bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the Automated Electronic Microemboli Detection System in Patients Undergoing Carotid Endarterectomy
Authors: Leunissen Tesse , van Vriesland Daniel , den Ruijter Hester , Moll Frans , Mess Werner , de Borst Gert Jan 
Published: April 2017

Abstract
Purpose To assess the diagnostic value of automatic embolus detection software (AEDS) in transcranial Doppler (TCD) monitoring for the detection of solid microemboli in patients at risk for perioperative stroke during carotid endarterectomy (CEA).
Materials and Methods In 50 patients undergoing CEA, perioperative TCD registration was recorded. All recorded events, identified and saved by the AEDS, were analyzed off-line doubly by two human experts (HEs) within a time frame of > 4 months. The inter- and intraobserver variability was assessed. The overall agreement with the HEs, the sensitivity, specificity, negative and positive predictive values (NPV and PPV) of the AEDS were computed for different cut-offs (patient displaying perioperative 5, 10, 20, 25, or 50 microemboli).
Results 77 233 events were analyzed. The inter- and intraobserver variability was good (min κ = 0.72, max κ = 0.79). AEDS and the HEs identified 760 and 470 solid emboli, respectively. The agreement between AEDS and the HEs for solid emboli detection was poor (κ = 0.24, SE = 0.016). The specificity and NPV were high (99.2 % and 99.6 %) but the sensitivity and PPV were low (30.6 % and 19.8 %). Applying a threshold of > 20 microemboli resulted in the best sensitivity (100.0 %), specificity (84.4 %), PPV (42.7 %), NPV (100.0 %) and area under the curve (0.898). However, 58.3 % of the patients were false positive as classified by AEDS.
Conclusion In this validation cohort, AEDS has insufficient agreement with HEs in the identification of solid emboli. AEDS and HEs disagree with respect to the identification of specific patients at risk. Therefore, AEDS cannot be used as a standalone system to identify patients at risk for perioperative stroke during CEA.
Non-target effects of insect biocontrol agents and trends in host specificity since 1985.
Authors: Driesche R. van , Hoddle M. 
Published: April 2017

Abstract
Non-target impacts of parasitoids and predaceous arthropods used for classical biological control of invasive insects include five types of impact: (1) direct attacks on native insects; (2) negative foodweb effects, such as competition for prey, apparent competition, or displacement of native species; (3) positive foodweb effects that benefited non-target species; (4) hybridization of native species with introduced natural enemies; and (5) attacks on introduced weed biocontrol agents. Examples are presented and the commonness of effects discussed. For the most recent three decades (1985-2015), analysis of literature on the host range information for 158 species of parasitoids introduced in this period showed a shift in the third decade (2005-2015) towards a preponderance of agents with an index of genus-level (60%) or species-level (8%) specificity (with only 12% being assigned a family-level or above index of specificity) compared with the first and second decades, when 50 and 40% of introductions had family level or above categorizations of specificity and only 21-27 (1985-1994 and 1995-2004, respectively) with genus or 1-11% (1985-1994 and 1995-2004, respectively) with species-level specificity. In all three decades, 11-12% of introductions could not be classified in this manner due to lack of information. Recommendations for future actions to improve this record are made: (1) distinguish host use from population-level impact; (2) develop country-level online summaries of relevant information; (3) plan biological control projects with conservation partners; and (4) conduct post-release comparisons of actual impact to predicted risk based on quarantine studies.
Theoretical evaluation of the role of crystal defects on local equilibrium and effective diffusivity of hydrogen in iron
Authors: Bombac D. , Katzarov I. H. , Pashov D. L. , Paxton A. T. 
Published: April 2017

Hydrogen diffusion and trapping in ferrite is evaluated by quantum mechanically informed kinetic Monte Carlo simulations in defective microstructures. We find that the lattice diffusivity is attenuated by two to four orders of magnitude due to the presence of dislocations. We also find that pipe diffusivity is vanishingly small along screw dislocations and demonstrate that dislocations do not provide fast diffusion pathways for hydrogen as is sometimes supposed. We make contact between our simulations and the predictions of Oriani's theory of ‘effective diffusivity’, and find that local equilibrium is maintained between lattice and trap sites. We also find that the predicted effective diffusivity is in agreement with our simulated results in cases where the distribution of traps is spatially homogeneous; in the trapping of hydrogen by dislocations where this condition is not met, the Oriani effective diffusivity is in agreement with the simulations to within a factor of two. This paper is part of a thematic issue on Hydrogen in Metallic Alloys
Betweenness centrality profiles in trees
Authors: Fish Benjamin , Kushwaha Rahul , Turán György 
Published: April 2017

