bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of Invasive and Noninvasive Parameters for Diagnosing Ventilatory Overassistance During Pressure Support Ventilation*
Authors: Pletsch-Assuncao Renata , Caleffi Pereira Mayra , Ferreira Jeferson George , Cardenas Letícia Zumpano , de Albuquerque André Luis Pereira , de Carvalho Carlos Roberto Ribeiro , Caruso Pedro 
Published: November 2017

Objective:
Evaluate the accuracy of criteria for diagnosing pressure overassistance during pressure support ventilation.

Design:
Prospective clinical study.

Setting:
Medical-surgical ICU.

Patients:
Adults under mechanical ventilation for 48 hours or more using pressure support ventilation and without any sedative for 6 hours or more. Overassistance was defined as the occurrence of work of breathing less than 0.3 J/L or 10% or more of ineffective inspiratory effort. Two alternative overassistance definitions were based on the occurrence of inspiratory esophageal pressure-time product of less than 50 cm H2O s/min or esophageal occlusion pressure of less than 1.5 cm H2O.

Interventions:
The pressure support was set to 20 cm H2O and decreased in 3-cm H2O steps down to 2 cm H2O.

Measurements and Main Results:
The following parameters were evaluated to diagnose overassistance: respiratory rate, tidal volume, minute ventilation, peripheral arterial oxygen saturation, rapid shallow breathing index, heart rate, mean arterial pressure, change in esophageal pressure during inspiration, and esophageal and airway occlusion pressure. In all definitions, the respiratory rate had the greatest accuracy for diagnosing overassistance (receiver operating characteristic area = 0.92; 0.91 and 0.76 for work of breathing, pressure-time product and esophageal occlusion pressure in definition, respectively) and always with a cutoff of 17 incursions per minute. In all definitions, a respiratory rate of less than or equal to 12 confirmed overassistance (100% specificity), whereas a respiratory rate of greater than or equal to 30 excluded overassistance (100% sensitivity).

Conclusion:
A respiratory rate of 17 breaths/min is the parameter with the greatest accuracy for diagnosing overassistance. Respiratory rates of less than or equal to 12 or greater than or equal to 30 are useful clinical references to confirm or exclude pressure support overassistance.
Facial Treatment With Botulinum Toxin Improves Attractiveness Rated by Self and Others, and Psychological Wellbeing
Authors: Petrie Taylor , Moore Fhionna 
Published: November 2017

BACKGROUNDTreatment of dynamic facial lines with botulinum toxin has been shown to improve various measures of psychological wellbeing.OBJECTIVEHere we sought to determine whether the positive effects of treatment on wellbeing occurred via improvements in attractiveness rated by self and others, using a pretreatment and post-treatment comparison experimental design.MATERIALS AND METHODSWe tested the effects of treatment on self-esteem, satisfaction with life, attractiveness rated by self and others in a sample of 32 Scottish women. Participants completed validated psychological measures of self-esteem, satisfaction with life, and self-perceived attractiveness pretreatment and 4 weeks post-treatment. Facial photographs with neutral expression of participants were rated for attractiveness by a group of raters pretreatment and 4 weeks post-treatment.RESULTSTreatment significantly improved all measures (self-esteem, satisfaction with life, and attractiveness rated by self and others). Furthermore, self-rated attractiveness mediated the relationship between treatment and self-esteem.CONCLUSIONTreatment of dynamic facial lines with botulinum toxin significantly improves self-esteem and general life satisfaction. It also improves self-perceived attractiveness and attractiveness rated by others. The effects of treatment on self-esteem occur via the positive effects of treatment on self-perceived attractiveness. Our study is a carefully controlled analysis of the effects of treatment with botulinum toxin, using statistical analyses to show significant benefits of the treatment on psychology, wellbeing, and attractiveness as rated by self and others. This is further support for the psychological benefits of botulinum A facial therapy.
The dynamics of stress and fatigue across menopause: attractors, coupling, and resilience
Authors: Taylor-Swanson Lisa , Wong Alexander E. , Pincus David , Butner Jonathan E. , Hahn-Holbrook Jennifer , Koithan Mary , Wann Kathryn , Woods Nancy F. 
Published: November 2017

Abstract

Objective:
The objective of this study was to evaluate the regulatory dynamics between stress and fatigue experienced by women during the menopausal transition (MT) and early postmenopause (EPM). Fatigue and perceived stress are commonly experienced by women during the MT and EPM. We sought to discover relationships between these symptoms and to employ these symptoms as possible markers for resilience.

