optimal limb positions.
Brief Report: Higher ART Adherence Is Associated With Lower Systemic Inflammation in Treatment-Naive Ugandans Who Achieve Virologic Suppression
Authors: Castillo-Mancilla Jose R. , Morrow Mary , Boum Yap , Byakwaga Helen , Haberer Jessica E. , Martin Jeffrey N. , Bangsberg David , Mawhinney Samantha , Musinguzi Nicholas , Huang Yong , Tracy Russell P. , Burdo Tricia H. , Williams Kenneth , Muzzora Conrad , Hunt Peter W. , Siedner Mark J. 
Published: January 2018

Background:
Residual systemic inflammation persists despite suppressive antiretroviral therapy (ART) and is associated with non-AIDS clinical outcomes. We aimed to evaluate the association between ART adherence and inflammation in Ugandans living with HIV who were predominantly receiving nevirapine-based ART with a thymidine analog backbone and were virologically suppressed by conventional assays.

Methods:
Plasma concentrations of interleukin-6 (IL-6), D-dimer, soluble (s)CD14, sCD163, and the kynurenine/tryptophan ratio, in addition to CD8+ T-cell activation, were measured at baseline and 6 months after ART initiation in treatment-naive adults who achieved an undetectable plasma HIV RNA (<400 copies/mL) at their 6-month visit. Adherence was measured through medication event monitoring system and calculated as the ratio of observed/prescribed device openings per participant. We fit adjusted linear regression models to estimate the association between ART adherence and the log-transformed plasma concentrations of inflammatory biomarkers.

Results:
We evaluated 282 participants (median age, 35 years; 70% women). The median (interquartile range) adherence was 93% (84–98). In the adjusted analyses, for every 10% increase in average ART adherence, we found a 15% [P < 0.0001; 95% confidence interval (CI), −21.0 to −7.9], 11% (P = 0.017; 95% CI, −18.3 to −2.0), and 3% (P = 0.028; 95% CI, −5.0 to −0.3) decrease in IL-6, D-dimer, and sCD14, respectively.

Conclusions:
Higher ART adherence was associated with lower levels of biomarkers of inflammation, immune activation, and coagulopathy among Ugandans living with HIV who achieved viral suppression shortly after ART initiation. This suggests that ART adherence could have biological consequences beyond viral suppression. Whether ART adherence optimization in virologically suppressed individuals could reduce residual inflammation remains unknown.
Mycobacterium avium complex pulmonary disease: new epidemiology and management concepts
Authors: Lande Leah , George Jason , Plush Theodore 
Published: January 2018

Purpose of review
The prevalence of Mycobacterium avium complex (MAC)-related pulmonary disease has been increasing because of environmental factors, changes in organism virulence, and evolving host susceptibility. Treatment is often complicated by adverse effects, development of drug resistance, and refractory disease, with recurrence rates as high as 25–45%.

Recent findings
Aerosolization of water, soil, or dusts are the likely sources of MAC-related pulmonary disease in susceptible individuals. The management of MAC-related pulmonary disease requires a multimodality approach, including antimicrobial therapy in appropriate patients, employment of mucus clearance techniques, instituting changes in the individual's home environment and personal habits to reduce environmental exposure to MAC, prevention of reflux, and maintenance of a healthy body weight. When the standard treatment for MAC-related pulmonary disease is not possible because of drug intolerance, antibiotic resistance, or progression of disease, second-line agents such as inhaled amikacin, clofazimine, bedaquiline, and delamanid must be considered, despite limited experience and few studies to guide their use.