Abstract
Betweenness centrality of a vertex in a graph measures the fraction of shortest paths going through the vertex. This is a basic notion for determining the importance of a vertex in a network. The $k$-betweenness centrality of a vertex is defined similarly, but only considers shortest paths of length at most $k$. The sequence of $k$-betweenness centralities for all possible values of $k$ forms the betweenness centrality profile of a vertex. We study properties of betweenness centrality profiles in trees.
We show that for scale-free random trees, for fixed $k$, the expectation of $k$-betweenness centrality strictly decreases as the index of the vertex increases. We also analyse worst-case properties of profiles in terms of the distance of profiles from being monotone, and the number of times pairs of profiles can cross. This is related to whether $k$-betweenness centrality, for small values of $k$, may be used instead of having to consider all shortest paths. Bounds are given that are optimal in order of magnitude. We also present some experimental results for scale-free random trees.
Fibromyalgia, a missed comorbidity in spondyloarthritis: prevalence and impact on assessment and treatment
Authors: Mease Philip J. 
Published: April 2017

Purpose of review
Fibromyalgia is a clinical representation of the neurobiological phenomenon of central sensitization, characterized by chronic widespread pain, fatigue, sleep disturbance, and other symptoms. Fibromyalgia may occur in conjunction with chronic rheumatic diseases, driven by the effects of chronic pain and inflammation and likely influenced by the patient's genetic and psychoemotional background. This article reviews the data on prevalence of concomitant fibromyalgia and its impact on disease assessment in patients with spondyloarthritis (SpA) and psoriatic arthritis (PsA).

Recent findings
Fibromyalgia occurs in 2–8% of the general population. In AxSpA cohorts the prevalence has been reported in 4–25%, and in PsA, 16–22%, the majority being female. Measures of disease activity which are comprised partly or wholly of patient-reported outcomes such as pain and patient global are significantly higher in patients with concomitant fibromyalgia and do not improve as much with treatment as more objective measures, a finding which has been observed in other diseases such as rheumatoid arthritis and lupus.

Summary
Fibromyalgia occurs in a significant proportion of patients with SpA and PsA. Disease activity measures with subjective elements are conflated in patients with fibromyalgia and do not reliably assess true inflammatory disease. This needs to be taken into account when evaluating the impact of immunomodulatory therapy.
Myxoid Spitz Nevi: Report of 6 Cases
Authors: Fernandez-Flores Angel , Riveiro-Falkenbach Erica , Cassarino David S. 
Published: April 2017

Abstract:
Mucin deposition in Spitz nevus seems to be a very rare phenomenon, as there have only been 3 cases previously published. We report 6 additional cases, half of them in women, and half in men. The ages of the patients varied from 5 to 47 years (mean = 30.17). Sizes of the nevi varied from 3 to 6 mm. Four lesions were located on the extremities, whereas one was located on the trunk (there was no clinical information about the other). A vascular lesion was suspected in 2 cases. Excision with clear margins was achieved in all cases but one. So far, there have been no recurrences after follow-ups varying from 1 to 5 years. The biopsy showed a symmetrical melanocytic Spitz nevus in all cases. Three cases were compound, and 3 cases were junctional nevi. The epidermis was either acanthotic or hyperplastic in all cases, with no epidermal consumption. Kamino bodies were found in 4 cases. The deposit of mucin was moderate in 5 cases and mild in one case. Mucin was found in the stroma between the dermal melanocytes in cases of compound nevi and in the melanocytic nests of the junctional component.
The Facial Platysma and Its Underappreciated Role in Lower Face Dynamics and Contour
Authors: de Almeida Ada R.T. , Romiti Alessandra , Carruthers Jean D.A. 
Published: April 2017

BACKGROUND
The platysma is a superficial muscle involved in important features of the aging neck. Vertical bands, horizontal lines, and loss of lower face contour are effectively treated with botulinum toxin A (BoNT-A). However, its pars facialis, mandibularis, and modiolaris have been underappreciated.

