bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of the GLP‐1 analogue Exenatide on functional connectivity within an NTS‐based network in women with and without obesity
Authors: Coveleskie K. , Kilpatrick L. A. , Gupta A. , Stains J. , Connolly L. , Labus J. S. , Sanmiguel C. , Mayer E. A. 
Published: July 2017

SummaryObjectiveThe differential effect of GLP‐1 agonist Exenatide on functional connectivity of the nucleus tractus solitaries (NTS), a key region associated with homeostasis, and on appetite‐related behaviours was investigated in women with normal weight compared with women with obesity.MethodsFollowing an 8‐h fast, 19 female subjects (11 lean, 8 obese) participated in a 2‐d double blind crossover study. Subjects underwent functional magnetic resonance imaging at fast and 30‐min post subcutaneous injection of 5 μg of Exenatide or placebo. Functional connectivity was examined with the NTS. Drug‐induced functional connectivity changes within and between groups and correlations with appetite measures were examined in a region of interest approach focusing on the thalamus and hypothalamus.ResultsWomen with obesity reported less hunger after drug injection. Exenatide administration increased functional connectivity of the left NTS with the left thalamus and hypothalamus in the obese group only and increased the correlation between NTS functional connectivity and hunger scores in all subjects, but more so in the obese.ConclusionsObesity can impact the effects of Exenatide on brain connectivity, specifically in the NTS and is linked to changes in appetite control. This has implications for the use of GLP‐1 analogues in therapeutic interventions.
Electrochemical and structural characterization of Azotobacter vinelandii flavodoxin II
Authors: Segal Helen M. , Spatzal Thomas , Hill Michael G. , Udit Andrew K. , Rees Douglas C. 
Published: July 2017

AbstractAzotobacter vinelandii flavodoxin II serves as a physiological reductant of nitrogenase, the enzyme system mediating biological nitrogen fixation. Wildtype A. vinelandii flavodoxin II was electrochemically and crystallographically characterized to better understand the molecular basis for this functional role. The redox properties were monitored on surfactant‐modified basal plane graphite electrodes, with two distinct redox couples measured by cyclic voltammetry corresponding to reduction potentials of −483 ± 1 mV and −187 ± 9 mV (vs. NHE) in 50 mM potassium phosphate, 150 mM NaCl, pH 7.5. These redox potentials were assigned as the semiquinone/hydroquinone couple and the quinone/semiquinone couple, respectively. This study constitutes one of the first applications of surfactant‐modified basal plane graphite electrodes to characterize the redox properties of a flavodoxin, thus providing a novel electrochemical method to study this class of protein. The X‐ray crystal structure of the flavodoxin purified from A. vinelandii was solved at 1.17 Å resolution. With this structure, the native nitrogenase electron transfer proteins have all been structurally characterized. Docking studies indicate that a common binding site surrounding the Fe‐protein [4Fe:4S] cluster mediates complex formation with the redox partners Mo‐Fe protein, ferredoxin I, and flavodoxin II. This model supports a mechanistic hypothesis that electron transfer reactions between the Fe‐protein and its redox partners are mutually exclusive.
Amino‐acid composition after loop deletion drives domain swapping
Authors: Nandwani Neha , Surana Parag , Udgaonkar Jayant B. , Das Ranabir , Gosavi Shachi 
Published: July 2017

AbstractRational engineering of a protein to enable domain swapping requires an understanding of the sequence, structural and energetic factors that favor the domain‐swapped oligomer over the monomer. While it is known that the deletion of loops between β‐strands can promote domain swapping, the spliced sequence at the position of the loop deletion is thought to have a minimal role to play in such domain swapping. Here, two loop‐deletion mutants of the non‐domain‐swapping protein monellin, frame‐shifted by a single residue, were designed. Although the spliced sequence in the two mutants differed by only one residue at the site of the deletion, only one of them (YEIKG) promoted domain swapping. The mutant containing the spliced sequence YENKG was entirely monomeric. This new understanding that the domain swapping propensity after loop deletion may depend critically on the chemical composition of the shortened loop will facilitate the rational design of domain swapping.
Vascular Compression of the Anterior Optic Pathway: A Rare Occurrence?
Authors: Tsutsumi Satoshi , Ono Hideo , Yasumoto Yukimasa 
Published: July 2017

