bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coiling Versus Microsurgical Clipping in the Treatment of Unruptured Middle Cerebral Artery Aneurysms: A Meta-Analysis
Authors: Alreshidi Meshal , Cote David J , Dasenbrock Hormuzdiyar H , Acosta Michael , Can Anil , Doucette Joanne , Simjian Thomas , Hulou M Maher , Wheeler Lee A , Huang Kevin , Zaidi Hasan A , Du Rose , Aziz-Sultan M Ali , Mekary Rania A , Smith Timothy R 
Published: December 2017

Abstract

BACKGROUND
Open microsurgical clipping of unruptured intracranial aneurysms has long been the gold standard, yet advancements in endovascular coiling techniques have begun to challenge the status quo.

OBJECTIVE
To compare endovascular coiling with microsurgical clipping among adults with unruptured middle cerebral artery aneurysms (MCAA) by conducting a meta-analysis.

METHODS
A systematic search was conducted from January 2011 to October 2015 to update a previous meta-analysis. All studies that reported unruptured MCAA in adults treated by microsurgical clipping or endovascular coiling were included and cumulatively analyzed.

RESULTS
Thirty-seven studies including 3352 patients were included. Using the random-effects model, pooled analysis of 11 studies of microsurgical clipping (626 aneurysms) revealed complete aneurysmal obliteration in 94.2% of cases (95% confidence interval [CI] 87.6%-97.4%). The analysis of 18 studies of endovascular coiling (759 aneurysms) revealed complete obliteration in 53.2% of cases (95% CI: 45.0%-61.1%). Among clipping studies, 22 assessed neurological outcomes (2404 aneurysms), with favorable outcomes in 97.9% (95% CI: 96.8%-98.6%). Among coiling studies, 22 examined neurological outcomes (826 aneurysms), with favorable outcomes in 95.1% (95% CI: 93.1%-96.5%). Results using the fixed-effect models were not materially different.

CONCLUSION
This updated meta-analysis demonstrates that surgical clipping for unruptured MCAA remains highly safe and efficacious. Endovascular treatment for unruptured MCAAs continues to improve in efficacy and safety; yet, it results in lower rates of occlusion.
Open Wide and Say A-Ha: Adding Oral Health Content to the Nurse Practitioner Curriculum
Authors: Kent Kathleen A. , Clark Carol A. 
Published: December 2017

Abstract
While aligning our nurse practitioner curriculum to the competencies of the National Organization of Nurse Practitioner Faculties, we realized that there was a lack of oral health content in our program. As we did not possess the knowledge needed to teach this content, we invited a dental school faculty member to do this for our class. This experience led to a change in the delivery of our teaching content through the use of the STAR Legacy Cycle model and the How People Learn theory. The purpose of this article is to share our journey with others.
Caring from a Christian Worldview
Authors: Rieg Linda S. , Newbanks R. Shirlene , Sprunger Rose 
Published: December 2017

ABSTRACT:
This study explored Christian nurses' views of their source of caring (Deity or other), adherence to biblical faith practices, and view of nursing as a job, career, profession, or calling. Participants who reported Deity (God, Christ, Holy Spirit) as their source of caring were more likely to view nursing as a calling and report a higher degree of volunteering (serving), giving (financially to a religious community), devotions and prayer (personal walk), and fellowship (meeting with a community of other believers). Results have implications for understanding the concept of caring within the context of a Christian worldview.
Effect of night-time temperatures on cause and age-specific mortality in London
Authors: Murage Peninah , Hajat Shakoor , Kovats R. Sari 
Published: December 2017

Background:
High ambient temperatures are associated with an acute increase in mortality risk. Although heat exposure during the night is anecdotally cited as being important, this has not been rigorously demonstrated in the epidemiological literature.

Methods:
We quantified the contribution of nighttime temperatures using time-series quasi-Poisson regression on cause and age-specific daily mortality in London between 1993 and 2015. Daytime and nighttime exposures were characterized by average temperatures between 9 am and 9 pm and between 4 am and 8 am, respectively, lagged by 7 days. We also examined the differential impacts of hot and cool nights preceded by very hot days. All models were adjusted for air quality, season, and day of the week. Nighttime models were additionally adjusted for daytime exposure.

