bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mitochondrial calcium homeostasis: Implications for neurovascular and neurometabolic coupling
Authors: Kannurpatti Sridhar S 
Published: November 2016

Mitochondrial function is critical to maintain high rates of oxidative metabolism supporting energy demands of both spontaneous and evoked neuronal activity in the brain. Mitochondria not only regulate energy metabolism, but also influence neuronal signaling. Regulation of “energy metabolism” and “neuronal signaling” (i.e. neurometabolic coupling), which are coupled rather than independent can be understood through mitochondria’s integrative functions of calcium ion (Ca2+) uptake and cycling. While mitochondrial Ca2+ do not affect hemodynamics directly, neuronal activity changes are mechanistically linked to functional hyperemic responses (i.e. neurovascular coupling). Early in vitro studies lay the foundation of mitochondrial Ca2+ homeostasis and its functional roles within cells. However, recent in vivo approaches indicate mitochondrial Ca2+ homeostasis as maintained by the role of mitochondrial Ca2+ uniporter (mCU) influences system-level brain activity as measured by a variety of techniques. Based on earlier evidence of subcellular cytoplasmic Ca2+ microdomains and cellular bioenergetic states, a mechanistic model of Ca2+ mobilization is presented to understand systems-level neurovascular and neurometabolic coupling. This integrated view from molecular and cellular to the systems level, where mCU plays a major role in mitochondrial and cellular Ca2+ homeostasis, may explain the wide range of activation-induced coupling across neuronal activity, hemodynamic, and metabolic responses.
Simultaneous acquisition of high-contrast and quantitative liver T1 images using 3D phase-sensitive inversion recovery: a feasibility study
Authors: Fujiwara Yasuhiro , Maruyama Hirotoshi , Kosaka Nobuyuki , Ishimori Yoshiyuki 
Published: November 2016

Background Tumor-to-liver contrast is low in images of chronically diseased livers because gadolinium-based hepatocyte-specific contrast agents (Gd-EOB-DTPA) accumulate less to hepatocytes. Purpose To determine whether phase-sensitive inversion recovery (PSIR) could improve the T1 contrasts of Gd-based contrast agents and liver parenchyma and simultaneously provide accurate T1 values for abdominal organs. Material and Methods The image contrasts of phantoms with different Gd concentrations that were obtained using PSIR were compared to conventional turbo field echo (TFE) results. T1 value was estimated using PSIR by performing iterations to investigate the two IR magnetization evolutions. The estimated T1 values were validated using IR-spin echo (IR-SE) and Look-Locker (L-L) sequences. In an in vivo study, the liver-to-spleen and liver-to-muscle contrasts of the PSIR and TFE images of seven volunteers were compared, as were the T1 values of liver parenchyma, spleen, and muscle obtained using PSIR and L-L sequences. Results The PSIR images showed T1 contrasts higher than those in the TFE results. The PSIR and IR-SE T1 values were linearly correlated. Additionally, the R1 estimated using PSIR were correlated with those measured using IR-SE and L-L. In the in vivo study, the liver-to-spleen and liver-to-muscle contrasts of PSIR were significantly higher than those obtained using TFE. T1 values of abdominal organs obtained using PSIR and L-L were clearly correlated. Conclusion PSIR may be capable of improving liver image T1 contrasts when Gd-based contrast agents are employed and simultaneously yielding accurate T1 values of abdominal organs.
Bone subtraction radiography in adult patients with cystic fibrosis
Authors: Obmann Verena C , Christe Andreas , Ebner Lukas , Szucs-Farkas Zsolt , Ott Sebastian R , Yarram Sai , Stranzinger Enno 
Published: November 2016