Background Vascular compression of the anterior optic pathway has been documented as an infrequent cause of visual impairments. Here we characterize such vascular compression using magnetic resonance imaging. Methods A total of 183 patients without pathologies affecting the optic pathways underwent T2-weighted or constructive interference steady-state sequence magnetic resonance imaging. Imaging data from coronal sections were analyzed. Results A vascular compression of the anterior optic pathway was identified in 20 patients (11%). They comprised 13 men and 7 women with a mean age of 60.8 years. The vascular compressions were observed at 22 sites, 15 on the optic nerve (ON) and 7 on the optic chiasm (OC). Twelve of them were on the right and 10 were on the left side. The offending vessels were the supraclinoid portion of the internal carotid artery in 86.4% and the A1 segment of the anterior cerebral artery in 13.6%. Compression sites at the ON and OC were variable, with the inferolateral surface being the most frequent (77.3% occurrences). In 2 patients (9.1%), the ON was compressed in a sandwich manner. Conclusions Vascular compression of the ON and OC may not be an infrequent occurrence in the cranial cavity. Progressive and unexplainable visual impairment might possibly be caused by vascular-compressive neuropathy.
Targeting anxiety to improve quality of life in patients with schizophrenia
Authors: Buonocore M. , Bosia M. , Bechi M. , Spangaro M. , Cavedoni S. , Cocchi F. , Bianchi L. , Guglielmino C. , Mastromatteo A.R. , Cavallaro R. 
Published: July 2017

AbstractBackground:Several studies suggested that anxiety can significantly affect the outcome of schizophrenia. Despite this evidence, non-pharmacological interventions targeting anxiety are still heterogenous. This study aims to test the efficacy of a novel training specifically designed to target anxiety in patients with schizophrenia. Innovatively, this training, beyond psychoeducation and problem solving, also targets Theory of Mind, as it provides coping strategies.Method:Twenty-seven outpatients with schizophrenia received a novel rehabilitative training targeting anxiety (Anxiety Management Group [AMG]) combined with a Computer-Assisted Cognitive Remediation (CACR), and twenty received CACR plus a control intervention (Control Newspaper discussion Group [CNG]). All patients were assessed at baseline and after treatment for quality of life, neurocognition and anxiety.Results:After training, patients treated with AMG + CACR showed significantly greater improvements on anxiety. A significant increase in quality of life was observed only for AMG + CACR group. Moreover, the participants’ appraisal showed a significant difference between treatment groups with higher ratings among patients who received the AMG + CACR.Conclusions:This study thus suggests feasibility and efficacy of the proposed intervention, that could be implemented in rehabilitative programs for patients with schizophrenia with potential benefits also on disease course and outcome.
Developmental vitamin D deficiency alters multiple neurotransmitter systems in the neonatal rat brain
Authors: Kesby James P. , Turner Karly M. , Alexander Suzanne , Eyles Darryl W. , McGrath John J. , Burne Thomas H.J. 
Published: July 2017

AbstractBackgroundEpidemiological evidence suggests that developmental vitamin D (DVD) deficiency is a risk factor for neuropsychiatric disorders, such as schizophrenia. DVD deficiency in rats is associated with altered brain structure and adult behaviours indicating alterations in dopamine and glutamate signalling. Developmental alterations in dopamine neurotransmission have also been observed in DVD‐deficient rats but a comprehensive assessment of brain neurochemistry has not been undertaken. Thus, the current study determined the regional concentrations of dopamine, noradrenaline, serotonin, glutamine, glutamate and γ‐aminobutyric acid (GABA), and associated metabolites, in DVD‐deficient neonates.MethodsSprague‐Dawley rats were fed a vitamin D deficient diet or control diet six weeks prior to mating until birth and housed under UVB‐free lighting conditions. Neurotransmitter concentration was assessed by high‐performance liquid chromatography on post‐mortem neonatal brain tissue.ResultsUbiquitous reductions in the levels of glutamine (12–24%) were observed in DVD‐deficient neonates compared with control neonates. Similarly, in multiple brain regions DVD‐deficient neonates had increased levels of noradrenaline and serine compared with control neonates. In contrast, increased levels of dopamine and decreased levels of serotonin in DVD‐deficient neonates were limited to striatal subregions compared with controls.ConclusionsOur results confirm that DVD deficiency leads to changes in multiple neurotransmitter systems in the neonate brain. Importantly, this regionally‐based assessment in DVD‐deficient neonates identified both widespread neurotransmitter changes (glutamine/noradrenaline) and regionally selective neurotransmitter changes (dopamine/serotonin). Thus, vitamin D may have both general and local actions depending on the neurotransmitter system being investigated. Taken together, these data suggest that DVD deficiency alters neurotransmitter systems relevant to schizophrenia in the developing rat brain.
Sphincter-saving extrasphincteric rectal dissection and proximal segmental sphincteric excision techniques by using combined abdominal and transvaginal anterior perineal access in female patients who have lower rectal cancer (Transvaginal low anterior rectal resection)
Authors: Yücesoy Ali Naki 
Published: July 2017