Results:
Effects from nighttime exposure persisted after adjusting for daytime exposure. This was highest for stroke, RR (relative risk) = 1.65 (95% confidence interval (CI) = 1.27 to 2.14) estimated by comparing mortality risk at the 80th and 99th temperature percentiles. Compared to daytime exposure, nighttime exposure had a higher mortality risk on chronic ischemic and stroke and in the younger age groups. Respiratory mortality was most sensitive to daytime temperatures. Hot days followed by hot nights had a greater mortality risk than hot days followed by cool nights.

Conclusions:
Nighttime exposures make an additional important contribution to heat-related mortality. This impact was highest on warm nights that were preceded by a hot day, which justifies the alert criteria in heat–health warning system that is based on hot days followed by hot nights. The highest mortality risk was from stroke; targeted interventions would benefit patients most susceptible to stroke.
Well Preserved Renal Function in Children With Untreated Chronic Liver Disease
Authors: Berg Ulla B. , Németh Antal 
Published: December 2017

ABSTRACTObjectives:On the basis of studies with hepatorenal syndrome, it is widely regarded that renal function is impacted in chronic liver disease (CLD). Therefore, we investigated renal function in children with CLD.Methods:In a retrospective study of 277 children with CLD, renal function was investigated as glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), measured as clearance of inulin and para‐amino hippuric acid or clearance of iohexol. The data were analyzed with regard to different subgroups of liver disease and to the grade of damage.Results:Hyperfiltration (>+2 SD of controls) was found in the subgroups of progressive familial intrahepatic cholestasis (44%), glycogenosis (75%), and acute fulminant liver failure (60%). Patients with biliary atresia, most other patients with metabolic disease and intrahepatic cholestasis, and those with vascular anomalies and cryptogenic cirrhosis had normal renal function. Decreased renal function was found in patients with Alagille's syndrome (64% < −2 SD). Increased GFR and ERPF was found in patients with elevated transaminases, low prothrombin level, high bile acid concentration, and high aspartate‐aminotransferase‐to‐platelet ratio.Conclusions:Most children with CLD had surprisingly well preserved renal function and certain groups had even hyperfiltration. The finding that children with decompensated liver disease and ongoing liver failure had stable kidney function suggests that no prognostic markers of threatening hepatorenal syndrome were at hand. Moreover, estimation of GFR based on serum creatinine fails to reveal hyperfiltration.
Surgical Consultation as Social Process
Authors: Clapp Justin T. , Arriaga Alexander F. , Murthy Sushila , Raper Steven E. , Schwartz J. Sanford , Barg Frances K. , Fleisher Lee A. 
Published: December 2017

Objective:
This qualitative study examines surgical consultation as a social process and assesses its alignment with assumptions of the shared decision-making (SDM) model.

Summary of Background Data:
SDM stresses the importance of patient preferences and rigorous discussion of therapeutic risks/benefits based on these preferences. However, empirical studies have highlighted discrepancies between SDM and realities of surgical decision making. Qualitative research can inform understanding of the decision-making process and allow for granular assessment of the nature and causes of these discrepancies.

Methods:
We observed consultations between 3 general surgeons and 45 patients considering undergoing 1 of 2 preference-sensitive elective operations: (1) hernia repair, or (2) cholecystectomy. These patients and surgeons also participated in semi-structured interviews.

Results:
By the time of the consultation, patients and surgeons were predisposed toward certain decisions by preceding events occurring elsewhere. During the visit, surgeons had differential ability to arbitrate surgical intervention and construct the severity of patients’ conditions. These upstream dynamics frequently displaced the centrality of the risk/benefit-based consent discussion.

Conclusion:
The influence of events preceding consultation suggests that decision-making models should account for broader spatiotemporal spans. Given surgeons’ authority to define patients’ conditions and control service provision, SDM may be premised on an overestimation of patients’ power to alter the course of decision making once in a specialist's office. Considering the subordinate role of the risk/benefit discussion in many surgical decisions, it will be important to study if and how the social process of decision making is altered by SDM-oriented decision aids that foreground this discussion.
Immediate Effects of Transcranial Direct Current Stimulation on Obsession-Induced Anxiety in Refractory Obsessive-Compulsive Disorder
Authors: Todder Doron , Gershi Adi , Perry Zvi , Kaplan Zeev , Levine Joseph , Avirame Keren 
Published: December 2017

Objective
Studies have shown that transcranial direct current stimulation (tDCS) has immediate effects on brain activity. The aim of this study was to investigate the potential use of tDCS to regulate obsession-induced anxiety immediately after symptom provocation in patients with refractory obsessive-compulsive disorder (OCD).