OBJECTIVE
To demonstrate the role of BoNT-A treatment of the upper platysma and its impact on lower face dynamics and contour.

MATERIAL AND METHODS
Retrospective analysis of cases treated by an injection pattern encompassing the facial platysma components, aiming to block the lower face as a whole complex. It consisted of 2 intramuscular injections into the mentalis muscle and 2 horizontal lines of BoNT-A injections superficially performed above and below the mandible (total dose, 16 onabotulinumtoxinA U/side). Photographs were taken at rest and during motion (frontal and oblique views), before and after treatment.

RESULTS
A total of 161 patients have been treated in the last 2 years with the following results: frontal and lateral enhancement of lower facial contour, relaxation of high horizontal lines located just below the lateral mandibular border, and lower deep vertical smile lines present lateral to the oral commissures and melomental folds.

CONCLUSION
The upper platysma muscle plays a relevant role in the functional anatomy of the lower face that can be modulated safely with neuromodulators.
Comparison of Intracoronary and Intravenous Ultrasound-targeted Microbubble Destruction–mediated Ang1 Gene Transfection on Left Ventricular Remodeling in Canines With Acute Myocardial Infarction
Authors: Cao Sheng , Zhou Qing , Chen Jin-ling , Cui Jing-jing , Shan Ying-guang , Hu Bo , Guo Rui-qiang 
Published: April 2017

Abstract:
Intravenous ultrasound-targeted microbubble destruction (IV-UTMD) has made distinct but limited progress in gene therapy. Intracoronary (IC) injection may lead to more gene transfection than IV injection. This study compared the therapeutic effects of IC-UTMD–mediated and conventional IV-UTMD–mediated gene transfection in acute myocardial infarction (MI). A canine MI model was successfully established through transcatheter coronary artery embolism, and the animals were divided into several treatment groups: IC injection with UTMD and the negative control plasmid (IC-UTMD); IC injection of the angiopoietin 1 (Ang1) plasmid (IC-Ang1); IC injection with UTMD and the Ang1 plasmid (IC-UTMD-Ang1); and IV injection with UTMD and the Ang1 plasmid (IV-UTMD-Ang1). At 12 hours after injection, more green fluorescence was observed from the fluorescein isothiocyanate-labeled Ang1 plasmid in the IC-UTMD-Ang1 group. After 1 month, compared with the IV-UTMD-Ang1 group, echocardiography showed that the IC-UTMD-Ang1 group exhibited increased left ventricular systolic function and myocardial infusion, with lower fibrous tissue levels and higher blood vessel density and Ang1 mRNA and protein levels. Similar cardiac troponin I and N-terminal pro-B type natriuretic peptide levels were observed in all groups. Compared with IV-UTMD, IC-UTMD can enhance Ang1 plasmid transfection efficiency after MI, promote gene expression and angiogenesis, and improve left ventricular remodeling without decreasing safety.
Peripheral inflammatory pain sensitisation is independent of mast cell activation in male mice
Authors: Lopes Douglas M. , Denk Franziska , Chisholm Kim I. , Suddason Tesha , Durrieux Camille , Thakur Matthew , Gentry Clive , McMahon Stephen B. 
Published: April 2017

Abstract
The immune and sensory systems are known for their close proximity and interaction. Indeed, in a variety of pain states, a myriad of different immune cells are activated and recruited, playing a key role in neuronal sensitisation. During inflammatory pain it is thought that mast cells (MC) are one of the immune cell types involved in this process, but so far the evidence outlining their direct effect on neuronal cells remains unclear. To clarify whether MC are involved in inflammatory pain states, we used a transgenic mouse line (Mctp5Cre-iDTR) in which MC could be depleted in an inducible manner by administration of diphtheria toxin. Our results show that ablation of MC in male mice did not result in any change in mechanical and thermal hypersensitivity in the CFA model of inflammatory pain. Similarly, edema and temperature triggered by CFA inflammation at the injection site remained identical in MC depleted mice compared with their littermate controls. In addition, we show that Mctp5Cre-iDTR mice display normal levels of mechanical hypersensitivity after local injection of nerve growth factor (NGF), a factor well characterised to produce peripheral sensitisation and for being upregulated upon injury and inflammation. We also demonstrate that NGF treatment in vitro does not lead to an increased level of tumor necrosis factor-α in bone marrow-derived MC. Furthermore, our qRT-PCR data reveal that MC express negligible levels of NGF receptors, thereby explaining the lack of response to NGF. Together, our data suggest that MC do not play a direct role in peripheral sensitisation during inflammatory conditions.
Optimizing Portable Pulse Oximeter Measurement Accuracy and Consistency During Exercise
Authors: LaPier Jonas , Chatellier Megan 
Published: April 2017

