bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Saccular Function on Recovery of Subjective Dizziness After Vestibular Rehabilitation
Authors: Jeong Junhui , Jung Jinsei , Lee Jeon Mi , Suh Michelle J. , Kwak Sang Hyun , Kim Sung Huhn 
Published: May 2017

Objective:
We attempted to investigate whether the integrity of saccular function influences the severity of subjective dizziness after vestibular rehabilitation in vestibular neuritis.

Study Design:
Retrospective analysis.

Setting:
Tertiary referral center.

Patients:
Forty-six patients with acute unilateral vestibular neuritis were included.

Interventions:
Diagnostic, therapeutic, and rehabilitative.

Main Outcome Measures:
All the patients completed vestibular rehabilitation therapy until their computerized dynamic posturography and rotary chair test results were significantly improved. The rehabilitation patients were classified into the normal to mild subjective dizziness and moderate to severe subjective dizziness groups according to the dizziness handicap inventory score (cutoff of 40). Differences between the two groups were analyzed.

Results:
After rehabilitation, 32.6% of the patients still complained of moderate to severe dizziness. Age, sex distribution, the presence of comorbidities, caloric weakness, pre- and postrehabilitation gain values in rotary chair test, postrehabilitation composite scores in posturography, and the duration of rehabilitation were not significantly different between the two groups. However, initial dizziness handicap inventory (DHI) score and composite score in dynamic posturography were worse and the proportion of patients with absent cervical vestibular-evoked myogenic potential in the moderate to severe group was much higher (93.3% vs. 35.5%, p < 0.001). After multiple regression analysis of those factors, initial DHI score and absent cervical vestibular-evoked myogenic potential response were identified as being associated with higher postrehabilitation DHI score.

Conclusion:
Saccular dysfunction in acute vestibular neuritis can contribute to persistent subjective dizziness, even after the objective parameters of vestibular function tests have been improved by vestibular rehabilitation.
Diagnostic accuracy of contrast-enhanced ultrasound for the differential diagnosis of hepatocellular carcinoma: ESCULAP versus CEUS-LI-RADS
Authors: Schellhaas Barbara , Görtz Ruediger S. , Pfeifer Lukas , Kielisch Christian , Neurath Markus F. , Strobel Deike 
Published: May 2017

Objective
A comparison is made of two contrast-enhanced ultrasound (CEUS) algorithms for the diagnosis of hepatocellular carcinoma (HCC) in high-risk patients: Erlanger Synopsis of Contrast-enhanced Ultrasound for Liver lesion Assessment in Patients at Risk (ESCULAP) and American College of Radiology Contrast-Enhanced Ultrasound-Liver Imaging Reporting and Data System (ACR-CEUS-LI-RADSv.2016).

Patients and methods
Focal liver lesions in 100 high-risk patients were assessed using both CEUS algorithms (ESCULAP and CEUS-LI-RADSv.2016) for a direct comparison. Lesions were categorized according to size and contrast enhancement in the arterial, portal venous and late phases.
For the definite diagnosis of HCC, categories ESCULAP-4, ESCULAP-Tr and ESCULAP-V and CEUS-LI-RADS-LR-5, LR-Tr and LR-5-V were compared. In addition, CEUS-LI-RADS-category LR-M (definitely/probably malignant, but not specific for HCC) and ESCULAP-category C [intrahepatic cholangiocellular carcinoma (ICC)] were compared.
Histology, CE-computed tomography and CE-MRI served as reference standards.

Results
The reference standard among 100 lesions included 87 HCCs, six ICCs and seven non-HCC-non-ICC-lesions. For the diagnosis of HCC, the diagnostic accuracy of CEUS was significantly higher with ESCULAP versus CEUS-LI-RADS (94.3%/72.4%; p<0.01). Sensitivity, specificity and positive predictive value (PPV) and negative predictive value for ESCULAP/CEUS-LI-RADS were 94.3%/72.4%; 61.5%/69.2%; 94.3%/94%; and 61.5%/27.3%, respectively.
The diagnostic accuracy for ICC (LR-M/ESCULAP-C) was identical with both algorithms (50%), with higher PPV for ESCULAP-C versus LR-M (75 vs. 50%).

Conclusion
CEUS-based algorithms contribute toward standardized assessment and reporting of HCC-suspect lesions in high-risk patients. ESCULAP shows significantly higher diagnostic accuracy, sensitivity and negative predictive value with no loss of specificity compared with CEUS-LI-RADS. Both algorithms have an excellent PPV. Arterial hyperenhancement is the key feature for the diagnosis of HCC with CEUS. Washout should not be a necessary prerequisite for the diagnosis of definite HCC. CEUS-LI-RADS in its current version is inferior to ESCULAP for the noninvasive diagnosis of HCC. There are two ways to improve CEUS-LI-RADS: firstly, combination of the categories LR-4 and LR-5 for the diagnosis of definite HCC, and secondly, use of subtotal infiltration of a liver lobe as an additional feature.
Controlled attenuation parameter for diagnosing steatosis in bariatric surgery candidates with suspected nonalcoholic fatty liver disease
Authors: Naveau Sylvie , Voican Cosmin S. , Lebrun Amandine , Gaillard Martin , Lamouri Karima , Njiké-Nakseu Micheline , Courie Rodi , Tranchart Hadrien , Balian Axel , Prévot Sophie , Dagher Ibrahim , Perlemuter Gabriel 
Published: May 2017

Introduction
Steatosis in patients with nonalcoholic fatty liver disease (NAFLD) is often benign, but may progress to fibrosis. The accurate diagnosis of hepatic steatosis is therefore important for clinical decision-making and prognostic assessments. The controlled attenuation parameter (CAP), a noninvasive measurement obtained with Fibro-Scan, has been developed for liver steatosis assessment. CAP performs poorly in patients with high BMI. The XL probe was initially developed for measuring liver stiffness in overweight patients. We assessed the diagnostic value of CAP in candidates for bariatric surgery with suspected NAFLD examined with the XL probe.