Methods
Twelve patients with refractory OCD received cathode, anode, and sham transcranial direct current stimulation over the medial prefrontal cortex conjugant to pharmacological treatment in a crossover design. Before and after the DC stimulation, patients graded the intensity of their anxiety after a short exposure to a provoking stimulus using the visual analogue scale. Clinical questionnaires assessing symptoms severity were also applied before each stimulation mode.

Results
We found a statistically significant decrease in the severity of the obsession-induced anxiety (decreased visual analogue scale) as a result of cathode tDCS in comparison with the anode and sham stimulation. Reduction in obsession-induced anxiety was consistent, yet short lasting, and was independent of symptom severity.

Conclusions
Cathode tDCS could be potentially used to regulate obsession-induced anxiety in refractory OCD patients. Further studies are warranted to confirm our results as well as to determine whether tDCS can achieve prolonged benefits in OCD and be of aid in behavioral treatments based on exposure.
Identifying chemogenetic interactions from CRISPR knockout screens with drugZ
Authors: Colic Medina , Wang Gang , Zimmermann Michal , Mascall Keith , McLaughlin Megan , Bertolet Lori , Lenoir W. Frank , Moffat Jason , Angers Stephane , Durocher Daniel , Hart Traver 
Published: December 2017

AbstractChemogenetic profiling enables the identification of gene mutations that enhance or suppress the activity of chemical compounds. This knowledge provides insights into drug mechanism-of-action, genetic vulnerabilities, and resistance mechanisms, all of which may help stratify patient populations and improve drug efficacy. CRISPR-based screening enables sensitive detection of drug-gene interactions directly in human cells, but until recently has largely been used to screen only for resistance mechanisms. We present drugZ, an algorithm for identifying both synergistic and suppressor chemogenetic interactions from CRISPR screens. DrugZ identifies synthetic lethal interactions between PARP inhibitors and both known and novel members of the DNA damage repair pathway. Additionally, drugZ confirms KEAP1 loss as a resistance factor for ERK inhibitors in oncogenic KRAS backgrounds and identifies additional cell-specific mechanisms of drug resistance. The software is available at github.com/hart-lab/drugz.
Cryptic genetic variation defines the adaptive evolutionary potential of enzymes
Authors: Baier Florian , Hong Nansook , Yang Gloria , Pabis Anna , Barrozo Alexandre , Carr Paul D , Kamerlin Shina CL , Jackson Colin J , Tokuriki Nobuhiko 
Published: December 2017

AbstractGenetic variation among orthologous proteins can cause cryptic phenotypic properties that only manifest in changing environments. Such variation may also impact the evolutionary potential of proteins, but the molecular basis for this remains unclear. Here we perform comparative directed evolution in which four orthologous metallo-β-lactamases were evolved toward a new function. We found that genetic variation between these enzymes resulted in distinct evolutionary outcomes. The ortholog with the lower initial activity reached a 20-fold higher fitness plateau exclusively via increasing catalytic activity. By contrast, the ortholog with the highest initial activity evolved to a less-optimal and phenotypically distinct outcome through changes in expression, oligomerization and activity. We show that the cryptic molecular properties and conformational variation of residues in the initial genotypes cause epistasis, thereby constraining evolutionary outcomes. Our work highlights that understanding the molecular details relating genetic variation to protein functions is essential to predicting the evolution of proteins.
Who guarantees the quality of the quality assurance agencies? The exploration of the establishment and growth of the Asia-Pacific Quality Register (APQR)
Authors: Zhang Jianxin , Patil Jagannath 
Published: December 2017

Purpose
After the “quantity era,” today higher education has entered into the “quality era” and as “the gate keepers of quality,” quality assurance agencies (QAAs) are playing more and more irreplaceable important roles and their social status are becoming more and more prominent. However, how to guarantee the quality of the QAAs? Who can review the QAAs? The purpose of this paper is based exploration of these questions.