Methods:
Participants were drawn from the longitudinal Seattle Midlife Women's Health Study. Eligible women completed questionnaires on 60+ occasions (annual health reports and monthly health diaries) (n = 56 women). The total number of observations across the sample was 4,224. STRAW+10 criteria were used to stage women in either in late reproductive, early or late transition, or EPM stage. Change values were generated for fatigue and stress and analyzed with a multilevel structural equation model; slopes indicate how quickly a person returns to homeostasis after a perturbation. Coupling of stress and fatigue was modeled to evaluate resilience, the notion of maintaining stability during change.

Results:
Eligible women were on average 35 years old (SD = 4.71), well educated, employed, married or partnered, and white. Fit indices suggested the model depicts the relationships of stress and fatigue (χ
2(9 df) = 7.638, P = 0.57, correction factor = 4.9244; root mean square error of approximation (RMSEA) 90% CI = 0.000 ≤ 0.000 ≤ 0.032; comparative fit index (CFI) = 1.00). A loss in model fit across stages suggests that the four stages differed in their dynamics (χ
2Δ(12 df) = 21.181, P = .048). All stages showed fixed-point attractor dynamics: fatigue became less stable over time; stress generally became more stable over time. Coupling relationships of stress on fatigue show evidence for shifts in regulatory relationships with one another across the MT.

Conclusions:
Results are suggestive of general dysregulation via disruptions to coupling relationships of stress and fatigue across the MT. Findings support a holistic approach to understanding symptoms and supporting women during the MT.
Gluteal Black Market Silicone–induced Renal Failure: A Case Report and Literature Review
Authors: Matson Andrea , Faibisoff Burt 
Published: November 2017

Summary:
Very few cases of successful surgical treatment for renal failure due to gluteal silicone injections have been reported in the literature. The silicone toxicity and subsequent renal failure seem to follow repetitive silicone injections and silicone injections in large quantities. This is a case of a 31-year-old woman who developed renal failure after 6 years of gluteal silicone injections who underwent radical resection of bilateral gluteal regions in an attempt to mitigate her impending complete renal failure. A systematic review of the literature was conducted using PubMed database and with assistance from medical library staff to conduct keyword searches for “Silicone,” “Renal failure,” “Silicone emboli syndrome,” “Silicone granuloma,” and “Silicone end organ toxicity.” The search results were reviewed by the authors and selected based on the relevance to the case report presented. Extensive literature relating to silicone granulomas and their systemic effects supports the use of steroids for immediate treatment and eventual surgical resection for cure of the various silicone-related end-organ toxicities including renal failure.
Considerations in the Care of Athletes With Attention Deficit Hyperactivity Disorder
Authors: Pujalte George G. A. , Maynard Jennifer R. , Thurston McKennan J. , Taylor Walter C. , Chauhan Mohit 
Published: November 2017

Objectives:
Uncover literature pertaining to: (1) attention deficit hyperactivity disorder (ADHD) and how it impacts athletes; (2) ADHD medication effects; (3) regulations regarding ADHD medications; (4) approaches to conditions similar to, and occurring with, ADHD; and (5) use of stimulants.

Data Sources:
MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Ovid interface.

Main Results:
ADHD can have many effects on athletes and sports participation. Exercise has positive benefits on ADHD behaviors and players' attitudes. Athletes with ADHD can have worsened ADHD symptoms after concussions. Attention deficit hyperactivity disorder is a modifier of return to play; baseline ADHD symptoms should be used to guide management. Management should include medications, behavioral/psychosocial therapy, and academic accommodations. Behavioral therapy combined with medication is superior to behavioral treatment alone. Sustained exercise as ADHD treatment should be considered mainstay in management. Sports can increase thermogenic effects of stimulants, heat injury, and cardiac arrhythmias. Increased aggressiveness, improved pain tolerance, and decreased sense of fatigue are some attributes of stimulants that are presumed to impart some advantage to athletes, but evidence is uncertain. Attention deficit hyperactivity disorder medications may lead to myocardial infarctions, cerebrovascular accidents, paranoid psychoses, seizures, insomnia, tremors, anxiety, hypertension, and death.

