bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and Safety of a Novel Method of Insulated Intralesional Radiofrequency Ablation for Deep Dermal and Subcutaneous Lesions: A 3-Year Institutional Experience
Authors: Subhadarshani Sweta , Gupta Vishal , Taneja Neha , Yadav Savita , Gupta Somesh 
Published: December 2017

BACKGROUND
Although insulated intralesional radiofrequency ablation (IL-RFA) is being increasingly used in other specialties, not much information on its safety and efficacy in dermatology is available.

OBJECTIVE
To describe our experience with insulated IL-RFA for various dermatological conditions.

METHODS
This is a retrospective review of the patients who underwent IL-RFA in the past 3 years. Our technique involved creating a small window in the proximal end of plastic sheath of an intravenous cannula using a surgical blade, and then touching the RF probe to the cannula through the window to deliver the electric current. Information regarding diagnosis, number of sessions, adverse effects, and follow-up was recorded. Clinical improvement was assessed on a visual analog scale by the patient and 2 independent observers.

RESULTS
Data on 19 patients with lymphangioma circumscriptum (n = 9), venous or capillary-venous malformation (n = 4), angiolymphoid hyperplasia with eosinophilia (n = 3), arteriovenous malformation, hidradenitis suppurativa, and hypertrophic scar (n = 1 each) was available. The mean number of IL-RFA sessions was 2.26 ± 1.61. The mean patient and physician global assessment scores were 7.6 ± 2.22 and 7.3 ± 2.42, respectively. Adverse effects were seen in 9 (47.4%) patients. All patients, except 1, had sustained improvement in the mean follow-up period of 11.4 ± 11.6 months.

CONCLUSION
Insulated IL-RFA seems to be safe and effective in selectively targeting deep-seated cutaneous lesions.
Trends in Hospitalization, Acute Kidney Injury, and Mortality in Patients With Spontaneous Bacterial Peritonitis
Authors: Devani Kalpit , Charilaou Paris , Jaiswal Palashkumar , Patil Nirav , Radadiya Dhruvil , Patel Pranav , Young Mark , Rockey Don C. , Reddy Chakradhar M. 
Published: December 2017

Goals:
The purpose of our study was to evaluate trends of hospitalization, acute kidney injury (AKI) and mortality in cirrhotic patients with spontaneous bacterial peritonitis (SBP).

Background:
SBP is a frequent bacterial infection in cirrhotic patients leading to increased morbidity and mortality.

Materials and Methods:
A total of 4,840,643 patients hospitalized with cirrhosis from 2005 to 2014 were identified using the Nationwide Inpatient Sample database, of which 115,359 (2.4%) had SBP. We examined annual trends and used multivariable mixed-effects logistic regression analyses to obtain adjusted odds ratios by accounting for hospital level and patient level variables.

Results:
We identified a striking increase in hospitalizations for SBP in cirrhotic patients (0.45% to 3.12%) and AKI in SBP patients (25.6% to 46.7%) from 2005 to 2014. Inpatient mortality decreased over the study period in patients with SBP (19.1% to 16.1%) and in patients with SBP plus AKI (40.9% to 27.6%). Patients with SBP had a higher inpatient mortality rate than those without SBP [15.5% vs. 6%, adjusted odd ratio (aOR): 2.02, P<0.001]. AKI was 2-fold more prevalent in cirrhotics with SBP than those without SBP (42.8% vs. 17.2%, aOR: 1.91, P<0.001) and concomitant AKI was associated with a 6-fold mortality increase (aOR: 5.84, P<0.001). Cirrhotic patients with SBP had higher hospitalization costs and longer length of stays than patients without SBP.

Conclusions:
Despite a higher hospitalization rate and prevalence of concomitant AKI, mortality in patients with SBP decreased during the study period. SBP is associated with high likelihood of development of AKI, which in turn, increases mortality.
Improved outcomes in elderly trauma patients with the implementation of two innovative geriatric-specific protocols—Final report
Authors: Bradburn Eric H. , Gross Brian W. , Jammula Shreya , Adams William H. , Miller Jo Ann 
Published: December 2017

BACKGROUND
Elderly trauma care is challenging owing to the unique physiology and comorbidities prevalent in this population. To improve the care of these patients, two practice management guidelines (PMGs) were implemented: high-risk geriatric protocol (HRGP), which triages patients based on injury patterns and comorbid conditions for occult hypotension, and the anticoagulation and trauma (ACT) alert, which is designed to streamline the care of geriatric trauma patients on anticoagulants. We hypothesized that both HRGP and ACT would decrease mortality and complications in geriatric trauma patients.

