bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPARISON OF GANGLION CELL INNER PLEXIFORM LAYER THICKNESS BY CIRRUS AND SPECTRALIS OPTICAL COHERENCE TOMOGRAPHY IN DIABETIC MACULAR EDEMA
Authors: Hafner Julia , Prager Sonja , Lammer Jan , Kriechbaum Katharina , Scholda Christoph , Pablik Eleonore , Schmidt-Erfurth Ursula 
Published: April 2017

Purpose:
Reduced thickness of the ganglion cell inner plexiform layer indicates diabetic neurodegeneration and can be assessed by spectral domain optical coherence tomography. The authors investigated the comparability of ganglion cell inner plexiform layer measurements from two spectral domain optical coherence tomography devices in patients with diabetic macular edema (DME).

Methods:
Analysis of optical coherence tomography data sets of eyes with and fellow eyes without DME. Macular cube scans of sufficient signal strength on Cirrus (Carl Zeiss Meditec) were compared with correlating scans on Spectralis (Heidelberg Engineering, Germany) being acquired within 1 hour.

Results:
Eighty-one equivalent data sets for 20 eyes with DME (20 patients; 6 female) and 33 for 9 fellow eyes without DME (9 patients; 2 female) were included from each device. In DME eyes, mean ganglion cell inner plexiform layer thicknesses were 62.5 ± 20.4 μm on Cirrus and 91.2 ± 9.3 μm on Spectralis. Ganglion cell inner plexiform layer was significantly thicker on Spectralis analyzing eyes with and without signs of DME (P < 0.001). The ganglion cell inner plexiform layer variance (54.2%) related to device differences decreased to 34.8% in eyes without DME.

Conclusion:
Ganglion cell inner plexiform layer data from different devices vary considerably and cannot be used interchangeably. As spectral domain optical coherence tomography is indispensable for identifying ganglion cell loss associated with diabetic neurodegeneration, clinicians should be aware of the difference when monitoring patients.
EFFECT OF BODY POSITION ON INTRAOCULAR PRESSURE IN SILICONE OIL TAMPONADE EYES
Authors: Pan Jiandong , Cheng Dan , Feng Xiaofen , Zheng Liya , Dong Yugui , Hou Qiang , Chen Feng 
Published: April 2017

Purpose:
To investigate the effect of body position on intraocular pressure (IOP) in silicone oil tamponade eyes.

Methods:
This prospective study included 18 eyes from 18 silicone oil tamponade patients and 24 eyes from 24 healthy subjects. Intraocular pressures were measured by Accupen Applanation Tonometer sitting with face forward, sitting with face down, supine, nondependent lateral decubitus, dependent lateral decubitus, and prone positions. The IOPs in each position and the magnitudes of IOP change were compared between the silicone oil and normal groups.

Results:
In both groups, the IOPs in sitting positions were significantly lower than that of each recumbent position. The IOPs were highest in prone among all positions. No significant difference was found between IOPs of each group in each position. Between both groups, the IOP elevations in each position had no statistical difference compared with sitting with face forward.

Conclusion:
The IOP is lowest in the sitting position and highest in the prone position in both silicone oil and normal groups. Between both groups, the amount of IOP elevations is equivalent in each position compared with sitting with face forward. Ophthalmologists should be aware that IOP is higher in the prone position and that it should be monitored accordingly.
Clinician Perceptions of the Importance of Hospital Discharge Components for Children
Authors: Blaine Kevin , Rogers Jayne , O'Neill Margaret R. , McBride Sarah , Faerber Jennifer , Feudtner Chris , Berry Jay G. 
Published: April 2017

Background:
Discharging hospitalized children involves several different components, but their relative value is unknown. We assessed which discharge components are perceived as most and least important by clinicians.

Methods:
March and June of 2014, we conducted an online discrete choice experiment (DCE) among national societies representing 704 nursing, physician, case management, and social work professionals from 46 states. The DCE consisted of 14 discharge care components randomly presented two at a time for a total of 28 choice tasks. Best-worst scaling of participants' choices generated mean relative importance (RI) scores for each component, which allowed for ranking from least to most important.

Results:
Participants, regardless of field or practice setting, perceived “Discharge Education/Teach-Back” (RI 11.1 [95% confidence interval, CI: 11.0–11.3]) and “Involve the Child's Care Team” (RI 10.6 [95% CI: 10.4–10.8]) as the most important discharge components, and “Information Reconciliation” (RI 4.1 [95% CI: 3.9–4.4]) and “Assigning Roles/Responsibilities of Discharge Care” (RI 2.8 [95% CI: 2.6–3.0]) as least important.