Summary
Individuals who have proven to be susceptible to MAC-related pulmonary disease should institute measures to reduce exposure to environmental sources of infection. Further research is needed to assess the impact of such preventive strategies on the incidence of new infection and disease recurrence. The efficacy of new medications for MAC-related pulmonary disease and their use in different combinations also requires further study.
The role of tedizolid in skin and soft tissue infections
Authors: Bouza Emilio , Muñoz Patricia , Burillo Almudena 
Published: January 2018

Purpose of review
Tedizolid is a second-generation oxazolidinone with activity against Gram-positive bacteria, including MRSA isolates resistant to linezolid. Pivotal clinical trials showed that tedizolid at 200 mg once-daily for 6 days is not inferior to linezolid 600 mg twice daily for 10 days in patients with SSTI. The comparison of adverse events is favorable to tedizolid under the circumstances of the clinical trials. This is a review of recent literature on tedizolid, its use in special populations and potential adverse effects.

Recent findings
Findings suggest that tedizolid can be used in SSTI in adolescents, those older than 65 years, obese individuals and patients with diabetic foot infections. Forthcoming research to determine the future uses of this drug in other clinical syndromes requires demonstration of tolerance whenever tedizolid is administered for longer than 6 days.
We also speculate on missing data and potential future indications of tedizolid in the highly competitive field of the treatment of severe Gram-positive infections other than SSTI.

Summary
Tedizolid is a second-generation oxazolidinone, very convenient for treatment of SSTI, in search for other indications including nosocomial pneumonia and bone and joint infections.

Video abstract

http://links.lww.com/COID/A22
A Validation Argument for a Simulation-Based Training Course Centered on Assessment, Recognition, and Early Management of Pediatric Sepsis
Authors: Geis Gary L. , Wheeler Derek S. , Bunger Amy , Militello Laura G. , Taylor Regina G. , Bauer Jerome P. , Byczkowski Terri L. , Kerrey Benjamin T. , Patterson Mary D. 
Published: January 2018

Introduction
Early recognition of sepsis remains one of the greatest challenges in medicine. Novice clinicians are often responsible for the recognition of sepsis and the initiation of urgent management. The aim of this study was to create a validity argument for the use of a simulation-based training course centered on assessment, recognition, and early management of sepsis in a laboratory-based setting.

Methods
Five unique simulation scenarios were developed integrating critical sepsis cues identified through qualitative interviewing. Scenarios were piloted with groups of novice, intermediate, and expert pediatric physicians. The primary outcome was physician recognition of sepsis, measured with an adapted situation awareness global assessment tool. Secondary outcomes were physician compliance with pediatric advanced life support (PALS) guidelines and early sepsis management (ESM) recommendations, measured by two internally derived tools. Analysis compared recognition of sepsis by levels of expertise and measured association of sepsis recognition with the secondary outcomes.

Results
Eighteen physicians were recruited, six per study group. Each physician completed three sepsis simulations. Sepsis was recognized in 19 (35%) of 54 simulations. The odds that experts recognized sepsis was 2.6 [95% confidence interval (CI) = 0.5–13.8] times greater than novices. Adjusted for severity, for every point increase in the PALS global performance score, the odds that sepsis was recognized increased by 11.3 (95% CI = 3.1–41.4). Similarly, the odds ratio for the PALS checklist score was 1.5 (95% CI = 0.8–2.6). Adjusted for severity and level of expertise, the odds of recognizing sepsis was associated with an increase in the ESM checklist score of 1.8 (95% CI = 0.9–3.6) and an increase in ESM global performance score of 4.1 (95% CI = 1.7–10.0).

Conclusions
Although incomplete, evidence from initial testing suggests that the simulations of pediatric sepsis were sufficiently valid to justify their use in training novice pediatric physicians in the assessment, recognition, and management of pediatric sepsis.
Preparing Physiotherapy Students for Clinical Placement
Authors: Dalwood Narelle , Maloney Stephen , Cox Narelle , Morgan Prue 
Published: January 2018