METHODS
Geriatric blunt trauma patients (aged ≥65) presenting to our Level II center from January 2000 to July 2016 were extracted from the trauma registry. Do-not-resuscitate patients were excluded. The study period was divided into three phases: Phase 1, no PMGs in place (2000 to January 2006); Phase 2, HRGP only (February 2006 to February 2012); and Phase 3, HRGP + ACT (March 2012 to July 2016). Multivariate logistic regression models assessed adjusted mortality and complications during these phases to quantify the impact of these protocols. Statistical significance was set at p < 0.05.

RESULTS
A total of 8,471 geriatric trauma patients met inclusion criteria. Overall mortality rate was 5.6% (Phase 1, 7.2%; Phase 2, 6.1%; Phase 3, 4.0%). No significant change in mortality was observed during Phase 2 with the HRGP only (adjusted odds ratio (OR), 0.98; 95% confidence interval, 0.73–1.34; p = 0.957); however, a significantly reduced OR of mortality was found during Phase 3 with the combination of both the HRGP and ACT (adjusted OR, 0.67; 95% confidence interval, 0.47–0.94; p = 0.021). No significant changes in incidence of complications was observed over the study duration.

CONCLUSIONS
Geriatric trauma patients are not simply older adults. Improved outcomes can be realized with specific PMGs tailored to the geriatric trauma patients’ needs.

LEVEL OF EVIDENCE
Epidemiologic study, level III.
Safety and efficacy of brain injury guidelines at a Level III trauma center
Authors: Martin Grace E. , Carroll Christopher P. , Plummer Zachary J. , Millar D A. , Pritts Timothy A. , Makley Amy T. , Joseph Bellal A. , Ngwenya Laura B. , Goodman Michael D. 
Published: December 2017

BACKGROUND
Patients with mild to moderate traumatic brain injury (TBI) are often primarily managed by emergency medicine and trauma/acute care physicians. The Brain Injury Guidelines (BIG) were developed at an American College of Surgeons–accredited Level 1 trauma center to triage mild to moderate TBI patients and help identify patients who warrant neurosurgical consultation. The BIG have not been validated at a Level III trauma center. We hypothesized that BIG criteria can be safely adapted to an American College of Surgeons–accredited Level III trauma center to guide transfers to a higher echelon of care.

METHODS
We reviewed the trauma registry at a Level III trauma center to identify TBI patients who presented with an Abbreviated Injury Severity-Head score greater than zero. Demographic data, injury details, and clinical outcomes were abstracted with primary outcome measures of worsening on second computed tomography of the head, neurosurgical intervention, transfer to a Level I trauma center, and in-hospital mortality. Patients were classified using the BIG criteria. After validating the BIG in our cohort, we reclassified patients using updated BIG criteria. Updated criteria included mechanism of injury, reclassification of anticoagulation or antiplatelet use, and replacement of the neurologic examination component with stratification by admission Glasgow Coma Scale (GCS) score.

RESULTS
From July 2013 to June 2016, 332 TBI patients were identified: 115 BIG-1, 25 BIG-2, and 192 BIG-3. Patients requiring neurosurgical intervention (n = 30) or who died (n = 29) were BIG-3 with one exception. Patients with GCS score of less than 12 had worse outcomes than those with a GCS score of 12 or greater, regardless of BIG classification. Anticoagulant or antiplatelet use was not associated with worsened outcomes in patients not meeting other BIG-3 criteria. The updated BIG resulted in more patients in BIG-1 (n = 109) and BIG-2 (n = 100) without negatively affecting outcomes.

CONCLUSION
The BIG can be applied in the Level III trauma center setting. Updated BIG criteria can aid triage of mild to moderate TBI patients to a Level I trauma center and may reduce secondary overtriage.