Conclusions:
A diverse group of pediatric clinicians value certain components of the pediatric discharge care process much more than others. Efforts to optimize the quality of hospital discharge for children should consider these findings.
Two Tumors in 1: What Should be the Therapeutic Target? Pediatric Germ Cell Tumor With Somatic Malignant Transformation
Authors: Faure Conter Cecile , Fresneau Brice , Thebaud Estelle , Bertrand Amandine , Dijoud Frederique , Rome Angelique , Dumesnil Cecile , Castex Marie Pierre , Ghanem Anguella , Orbach Daniel 
Published: April 2017

Background:
Germ cell tumors with somatic malignant transformation (GCT with SMT) are rare in children and poorly described. Data are missing to determine if therapies should target the GCT, the SMT compound, or both simultaneously.

Patients and Methods:
A retrospective national study was conducted in the Société Française des cancers de l’Enfant (SFCE) Centers. Medical records from patients aged 0 to 18 years diagnosed with GCT with SMT between 2000 and 2015 were analyzed. Any stages and primary sites were considered as well as synchronous and metachronous cases.

Results:
Fifteen patients were identified. Thirteen patients had synchronous GCT with SMT. In the latter cases, primaries were ovary (5), mediastinum (3), pineal gland (3), sacrococcyx (1), and parametrium (1). SMT histologies were central primitive neuroectodermal tumor (5), embryonal rhabdomyosarcomas (3) or thyroid papillary adenocarcinoma, leukemia, poorly differentiated carcinoma, mixed sarcomas, and miscellaneous histology (1 case each). Chemotherapy was targeted against the GCT (3), the SMT (6), or both components (3). The last patient received surgery exclusively. Partial or complete response to chemotherapy was observed in 5/10 assessable cases: 2/3 patients treated with GCT-dedicated chemotherapy, 3/6 patients treated with SMT-dedicated therapy, and 0/1 treated with combined therapy. In addition, 2 patients with mediastinal GCT primary had metachronous SMT, with acute myeloid leukemia and thyroid papillary adenocarcinoma, 8 months and 8 years, respectively, after the diagnoses of GCT. Two patients (1 synchronous and 1 metachronous) were cured with surgery exclusively. At the end of follow-up, 6 patients died of their disease including all 4 with postsurgical macroscopic residue.

Conclusions:
GCT with SMT constitutes a very rare entity in children and adolescents. Surgical removal of the tumor is the cornerstone of the treatment and might be sufficient in selected cases. In the remaining cases, the best management is still unknown and should take into account both components and their respective chemosensitivity. Long-term surveillance is advised for patient with unresected teratoma as late transformation can occur.
Postpartum Hypertension: Etiology, Diagnosis, and Management
Authors: Sharma Kathryn J. , Kilpatrick Sarah J. 
Published: April 2017

Importance
Postpartum hypertension complicates approximately 2% of pregnancies and, similar to antepartum severe hypertension, can have devastating consequences including maternal death.

Objective
This review aims to increase the knowledge and skills of women’s health care providers in understanding, diagnosing, and managing hypertension in the postpartum period.

Results
Hypertension complicating pregnancy, including postpartum, is defined as systolic blood pressure 140 mm Hg or greater and/or diastolic blood pressure 90 mm Hg or greater on 2 or more occasions at least 4 hours apart. Severe hypertension is defined as systolic blood pressure 160 mm Hg or greater and/or diastolic blood pressure 110 mm Hg or greater on 2 or more occasions repeated at a short interval (minutes). Workup for secondary causes of hypertension should be pursued, especially in patients with severe or resistant hypertension, hypokalemia, abnormal creatinine, or a strong family history of renal disease. Because severe hypertension is known to cause maternal stroke, women with severe hypertension sustained over 15 minutes during pregnancy or in the postpartum period should be treated with fast-acting antihypertension medication. Labetalol, hydralazine, and nifedipine are all effective for acute management, although nifedipine may work the fastest. For persistent postpartum hypertension, a long-acting antihypertensive agent should be started. Labetalol and nifedipine are also both effective, but labetalol may achieve control at a lower dose with fewer adverse effects.