Conclusions:
Athletes' performance and quality of life can be negatively affected by ADHD. Risks exist for those who take ADHD medications. More research is needed on the implications ADHD may have in specific sports, and on possible advantages of medication use. Potential deleterious effects of these medications should be addressed.
Outcomes of Anterior Cruciate Ligament Reconstruction in Obese and Overweight Patients: A Systematic Review
Authors: DiSilvestro Kevin J. , Jauregui Julio J. , Glazier Elizabeth , Cherkalin Denis , Bennett Craig H. , Packer Jonathan D. , Henn Ralph Frank 
Published: November 2017

Objective:
To evaluate the mechanism of injury, outcomes, and complications of anterior cruciate ligament (ACL) reconstruction in overweight and obese patients.

Data Sources:
MEDLINE, EMBASE, and OVID electronic libraries were systematically searched from inception to December, 2017 for any eligible articles using a combination of the phrases “anterior cruciate ligament,” “ACL,” “overweight,” “obese,” and “BMI.”

Results:
Studies that evaluated patients with primary ACL reconstruction, classified patients as overweight or obese, and reported a minimum of 1-year follow-up data were included. Eight cohorts from 9 studies fulfilled the inclusion criteria. There were no significant differences for mechanism of injury, Lysholm scores, Knee injury and Osteoarthritis Outcome Scores values, or return to sports with a body mass index (BMI) above or below 25 kg/m2. A significant difference was described in International Knee Documentation Committee (IKDC) scores when comparing obese patients (BMI >30 kg/m2) to patients with BMI <25 kg/m2 (P <0.01). In patients with BMI >25 kg/m2, the risk for arthritis was significantly higher but the risk for revision surgery or contralateral ACL tear was lower (P <0.05). There was no significant difference in complication rates (P = 0.77).

Conclusion:
Patient-reported outcome measures were similar for patients with BMI above and below 25 kg/m2, but there is evidence that obese patients have lower IKDC scores. There is a consistent association between overweight status and developing arthritis among patients having an ACL reconstruction. Overweight and obese patients have a lower risk of revision ACL reconstruction and contralateral ACL tear. There is insufficient data to make any conclusions regarding mechanism of injury or complications. More research is needed to better understand what is the appropriate counsel and treatment for overweight or obese patients with ACL tears.

Prospero Registration Number:
CRD42017055594.
Dendritic Cell Markers and PD-L1 are Expressed in Mediastinal Gray Zone Lymphoma
Authors: Pelland Kevin , Mathews Stephanie , Kamath Anitha , Cohen Paul , Hudnall S. David , Cotta Claudiu V. , Xu Mina L. 
Published: November 2017

Aims:
Mediastinal gray zone lymphoma (MGZL) is a rare entity with morphologic, immunophenotypic, and genetic features intermediate between classic Hodgkin lymphoma (CHL) and primary mediastinal large B-cell lymphoma (PMBL). It is challenging to differentiate from CHL and PMBL. A specific dendritic cell gene expression profile can distinguish CHL and MGZL from PMBL. We hypothesized that the dendritic markers fascin and CD123 may be helpful in distinguishing MGZL from CHL and PMBL. We also investigated programmed death-ligand 1 (PD-L1) expression in MGZL, which may have therapeutic significance in this difficulty to treat tumor.

Methods:
Representative sections from 89 CHL, 20 PMBL, and 7 MGZL cases were stained for fascin, CD123, and PD-L1, and scored on a scale from 0 to 3+. Most (71%) MGZLs stained for CD123, as well as some (23%) CHLs, and few (11%) PMBLs. All MGZLs stained for fascin, as well as most (90%) CHLs, and approximately half (53%) of the PMBLs. PD-L1 was positive in all MGZLs, most (77%) CHLs and most (66%) PMBLs.

Conclusions:
Our study is the first to show CD123 is positive in a subset of formalin-fixed, paraffin-embedded MGZLs and CHLs, in contrast to PMBL which is largely negative. Staining for fascin was not significantly different between the lymphomas, but was less likely to be positive in PMBL. These findings suggest a role for CD123 and fascin in supporting diagnoses of MGZL and CHL, and in ruling out PMBL. By immunohistochemistry, PD-L1 is positive in MGZL, pointing to its therapeutic potential.
Comparison of Complication Rate Between LeFort III and Monobloc Advancement With or Without Distraction Osteogenesis
Authors: Knackstedt Rebecca , Bassiri Gharb Bahar , Papay Frank , Rampazzo Antonio 
Published: November 2017

Background:
LeFort III osteotomies or monobloc advancements, with or without distraction, can be used to treat mid-facial hypoplasia causing exorbitism and obstructive sleep apnea in syndromic patients. This report is a meta-analysis of the complication rates following LeFort III osteotomies or monobloc advancement with or without distraction.