Purpose:
Monitoring oxygen saturation (SpO2) in some patient populations during exercise is vital. The objectives of this study were to determine whether under conditions of artificial hypoperfusion pulse oximeter performance during exercise was influenced by sensor type, attachment clip reinforcement, or a low pressure arm cuff.

Methods:
Six different portable oximeter models were tested on study participants at rest with a control (normothermic) and experimental (hypothermic) hand. Oximeters were then tested during treadmill walking at 1 and 2 mph with the experimental hand remaining hypothermic. Electrocardiographic measurements of heart rate were also taken simultaneously.

Results:
There were differences in SpO2 values between oximeter pairs following cold exposure at rest for most models (5 out of 6) but during walking for only 1 model. There were also differences between oximeter and electrocardiographic heart rate measurements for some models when study participants walked on a treadmill at 1 mph (1 out of 6) and 2 mph (3 out of 6).

Conclusions:
Results suggest that oximeter performance is better when measuring SpO2 than heart rate. Cold-induced hypoperfusion caused inaccuracies in SpO2 measurements, which were greater at rest than during exercise. Study results also suggest that some pulse oximeters perform better when the oximeter sensor attachment clip is reinforced with an elastic band.
Relationship Between Physical Therapy, Occupational Therapy, Palliative Care Consultations, and Hospital Length of Stay
Authors: Wilson Christopher , Roy Danielle 
Published: April 2017

Purpose:
Physical therapy (PT) and occupational therapy (OT) treatment utilization in palliative care (PC) is not well documented. This study analyzed which hospitalized patients have received an order for a PC consultation and also received an order for PT or OT during that admission and described the patients most likely to have these services ordered.

Methods:
Palliative care orders were examined retrospectively for presence or absence of PT/OT orders in the context of primary PC diagnoses, age, and length of stay (LOS).

Results:
Of the 824 unique patients, 681 patients (83%) received at least 1 order for PT while 615 patients (75%) received at least 1 order for OT. Palliative care patients who received orders for PT and OT (9.7 days) and PT and/or OT (9.3 days) had a longer LOS (P < .0001) compared with those who did not receive either PT or OT (5.0 days).

Conclusions:
A large percentage of patients who received PC consultations also received PT and/or OT orders, and most of the time therapy was ordered before PC. On the basis of these findings, ordering providers may be consulting PT/OT to assist with discharge planning for medically complex patients with a longer anticipated LOS.
Microsurgery for Recurrent Vestibular Schwannoma After Previous Gross Total Resection
Authors: Perry Avital , Graffeo Christopher S. , Copeland William R. , Carlson Matthew L. , Neff Brian A. , Driscoll Colin L. , Link Michael J. 
Published: April 2017

Objective:
To present a single-institution experience and supportive systematic literature review examining outcomes after repeat microsurgery for recurrent vestibular schwannoma (VS) following previous gross total resection (GTR).

Study Design:
Retrospective review of prospectively maintained VS database. Systematic literature review.

Setting:
Tertiary referral center.

Patients:
Six proven VS recurrences after primary GTR, treated via repeat microsurgery.

Intervention:
Repeat microsurgery.

Main Outcome Measures:
Facial nerve function, extent-of-resection, time-to-repeat surgery, same versus alternate approach at repeat surgery (relative to primary operation).

Results:
GTR was achieved in four (67%). House–Brackmann (HB) grade I–II facial nerve function was achieved in five (87%), including one that improved from preoperative HB grade V. An alternate surgical approach was chosen in four (67%). Systematic review identified four studies documenting 50 cases with patient-specific outcomes after repeat microsurgery for recurrent VS. Our cohort had significantly longer mean time-to-repeat surgery (117 vs. 64 months, p = 0.03), was significantly less likely to have HB III–VI function postrepeat (17% vs. 68%, p = 0.04), and was significantly less likely to undergo same approach surgery (33% vs. 90%, p = 0.0002); rates of GTR were nonsignificant (67% vs. 94%, p = 0.1).