Abstract
Background Combined abdominal and transvaginal anterior perineal approaches have been used as an alternative surgical method for the surgical treatment of the lower rectal cancer. The main aim of this paper is to describe the surgical stages of the combined abdominal and transvaginal approaches performed for lower rectal cancer, especially in transvaginal anterior perineal stage.
Method We have performed sphincter-saving surgical operations by using transvaginal anterior perineal access by combining with the abdominal access in four female patients who had lower rectal cancer.
Results Sphincter-saving extrasphincteric dissection and proximal segmental sphincteric excision techniques were performed in four female patients operated with combined abdominal and transvaginal anterior perineal approach. All patients were found to have continence. Postoperatively, one patient was converted to abdominoperineal rectal amputation due to the detected distal resection margin positivity.
Conclusion Transvaginal anterior perineal access provides the extrasphincteric rectal dissection possibility in the ischioanal fossa. Therefore, the combined abdominal and transvaginal anterior perineal approaches have been based on the different anatomical and surgical features when compared to intersphincteric dissection technique which is the most common used surgical procedure in lower rectal cancer surgery.
Alumnos tutores y el aprendizaje de la lectura crítica en internado de pregrado
Authors: Cobos Aguilar Héctor , Pérez Cortés Patricia , Sánchez López Sophia , Sámano Guerrero Alejandro , Elizondo Pereo Rogelio A. , Ochoa Castro Carlos E. 
Published: July 2017

Introducción: En pregrado las habilidades docentes de los estudiantes son soslayadas.
Objetivo: Comparar los resultados obtenidos en lectura crítica de investigación por médicos internos de pregrado (MIP) en un curso impartido por alumnos tutores versus profesores, así como su desempeño docente.
Método: Se estudiaro 100 MIP en 4 grupos: G1 (n: 16), G2 (n: 29), G3 (n: 28), G4 (n: 27). Alumnos tutores (G: 1, 2, 3 ) y profesores (G4 ). Se impartió un curso de 40 h, con lectura de artículos de investigación publicados y resolución de guías, revisión de tareas, con discusión grupal. Se usó un instrumento: válido y consistente (KR 0.78) con 96 reactivos, equilibrado, 32 para interpretar, enjuiciar y proponer, y con 12 por diseño (casos-controles, pruebas diagnósticas, encuestas, instrumentos, ensayo clínico aleatorizado, cohortes, metaanálisis y seguimiento; equilibrado, con 48 respuestas falsas y verdaderas. Se aplicó al inicio y final del curso. Se utilizó la mediana como análisis antes y después, por indicador, diseño y globales. Se determinó el azar de respuestas y avance ponderado por grupo. Los MIP calificaron el desempeño docente de los profesores con 17 reactivos.
Resultados: Globales inicial vs. final (G1: 14 vs. 22*, G2: 11 vs. 28*, G3: 13 vs. 21 y G4: 21 vs. 33. (*Wilcoxon < 0.05). Kruskal-Wallis, > 0.05, inicial global entre grupos y < 0.05 en final a avor G2 y G4 . El azar disminuyó al 38, 24, 36 y 7%; y el avance ponderado fue 1.9, 3.1, 1.9 y 2.5 en los 4 grupos respectivamente. En diseños hubo más avances en instrumentos y CA. Los 4 profesores fueron calificados de manera semejante (U de Mann-Whitney > 0.05).
Conclusiones: Los resultados confirman que los alumnos tutores seleccionados pueden con estrategias participativas estimular el aprendizaje de la lectura crítica de investigación en MIP, y aproximarse a los obtenidos por los profesores experimentados. Se debe estimular y fortalecer esta habilidad en los jóvenes médicos.
Exploración del nivel de neurofobia en estudiantes de medicina en México
Authors: Eraña Rojas Irma Elisa , Segura-Azuara Nancy De los Ángeles , López Cabrera Mildred Vanessa 
Published: July 2017