Methods:
Triple database search was conducted to identify articles addressing mid-facial hypoplasia treated with LeFort III or monobloc in which complications were detailed. Complications were considered major if they required a second operation or were potentially life threatening. Statistical analysis was performed with Student t test.

Results:
Fifteen studies fit inclusion criteria. This yielded 363 total patients. In patients treated with a monobloc advancement, there was a statistically higher rate of major (P < 0.0001) and minor (P < 0.0001) complications, death (P = 0.02), cerebrospinal fluid (CSF) leaks (P < 0.0001), and meningitis/abscess (P < 0.0001) when distraction was used. In patients treated with a LeFort III, there was a statistically higher rate of reoperation when distraction was used (P = 0.001). In patients treated without distraction, there was a statistically higher rate of major (P < 0.0001) complications, death (P = 0.008), CSF leaks (P = 0.003), and reoperation (P < 0.0001) with a monobloc and a statistically higher rate of minor complications (P < 0.001) with a LeFort III.

Conclusion:
LeFort III proved to be a safer technique for the treatment of mid-facial hypoplasia. Although distraction was initially introduced to reduce complications, in this review, monobloc with distraction had the highest rate of major complications. There are multiple confounding factors that influence success of mid-face surgery and every patient must be evaluated and treated individually.
Long-term Prognosis and Recurrence of Primary Sclerosing Cholangitis After Liver Transplantation: A Single-Center Experience
Authors: Ueda Yoshihide , Kaido Toshimi , Okajima Hideaki , Hata Koichiro , Anazawa Takayuki , Yoshizawa Atsushi , Yagi Shintaro , Taura Kojiro , Masui Toshihiko , Yamashiki Noriyo , Haga Hironori , Nagao Miki , Marusawa Hiroyuki , Seno Hiroshi , Uemoto Shinji 
Published: November 2017

BackgroundPrimary sclerosing cholangitis (PSC) is a progressive cholestatic liver disease, with liver transplantation being the sole life-saving treatment for end-stage PSC-related liver disease. However, recurrence of PSC after liver transplantation is a common complication, with the risk factors for recurrence being controversial.MethodsWe conducted a retrospective chart review of 45 patients who had undergone liver transplantation for PSC at our institute. The risk factors for PSC recurrence and graft failure after liver transplantation were analyzed.ResultsThe graft survival rates were 55.4% at 5 years and 32.8% at 10 years after liver transplantation for PSC. PSC recurrence was diagnosed in 16 (40%) of 40 patients, at a median 30 months (range, 9-70 months) after liver transplantation. The cumulative incidence rate of PSC recurrence was 24.5% at 3 years, 39.3% at 5 years, and 45.8% at 6 years. Among the 16 patients diagnosed with PSC recurrence, the graft survival rate was 56.3% at 5 years, and 21.9% at 10 years after the recurrence. Active inflammatory bowel disease after liver transplantation was identified as an independent risk factor for PSC recurrence. Age younger than 30 years at the time of PSC diagnosis and bacteremia were factors significantly associated with graft failure after liver transplantation on multivariate analysis.ConclusionsPSC frequently recurred and progressed to graft failure after liver transplantation for PSC. Maintaining an inactive status of inflammatory bowel disease might offer protection against PSC recurrence.
EGLN Inhibition Reduces Gastrointestinal Radiation Toxicity and Improves Survival in a Murine Model of Locally Advanced Pancreatic Cancer
Authors: Fujimoto Tara N. , Colbert Lauren E. , Molkentine Jessica M. , Baseler Laura , Deorukukhar Amit , Kingsley Charles V. , Tailor Ramesh C. , Sawakuchi Gabriel O. , Taniguchi Cullen M. 
Published: November 2017