IntroductionSimulation is increasingly used in health care education, yet the organizational and financial costs can be prohibitive. This study aimed to investigate whether peer simulation is perceived by third-year undergraduate physiotherapy students as valuable for clinical placement preparation.MethodsThird-year undergraduate physiotherapy students participated in a 9-week peer simulation program, using each other as patients, and were invited to complete two surveys evaluating perceptions of the program. The program consisted of weekly patient interactions during which students were required to assess and treat a “patient” under strict simulation guidelines and in accordance with stated learning objectives. Items rated included self-perceived skills, confidence, time management, and clinical placement readiness and included collection of qualitative responses. Surveys were released at commencement and completion of the simulation program.ResultsOf 79 third-year students, 63% completed survey 1 and 66% completed survey 2. Students had high expectations of the program and these were consistently met. Peer simulation rated highly for all items, including identifying knowledge and skill deficits, and improving confidence, clinical reasoning, time management, and communication. Simulation was considered safe, supportive, engaging, and valuable for clinical placement preparation. Students identified some lack of authenticity when working with peers.ConclusionsPeer simulation was perceived by students as valuable in preparing them for clinical placement, despite a perceived lack of realism. These findings support the use of peer simulation as an alternative to the use of more formalized standardized patients in an undergraduate physiotherapy program. Further investigation is required to establish a detailed cost analysis of the program and to determine the amount of realism required to optimize the benefits of this promising educational strategy.
Validating Lung Models Using the ASL 5000 Breathing Simulator
Authors: Dexter Amanda , McNinch Neil , Kaznoch Destiny , Volsko Teresa A. 
Published: January 2018

Objective
This study sought to validate pediatric models with normal and altered pulmonary mechanics.

Methods
PubMed and CINAHL databases were searched for studies directly measuring pulmonary mechanics of healthy infants and children, infants with severe bronchopulmonary dysplasia and neuromuscular disease. The ASL 5000 was used to construct models using tidal volume (V
T), inspiratory time (T
I), respiratory rate, resistance, compliance, and esophageal pressure gleaned from literature. Data were collected for a 1-minute period and repeated three times for each model. t tests compared modeled data with data abstracted from the literature. Repeated measures analyses evaluated model performance over multiple iterations. Statistical significance was established at a P value of less than 0.05.

Results
Maximum differences of means (experimental iteration mean − clinical standard mean) for T
I and V
T are the following: term infant without lung disease (T
I = 0.09 s, V
T = 0.29 mL), severe bronchopulmonary dysplasia (T
I = 0.08 s, V
T = 0.17 mL), child without lung disease (T
I = 0.10 s, V
T = 0.17 mL), and child with neuromuscular disease (T
I = 0.09 s, V
T = 0.57 mL). One-sample testing demonstrated statistically significant differences between clinical controls and V
T and T
I values produced by the ASL 5000 for each iteration and model (P < 0.01). The greatest magnitude of differences was negligible (V
T < 1.6%, T
I = 18%) and not clinically relevant.

Conclusions
Inconsistencies occurred with the models constructed on the ASL 5000. It was deemed accurate for the study purposes. It is therefore essential to test models and evaluate magnitude of differences before use.
Deep learning with EEG spectrograms in rapid eye movement behavior disorder
Authors: Ruffini Giulio , Ibañez David , Castellano Marta , Dubreuil Laura , Gagnon Jean-François , Montplaisir Jacques , Soria-Frisch Aureli 
Published: January 2018