Introducción: El temor a tratar pacientes con padecimientos neurológicos, mejor conocido como neurofobia, incapacita a estudiantes y profesionales de la salud en el manejo efectivo de estos pacientes.
Objetivo: El objetivo de esta investigación fue medir el nivel de neurofobia de los estudiantes de medicina a través de una autoevaluación sobre sus actitudes hacia el manejo de pacientes con problemas neurológicos.
Método: El diseño de la investigación fue cuantitativo, descriptivo y de corte transeccional, se condujo con una muestra de 131 alumnos del programa de medicina de una universidad privada. Se adaptó un instrumento, y se utilizaron ocho ítems para evaluar la ansiedad hacia: la complejidad de las neurociencias, el encuentro clínico con un paciente neurológico, y la falta de conocimiento o habilidades procedimentales.
Resultados: El análisis estadístico confirmó la confiabilidad interna del instrumento y la estadística descriptiva evidenció algunas tendencias de los estudiantes hacia la neurofobia. Conclusiones: Los resultados indican que los estudiantes atribuyeron esta ansiedad específicamente a tratar pacientes con enfermedades neurológicas como a la complejidad percibida de las neurociencias.
Evaluación de identificación de signos en radiografía de tórax en estudiantes de medicina
Authors: Erguera Aguirre Laura Raquel , De los Santos Rodríguez Moisés Natanael , Sierra Basto Gilberto 
Published: July 2017

Introducción: Existen enfermedades prevalentes con alto impacto en la salud pública que utilizan la radiografía de tórax como una herramienta de apoyo por su accesibilidad y gran valor diagnóstico. Estudios recientes muestran evidencia de que la habilidad para identificación de signos en radiografía de tórax es deficiente en estudiantes de pregrado.
Objetivo: Se evaluó el nivel de habilidad para la identificación de signos clínicos en la radiografía de tórax de los estudiantes de pregrado de la Facultad de Medicina.
Método: Se realizó un estudio prospectivo, transversal, descriptivo y observacional. Se evaluó la habilidad para la identificación de signos radiográficos en una muestra representativa de la población de estudiantes de ciencias clínicas de la facultad de Medicina conformada por 34 participantes mediante un instrumento construido y validado para la población.
Resultados: El 50%(17estudiantes) mostró una habilidad insuficiente para identificar signos en la radiografía de tórax. Entre los signos menos identificados se encontraron: aumento de radiolucidez con un 5.8%, broncograma aéreo 23.5% y borramiento de ángulo costofrénico con 38.2% respectivamente. Los signos más identificados fueron corazón en forma de gota con un 94.1%, cavitación con 91.1% e infiltrado alveolar con un 82.3% de aciertos.
Conclusiones: Al menos la mitad de los estudiantes no contaban con la habilidad para identificar signos radiológicos característicos. Numerosos factores explicaron estos resultados, entre los que se encuentran la falta de práctica de la habilidad para la identificación radiológica de los estudiantes y la ausencia de tutoría al estudiante de pregrado en el hospital.
Automatic classification of traffic incident's severity using machine learning approaches
Authors: Nguyen Hoang , Cai Chen , Chen Fang 
Published: July 2017

During daily work at a Transport Management Centre (TMC), the operators have to record and process a large volume of traffic information especially incident records. Their tasks involve manual classification of the data and then decide appropriate operations to clear the incidents on time. A real‐time automatic decision support system can minimise an operator's responded time and hence reduce congestion. Besides standard descriptions (e.g. incident location, date, time, lanes affected), severity is an important criteria that operators have to evaluate based on all available information before any control commands can be issued. The NSW TMC and the research organisation Data61 in Sydney have collaborated to discover and visualise frequent patterns in historical incident response records, leading to the automatic classification of severity levels among past incidents using advanced machine learning, active learning and outlier detection techniques. The experiments were executed using 4 years TMC's incident logs from 2011 to 2014 which includes >40,000 records. The classification model achieved nearly 90% accuracy in five‐fold cross‐validation and is expected to help the TMC to improve its procedures, response plans, and resource allocations.
Trauma systems around the world: A systematic overview
Authors: Dijkink Suzan , Nederpelt Charlie J. , Krijnen Pieta , Velmahos George C. , Schipper Inger B. 
Published: July 2017

BACKGROUND
Implementation of trauma care systems has resulted in improved patient outcomes, but international differences obviously remain. Improvement of care can only be established if we recognize and clarify these differences. The aim of the current review is to provide an overview of the recent literature on the state of trauma systems globally.