Background Bone subtraction radiography allows reading pulmonary changes of chest radiographs more accurately without superimposition of bones. Purpose To evaluate the value of bone subtraction chest radiography using dual energy (DE) bone subtracted lung images compared to conventional radiographs (CR) in adult patients with cystic fibrosis (CF). Material and Methods Forty-nine DE radiographs of 24 patients (16 men) with CF (mean age, 32 years; age range, 18–71 years) were included. Lung function tests were performed within 10 days of the radiographs. Two radiologists evaluated all CR, DE, and CR + DE radiographs using the modified Chrispin-Norman score (CNS) and a five-point score for the confidence. Findings were statistically evaluated by Friedman ANOVA and Wilcoxon matched-pairs test. Results There was significant difference of CNS between CR and DE ( P = 0.044) as well as CR and CR + DE ( P < 0.001). CNS of CR images showed moderate correlation with FEV1% (R = 0.287, P = 0.046) while DE and CR + DE correlated poorly with FEV1% (R = 0.023, P = 0.874 and R = 0.04, P = 0.785). A higher confidence was achieved with bone-subtracted radiographs compared to radiographs alone (median, CR 3.3, DE 3.9, CR + DE 4.1, for both P < 0.001). Conclusion DE radiographs are reliable for the evaluation of adult patients with CF in acute exacerbation. For yearly surveillance, CR and DE radiographs may play a limited role. However, in clinical routine, DE radiographs are useful for adult CF patients and may depict more accurately inflammatory changes than CR.
Elevated Modified Shock Index Within 24 Hours of ICU Admission Is an Early Indicator of Mortality in the Critically Ill
Authors: Smischney Nathan J. , Seisa Mohamed O. , Heise Katherine J. , Schroeder Darrell R. , Weister Timothy J. , Diedrich Daniel A. 
Published: November 2016

Purpose: To assess whether exposure to modified shock index (MSI) in the first 24 hours of intensive care unit (ICU) admission is associated with increased in-hospital mortality. Methods: Adult critically ill patients were included in a case–control design with 1:2 matching. Cases (death) and controls (alive) were abstracted by a reviewer blinded to exposure status (MSI). Cases were matched to controls on 3 factors—age, end-stage renal disease, and ICU admission diagnosis. Results: Eighty-three cases and 159 controls were included. On univariate analysis, lorazepam administration (odds ratio [OR]: 5.75, confidence interval [CI] = 2.28-14.47; P ≤ .01), shock requiring vasopressors (OR: 3.62, CI = 1.77-7.40; P ≤ .01), maximum MSI (OR: 2.77 per unit, CI = 1.63-4.71; P ≤ .001), and elevated acute physiologic and chronic health evaluation (APACHE) III score at 1 hour (OR: 1.41 per 10 units, CI = 1.19-1.66; P ≤ .001) were associated with mortality. Maximum MSI (OR: 1.93 per unit, CI = 1.07-3.48, P = .03) and APACHE III score at 1 hour (OR: 1.29 per 10 units, CI = 1.09-1.53; P = .003) remained significant with mortality in the multivariate analysis. The optimal cutoff point for high MSI and mortality was 1.8. Conclusion: Critically ill patients who demonstrate an elevated MSI within the first 24 hours of ICU admission have a significant mortality risk. Given that MSI is easily calculated at the bedside, clinicians may institute interventions earlier which could improve survival.
Evaluating Coincident Relationships Between Obesity Incidence and Normal Weight Incidence From Birth Through Kindergarten for US Children
Authors: Yeaton William H. , Shah Megha K. , Moss Brian G. 
Published: November 2016

Purpose: We examine the concurrent relationship between obesity incidence and normal weight status incidence and prevalence in children between 9 months and kindergarten. Design: Multistage, probability sample from the Early Childhood Longitudinal Study–Birth cohort. Setting: United States. Participants: Representative sample of US preschool children (n = 9950) followed from birth through kindergarten. Measures: From direct, anthropometric measures, we reported prevalence and incidence rates across 4 follow-up periods. Analysis: In addition to prevalence and incidence rates, we reported risk ratios based on multiple definitions and estimated predicted probabilities of obesity and normal weight status using clinically meaningful body mass index (BMI)-for-age percentiles. Results: Obesity prevalence (13%-20%) was much smaller than normal weight status prevalence (66%-70%). Lower socioeconomic status, Hispanic, and non-Hispanic black children had greater risk of obesity. During 9 months to kindergarten, obesity incidence decreased two-thirds (15.6%), while normal weight status incidence decreased almost one-half (44.6%). Coincidently, normal weight status incidence (ranged from 23% to 45%) was consistently and substantially higher than obesity incidence (ranged from 5% to 15%). During 4 years to kindergarten, the obesity risk for overweight children was 13 times higher than that for normal weight status children. Conclusion: Overall rates of obese and normal weight incidence were substantial at 9 months, trended lower, but remained high through kindergarten. At 4 years to kindergarten, children with relatively high initial BMI were very likely to become obese but far less likely to achieve normal weight status.
Comparison of estimates of body fat content in childhood-onset systemic lupus erythematosus
Authors: Sinicato N A , Peres F A , de Oliveira Peliçari K , de Oliveira Santos A , Ramos C D , Marini R , Appenzeller S 
Published: November 2016

