bluuebunny/crossref_metadata_2025_split huggingface dataset:
From feldschers to physician assistants in Bulgaria
Authors: Vracheva Penka Petkova 
Published: July 2017

ABSTRACT
The physician assistant (PA) profession was established in Bulgaria in 2014 in response to a growing shortage of medical staff and was modeled on the United States experience. Feldschers provided a similar role in Bulgaria from 1878 to 1999 but feldscher training was discontinued in 1999 because of a physician surplus. However, healthcare in Bulgaria changed after the country joined the European Union, and some physicians left for better opportunities elsewhere. The loss of physicians and an aging population meant that PAs were seen as a strategy to offset Bulgaria's growing healthcare demand.
Beyond the PSA test
Authors: Lewis Ryan , Hornberger Brad 
Published: July 2017

ABSTRACT
The primary method of screening for and detecting prostate cancer is the prostate-specific antigen (PSA) test. Although this test is very prostate-specific, it is not cancer-specific; conditions other than prostate cancer can cause an elevated PSA. Many efforts have been made to discover more specific tests and methods beyond the PSA. This article describes several literature-supported tests and methods to better stratify a man's risk of having prostate cancer.
Nutrition (Micronutrients) in Child Growth and Development: A Systematic Review on Current Evidence, Recommendations and Opportunities for Further Research
Authors: Yakoob Mohammad Yawar , Lo Clifford W. 
Published: July 2017

ABSTRACT:

Objective:
An important aspect of malnutrition is deficiency of different micronutrients during pregnancy or early childhood. We systematically reviewed the role of nutrition in child growth (weight or height gain) and development.

Methods:
A comprehensive literature search was done on PubMed/Cochrane Library browsing through 38,795 abstracts until December 31, 2016 to select systematic reviews/meta-analyses and individual randomized controlled trials (RCTs) of micronutrient supplementation.

Results:
Micronutrients studied included iron, iodine, folate, zinc, calcium, magnesium, selenium, vitamin D, vitamin A, vitamin B complex, and multiple micronutrients. We summarize evidence with details and results of RCTs, highlight strengths/weaknesses, and critically interpret findings. Effects of breastfeeding-promotion, food-supplementation (complementary and school feeding), conditional-cash-transfers, and integrated nutrition/psychosocial interventions are discussed.

Conclusion:
Based on this evidence we make policy and programmatic recommendations for supplementation to mothers and children at high-risk of deficiency.
Prednisolone and Prednisone Pharmacokinetics in Pediatric Renal Transplant Recipients—A Prospective Study
Authors: Skauby Ragnhild Heier , Bjerre Anna , Sæves Ingjerd , Vethe Nils Tore , Bremer Sara , Svarstad Anja , Bergan Stein 
Published: July 2017

Background:
Prednisolone is a standard component of immunosuppressive protocols in renal transplantation (Tx) and despite standardized treatment regimens, adverse side effects are still frequent. The aim of this study was to characterize the pharmacokinetics of prednisolone and prednisone in pediatric renal transplant recipients in the first 52 weeks post Tx, to describe the relationship between prednisolone and prednisone, and to investigate a possible relationship between the development of new-onset diabetes after Tx (NODAT) and glucocorticoid exposure.

Methods:
Renal transplant recipients receiving prednisolone (n = 11, age 1–15 years) were included in this prospective open-label, descriptive, nonrandomized, and noninterventional study. Blood samples were drawn pre-Tx and during selected dose intervals (0, 1, 2, 4, 6, and 12 hours postdose; less frequent in children <10 kg) at 1, 2, 3, 4, 12, and 52 weeks post-Tx. Concentrations of prednisolone and cortisol, their inactive keto forms, plus methylprednisolone, were measured using a validated LC-MS/MS method. Genetic variants in the CYP3A4, CYP3A5, ABCB1, and HSD11B2 genes were analyzed using real-time polymerase chain reaction and Sanger sequencing. Correlation with NODAT was investigated.

Results:
The patients displayed considerable intra- and inter-individual variability in prednisolone exposure, with up to 5-fold differences in the area under the concentration–time curve (AUC). There were up to 7-fold differences in prednisolone/prednisone AUC ratio between patients, and patients experiencing NODAT tended to have a higher ratio (>12) compared with patients without NODAT (<12). Genetic variants in CYP3A5 and ABCB1 were found, but due to the limited study population causality cannot be definitive.