LEVEL OF EVIDENCE
Care management, level IV.
Speed is not everything: Identifying patients who may benefit from helicopter transport despite faster ground transport
Authors: Chen Xilin , Gestring Mark L. , Rosengart Matthew R. , Billiar Timothy R. , Peitzman Andrew B. , Sperry Jason L. , Brown Joshua B. 
Published: December 2017

BACKGROUND
Helicopter emergency medical services (HEMS) have demonstrated survival benefits over ground emergency medical services (GEMS) for trauma patient transport. While HEMS speed is often-cited, factors such as provider experience and level of care may also play a role. Our objective was to identify patient groups that may benefit from HEMS even when prehospital time for helicopter utilization is longer than GEMS transport.

METHODS
Adult patients transported by HEMS or GEMS from the scene of injury in the Pennsylvania State Trauma Registry were included. Propensity score matching was used to match HEMS and GEMS patients for likelihood of HEMS, keeping only pairs in which the HEMS patient had longer total prehospital time than the matched GEMS patient. Mixed-effects logistic regression evaluated the effect of transport mode on survival while controlling for demographics, admission physiology, transfusions, and procedures. Interaction testing between transport mode and existing trauma triage criteria was conducted and models stratified across significant interactions to determine which criteria identify patients with a significant survival benefit when transported by HEMS even when slower than GEMS.

RESULTS
From 153,729 eligible patients, 8,307 pairs were matched. Helicopter emergency medical services total prehospital time was a median of 13 minutes (interquartile range, 6–22) longer than GEMS. Patients with abnormal respiratory rate (odds ratio [OR], 2.39; 95% confidence interval [CI], 1.26–4.55; p = 0.01), Glasgow Coma Scale score of 8 or less (OR, 1.61; 95% CI, 1.16–2.22; p < 0.01), and hemo/pneumothorax (OR, 2.25; 95% CI, 1.06–4.78; p = 0.03) had a significant survival advantage when transported by HEMS even with longer prehospital time than GEMS. Conversely, there was no association between transport mode and survival in patients without these factors (p > 0.05).

CONCLUSION
Patients with abnormal respiratory rate, Glasgow Coma Scale score of 8 or less, and hemo/pneumothorax benefit from HEMS transport even when GEMS transport was faster. This may indicate that these patients benefit primarily from HEMS care, such as advanced airway and chest trauma management, rather than simply faster transport to a trauma center.

LEVEL OF EVIDENCE
Therapeutic, level III.
Demographic causes of adult sex ratio variation and their consequences for parental cooperation
Authors: Eberhart-Phillips Luke J. , Küpper Clemens , Carmona-Isunza María Cristina , Vincze Orsolya , Zefania Sama , Cruz-López Medardo , Kosztolányi András , Miller Tom E. X. , Barta Zoltán , Cuthill Innes C. , Burke Terry , Székely Tamás , Hoffman Joseph I. , Krüger Oliver 
Published: December 2017

AbstractThe adult sex ratio (ASR) is a fundamental concept in population biology, sexual selection, and social evolution. However, it remains unclear which demographic processes generate ASR variation and how biases in ASR in turn affect social behaviour. Here, we evaluate the demographic mechanisms shaping ASR and their consequences for parental cooperation using detailed survival, fecundity, and behavioural data on 6,119 individuals from six wild shorebird populations exhibiting flexible parental strategies. We show that these closely related populations express strikingly different ASRs, despite having similar ecologies and life histories, and that ASR variation is largely driven by sex differences in the apparent survival of juveniles. Furthermore, families in populations with biased ASRs were predominantly tended by a single parent, suggesting that parental cooperation breaks down with unbalanced sex ratios. Taken together, our results indicate that sex biases emerging during early life have profound consequences for social behaviour.
Intrinsic neuronal dynamics predict distinct functional roles during working memory
Authors: Wasmuht DF , Spaak E , Buschman TJ , Miller EK , Stokes MG 
Published: December 2017