AbstractLocally advanced pancreatic cancer (LAPC) almost always fatal since it is unresectable and chemotherapy is only modestly effective. The efficacy of radiation therapy (RT) for LAPC is limited by the potentially fatal toxicity to nearby intestines. There are no FDA-approved medications that can prevent this radiotoxicity, but we find that FG-4592, a small molecule inhibitor of EGLN proteins, significantly reduces radiation damage to the intestines without radioprotecting tumors. KPC (KrasLSL/+; Trp53FL/+; Ptf1aCre/+) animals received dose-escalated radiation treatments with and without FG-4592 for radioprotection. High-dose RT reduced death from local progression, improved survival, and shifted the patterns of failure to a late metastatic death compared to controls. The addition of FG-4592 to RT further improved survival compared to vehicle controls by eliminating radiation-induced gastrointestinal toxicity. Thus, selective protection of the intestinal tract by EGLN inhibition may enable higher, and potentially definitive doses of cytotoxic therapy to be delivered to LAPC.One Sentence SummaryThe EGLN inhibitor FG-4592 allows higher, and potentially definitive, doses of radiation to be delivered to pancreatic cancer by reducing normal tissue toxicity without protecting tumors.
WeSeqMiner: A Weka package for building machine-learning models for sequence data
Authors: Hogan Daniel , Maruthachalam Bharathikumar V. , Geyer C. Ronald , Kusalik Anthony 
Published: November 2017

AbstractIn most cases, the application of machine learning techniques to biological sequence data requires a vector representation of the sequences. Extracting the numerical features from sequence data can be time consuming, especially if the user lacks programming skills. To this end, we propose a Weka package called WeSeqMiner, which provides several useful filters for extracting numerical features from sequence data for use in the Weka machine learning workbench. Motivated with an example, we show that the WeSeqMiner package integrates well with the Weka API, allowing transformations to be incorporated into Weka workflows for predictive model generation. WeSeqMiner can be installed by pointing the Weka package manager to the URL github.com/djhogan/WeSeqMiner/raw/master/WeSeqMiner.zip. The Javadoc for WeSeqMiner classes can be accessed at djhogan.github.io/seqminer.
EEG Decoding Reveals the Temporal Dynamics and Functional Relevance of Goal-Relevant Representations
Authors: Hubbard Jason , Kikumoto Atsushi , Mayr Ulrich 
Published: November 2017

AbstractModels of action control assume that abstract task-set settings regulate lower-level stimulus/response representations. Yet, we know little about the functional and dynamic properties of task-set representations in humans. Using a cued task-switching paradigm, we show that information about task sets and lower-level stimulus/response aspects can be extracted through decoding analyses from the scalp electrophysiological signal (EEG) on the single-trial level and with high temporal resolution. Task-sets are active throughout the entire processing cascade and trial-to-trial variations in task-set strength emerges as a remarkably strong predictor of variability in performance, both within and between individuals. Also, taskset strength is related to stimulus representation strength at an early period and to the strength of response representations at a later period, consistent with the notion that task-sets coordinate successive, lower-level representations in a concurrent manner. These results demonstrate a powerful approach towards uncovering stages of information processing and their relative importance for performance.
Transgenerational Epigenetic Inheritance Factors Localize to Spatially and Temporally Ordered Liquid Droplet Assemblages
Authors: Wan Gang , Fields Brandon D. , Spracklin George , Phillips Carolyn , Kennedy Scott 
Published: November 2017

AbstractEpigenetic information can be inherited for multiple generations (termed transgenerational epigenetic inheritance or TEI)1,2. Non-coding RNAs have emerged as important mediators of TEI, although the mechanism(s) by which non-coding RNAs mediate TEI remains poorly understood. dsRNA-mediated gene silencing (RNAi) inC. elegansis a robust example of RNA-directed TEI3–5. To further our understanding of RNA-directed TEI, we conducted a genetic screen inC. elegansto identify genes required for RNAi inheritance. Our screen identified the conserved RNA helicase/Zn finger protein ZNFX-1 and the Argonaute protein WAGO-4. We find that WAGO-4 and ZNFX-1 act cooperatively in inheriting generations to maintain small interfering (si)RNA expression over generational time. ZNFX-1/ WAGO-4 localize to a liquid droplet organelle termed the P granule in early germline blastomeres. Later in development, ZNFX-1/WAGO-4 appear to separate from P granules to form independent foci that are adjacent to, yet remain distinct, from P granules. ZNFX-1/WAGO-4 labeled foci exhibit properties reminiscent of liquid droplets and we name these foci Z granules. In the adult germline, Z granules assemble into ordered tri-droplet assemblages with P granules and another germline droplet-like foci termed theMutatorfoci. This work identifies a conserved RNA-binding protein that drives RNA-directed TEI inC. elegans, defines a new germline foci that we term the Z granule, demonstrates that liquid droplet formation is under developmental control, and shows that liquid droplets can assemble into spatially ordered multi-droplet structures. We speculate that temporal and spatial ordering of liquid droplets helps cells organize and coordinate the complex RNA processing pathways underlying gene regulatory systems, such as RNA-directed TEI.