Conclusions and Relevance
Providers must be aware of the risks associated with postpartum hypertension and educate women about the symptoms of postpartum preeclampsia. Severe acute hypertension should be treated in a timely fashion to avoid morbidity and mortality. Women with persistent postpartum hypertension should be administered a long-acting antihypertensive agent.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner should be better able to assist patients and providers in identifying postpartum hypertension; provide a framework for the evaluation of new-onset postpartum hypertension; and provide instructions for the management of acute severe and persistent postpartum hypertension.
Mycoplasma genitalium Antibiotic Resistance–Mediating Mutations in Canadian Women With or Without Chlamydia Trachomatis Infection
Authors: Chernesky Max A. , Jang Dan , Martin Irene , Hoang Linda M.N. , Naidu Prenilla , Levett Paul N. , Wylie John , Rebbapragada Anu , Ratnam Sam , Smieja Marek , Weinbaum Barbara , Getman Damon 
Published: April 2017

AbstractTesting remnant Aptima specimens from women infected withChlamydia trachomatisdetected 13.4% (53/396) withMycoplasma genitaliumcompared with 5.4% (22/406) in matchedC. trachomatis–negative women. Overall, 9.4% (provincial ranges of 3–20%) were infected withM. genitaliumand resistance mediating mutations were found in 47.3% (26/55) to macrolides and 1.9% (1/53) to fluoroquinolones by sequencing.
Is Patient-Reported Exposure a Reliable Indicator for Anogenital Gonorrhea and Chlamydia Screening in Young Black Men Who Have Sex With Men?
Authors: Chamberlain Nicholas , Crosby Richard A. , Mena Leandro , Chan Philip A. , Mayer Kenneth H. 
Published: April 2017

Abstract
Among 485 young black men who have sex with men recruited in Jackson, MS, 90-day anal sexual exposure significantly predicted rectal infection, but 19.4% of rectal infections would have been missed among men denying receptive anal sex. Reports of consistent condom use were associated with lower infection rates only in men reporting insertive anal sex.
Sexually Transmitted Infection Prevention With Long-Acting Reversible Contraception: Factors Associated With Dual Use
Authors: Thompson Erika L. , Vamos Cheryl A. , Griner Stacey B. , Logan Rachel , Vázquez-Otero Coralia , Daley Ellen M. 
Published: April 2017

Background
Long-acting reversible contraception (LARC) is extremely effective in preventing pregnancy; however, it does not provide sexually transmitted infection (STI) prevention. Therefore, dual use is recommended for the prevention of STIs, in addition to pregnancy, by using LARC methods with condoms. This study assessed factors associated with LARC only use and dual-LARC and condom use among college women.

Methods
The National College Health Assessment-II Fall 2012 to 2013 was used for this analysis. The analytic sample was restricted to women who used a LARC method (ie, intrauterine device or implant) (N = 1658). The main outcome was dual method use, LARC and condom, at last sex. An adjusted logistic regression model assessed sociodemographic factors (age, relationship, race), health care utilization (routine gynecological examination), and sexual behavior (number of partners) as factors associated with dual condom-LARC use at the last time of vaginal-sex. Prevalence ratios (PR) and 95% confidence intervals (CI) were estimated.

Results
Among women reporting LARC use, 24% used a condom. Dual users were less likely to have only 1 sexual partner (adjusted PR [aPR], 0.66; 95% CI, 0.54–0.81) and be in a relationship. Dual users were more likely than LARC-only users to be Hispanic (aPR, 1.34; 95% CI, 1.01–1.78), black (aPR, 1.40; 95% CI, 1.07–1.83), and biracial/multiracial (aPR, 1.38; 95% CI, 1.10–1.73).

Conclusions
These findings illustrate differences between dual-condom LARC and LARC-only college users. It is likely that relationship status and number of partners influences perceived risk for STIs and decision making for dual use among this population.
Effect of gastroretentive gabapentin (Gralise) on postmastectomy pain syndrome: a proof-of-principle open-label study
Authors: Belfer Inna , Pollock Netanya I. , Martin Jodi L. , Lim Katherine G. , De La Cruz Carolyn , Van Londen Gijsberta , Nunziato-Virga Stephanie R. , Stranieri Katherine , Brufsky Adam M. , Wang Haibin 
Published: April 2017

Abstract

Introduction:
Chronic pain is a common and debilitating complication following breast surgery. One of the most challenging for treatment is the neuropathic pain condition, postmastectomy pain syndrome (PMPS). Gabapentin is a pharmacotherapy for neuropathic pain disorders; however, its once-daily, gastroretentive formulation, Gralise, has not been evaluated in PMPS.

