bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complexities of Consent
Authors: Dreisinger Naomi , Zapolsky Nathan 
Published: April 2017

Abstract
Informed consent is a communicative process of sharing information with patients, which helps assure their understanding of the information provided and asks for their permission to proceed. Informed consent allows a patient or a patient's family to use his or her own value system to determine the need for a particular procedure or test. Asking a patient for permission to treat requires the provider to respect the patient's autonomy through allowing him or her to be an active part of the decision-making process. Consent in the pediatric emergency department can be a complex process. Parental consent is generally required for medical evaluation and treatment of pediatric patients, but in the pediatric emergency department, there are exceptions to this rule. If the provider determines that a parent's refusal of consent places the child at risk of harm, then consent is not necessary. By using the concepts of Emergency Medical Treatment and Active Labor Act, in emergent situations, consent may not be necessary. Finally, adolescents are often deeply concerned about privacy—their acceptance of appropriate care is often based on this promise of confidentiality. In the emergency department, adolescents can therefore be treated for issues relating to reproductive care without parental consent. It is important for the emergency department physician to understand the rules surrounding the care of pediatric patients to avoid compromising their privacy and ultimately their well-being and medical care.
Performance of Virological Testing for Early Infant Diagnosis: A Systematic Review
Authors: Mallampati Divya , Ford Nathan , Hanaford Alisse , Sugandhi Nandita , Penazzato Martina 
Published: April 2017

Background:
Improved access to both maternal antiretroviral therapy and infant prophylaxis may have an impact on the performance of virological assays for diagnosis of HIV infection in infants. This systematic review was performed to assess the diagnostic accuracy of virological testing at birth as well as the performance of virological testing on dried blood spots at 6 weeks among HIV- and antiretroviral (ARV)-exposed infants.

Methods:
A systematic review was performed for studies published between January 1, 2009 and January 30, 2015. The search strategy included studies related to HIV, nucleic acid amplification tests, and newborns/infants and queried PubMed, Embase, the Cochrane Library, LILACS as well as several conference proceedings. Two independent reviewers collected studies and extracted data. The final analysis includes summary estimates of the sensitivities and specificities of the virological assays assessed. The GRADE approach was used to assess the overall quality of evidence and Quality Assessment of Diagnostic Accuracy Studies was used to evaluate the risk of bias in the studies.

Results:
A total of 2243 records were screened with a final selection of 5 manuscripts. To assess the test characteristics of virological testing at birth, 2 studies were used to calculate a pooled sensitivity of 69.3% (95% confidence interval: 61.1 to 77.4) and a specificity of 99.9% (98.6–100%). The quality of evidence to support the sensitivity of assays at birth was low, whereas the quality of evidence for the specificity of such tests was intermediate-high. In terms of the performance of virological testing on dried blood spots for HIV- and ARV-exposed infants, 3 studies were used to calculate a pooled sensitivity of 99.4% (98.3–100.00%) and specificity of 99.6% (99.1–100.00%). The quality of evidence for both outcomes was low.

Conclusion:
The performance of polymerase chain reaction at birth demonstrates low sensitivity and high specificity, reflecting the difficulty of detecting intrapartum infections at birth and transmission dynamics. In addition, there is no evidence to suggest poor performance of virological testing on dried blood spots for ARV-exposed infants. Overall, given the very limited and low-quality evidence, further research is needed to assess the accuracy of polymerase chain reaction at different time points and in the context of more effective prevention of mother-to-child transmission interventions.
Interrelations of Epicardial Fat Volume, Left Ventricular T1-Relaxation Times and Myocardial Strain in Hypertensive Patients
Authors: Homsi Rami , Kuetting Daniel , Sprinkart Alois , Steinfeld Nina , Meier-Schroers Michael , Luetkens Julian , Nadal Jennifer , Dabir Darius , Fischer Stefan , Gieseke Juergen , Schild Hans , Thomas Daniel 
Published: April 2017

Purpose:
This cardiac magnetic resonance study was performed to assess myocardial fibrosis by evaluating T1-relaxation time (T1), to measure left ventricular (LV) strain, and to determine epicardial fat volume (EFV) in hypertensive patients with no history of cardiovascular (CV) events and to relate the results to the presence of coronary atherosclerotic artery disease (CAD) in these patients.