AbstractWorking memory (WM) is characterized by the ability to maintain stable representations over time; however, neural activity associated with WM maintenance can be highly dynamic. We explore whether complex population coding dynamics during WM relate to the intrinsic temporal properties of single neurons in lateral prefrontal cortex (lPFC), the frontal eye fields (FEF) and lateral intraparietal cortex (LIP) of two monkeys (Macaca mulatta). We found that cells with short timescales carried memory information relatively early during memory encoding in lPFC; whereas long timescale cells played a greater role later during processing, dominating coding in the delay period. We also observed a link between functional connectivity at rest and intrinsic timescale in FEF and LIP. Our results indicate that individual differences in the temporal processing capacity predicts complex neuronal dynamics during WM; ranging from rapid dynamic encoding of stimuli to slower, but stable, maintenance of mnemonic information.
Ultrasound Produces Extensive Brain Activation via a Cochlear Pathway
Authors: Guo Hongsun , Hamilton Mark , Offutt Sarah J. , Gloeckner Cory D. , Li Tianqi , Kim Yohan , Legon Wynn , Alford Jamu K. , Lim Hubert H. 
Published: December 2017

SummaryUltrasound (US) can noninvasively activate intact brain circuits, making it a promising neuromodulation technique. However, little is known about the underlying mechanism. Here, we apply transcranial US and perform brain mapping studies in guinea pigs using extracellular electrophysiology. We find that US elicits extensive activation across cortical and subcortical brain regions. However, transection of the auditory nerves or removal of cochlear fluids eliminates the US-induced activity, revealing an indirect auditory mechanism for US neural activation. US likely vibrates the cerebrospinal fluid in the brain, which is continuous with the fluid in the cochlea via cochlear aqueducts; thus, US can activate the ascending auditory pathways and other non-auditory regions through cross-modal projections. This finding of a cochlear fluid-induced vibration mechanism challenges the idea that US can directly activate neurons in the intact brain, suggesting that future US stimulation studies will need to control for this effect to reach reliable conclusions.
Probabilistic thresholding of functional connectomes: application to schizophrenia
Authors: Váša František , Bullmore Edward T. , Patel Ameera X. 
Published: December 2017

AbstractFunctional connectomes are commonly analysed as sparse graphs, constructed by thresholding cross-correlations between regional neurophysiological signals. Thresholding generally retains the strongest edges (correlations), either by retaining edges surpassing a given absolute weight, or by constraining the edge density. The latter (more widely used) method risks inclusion of false positive edges at high edge densities and exclusion of true positive edges at low edge densities. Here we apply new wavelet-based methods, which enable construction of probabilistically-thresholded graphs controlled for type I error, to a dataset of resting-state fMRI scans of 56 patients with schizophrenia and 71 healthy controls. By thresholding connectomes to fixed edge-specific P value, we found that functional connectomes of patients with schizophrenia were more dysconnected than those of healthy controls, exhibiting a lower edge density and a higher number of (dis)connected components. Furthermore, many participants’ connectomes could not be built up to the fixed edge densities commonly studied in the literature (~5-30%), while controlling for type I error. Additionally, we showed that the topological randomisation previously reported in the schizophrenia literature is likely attributable to “non-significant” edges added when thresholding connectomes to fixed density based on correlation. Finally, by explicitly comparing connectomes thresholded by increasing P value and decreasing correlation, we showed that probabilistically thresholded connectomes show decreased randomness and increased consistency across participants. Our results have implications for future analysis of functional connectivity using graph theory, especially within datasets exhibiting heterogenous distributions of edge weights (correlations), between groups or across participants.
Individual differences in fear acquisition: Multivariate analyses of different Emotional Negativity scales, physiological responding, subjective measures, and neural activation
Authors: Sjouwerman Rachel , Scharfenort Robert , Lonsdorf Tina B. 
Published: December 2017

AbstractNegative emotionality is a well-established and stable risk factor for affective disorders. Individual differences in negative emotionality have been linked to associative learning processes which can be captured experimentally in fear conditioning paradigms. Literature suffers from underpowered samples, suboptimal methods, and an isolated focus on single questionnaires and single outcome measures. Here, we apply multivariate and dimensional approaches for three commonly investigated questionnaires in the field (STAI-T, NEO-FFI Neuroticism, Intolerance of Uncertainty Scale) across multiple analysis units (ratings, skin conductance, startle, BOLD-fMRI) during fear acquisition-training in two large samples (NStudy1=356; NStudy2=113). We investigate whether the specific or shared variance of these questionnaires is linked with CS-discrimination in specific outcome measures (Study 1). We identify a significant negative association between STAI-T and CS-discrimination in SCRs and between Intolerance of Uncertainty and CS-discrimination in startle responding. Yet, correlation coefficients for all questionnaire-outcome measure combinations did not differ significantly from each other. In Study 2 the STAI-T score was positively associated with CS-discrimination in a number of brain areas linked to conditioned fear (amygdala, putamen, thalamus), but not to SCRs or ratings. Importantly, we replicate potential sampling biases between fMRI and behavioral studies regarding anxiety levels. We discuss the implications of these results.
Verbalizing phylogenomic conflict: Representation of node congruence across competing reconstructions of the neoavian explosion
Authors: Franz Nico M. , Musher Lukas J. , Brown Joseph W. , Yu Shizhuo , Ludäscher Bertram 
Published: December 2017