Conclusion:
We report a six-patient series of microsurgery for recurrent VS after GTR, and the first systematic review of this rare and challenging entity. Anecdotally, our findings suggest that an alternate surgical approach may facilitate easier access to the tumor, with less scar encountered during the approach. Our results confirm that repeat microsurgery for recurrent VS is safe and effective, even for larger tumors not typically amenable to stereotactic radiosurgery.
Are Cervical Collars a Necessary Postprocedure Restriction in Patients With Benign Paroxysmal Positional Vertigo Treated With Particle Repositioning Maneuvers?
Authors: Stewart Kirsten E. , Whelan Darren M. , Banerjee Anirvan 
Published: April 2017

Introduction:
Benign paroxysmal positional vertigo (BPPV) is managed with particle repositioning maneuvers (PRM), following which patients are advised of activity restrictions to prevent recurrence. This can include wearing a cervical collar.

Objective:
Does the use of BPPV postprocedure restriction with a cervical collar impact on the number of PRMs required to resolve a patient's symptoms?

Method:
Combination of retrospective and prospective review of 624 patients treated in a tertiary UK hospital. All were diagnosed with posterior canal BPPV and received a modified Epley maneuver (PRM). The “with cervical collar” (WC) retrospective group 2002 to 2009 (n = 263) were advised to wear a cervical collar for 48 hours postprocedure, and the “no cervical collar” (NC) prospective group 2010 to 2014 (n = 361) were not. The main outcome measure was the resolution of patient symptoms following a PRM for BPPV. Quantitative and statistical analysis using χ2 test was undertaken.

Results:
In the WC group, 84% (n = 221) had resolution of symptoms after the first PRM, versus 82.8% (n = 299) in the NC group. After the second PRM 11% (n = 29) resolved, versus 13.6% (n = 49) in the NC group. After the third PRM 4.9% (n = 13) resolved, versus 3.6% (n = 13) in the NC group. Both clinically and statistically there was no significant difference in outcome between groups.

Conclusions:
Our review of 624 patients is the largest study in this subject and the results demonstrate that wearing a cervical collar following PRM for BPPV concedes no significant benefit. Excluding this from postprocedure guidance allows patients to manage without the inconvenience of wearing a cervical collar, and allows departments to update clinical guidance.
Atlantean Evolution in Darwin’s Finches—Issues and Perspectives in Species Delimitation using Phenotypic Data
Authors: Cadena Carlos Daniel , Jiménez Iván , Zapata Felipe 
Published: April 2017

AbstractProgress in the development and use of methods for species delimitation employing phenotypic data lags behind conceptual and practical advances in molecular genetic approaches. The basic evolutionary model underlying the use of phenotypic data to delimit species assumes random mating and quantitative polygenic traits, so that phenotypic distributions within a species should be approximately normal for individuals of the same sex and age. Accordingly, two or more distinct normal distributions of phenotypic traits suggest the existence of multiple species. In light of this model, we show that analytical approaches employed in taxonomic studies using phenotypic data are often compromised by three issues: (1) reliance on graphical analyses of phenotypic space that do not consider the frequency of phenotypes; (2)exclusion of characters potentially important for species delimitation following reduction of data dimensionality; and (3) use of measures of central tendencies to evaluate phenotypic distinctiveness. We outline approaches to overcome these issues based on statistical developments related to normal mixture models and illustrate them empirically with a reanalysis of morphological data recently used to claim that there are no morphologically distinct species of Darwin’s ground-finches (Geospiza). We found negligible support for this claim relative to taxonomic hypotheses recognizing multiple species. Although species limits among ground-finches merit further assessments using additional sources of information, our results bear implications for other areas of inquiry including speciation research: because ground-finches have likely speciated and are not trapped in a process of “Sisyphean” evolution as recently argued, they remain useful models to understand the evolutionary forces involved in speciation. Our work underscores the importance of statistical approaches grounded on appropriate evolutionary models for species delimitation. Approaches allowing one to fit normal mixture models withouta prioriinformation about species limits offer new perspectives in the kind of inferences available to systematists, with significant repercusions on ideas about the structure of biological biodiversity. [morphology; normal mixture model; phenotype; principal components analysis; species limits; variable selection.]