Conclusions:
The study suggests that a high prednisolone/prednisone AUC ratio may be a possible risk factor for NODAT. Further studies of individualization of glucocorticoid treatment in pediatric organ Tx are warranted.
Association of Insurance Status with the Use of Immediate Breast Reconstruction in Women with Breast Cancer
Authors: Pasalic Dario , Jiang Jing , Jagsi Reshma , Giordano Sharon H. , Smith Benjamin D. 
Published: July 2017

Background:
Our group sought to determine the influence of health insurance coverage on use of immediate breast reconstruction for working-age women undergoing mastectomy for breast cancer.

Methods:
We used 2 complementary databases, the Texas Cancer Registry–linked Medicaid database and the MarketScan private insurance database, to identify working-age women in Texas from 2000 to 2007 treated with mastectomy for incident breast cancer. Logistic regression tested the association between Medicaid versus private insurance and receipt of immediate breast reconstruction, adjusting for patient, treatment, and socio-demographic covariates. Reimbursement for reconstruction, adjusted for inflation and reported in 2014 dollars, was estimated from claims.

Results:
Median age was 49.7 years for the Medicaid cohort compared with 50.4 years for the MarketScan cohort (P = 0.02). From 2000 to 2007, use of reconstruction increased significantly for patients in the MarketScan cohort (38.1–53.9%; P
trend = 0.009) but not those in the Medicaid cohort (10.5–16.6%; P
trend = 0.24). In total, 15.7% of patients in the Medicaid cohort underwent immediate reconstruction (n = 213/1,360) compared with 50.7% (n = 1,405/2,772) of patients in the MarketScan cohort (adjusted relative risk, 3.09; 95% CI, 2.78–3.40). Reimbursement for reconstruction was $3,167 (95% CI, $2,512–$3,820) for patients in the Medicaid cohort compared with $15,432 (95% CI, $14,030–$16,834) for patients in the MarketScan cohort.

Conclusions:
Type of insurance coverage is an important factor associated with receipt of immediate breast reconstruction. We postulate that the marked difference in reimbursement for reconstruction between Medicaid and private insurance creates a relative disincentive for plastic surgeons and hospitals to offer breast reconstruction to patients with Medicaid.
Characterization of the Capsule Surrounding Smooth and Textured Tissue Expanders and Correlation with Contracture
Authors: Kuriyama Erika , Ochiai Hiroko , Inoue Yoshikazu , Sakamoto Yoshiaki , Yamamoto Naoki , Utsumi Toshiaki , Kishi Kazuo , Okumoto Takayuki , Matsuura Akihiro 
Published: July 2017

Background:
Capsular contracture is a common complication after breast augmentation surgery. This study pathologically evaluated the soft-tissue response to surface modifications in both smooth and textured tissue expander prostheses.

Methods:
Smooth tissue expanders and textured tissue expanders in 5 cases each were used for breast reconstruction after mastectomy. Histological samples were harvested from the capsules when the tissue expanders were replaced by silicone implants. Collagen orientation and cellular responses were assessed histologically. Capsular contracture was evaluated using the Baker classification 6 months and 2 years after the removal of the tissue expander.

Results:
The capsules surrounding the smooth tissue expanders tended to produce more contracture than those surrounding the textured tissue expanders. The collagen architecture of the capsules of the smooth tissue expanders showed random orientation with fragmentation. Conversely, the capsules of the textured tissue expanders showed parallel orientation with collagen bundles of almost normal structure. Significantly more fibrils of elastin and myofibroblasts were found in the capsules surrounding the smooth tissue than in those surrounding the textured ones.