Materials and Methods:
A total of 123 subjects were examined at 1.5 T. Of them, 98 were hypertensive patients (58 men; mean age, 62.9±10.7 y; body mass index, 29.0±5.6 kg/m2) and 25 were controls without CV risk factors or disease (13 men; 60.1±10.7 y; 28.1±5.4 kg/m2). All patients had a well-treated blood pressure. In the hypertensive group, 56 patients had no CAD, whereas 42 patients had CAD. T1 was assessed by a modified Look-Locker inversion recovery sequence. Longitudinal and circumferential peak systolic strain (LS; CS) was determined with dedicated cardiac magnetic resonance software (feature tracking). EFV (normalized to the body surface area) was assessed by a 3D Dixon sequence.

Results:
T1 (ms) and EFV (mL/m2) were higher and CS and LS (%) were lower in hypertensive patients compared with those in nonhypertensive controls (P<0.05), independent of the presence of CAD (controls: T1=967.2±16.9, LS=−25.2±4.6, CS=−28.7±5.0, EFV=58.2±21.1; hypertensive patients overall: T1=991.3±45.5, LS=−21.0±4.5, CS=−25.0±5.9, EFV=71.1±25.3; hypertensive patients without CAD: T1=991.6±48.4, LS=−21.0±4.7, CS=−24.6±6.3, EFV=71.3±26.6; hypertensive patients with CAD: T1=986.7±39.2, LS=−21.1±4.3, CS=−25.5±5.4, EFV=70.9±23.6). There were no significant differences between hypertensive patients with and those without CAD and between patients grouped according to the number of vessels affected (0-vessel disease, 1-vessel disease, 2-vessel disease, or 3-vessel disease).

Conclusions:
Hypertension is associated with signs of myocardial fibrosis and an impaired LV contractility despite a normal LV ejection fraction, as well as with an increased EFV. However, CAD, in the absence of previous pathologies with consecutive myocardial ischemic damage, did not additionally affect these parameters.
Invasive Candida Infections in Liver Transplant Recipients: Clinical Features and Risk Factors for Mortality
Authors: Bassetti Matteo , Peghin Maddalena , Carnelutti Alessia , Righi Elda , Merelli Maria , Ansaldi Filippo , Trucchi Cecilia , Alicino Cristiano , Sartor Assunta , Wauters Joost , Lagrou Katrien , Tascini Carlo , Menichetti Francesco , Mesini Alessio , De Rosa Francesco G. , Lagunes Leonel , Rello Jordi , Colombo Arnaldo L. , Vena Antonio , Munoz Patricia , Tumbarello Mario , Sganga Gabriele , Martin-Loeches Ignacio , Viscoli Claudio 
Published: April 2017

Background
Invasive fungal infections remain a leading cause of morbidity and mortality among liver transplant recipients (LTRs). In this patient population, invasive Candida infections (ICIs) account for the large majority of cases. To date, only small studies and case-series analysing clinical presentation and risk factors for mortality in LTRs with ICIs are available.

Methods
We performed a retrospective multicenter multinational study in 10 centers in Europe and Brazil. All consecutive LTRs developing ICIs during the period January 2011 to December 2013 were included in the study.

Results
A total of 42 LTRs were included. Median age was 52.5 years, and 78.6% of patients were men. Viral hepatitis was the most common cause for liver transplantation (42.9%). Candidemia represented the majority of cases (24, 57.1%), followed by intra-abdominal candidiasis (18, 42.9%). Overall 30-day mortality was 23.8%, with higher mortality in patients with candidemia compared with intra-abdominal candidiasis (37.5% vs 5.6%, P = 0.02). Multivariate analysis showed candidemia to be a risk factor associated with mortality among LTRs presenting ICIs (odds ratio, 11.86; 95% confidence interval, 1.5-280; P = 0.01). Candida albicans represented the most common isolate (59.5%). High rates of antifungal resistances were found, with 16.7% and 4.8% of isolates displaying resistance to azoles and caspofungin, respectively.