METHODS
The literature review over the period 2000 to 2016 was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Prehospital care, acute hospital care and quality assurance were classified using the World Health Organization Trauma System Maturity Index in four levels from I (least mature) to IV (most mature).

RESULTS
The search yielded 93 articles about trauma systems in 32 countries: 23 high-income (HI), 8 middle-income (MI) countries and 1 low-income (LI) country. Trauma-related mortality was highest in the MI and LI countries. Level IV prehospital care with Advanced Life Support was established in 19 HI countries, in contrast to the MI and LI countries where this was only reported in Brazil, China, and Turkey. In 18 HI countries, a Level III/IV hospital-based trauma system was implemented, whereas in nine LI- and MI countries Level I/II trauma systems were seen, mostly lacking dedicated trauma centers and teams. A national trauma registry was implemented in 10 HI countries.

CONCLUSION
Despite the presence of seemingly sufficient resources and the evidence-based benefits of trauma systems, only nine of the 23 HI countries in our review have a well-defined and documented national trauma system. Although 90% of all lethal traumatic injuries occur in middle and LI countries, according to literature which our study is limited to, only few of these countries a hold formal trauma system or trauma registry. Much can be gained concerning trauma systems in these countries, but unfortunately, the economic situation of many countries may render trauma systems not at their top priority list.

LEVEL OF EVIDENCE
Systematic review, level III.
Decompressive craniectomy versus craniotomy only for intracranial hemorrhage evacuation: A propensity matched study
Authors: Jehan Faisal , Azim Asad , Rhee Peter , Khan Muhammad , Gries Lynn , O'Keeffe Terence , Kulvatunyou Narong , Tang Andrew , Joseph Bellal 
Published: July 2017

BACKGROUND
Decompressive craniectomy (DC) is often performed in conjunction with evacuation of intracranial hemorrhage (ICH) to control intracranial pressure (ICP) in patients with a traumatic brain injury (TBI). The efficacy of DC in lowering ICP is well established; however, its effect on clinical outcomes remains controversial. The aim of our study is to assess outcomes in TBI patients undergoing DC versus craniotomy only (CO) for the evacuation of ICH.

METHODS
We performed a 5-year retrospective analysis of TBI patients with ICH who underwent craniotomy or craniectomy for traumatic ICH. Patients were divided into two groups, those who underwent CO and those who underwent DC. Propensity scoring matched patients in a 1:2 ratio for demographics, admission Glasgow Coma Scale (GCS) score, severity of injury, type and size of ICH, and anticoagulant use. Outcome measures included mortality, adverse discharge disposition (skilled nursing facility), discharge GCS and Glasgow Outcome Scale scores, and complications.

RESULTS
We reviewed 1,831 patients with TBI, of which 155 underwent craniotomy and/or craniectomy. After propensity score matching, we included 99 of those patients in our study (DC, 33; CO, 66). Matched groups were similar in age (p = 0.68), admission GCS score (p = 0.50), Injury Severity Score (p = 0.70), head Abbreviated Injury Scale score (p = 0.32), and intracranial bleeding characteristics. Overall, 26.3% (n = 26) of the patients died and 62.6% (n = 62) were discharged to Rehab/skilled nursing facility. There was no difference in the mortality rate (27.3% vs. 25.0%; p = 0.99), adverse discharge disposition (45% vs. 33%; p = 0.66), GCS score (p = 0.53), and Glasgow Outcome Scale (p = 0.80) at discharge between the DC and the CO groups. However, patients in DC group had higher complication rates and ventilator days.

CONCLUSION
This study showed no significant difference in clinical outcomes for patients undergoing evacuation of ICH regardless of the procedure performed. DC did not appear to be superior to craniotomy alone for the treatment of acute ICH.

LEVEL OF EVIDENCE
Therapeutic, level III.