Objective:
To evaluate the safety and effectiveness of Gralise in patients with moderate-to-severe PMPS.

Methods:
The primary effectiveness endpoint was a change in the worst pain intensity score from baseline to completion of 8 weeks of Gralise therapy. The secondary endpoints included the change in mood, coping behavior, sleep, and function. Sensitivity to experimental stimuli was tested before and after treatment via quantitative sensory testing. The incidence and type of adverse event were used to evaluate the safety and tolerability of Gralise.

Results:
Twenty-one patients with confirmed moderate-to-severe PMPS were enrolled. Nineteen of 21 (90.5%) patients completed the 8-week treatment with Gralise. A significant positive change was found in pain intensity, pain impact, and sleep. There was no change in sensory testing scores. Of total, 63.16% of patients reported reduction in present pain, 78.95% in average pain, 89.47% in worst pain, and 84.21% in overall pain severity at posttreatment visit. No significant adverse effects were noted in the study.

Limitations:
Variation in type of breast surgery, small sample size, lack of placebo control.

Conclusion:
There was a significant improvement in pain and sleep, and Gralise was well tolerated in patients with PMPS. Further investigation is warranted.
A National Study of the Impact of Delayed Flap Timing for Treatment of Patients with Deep Sternal Wound Infection
Authors: Sears Erika D. , Momoh Adeyiza O. , Chung Kevin C. , Lu Yu-Ting , Zhong Lin , Waljee Jennifer F. 
Published: April 2017

Background:
This study aimed to evaluate the impact of delayed flap closure on mortality and resource use for treatment of deep sternal wound infection.

Methods:
The authors analyzed the Truven MarketScan Databases from 2009 to 2013 to identify adult patients who developed deep sternal wound infection after open cardiac surgery and who underwent flap closure for treatment. A multivariable logistic regression model was created to evaluate the relationship between mortality and flap timing. Multivariable Poisson regressions were used to investigate the relationship between flap timing and number of procedures, number of hospitalizations, and length of stay outcomes. A multivariable log-linear regression model was created for cost analysis. All analyses were adjusted for patient risk factors and treatment characteristics.

Results:
The authors identified 612 patients with deep sternal wound infection who underwent flap closure. The timing of flap closure was delayed more than 7 days after diagnosis in 39 percent of patients. Delayed time to flap closure greater than 3 days after diagnosis of infection was associated with higher mortality odds for delay 4 to 7 days (OR, 2.94) and delay greater than 7 days (OR, 2.75; p < 0.03), greater additional procedures for delay 4 to 7 days (incidence rate ratio, 1.72) and delay greater than 7 days (incidence rate ratio, 1.93; p < 0.001), and up to 43 percent longer hospital length of stay and 37 percent greater costs compared with patients undergoing flap closure 0 to 3 days after diagnosis.

Conclusions:
Delay in flap closure was associated with greater mortality and resource use. Prompt involvement of reconstructive surgeons may improve quality and efficiency of deep sternal wound infection care.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Heterogeneity in 14-year Dementia Incidence Between Asian American Subgroups
Authors: Mayeda Elizabeth R. , Glymour M. Maria , Quesenberry Charles P. , Whitmer Rachel A. 
Published: April 2017

Background:
Asian Americans are a rapidly growing and diverse population. Prior research on dementia among Asian Americans focused on Japanese Americans or Asian Americans overall, although marked differences in cardiometabolic conditions between subgroups have been documented.

Materials and Methods:
We compared dementia incidence among 4 Asian American subgroups (n=8384 Chinese; n=4478 Japanese; n=6210 Filipino; n=197 South Asian) and whites (n=206,490) who were Kaiser Permanente Northern California members aged 64 years and above with no dementia diagnoses as of January 1, 2000. Dementia diagnoses were collected from medical records January 1, 2000 to December 31, 2013. Baseline medical utilization and comorbidities (diabetes, depression, hypertension, stroke, cardiovascular disease) were abstracted from medical records January 1, 1996 to December 31, 1999. We calculated age-standardized dementia incidence rates and Cox models adjusted for age, sex, medical utilization, and comorbidities.