Design/methodology/approach
Following the founding of the European Quality Assurance Register (EQAR) for Higher Education, the Asia Pacific Quality Register (APQR) became the second in the international quality assurance (QA) networks to implement QA register, in 2015 with initiative of Asia-Pacific Quality Network.

Findings
This paper first retrospects the history and process of APQR, and subsequently the implementation of APQR is described in detail from the two aspects of the criteria and the procedure, and at the end, the paper concludes with a summary of the three characteristics of this first formal implement of APQR: APQR is an international register open to all the QAAs; APQR emphasizes characteristics evaluation of diversity; and APQR highlights the combination of quantitative assessment and qualitative assessment.

Originality/value
Today on the international stage of QA, APQR has emerged as “the watchman of quality” in the Asia-Pacific region as counterpart of EQAR in Europe. How far away does such newly emerging form of guaranteeing the QAAs’ quality go forward, what is its future prospects and other concerning issues, are some of the question that need enthusiastic attention and contribution.
Ultrastructural observations of Beauveria bassiana infection in Xylotrechus rusticus larvae
Authors: Ding Jun‐Nan , Chi De‐Fu 
Published: December 2017

AbstractIn the present study we investigated the infection process of Beauveria bassiana on Xylotrechus rusticus larvae using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The SEM results showed that B. bassiana spores germinated on the surface of the larval body and invaded the larva as an appressorium. The hyphae then germinated from the spores and spread throughout the larval body. After the death of the larva, conidiophores formed at one end of the hypha on the surface of the larval body and prepared for a new round of infection. The TEM results showed severe damage to the larval cuticle after hyphae infection. The structure of the cuticle became thinner and eventually flocculent; muscle tissues were dissociated and eventually stuck to the hyphae, and the corpus adiposum was loose and deformed, and eventually degraded.
Investigating the genetic structure of trout from the Garden of Ninfa (central Italy): Suggestions for conservation and management
Authors: Fabiani A. , Gratton P. , Zappes I. A. , Seminara M. , D'Orsi A. , Sbordoni V. , Allegrucci G. 
Published: December 2017

AbstractMediterranean populations of brown trout (Salmo trutta L. complex) have lost a large part of their genetic distinctiveness, mostly due to massive restocking, and the waters of the Gardens of Ninfa (province of Latina, central Italy, Site of Community Importance since 2013) are regarded as one of a few potential reservoirs of autochthonous trout lineages in the Tyrrhenian drainage of the Italian peninsula. In this study, nuclear and mitochondrial markers were used on brown trout samples from Ninfa to estimate non‐Mediterranean influence in the population gene pool, potential changes of genetic structure over time and genetic relationships with other sites known (or suspected) to host native trout gene pools. Striking changes in both microsatellite and mtDNA allele frequencies over a 9‐year time span were found and provided evidence of unrecorded stocking from the nearby Lake Fibreno. Results are analysed in the light of potential ecological consequences of such events on a longer time scale and provide a scientific background for fisheries management and conservation programmes in the area.
Live attenuated influenza virus vaccine reduces virus shedding of newborn piglets in the presence of maternal antibody
Authors: Genzow Marika , Goodell Christa , Kaiser Troy J. , Johnson Wesley , Eichmeyer Marc 
Published: December 2017

BackgroundInfluenza A virus in swine (IAV‐S) causes an acute respiratory disease of swine which results in great economic losses in pig production. Major control strategies include the use of killed vaccines (KV) in breeding females to confer passive immunity to their offspring. A bivalent H1N1 and H3N2 NS1‐truncated live attenuated IAV‐S vaccine have recently become available, which showed promising results in young pigs.ObjectiveThe aim of this study was to investigate the effect of an intranasal vaccination of newborn pigs with or without maternally derived antibodies (MDA) on virus shedding (via nasal swabs tested by virus isolation).MethodsThe study was performed as intratracheal challenge experiments with either a heterologous H1N2 or H3N2 viruses.Results and conclusionThe results of this study showed a significant decrease in the incidence and duration of shedding viable virus for vaccinated newborn piglets with or without MDA, providing strong evidence that intranasal vaccination is overcoming passively acquired maternal immunity. This study indicates that intranasal vaccination with a truncated NS1 live attenuated IAV‐S vaccine of newborn piglets with maternal antibodies can be a valuable tool for reducing the prevalence of heterologous H1N2 and H3N2 IAV‐S in pig herds.
Dual‐Sensitivity Multiple Sclerosis Lesion and CSF Segmentation for Multichannel 3T Brain MRI
Authors: Meier Dominik S. , Guttmann Charles R.G. , Tummala Subhash , Moscufo Nicola , Cavallari Michele , Tauhid Shahamat , Bakshi Rohit , Weiner Howard L. 
Published: December 2017