Objective We aimed to compare estimates of body fat content with respect to their ability to predict the percentage of body fat, confirmed by dual-energy X-ray absorptiometry scans in childhood-onset systemic lupus erythematosus. Methods We included 64 consecutive childhood-onset systemic lupus erythematosus patients and 64 healthy age and sex-matched controls in a cross-sectional study. Anthropometric data, body mass index and body adiposity index were calculated for all subjects. Childhood-onset systemic lupus erythematosus patients were further assessed for clinical and laboratory childhood-onset systemic lupus erythematosus manifestations and fat mass, lean mass and percentage of body fat evaluated by dual-energy X-ray absorptiometry. Results Elevated waist/hip ratio was observed in childhood-onset systemic lupus erythematosus patients when compared to controls ( p < 0.001). We did not find differences between body mass index and body adiposity index classification in childhood-onset systemic lupus erythematosus patients and controls. Using dual-energy X-ray absorptiometry as gold standard we observed that all indirect estimates of body fat were correlated with whole body fat mass. We observed a correlation between height and cumulative corticosteroid dose adjusted by weight ( r = 0.429, p = 0.005) in childhood-onset systemic lupus erythematosus. On whole body analysis we observed a correlation between lean mass and ACR Damage Index scores ( r = −0.395; p = 0.019); percentage of body fat and adjusted Systemic Lupus Erythematosus Disease Activity Index ( r = 0.402; p = 0.008), disease duration ( r = −0.370; p = 0.012). On trunk analysis we observed a correlation between lean mass and ACR Damage Index ( r = −0.319; p = 0.042); percentage of body fat with adjusted Systemic Lupus Erythematosus Disease Activity Index ( r = 0.402; p = 0.005), disease duration ( r = −0.408; p = 0.005). Conclusions This is the first study analyzing body adiposity index in childhood-onset systemic lupus erythematosus patients. We observed that all indirect estimates of body fat were correlated with whole body fat mass. This study shows that we should not replace body mass index by body adiposity index to evaluating fat levels in childhood-onset systemic lupus erythematosus. In consideration of the importance of overweight classification in cardiovascular diseases, any direct estimates of body fat can be used in an attempt to improve the prognosis of patients. Note We believe that we have presented evidence of body adiposity index accuracy in childhood-onset systemic lupus erythematosus patients but further research on the generalizability of body adiposity index to other patient groups needs to be done.
Prevalence, Pattern and Factors Associated with Work-related Musculoskeletal Disorders (WRMD) among Housekeeping Workers in a Private Tertiary Care Hospital in Bangalore
Authors: B Joseph , R Naveen , A Suguna , A Surekha 
Published: November 2016

Introduction Work-related musculoskeletal disorders (WRMDs) represent one of the most common and important occupational health problems in the working population; they negatively impact the quality of life and are a cause for major economic burden in the form of compensation and lost wages. Objectives To assess the prevalence, pattern and factors associated with WRMD among housekeeping workers in a private tertiary care hospital in Bangalore. Methodology A cross-sectional study was conducted among housekeeping workers in a private tertiary care hospital from May to September 2014. A pre-tested semi-structured questionnaire was administered which included socio-demographic details and the standardized Nordic questionnaire (SNQ). Out of the 130 workers, we were able to contact 83 workers (as some were on long leave and some left the job). Results Among the 83 housekeeping workers studied, the mean age was 37.4 ± 2.42 years. Prevalence of WRMD was estimated to be 68.3 per cent and the pattern of pain was found to be high for low back and least for ankles. There was a significant association between the prevalence of pain with increased duration of work hours and years of employment. Conclusion This study showed a high prevalence of WRMD among housekeeping staff which is associated with long hours of work and years of work. We can aim at reducing the WRMD by giving health education about ergonomics, recommending job rotation and in severe cases even physiotherapy.
Incidence and Management of Thrombotic and Thromboembolic Complications Following the Norwood Procedure: A Systematic Review
Authors: Agarwal Arnav , Firdouse Mohammed , Brar Nishaan , Yang Andy , Lambiris Panos , Chan Anthony K. , Mondal Tapas K. 
Published: November 2016