Conclusions:
The collagen fibers surrounding the smooth tissue expanders could be cracked during expansion, which may lead to scarring and contracture. Conversely, the collagen orientation surrounding the textured tissue expanders was excellent. Moreover, the increase in elastic fibers and myofibroblasts in the capsules surrounding the smooth tissue expanders may be associated with in vivo contraction patterns. Therefore, the surface type of tissue expanders affects capsular contraction after replacement with definitive implants.
Distribution of Esophageal Motor Disorders in Diabetic Patients With Dysphagia
Authors: George Nina S. , Rangan Vikram , Geng Zhuo , Khan Freeha , Kichler Adam , Gabbard Scott , Ganocy Stephen , Fass Ronnie 
Published: July 2017

Background:
Diabetes mellitus can cause various gastrointestinal symptoms. Assessment of esophageal dysmotility in diabetic patients has been scarcely studied. The aim of this study was to determine the esophageal motor characteristics of diabetic versus nondiabetic patients who present with dysphagia.

Methods:
High-resolution esophageal manometries (HREMs) of 83 diabetic patients and 83 age and gender-matched nondiabetic patients with dysphagia from 2 medical centers were included in this study. Demographic information, medical comorbidities, and medication usage were recorded for each patient in a single registry. HREM of each patient was evaluated and the different functional parameters were recorded.

Key Results:
Overall, 46% of diabetic patients were found to have an esophageal motor disorder. Diabetic patients with dysphagia were more likely to have failed swallows on HREM (50.6% vs. 33.7%; P=0.03) as compared with nondiabetic patients. Among diabetic patients, those being treated with insulin were more likely to have failed (69.0% vs. 40.7%; P=0.01) and weak (65.5% vs. 33.3%; P=0.005) swallows as compared with diabetic patients not on insulin. Among diabetic patients, those with abnormal manometry were more likely to demonstrate diabetic retinopathy (27.0% vs. 8.7%; P=0.04). There was a trend toward increased incidence of esophagogastric junction outflow obstruction in diabetic patients (10.8% vs. 2.4%; P=0.057) as compared with nondiabetic patients.

Conclusions:
Nearly half of diabetic patients with dysphagia have some type of an esophageal motility disorder. Diabetic retinopathy and the use of insulin are predictive of esophageal motor abnormalities among diabetic patients.
Predictive Model for Neoplastic Potential of Gallbladder Polyp
Authors: Yang Ju-Il , Lee Jong Kyun , Ahn Dae Geon , Park Joo Kyung , Lee Kwang Hyuck , Lee Kyu Taek , Chi Sang Ah , Jung Sin-Ho 
Published: July 2017

Goal:
To provide the statistical predictive model for neoplastic potential of gallbladder polyp (GBP).

Background:
Many studies have attempted to define the risk factors for neoplastic potential of GBP. It remains difficult to precisely adapt the reported risk factors for the decision of surgery. Estimating the probability for neoplastic potential of GBP using a combination of several risk factors before surgical resection would be useful in patient consultation.

Study:
We collected data of patients confirmed as GBP through cholecystectomy at Samsung Medical Center between January 1997 and March 2015. Those with a definite evidence for malignancy, such as adjacent organ invasion, metastasis on preoperative imaging studies, polyp >15 mm, and absence of proper preoperative ultrasonographic imaging were excluded. A total of 1976 patients were enrolled. To make and validate the predictive model, we divided the cohort into the modeling group (n=979) and validation group (n=997). Clinical information, ultrasonographic findings, and blood tests were retrospectively analyzed.

Results:
Clinical factors of older age, single lesion, sessile shape, and polyp size showed statistical significance for neoplastic potential of GBP in the modeling group. A predictive model for neoplastic potential of GBP was constructed utilizing the statistical outcome of the modeling group. Statistical validation was performed with the validation group to determine the optimal clinical sensitivity and specificity of the predictive model. Optimal cut-off value for neoplastic probability was 7.4%.

Conclusions:
The predictive model for neoplastic potential of GBP may support clinical decisions before cholecystectomy.
United European Gastroenterology Week scientific abstracts and their progression to full publication
Authors: Raju Suneil A. , Sanders David S. , Akram Rahim , Glover Rebecca , Al-Rifaie Ammar , Peever Elise , Purves Josh , Scanu Emily , Kurien Matthew 
Published: July 2017

Objective
Abstracts presentations at scientific meetings enable rapid dissemination of novel research. The percentage of abstracts that proceed to full publication from differing medical specialties is highly variable. This study aims to evaluate the outcomes of abstracts presented at the United European Gastroenterology Week (UEGW).