ABSTRACTBACKGROUND AND PURPOSEA pipeline for fully automated segmentation of 3T brain MRI scans in multiple sclerosis (MS) is presented. This 3T morphometry (3TM) pipeline provides indicators of MS disease progression from multichannel datasets with high‐resolution 3‐dimensional T1‐weighted, T2‐weighted, and fluid‐attenuated inversion‐recovery (FLAIR) contrast. 3TM segments white (WM) and gray matter (GM) and cerebrospinal fluid (CSF) to assess atrophy and provides WM lesion (WML) volume.METHODSTo address nonuniform distribution of noise/contrast (eg, posterior fossa in 3D‐FLAIR) of 3T magnetic resonance imaging, the method employs dual sensitivity (different sensitivities for lesion detection in predefined regions). We tested this approach by assigning different sensitivities to supratentorial and infratentorial regions, and validated the segmentation for accuracy against manual delineation, and for precision in scan‐rescans.RESULTSIntraclass correlation coefficients of .95, .91, and .86 were observed for WML and CSF segmentation accuracy and brain parenchymal fraction (BPF). Dual sensitivity significantly reduced infratentorial false‐positive WMLs, affording increases in global sensitivity without decreasing specificity. Scan‐rescan yielded coefficients of variation (COVs) of 8% and .4% for WMLs and BPF and COVs of .8%, 1%, and 2% for GM, WM, and CSF volumes. WML volume difference/precision was .49 ± .72 mL over a range of 0–24 mL. Correlation between BPF and age was r = .62 (P = .0004), and effect size for detecting brain atrophy was Cohen's d = 1.26 (standardized mean difference vs. healthy controls).CONCLUSIONSThis pipeline produces probability maps for brain lesions and tissue classes, facilitating expert review/correction and may provide high throughput, efficient characterization of MS in large datasets.
Hardiness as moderator of the relationship between structural and psychological empowerment on burnout in middle managers
Authors: Ayala Calvo Juan‐Carlos , García Guadalupe Manzano 
Published: December 2017

Using a sample of 210 middle managers, a time‐lagged design with four data‐collection points was used to test whether hardiness moderates the relationship between structural empowerment (SE), psychological empowerment (PE), and burnout. The structural equation model analysed revealed an indirect effect of SE on burnout through PE. This indirect effect is moderated by hardiness. The results also show that this indirect effect is only significant when the subject shows medium or high levels of hardiness. Our findings suggest that work environment conditions are not enough to explain the levels of burnout.Practitioner points

The propensity to experience burnout is linked to structural empowerment (SE). Therefore, employers should promote changes in the structural conditions of the working environment.

Hardiness modifies the influence of SE on psychological empowerment (PE). Hardiness helps taking better advantage of the conditions of SE. Therefore, employers should promote training programmes on hardiness.

Psychological empowerment mediates the relationship between SE and burnout. A moderate or high level of hardiness is needed for SE to raise PE and to diminish burnout symptoms. In the case of low hardiness middle managers, organizations must develop hardiness before enhancing SE.
Why price‐level dispersion went up in Europe after the financial crisis
Authors: Hoeberichts Marco , Stokman Ad 
Published: December 2017

AbstractPersistent price differences across euro area countries are an indication of incomplete economic integration. We analyse long‐ and short‐run developments of price‐level dispersion in the euro area and compare the results with price dispersion across US cities. We find that monetary and economic integration in Europe has been successful in establishing a major downward trend in price‐level differences across countries since 1960. After the Global Financial Crisis and the European Sovereign Debt Crisis, diverging economic conditions across euro area countries led to higher income dispersion, which contributed to a widening of price‐level differences again.