AbstractREM Behavior Disorder (RBD) is now recognized as the prodromal stage of α-synucleinopathies such as Parkinson’s disease (PD). In this paper, we describe deep learning models for diagnosis/prognosis derived from a few minutes of eyes-closed resting electroencephalography data (EEG) collected from idiopathic RBD patients (n=121) and healthy controls (HC, n=91). A few years after the EEG acquisition (4 ± 2 years), a subset of the RBD patients eventually developed either PD (n=14) or Dementia with Lewy bodies (DLB, n=13), while the rest remained idiopathic. We describe first a simple convolutional neural network (DCNN) with a five-layer architecture combining filtering and pooling, which we train using stacked multi-channel EEG spectrograms. We treat the data as in audio or image classification problems where deep networks have proven highly successful by exploiting compositional and translationally invariant features in the data. For comparison, we study an even simpler deep recurrent neural network using three stacked Long Short Term Memory network (LSTM) cells or gated-recurrent unit (GRU) cells—with very similar results. The performance of these networks typically reaches 80% (±1%) classification accuracy in the balanced HC vs. PD-outcome classification problem. In particular, using data from a single EEG channel we obtain an area under the curve (AUC) of 87% (±1%) while avoiding spectral feature selection. The trained classifier can also be used to generate synthetic spectrograms to study what spectrogram features are relevant for classification, pointing to the presence of theta band bursts and a decrease of power in the alpha band in future PD or DLB patients compared to HCs. We conclude that deep networks may provide a key tool for the analysis of EEG dynamics even from relatively small datasets and enable the delivery of new biomarkers.
A structural mechanism for directing inverse agonism of PPARγ
Authors: Brust Richard , Shang Jinsai , Fuhrmann Jakob , Bass Jared , Cano Andrew , Heidari Zahra , Chrisman Ian M. , Blayo Anne-Laure , Griffin R. Patrick , Kamenecka Theodore M. , Hughes Travis S. , Kojetin Douglas 
Published: January 2018

AbstractSmall chemical modifications can have significant effects on ligand efficacy and receptor activity, but the underlying structural mechanisms can be difficult to predict from static crystal structures alone. Here we show how a simple phenyl-to-pyridyl substitution between two common covalent orthosteric ligands targeting peroxisome proliferator-activated receptor gamma (PPARγ) converts a transcriptionally neutral antagonist (GW9662) into an inverse agonist (T0070907). X-ray crystallography, molecular dynamics simulations, and mutagenesis coupled to activity assays reveal a water-mediated hydrogen bond network linking the T0070907 pyridyl group to Arg288 that is essential for inverse agonism. NMR spectroscopy reveals that PPARγ exchanges between two long-lived conformations when bound to T0070907 but not GW9662, including a conformation that prepopulates a corepressor-bound state, priming PPARγ for high affinity corepressor binding. Our findings demonstrate that ligand engagement of Arg288 may provide new routes for developing PPARγ inverse agonist.
PDE5 inhibition improves symptom-free survival and restores transverse tubule loss and catecholamine responsiveness in heart failure
Authors: Lawless Michael , Caldwell Jessica L. , Smith Charlotte E.R. , Radcliffe Emma J. , Madders George W.P. , Hutchings David C. , Woods Lori S. , Church Stephanie J. , Unwin Richard D. , Kirkwood Graeme J. , Becker Lorenz K. , Pearman Charles M. , Taylor Rebecca F. , Eisner David A. , Dibb Katharine M. , Trafford Andrew. W 
Published: January 2018

AbstractHeart failure is characterized by poor survival, a loss of catecholamine reserve and cellular structural remodeling in the form of disorganization and loss of the transverse tubule network. Indeed, survival rates for heart failure are worse than many common cancers and have not improved over time. Tadalafil is a clinically relevant drug that blocks phosphodiesterase 5 with high specificity and is used to treat erectile dysfunction. Using a sheep model of advanced heart failure, we show that tadalafil treatment results in a marked improvement in symptom-free survival, reverses transverse tubule loss and restore cardiac myocyte systolic calcium transient amplitude and the hearts chronotropic and contractile response to catecholamines. These effects are independent of changes in myocardial cGMP content and are associated with upregulation of both monomeric and dimerized forms of protein kinase G and of the cGMP hydrolyzing phosphodiesterase 2 and 3. We propose that the molecular switch for the loss of transverse tubules in heart failure and their restoration following tadalafil treatment involves the BAR domain protein Amphiphysin II (BIN1) and the restoration of catecholamine sensitivity is through reductions in G-protein receptor kinase 2, protein phosphatase 1 and protein phosphatase 2A abundance following phosphodiesterase 5 inhibition.