Results:
Mean baseline age was 71.7 years; mean follow-up was 9.6 years. Age-standardized dementia incidence rates were higher among whites than “All Asian-Americans” or any subgroup. Compared with Chinese (13.7/1000 person-years), dementia incidence was slightly higher among Japanese [14.8/1000 person-years; covariate-adjusted hazard ratio (adjusted-HR)=1.08; 95% confidence interval (CI), 0.99-1.18] and Filipinos (17.3/1000 person-years; adjusted-HR=1.20; 95% CI, 1.11-1.31), and lower among South Asians (12.1/1000 person-years; adjusted-HR=0.81; 95% CI, 0.53-1.25).

Conclusions:
Future studies are needed to understand how immigration history, social, environmental, and genetic factors contribute to dementia risk in the growing and diverse Asian American population.
Response threshold variance as a basis of collective rationality
Authors: Yamamoto Tatsuhiro , Hasegawa Eisuke 
Published: April 2017

Determining the optimal choice among multiple options is necessary in various situations, and the collective rationality of groups has recently become a major topic of interest. Social insects are thought to make such optimal choices by collecting individuals' responses relating to an option's value (=a quality-graded response). However, this behaviour cannot explain the collective rationality of brains because neurons can make only ‘yes/no’ responses on the basis of the response threshold. Here, we elucidate the basic mechanism underlying the collective rationality of such simple units and show that an ant species uses this mechanism. A larger number of units respond ‘yes’ to the best option available to a collective decision-maker using only the yes/no mechanism; thus, the best option is always selected by majority decision. Colonies of the ant
Myrmica kotokui
preferred the better option in a binary choice experiment. The preference of a colony was demonstrated by the workers, which exhibited variable thresholds between two options' qualities. Our results demonstrate how a collective decision-maker comprising simple yes/no judgement units achieves collective rationality without using quality-graded responses. This mechanism has broad applicability to collective decision-making in brain neurons, swarm robotics and human societies.
Motif Disruption Domains Lead To Cancer Gene Expression Rewiring
Authors: Lamaze Fabien C. , Chateigner Aurelien , Edgington Hilary A. , Fave Marie-Julie , Houle Armande Ang ,   PCAWG3, Awadalla Philip 
Published: April 2017

AbstractSomatic mutations accumulate in non-coding regions of the genome during tumorigenesis, but their functional characterization presents a challenge. Somatic non-coding mutations rarely overlap among patients, which necessitates large sample sizes to detect associations. We analysed somatic mutations called from whole-genome sequencing (WGS) and RNA sequencing (RNAseq) from 3000 tumors across the Pan-Cancer Analysis of Whole Genomes to identify and functionally characterize mutation accumulation and its impact on gene dysregulation in cancer. We identified 1.5 million motif disruption domains (MDDs) across 40 cancer types, which we characterized as pan-cancer targets for recurrent mutation accumulation. These MDDs deregulate gene expression in cancer-specific and pan-cancer patterns by disrupting transcription factor binding sites in regulatory and insulator elements. Disruption is most recurrent across individuals at MDDs in conserved open chromatin, revealing potential drivers. This accumulation of somatic variants targeting regulatory and structural elements in MDDs generates gene expression dysregulation during tumorigenesis.
Small effect-size mutations cumulatively affect yeast quantitative traits
Authors: Hua Bo , Springer Michael 
Published: April 2017

SummaryQuantitative traits are influenced by pathways that have traditionally been defined through genes that have a large loss- or gain-of-function effect. However, in theory, a large number of small effect-size genes could cumulative play a substantial role in pathway function, potentially by acting as “modifiers” that tune the levels of large effect size pathway components. To understand the role of these small effect-size genes, we used a quantitative assay to determine the number, strength, and identity of all non-essential genes that affect two galactose-responsive (GAL) traits, in addition to re-analyzing two previously screened quantitative traits. Over a quarter of assayed genes have a detectable effect; approximately two thirds of the quantitative trait variation comes from small effect-size genes. The functions of small effect-size genes are partially overlapping between traits and are enriched in core cellular processes. This implies that genetic variation in one process has the potential to influence behavior or disease in seemingly unconnected processes.HighlightsFour yeast quantitative traits are affected by thousands of small effect-size genes.Small effect-size genes are enriched in core cellular processesThe effects of these genes are quantitative trait-specific.