Background: The stage 1 Norwood procedure and its variants represent the first step of palliation for hypoplastic left heart syndrome. Although appropriate postoperative thromboprophylaxis is integral, significant variance remains across institutional practices. The purpose of this systematic review is to estimate the incidence of thrombosis and thromboembolism following the Norwood or modified Blalock-Taussig shunt procedure and examine current thromboprophylaxis regimens. Methods: Ovid MEDLINE and Embase were searched from January 2000 to June 2016 for primary studies explicitly reporting incidence of thrombosis, thromboembolism (strokes and pulmonary embolisms), or shunt occlusion in neonates, infants, and children undergoing the Norwood procedure or any variant. All-cause mortality was a secondary outcome of interest. Results: Of 887 identified articles, 15 cohort studies were deemed eligible, the majority including modified Blalock-Taussig shunt patients. Reported incidence of thrombosis ranged from 0% to 40%; thromboembolic events were rarely reported. Overall mortality ranged from 4.5% to 31.3% across studies. Although most studies involved the long-term acetylsalicylic acid use, thromboprophylaxis strategies varied across studies. Due to substantial variability in event rates, no correlation was identified with thrombotic complications. Discussion: Clinical practice guidelines recommend that patients receive intraoperative unfractionated heparin therapy and either aspirin or no antithrombotic therapy postoperatively. Our findings suggest a substantial risk of thrombosis and thromboembolism and demonstrate substantial variation in thromboprophylaxis practices. Conclusion: Although postoperative thromboprophylaxis seems optimal, it remains controversial whether the long-term aspirin use is most effective. Our findings highlight the lack of a gold-standard thromboprophylaxis strategy and emphasize the need for more consistency.
Democracy: Trap, Tragedy or Crisis?
Authors: Hobson Christopher 
Published: November 2016

A quarter of a century after the fall of the Berlin Wall and the confidence once surrounding liberal democracy has been replaced with increasing concerns over its health. Reflecting this change of mood, there has been a proliferation of books examining whether democracy may be in crisis. This review surveys some of these recent contributions, which are united by a much more pessimistic tone. As these books detail, democracy now confronts major problems in essentially every sphere, with changes in the economic realm arguably being the most consequential. Rather than theorising more expansive forms of democracy, the challenge increasingly seems to be one of holding onto what we already have. Brown W (2015) Undoing the Demos: Neoliberalism’s Stealth Revolution. New York: Zone books. Coggan P (2013) The Last Vote: The Threats to Western Democracy. London: Allen Lane. Dunn J (2013) Breaking Democracy’s Spell. New Haven, CT: Yale University Press. Johnston S (2015) American Dionysia: Violence, Tragedy, and Democratic Politics. New York: Cambridge University Press. Kurlantzick J (2013) Democracy in Retreat: The Revolt of the Middle Class and the Worldwide Decline of Representative Government. New Haven, CT: Yale University Press. Mair P (2013) Ruling the Void: The Hollowing of Western Democracy. London: Verso. Runciman D (2013) The Confidence Trap: A History of Democracy in Crisis from World War I to the Present. Princeton, NJ: Princeton University Press.
Do Anti-Union Policies Increase Inequality? Evidence from State Adoption of Right-to-Work Laws
Authors: Kogan Vladimir 
Published: November 2016

AbstractThe distribution of income lies at the intersection of states and markets, both influencing and responding to government policy. Reflecting this reality, increasing research focuses on the political origins of inequality in the United States. However, the literature largely assumes—rather than tests—the political mechanisms thought to affect the income gap. This study provides a timely reassessment of one such mechanism. Leveraging variation in labor laws between states and differences in the timing of adoption of right-to-work (RTW) legislation, I examine one political mechanism blamed by many for contributing to inequality. Using a variety of panel designs, I find little evidence that RTW laws have been a major cause of growing income inequality, pointing to the importance of grounding theoretical arguments about the interrelationships between states and markets in a sound empirical reality.
Management of Distal Tibial Metaphyseal Bone Defects With an Intramedullary Nitinol Scaffold: A Novel Technique
Authors: Ford Samuel E. , Ellington J. Kent 
Published: November 2016