AbstractPhylogenomic research is accelerating the publication of landmark studies that aim to resolve deep divergences of major organismal groups. Meanwhile, systems for identifying and integrating the novel products of phylogenomic inference – such as newly supported clade concepts – have not kept pace. However, the ability toverbalizeboth node concept congruence and conflict across multiple, (in effect) simultaneously endorsed phylogenomic hypotheses, is a critical prerequisite for building synthetic data environments for biological systematics, thereby also benefitting other domains impacted by these (conflicting) inferences. Here we develop a novel solution to the conflict verbalization challenge, based on a logic representation and reasoning approach that utilizes the language of Region Connection Calculus (RCC–5) to produce consistentalignmentsof node concepts endorsed by incongruent phylogenomic studies. The approach employs clade concept labels to individuate concepts used by each source, even if these carry identical names. Indirect RCC–5 modeling ofintensional(property-based) node concept definitions, facilitated by the local relaxation of coverage constraints, allows parent concepts to attain congruence in spite of their differentially sampled children. To demonstrate the feasibility of this approach, we align two recently published phylogenomic reconstructions of higher-level avian groups that entail strong conflict in the “neoavian explosion” region. According to our representations, this conflict is constituted by 26 instances of input “whole concept” overlap. These instances are further resolvable in the output labeling schemes and visualizations as “split concepts”, thereby providing the provenance services needed to build truly synthetic phylogenomic data environments. Because the RCC–5 alignments fundamentally reflect the trained, logic-enabled judgments of systematic experts, future designs for such environments need to promote a culture where experts routinely assess the intensionalities of node concepts published by our peers – even and especially when we are not in agreement with each other.
Pediatric Bone Age Assessment Using Deep Convolutional Neural Networks
Authors: Iglovikov Vladimir , Rakhlin Alexander , Kalinin Alexandr A. , Shvets Alexey 
Published: December 2017

AbstractSkeletal bone age assessment is a common clinical practice to diagnose endocrine and metabolic disorders in child development. In this paper, we describe a fully automated deep learning approach to the problem of bone age assessment using data from the 2017 Pediatric Bone Age Challenge organized by the Radiological Society of North America. The dataset for this competition consists of 12,600 radiological images. Each radiograph in this dataset is an image of a left hand labeled with bone age and sex of a patient. Our approach utilizes several deep neural network architectures trained end-to-end. We use images of whole hands as well as specific parts of a hand for both training and prediction. This approach allows us to measure the importance of specific hand bones for automated bone age analysis. We further evaluate the performance of the suggested method in the context of skeletal development stages. Our approach outperforms other common methods for bone age assessment.
Simulating Pedigrees Ascertained for Multiple Disease-Affected Relatives
Authors: Nieuwoudt Christina , Jones Samantha J. , Brooks-Wilson Angela , Graham Jinko 
Published: December 2017

AbstractBackground:Studies that ascertain families containing multiple relatives affected by disease can be useful for identification of causal, rare variants from next-generation sequencing data.Results:We present the R packageSimRVPedigree, which allows researchers to simulate pedigrees ascertained on the basis of multiple, affected relatives. By incorporating the ascertainment process in the simulation,SimRVPedigreeallows researchers to better understand the within-family patterns of relationship amongst affected individuals and ages of disease onset.Conclusions:Through simulation, we show that affected members of a family segregating a rare disease variant tend to be more numerous and cluster in relationships more closely than those for sporadic disease. We also show that the family ascertainment process can lead to apparent anticipation in the age of onset. Finally, we use simulation to gain insight into the limit on the proportion of ascertained families segregating a causal variant.SimRVPedigreeshould be useful to investigators seeking insight into the family-based study design through simulation.