Conclusions
Our study confirms the occurrence of high mortality rates in LTRs developing ICIs. Mortality rates varied according to the type of infection, with candidemia representing a risk factor for mortality. The high rates of antifungal resistance should be considered in the choice of the empiric antifungal regimen.
Biologics-associated Risks for Incident Skin and Soft Tissue Infections in Psoriasis Patients: Results from Propensity Score-Stratified Survival Analysis
Authors: Liu Su-Hsun , Hsieh Tsung-Han , Chen Leslie Y , Huang Yhu-Chering , Huang Yu-Huei 
Published: April 2017

ABSTRACTBackgroundHow biologics affect psoriasis patients’ risks for SSTIs in a pragmatic clinical setting remains unclear.MethodsIn a cohort of adult psoriasis outpatients (aged 20 years or older) who visited the Dermatology Clinic in 2010-2015, we compared incident SSTI risks between patients using biologics (users) versus nonbiologics (nonusers). We also estimated SSTI risks in biologics-associated time-periods relative to nonbiologics only in users. We applied random effects Cox proportional hazard models with propensity score-stratification to account for differential baseline hazards.ResultsOver a median follow-up of 2.8 years (interquartile range: 1.5, 4.3), 172 of 922 patients ever received biologics (18.7%); 233 SSTI incidents occurred during 2518.3 person-years, with an overall incidence of 9.3/100 person-years (95% confidence interval [CI]: 8.1, 10.6). In univariate analysis, users showed an 89% lower risk for SSTIs than nonusers (hazard ratio [HR]: 0.11, 95%CI: 0.05, 0.26); the association persisted in a multivariable model (adjusted HR: 0.26, 95%CI: 0.12, 0.58). Among biologics users, biologics-exposed time-periods were associated with a nonsignificant 21% increased risk (adjusted HR: 1.21, 95%CI: 0.41, 3.59).ConclusionsDespite of adjusting for the underlying risk profiles, risk comparisons between biologics users and nonusers remained confounded by treatment selection. By comparing time-periods being exposed versus unexposed to biologics among users, the current analysis did not find evidence for an increased SSTI risk that was associated with biologics use in psoriasis patients.
Experience-dependent plasticity in accessory olfactory bulb interneurons following male-male social interaction
Authors: Cansler Hillary L. , Maksimova Marina A. , Meeks Julian P. 
Published: April 2017

AbstractChemosensory information processing in the mouse accessory olfactory system (AOS) guides the expression of social behavior. After salient chemosensory encounters, the accessory olfactory bulb (AOB) experiences changes in the balance of excitation and inhibition at reciprocal synapses between mitral cells (MCs) and local interneurons. The mechanisms underlying these changes remain controversial. Moreover, it remains unclear whether MC-interneuron plasticity is unique to specific behaviors, such as mating, or whether it is a more general feature of the AOB circuit. Here, we describe targeted electrophysiological studies of AOB inhibitory internal granule cells (IGCs), many of which upregulate the immediate-early geneArcafter male-male social experience. Following the resident-intruder paradigm,Arc-expressing IGCs in acute AOB slices from resident males displayed stronger excitation than non-expressing neighbors when sensory inputs are stimulated. The increased excitability ofArc-expressing IGCs was not correlated with changes in the strength or number of excitatory synapses with MCs, but was instead associated with increased intrinsic excitability and decreased HCN channel-mediated IHcurrents. Consistent with increased inhibition by IGCs, MCs responded to sensory input stimulation with decreased depolarization and spiking following resident-intruder encounters. These results reveal that non-mating behaviors drive AOB inhibitory plasticity, and indicate that increased MC inhibition involves intrinsic excitability changes inArc-expressing interneurons.Significance StatementThe accessory olfactory bulb (AOB) is a site of experience-dependent plasticity between excitatory mitral cells (MCs) and inhibitory internal granule cells (IGCs), but the physiological mechanisms and behavioral conditions driving this plasticity remain unclear. Here, we report studies of AOB neuronal plasticity following male-male social chemosensory encounters. We show that the plasticity-associated immediate-early geneArcis selectively expressed in IGCs from resident males following the resident-intruder assay. After behavior,Arc-expressing IGCs are more strongly excited by sensory input stimulation and MC activation is suppressed.Arc-expressing IGCs do not show increased excitatory synaptic drive, but instead show increased intrinsic excitability. These data indicate that MC-IGC plasticity is induced after male-male social chemosensory encounters, resulting in enhanced MC suppression byArc-expressing IGCs.
Learning the high-dimensional immunogenomic features that predict public and private antibody repertoires
Authors: Greiff Victor , Weber Cédric R. , Palme Johannes , Bodenhofer Ulrich , Miho Enkelejda , Menzel Ulrike , Reddy Sai T. 
Published: April 2017