Difficult problems that are faced when reconstructing severe pilon fractures include filling metaphyseal defects and supporting an impacted, multifragmented articular surface. Supplements to plate fixation currently available in a surgeon’s armamentarium include cancellous bone autograft, structural bone allograft, demineralized bone matrix, and calcium-based cements. Cancellous autograft possesses limited inherent mechanical stability and is associated with graft site morbidity. Structural allografts incorporate inconsistently and are plagued by late resorption. Demineralized bone matrix also lacks inherent structural stability. Calcium phosphate cements are not rigidly fixed to bone unless fixation is applied from cortical bone or through a plate, which must be taken into consideration when planning fixation. The Conventus DRS (Conventus Orthopaedics, Maple Grove, MN) implant is an expandable nitinol scaffold that takes advantage of the elasticity and shape memory of nitinol alloy. Once deployed and locked, it serves as a stable intramedullary base for fragment-specific periarticular fracture fixation, even in the face of metaphyseal bone loss. Two cases of successful implant use are presented. In both cases, the implant is used to fill a metaphyseal void and provide stable articular support to the distal tibial plafond. Levels of Evidence: Therapeutic Level V: Case Report, Expert Opinion
Preoperative MR staging of cervical carcinoma: are oblique and contrast-enhanced sequences necessary?
Authors: Fridsten Susanne , Hellström Ann-Cathrin , Hellman Kristina , Sundin Anders , Söderén Boel , Blomqvist Lennart 
Published: November 2016

Background As the choice of treatment in patients with cervical carcinoma depends on cancer stage at diagnosis, accurate staging is essential. Purpose To compare three different combinations of magnetic resonance (MR) sequences for preoperative staging. Material and Methods Fifty-seven consecutive patients with biopsy proven cervical carcinoma underwent MR imaging (MRI) staging followed by primary surgical treatment. Thirty-two of 57 patients had had a cone biopsy prior to MRI. Three MR pulse sequence combinations were retrospectively reviewed by two experienced radiologists. The first imaging protocol consisted of pre-contrast sagittal and transverse images (protocol A), the second protocol included additionally oblique high-resolution T2-weighted (T2W) MR images of the cervix (protocol A+B), and the third included also contrast-enhanced sequences (protocol A+B+C). The imaging findings in the three steps (A, A+B, A+B+C) were recorded. The TNM stage was used for comparison between preoperative imaging and histopathology. Histopathology, together with surgical findings, served as gold standard. Results In 4/57 (7%) patients, the MR assessment of tumor stage (mrT) was altered when oblique sequences were added to the standard two plane imaging protocol (A+B). The mrT stage was altered in 1/57 (2%) patient when contrast-enhanced sequences were added to standard and oblique sequences (protocol A+B+C). The correlation between visible tumor on MRI and presence of tumor in the resected specimen did not change by adding oblique or contrast-enhanced images. Conclusion It is not necessary to perform oblique and contrast-enhanced sequences in small cervical carcinomas, i.e. without parametrial invasion. To avoid erroneous interpretation, information on previous cone biopsy is essential.
The Impact of Revised Discharge Instructions on Patient Satisfaction
Authors: Waniga Heather Markey , Gerke Travis , Shoemaker Alena , Bourgoine Derek , Eamranond Pracha 
Published: November 2016

Introduction: The impact of discharge instructions on a patient’s experience is not fully understood. This research explored whether nurse- and physician-generated discharge instructions had a positive effect on patient perceptions regarding their discharge experience. Methods: We compared Press Ganey discharge-related patient satisfaction scores for the year prior to and the year subsequent to implementing revised discharge instructions for all patients admitted to a 180-bed community-based hospital. Results: Following the implementation of our revised discharge instructions, patient satisfaction significantly improved (84.7% vs 83%, P < .01). Patients responded that they felt ready for discharge (86.6% vs 84.9%, P = .01) and were satisfied with instructions for home care (87.8% vs 85.3%, P < .01). Discussion: This study finds that a novel discharge instruction set produced by both the nursing and physician staff may improve patient perceptions with the discharge process.
Extended clinical and genetic spectrum associated with biallelic RTEL1 mutations
Authors: Touzot Fabien , Kermasson Laetitia , Jullien Laurent , Moshous Despina , Ménard Christelle , Ikincioğullari Aydan , Doğu Figen , Sari Sinan , Giacobbi-Milet Vannina , Etzioni Amos , Soulier Jean , Londono-Vallejo Arturo , Fischer Alain , Callebaut Isabelle , de Villartay Jean-Pierre , Leblanc Thierry , Kannengiesser Caroline , Revy Patrick 
Published: November 2016

Key Points
Biallelic RTEL1 mutations generate a large clinical spectrum ranging from classical Hoyeraal-Hreidarsson syndrome to isolated aplastic anemia.