Materials and methods
All abstracts presented at UEGW between 2009 and 2011 were assessed. Cross-referencing of the first author, senior author and at least one keyword of the abstract was performed using PubMed and EMBASE databases. Abstracts and possible resultant full publications were then examined in tandem to ensure that they represented the same study. Data were also collected on lag time to publication, journal impact factors, country of the author and factors influencing subsequent publication.

Results
A total of 6785 abstracts (1438 oral and 5347 poster presentations) were presented during the period assessed. Of these, 2099 (30.9%) proceeded to full publication in indexed journals. Oral abstract presentations were most likely to proceed to full publication compared with poster presentations (odds ratio: 1.38, 95% confidence interval: 1.22–1.56) and were more likely to achieve publication in higher impact journals (median impact factor 4.78 vs. 2.89, P<0.0005). The median lag time to full publication was 15 (IQR: 7–15) months. The Netherlands had the highest United European Gastroenterology abstract conversion rate to full publication (46.8%).

Conclusion
This is the first study to assess the publication rates of UEGW. Findings are favourable with similar studies from other societies.
Upper Lip Reconstruction
Authors: Luce Edward A. 
Published: July 2017

Summary:
Reconstruction of an aesthetically acceptable and functional upper lip requires a careful consideration of the transverse and vertical soft tissue, muscle, and skin deficiency. This review focuses on the reconstructive aspects of the upper lip. The functional anatomy of the upper lip is considerably complex and includes paired muscles in addition to the orbicularis, elevators of both the upper lip and commissure. The muscular action of facial expression recruits different sets of these paired muscles. Unlike the aesthetic uniform appearance of the lower lip commissure to commissure, the upper lip aesthetics can be divided into a central, philtrum unit, and a lateral upper lip unit. The lateral unit can be further subdivided into medial and lateral elements, with the medial more fixed and less mobile because of attachments superiorly at the alar sill and base. Reconstruction of the philtrum is best accomplished with an Abbe flap. Methods to reconstruct the lateral unit hinge on location, medial versus lateral, and defect size. A conceptual approach to successful reconstruction of upper lip defects entails the use of a classification based on the aesthetic unit, appropriate selection of the reconstructive option for a particular defect driven by location and size, and careful consideration given to a final result in harmony both transversely and vertically with the lower lip and the remainder of the midface.
Rapid Number Naming and Quantitative Eye Movements May Reflect Contact Sport Exposure in a Collegiate Ice Hockey Cohort
Authors: Hasanaj Lisena , Thawani Sujata P. , Webb Nikki , Drattell Julia D. , Serrano Liliana , Nolan Rachel C. , Raynowska Jenelle , Hudson Todd E. , Rizzo John-Ross , Dai Weiwei , McComb Bryan , Goldberg Judith D. , Rucker Janet C. , Galetta Steven L. , Balcer Laura J. 
Published: July 2017

Background:
The King-Devick (K-D) test of rapid number naming is a reliable visual performance measure that is a sensitive sideline indicator of concussion when time scores worsen (lengthen) from preseason baseline. Within cohorts of youth athletes <18 years old, baseline K-D times become faster with increasing age. We determined the relation of rapid number-naming time scores on the K-D test to electronic measurements of saccade performance during preseason baseline assessments in a collegiate ice hockey team cohort. Within this group of young adult athletes, we also sought to examine the potential role for player age in determining baseline scores.

Methods:
Athletes from a collegiate ice hockey team received preseason baseline testing as part of an ongoing study of rapid rink-side performance measures for concussion. These included the K-D test (spiral-bound cards and tablet computer versions). Participants also performed a laboratory-based version of the K-D test with simultaneous infrared-based video-oculographic recordings using an EyeLink 1000+. This allowed measurement of the temporal and spatial characteristics of eye movements, including saccadic velocity, duration, and intersaccadic interval (ISI).