AbstractRecent studies have revealed that immune repertoires contain a substantial fraction of public clones, which are defined as antibody or T-cell receptor (TCR) clonal sequences shared across individuals. As of yet, it has remained unclear whether public clones possess predictable sequence features that separate them from private clones, which are believed to be generated largely stochastically. This knowledge gap represents a lack of insight into the shaping of immune repertoire diversity. Leveraging a machine learning approach capable of capturing the high-dimensional compositional information of each clonal sequence (defined by the complementarity determining region 3, CDR3), we detected predictive public- and private-clone-specific immunogenomic differences concentrated in the CDR3’s N1-D-N2 region, which allowed the prediction of public and private status with 80% accuracy in both humans and mice. Our results unexpectedly demonstrate that not only public but also private clones possess predictable high-dimensional immunogenomic features. Our support vector machine model could be trained effectively on large published datasets (3 million clonal sequences) and was sufficiently robust for public clone prediction across studies prepared with different library preparation and high-throughput sequencing protocols. In summary, we have uncovered the existence of high-dimensional immunogenomic rules that shape immune repertoire diversity in a predictable fashion. Our approach may pave the way towards the construction of a comprehensive atlas of public clones in immune repertoires, which may have applications in rational vaccine design and immunotherapeutics.
A macrophage response toMycobacterium lepraephenolic glycolipid initiates nerve damage in leprosy
Authors: Madigan Cressida A. , Cambier C.J. , Kelly-Scumpia Kindra M. , Scumpia Philip O. , Cheng Tan-Yun , Zailaa Joseph , Bloom Barry R. , Moody D. Branch , Smale Steven T. , Sagasti Alvaro , Modlin Robert L. , Ramakrishnan Lalita 
Published: April 2017

SUMMARYMycobacterium lepraecauses leprosy, and is unique among mycobacterial diseases in producing peripheral neuropathy. This debilitating morbidity is attributed to axon demyelination resulting from direct interactions of theM. leprae-specific phenolic glycolipid 1 (PGL-1) with myelinating glia, and their subsequent infection. Here, we use transparent zebrafish larvae to visualize the earliest events ofM. leprae-induced nerve damage. We find that demyelination and axonal damage are not directly initiated byM. lepraebut by infected macrophages that patrol axons; demyelination occurs in areas of intimate contact. PGL-1 confers this neurotoxic response on macrophages: macrophages infected withM. marinumexpressing PGL-1 also damage axons. PGL-1 induces nitric oxide synthase in infected macrophages, and the resultant increase in reactive nitrogen species damages axons by injuring their mitochondria and inducing demyelination. Our findings implicate the response of innate macrophages toM. lepraePGL-1 in initiating nerve damage in leprosy.
TGH: Trans-Generational Hormesis and the Inheritance of Aging Resistance
Authors: Fang Ng Li , Suresh Jahnavi , Chaithanya Krishna , Linfan Xiao , Tan Tuan Zea , Gruber Jan , Tolwinski Nicholas S. 
Published: April 2017

AbstractAnimals respond to dietary changes by adapting their metabolism to available nutrients through insulin and insulin-like growth factor signalling. Restricting calorie intake generally extends life and health span, butDrosophilafed non-ideal sugars such as galactose are stressed and have shorter life spans. Here, we report that although these flies have shorter life spans, their offspring show significant life extension if switched to a normal sugar (glucose) diet. We define this as TGH or trans-generational hormesis, a beneficial effect that comes from a mild stress. We trace the effects to changes in stress responses in parents, ROS production, effects on lipid metabolism, and changes in chromatin and gene expression. We find that this mechanism is similar to what happens to the long livedIndymutants on normal food, but surprisingly find thatIndyis required for life span extension for galactose fed flies.Indymutant flies grown on galactose do not live longer as do their siblings grown on glucose, rather overexpression of Indy rescues lifespan for galactose reared flies. We define a process where sugar metabolism can generate epigenetic changes that are inherited by offspring, providing a mechanism for how transgenerational nutrient sensitivities are passed on.
Enzymes and Substrates Are Balanced at Minimal Combined Mass Concentrationin vivo
Authors: Dourado Hugo , Maurino Veronica G. , Lercher Martin J. 
Published: April 2017