Results:
Among 13 male athletes, aged 18–23 years (mean 20.5 ± 1.6 years), prolongation of the ISI (a combined measure of saccade latency and fixation duration) was the measure most associated with slower baseline time scores for the EyeLink-paired K-D (mean 38.2 ± 6.2 seconds, r = 0.88 [95% CI 0.63–0.96], P = 0.0001), the K-D spiral-bound cards (36.6 ± 5.9 seconds, r = 0.60 [95% CI 0.08–0.87], P = 0.03), and K-D computerized tablet version (39.1 ± 5.4 seconds, r = 0.79 [95% CI 0.42–0.93], P = 0.001). In this cohort, older age was a predictor of longer (worse) K-D baseline time performance (age vs EyeLink-paired K-D: r = 0.70 [95% CI 0.24–0.90], P = 0.008; age vs K-D spiral-bound cards: r = 0.57 [95% CI 0.03–0.85], P = 0.04; age vs K-D tablet version: r = 0.59 [95% CI 0.06–0.86], P = 0.03) as well as prolonged ISI (r = 0.62 [95% CI 0.11–0.87], P = 0.02). Slower baseline K-D times were not associated with greater numbers of reported prior concussions.

Conclusions:
Rapid number-naming performance using the K-D at preseason baseline in this small cohort of collegiate ice hockey players is best correlated with ISI among eye movement-recording measures. Baseline K-D scores notably worsened with increasing age, but not with numbers of prior concussions in this small cohort. While these findings require further investigation by larger studies of contact and noncontact sports athletes, they suggest that duration of contact sports exposure may influence preseason test performance.
Communication from learned to innate olfactory processing centers is required for memory retrieval inDrosophila
Authors: Dolan Michael-John , Belliart-Guérin Ghislain , Shakeel Bates Alexander , Aso Yoshinori , Frechter Shahar , Roberts Ruairí J.V. , Schlegel Philipp , Wong Allan , Hammad Adnan , Bock Davi , Rubin Gerald M. , Preat Thomas , Plaçais Pierre-Yves , Jefferis Gregory S.X.E. 
Published: July 2017

AbstractAnimals can show either learned or innate behavioral responses to a given stimulus. How these circuits interact to produce an appropriate behavioral response is unknown. In theDrosophilaolfactory system, the lateral horn (LH) and the mushroom body (MB) are thought to mediate innate and learned olfactory behavior respectively, although the function of the LH has not been directly tested. Here we identify two LH cell-types (PD2a1/b1) that receive input from an MB output neuron required for recall of aversive olfactory memories. In contrast to the model above we find that PD2a1/b1 are required for aversive memory retrieval. PD2a1/b1 activity is modulated by training, indicating that memory information is passed to the innate olfactory processing centre. We map the connectivity of PD2a1/b1 to other olfactory neurons with connectomic data. This provides a circuit mechanism by which learned and unlearned olfactory information can interact to produce appropriate behavior.
Long-term consolidation switches goal proximity coding from hippocampus to retrosplenial cortex
Authors: Patai E. Zita , Javadi Amir-Homayoun , Ozubko Jason D. , O’Callaghan Andrew , Ji Shuman , Robin Jessica , Grady Cheryl , Winocur Gordon , Rosenbaum Shayna R. , Moscovitch Morris , Spiers Hugo J. 
Published: July 2017

AbstractRecent research indicates the hippocampus may code the distance to the goal during navigation of newly learned environments. It is unclear however, whether this also pertains to highly familiar environments where extensive systems-level consolidation is thought to have transformed mnemonic representations. Here we recorded fMRI while University College London and Imperial College London students navigated virtual simulations of their own familiar campus (> 2 years of exposure) and the other campus learned days before scanning. Posterior hippocampal activity tracked the proximity to the goal in the newly learned campus, but not in the familiar campus. By contrast retrosplenial cortex tracked the distance to the goal in the familiar campus, but not in the recently learned campus. These responses were abolished when participants were guided to their goal by external cues. These results open new avenues of research on navigation and consolidation of spatial information and help advance models of how neural circuits support navigation in novel and highly familiar environments.Significance StatementHistorically, research on the hippocampal formation has focused on its role in long-term memory and navigation – often in isolation. No study to date has directly compared realistic navigation within familiar with recently learned environments, nor has it been explored how the neural substrates, along with computational codes, may change. In this study, we show for the first time, a shift from hippocampal to cortical coding of distance to a goal during active navigation. This study bridges the gap between memory consolidation and navigation, and paves the way for more functional and realistic understanding of the hippocampus.