AbstractA fundamental problem in biology is how cells organize their resource investment. Cellular metabolism, for example, typically involves hundreds of enzymes and metabolites, but it is unclear according to which principles their concentrations are set. Reasoning that natural selection will drive cells towards achieving a given physiological state at minimal cost, we derive a general equation that predicts the concentration of a metabolite from the concentration of the most abundant and costly enzyme consuming it. Simulations of cellular growth as well as experimental data demonstrate that costs are approximately proportional to molecular masses. For effectively irreversible reactions, the cell maximizes its metabolic efficiency by investing equally into substrate and unbound enzyme molecules. Without fitting any free parameters, the resulting model predictsin vivosubstrate concentrations from enzyme concentrations and substrate affinities with high accuracy across data fromE. coliand diverse eukaryotes (R2=0.79, geometric mean fold-error 1.74). The corresponding organizing principle – the minimization of the summed mass concentrations of solutes – may facilitate reducing the complexity of kinetic models and will contribute to the design of more efficient synthetic cellular systems.
A model for autonomous and non-autonomous effects of the Hippo pathway inDrosophila
Authors: Gou Jia , Lin Lin , Othmer Hans G. 
Published: April 2017

AbstractWhile significant progress has been made toward understanding morphogen-mediated patterning in development from both the experimental and the theoretical side, the control of size and shape of tissues and organs is poorly understood. Both involve adjustment of the scale of gene expression to the size of the system, but how growth and patterning are coupled to produce scale invariance and how molecular-level information is translated into organ- and organism-level functioning is one of the most difficult problems in biology. The Hippo pathway, which controls cell proliferation and apoptosis inDrosophilaand mammalian cells, contains a core kinase mechanism that affects control of the cell cycle and growth. Studies involving over- and under-expression of components in the morphogen and Hippo pathways inDrosophilareveal conditions that lead to over- or undergrowth. Herein we develop a mathematical model that incorporates the current understanding of the Hippo signal transduction network and which can explain qualitatively both the observations on whole-disc manipulations and the results arising from mutant clones. We find that a number of non-intuitive experimental results can be explained by subtle changes in the balances between inputs to the Hippo pathway. Since signal transduction and growth control pathways are highly conserved across species, much of what is learned aboutDrosophilaapplies in higher organisms, and may have direct relevance to tumor dynamics in mammalian systems.
Does motivation matter? The influence of the agency perspective on temporary agency workers
Authors: Chen Pei-Chen , Wang Ming-Chao , Fang Shih-Chieh 
Published: April 2017

PurposeBased on agency perspective on temporary agency workers, the purpose of this paper is to explore the relationship between firms’ agency problems and agency cost on agency workers; moreover, intrinsic motivation and extrinsic motivation are considered in seeking to understand how they moderate this relationship.Design/methodology/approachUsing the Hsinchu Science Park directory of corporate affiliations as a sample frame, the authors adopted a paired questionnaire which included two parts in order to consider the possible problem of common method variances. The first part is completed by the manager of the firms and the second part is completed by his/her temporary agency workers. Finally, 94 firms completed questionnaires, providing a total sample of 94 R&D managers and 458 temporary agency workers. The rate of participation was 31.65 percent.FindingsUsing a questionnaire survey of 94 high-tech firms, from which a total of 94 R&D managers and 458 temporary agency workers participated, the results show that firms’ agency problems have a positive influence on the agency cost of monitoring temporary agency workers. In addition, while this relationship is negatively moderated by extrinsic motivation, intrinsic motivation has a non-significant moderating effect.Originality/valueThe managers of firms should consider not only the short-term flexibility of employing temporary agency workers, but also the long-term cultivation of promoting great agency workers. This could maximize the efficiency of the interaction between intrinsic motivation and extrinsic motivation. Of course, the firms should think about how to reduce the agency problems created by goal conflict, information asymmetry and risk sharing with temporary agency workers, because this could also provide a chance for the firms to decrease agency costs spent on monitoring.