Patients and methods
For the retrospective group, raw ultrasonic radiofrequency signals were stored prospectively in the Fibro-Scan examination file for offline CAP calculation in 194 consecutive obese patients undergoing liver stiffness measurement in the 15 days before liver biopsy. For the prospective group, CAP was calculated automatically and prospectively from the XL probe in 123 obese patients.

Results
In the retrospective group, the diagnostic accuracy of CAP was satisfactory for differentiating S3 from S0–S1–S2 (0.79±0.03; 95% confidence interval: 0.71–0.84) and S3 from S0 (0.85±0.05; 95% confidence interval: 0.73–0.92). The Obuchowski measure demonstrated a very good discriminatory performance: 0.87±0.02 in the retrospective group and 0.91±0.02 in the prospective group.

Conclusion
CAP calculations from XL probe measurements efficiently detected severe steatosis in morbidly obese patients with suspected NAFLD. However, the cutoff values should now be confirmed in a larger prospective cohort.
Evaluation of the Isoniazid Preventive Therapy Care Cascade Among HIV-Positive Female Sex Workers in Mombasa, Kenya
Authors: LaCourse Sylvia M. , Deya Ruth W. , Graham Susan M. , Masese Linnet N. , Jaoko Walter , Mandaliya Kischorchandra N. , Overbaugh Julie , McClelland R. Scott 
Published: May 2017

Background:
Kenyan female sex workers (FSWs) have a high HIV prevalence, increasing their tuberculosis (TB) risk. Despite recommendations that HIV-positive individuals be offered isoniazid preventive therapy (IPT), uptake has been limited.

Methods:
In this longitudinal cohort of HIV-positive FSWs, we retrospectively characterized the IPT care cascade between March 2000 and January 2010, including reasons for cascade loss or appropriate exit. Cascade success required completion of 6 months of IPT. Baseline characteristics were assessed as potential correlates of cascade loss using multivariable logistic regression.

Results:
Among 642 HIV-positive FSWs eligible for IPT evaluation, median age was 31 years (IQR 26–35) with median CD4 lymphocyte count of 409 (IQR 292–604) cells per cubic millimeter. There were 249 (39%) women who successfully completed 6 months of IPT, 157 (24%) appropriately exited the cascade, and 236 (37%) were cascade losses. Most cascade losses occurred at symptom screen (38%, 90/236), chest radiograph evaluation (28%, 66/236), or during IPT treatment (30%, 71/236). Twenty-nine women were diagnosed with tuberculosis, including one after IPT initiation. Most women initiating IPT completed the course (71%, 249/351); <5% had medication intolerance. Younger women [<25 and 25–35 vs. >35 years; adjusted odds ratio (AOR) 2.65, 95% confidence interval (CI): 1.46 to 4.80 and AOR 1.78, 95% CI: 1.13 to 2.80, respectively], and those evaluated for IPT after antiretroviral availability in 2004 (AOR 1.92, 95% CI: 1.31 to 2.81), were more likely to be cascade losses.

Conclusions:
Implementation of IPT among HIV-positive FSWs in Kenya is feasible. However, significant losses along the IPT care cascade underscore the need for strategies improving retention in care.
Mathematical models of infection transmission in healthcare settings: recent advances from the use of network structured data
Authors: Assab Rania , Nekkab Narimane , Crépey Pascal , Astagneau Pascal , Guillemot Didier , Opatowski Lulla , Temime Laura 
Published: May 2017

Purpose of review
Mathematical modeling approaches have brought important contributions to the study of pathogen spread in healthcare settings over the last 20 years. Here, we conduct a comprehensive systematic review of mathematical models of disease transmission in healthcare settings and assess the application of contact and patient transfer network data over time and their impact on our understanding of transmission dynamics of infections.

Recent findings
Recently, with the increasing availability of data on the structure of interindividual and interinstitution networks, models incorporating this type of information have been proposed, with the aim of providing more realistic predictions of disease transmission in healthcare settings. Models incorporating realistic data on individual or facility networks often remain limited to a few settings and a few pathogens (mostly methicillin-resistant Staphylococcus aureus).

Summary
To respond to the objectives of creating improved infection prevention and control measures and better understanding of healthcare-associated infections transmission dynamics, further innovations in data collection and parameter estimation in modeling is required.
FN14 Blockade on Pulmonary Microvascular Endothelial Cells Improves the Outcome of Sepsis-Induced Acute Lung Injury
Authors: Zou Yun , Bao Suhong , Wang Fang , Guo Long , Zhu Jiali , Wang Jun , Deng Xiaoming , Li Jinbao 
Published: May 2017

ABSTRACT
Pulmonary microvascular leakage is one of the characteristics of blood–air barrier dysfunction in septic acute lung injury/acute respiratory distress syndrome (ALI/ARDS). Fibroblast growth factor-inducible 14 (Fn14) exerts diverse functions under certain circumstances. However, the role of Fn14 on the integrity of pulmonary microvascular endothelial cells (PMVECs) during sepsis remains unknown. Septic ALI was induced via cecal ligation and puncture (CLP). Fn14 expression on PMVECs was measured 24 h after surgery. The effects of Fn14 blockade on septic ALI were investigated in vivo and in vitro. Compared with the Sham group, Fn14 expressed in septic PMVECs was increased significantly 24 h after surgery. The protein level in bronchoalveolar lavage fluid, the lung wet to dry ratio, and neutrophil/macrophage infiltration in lungs were reduced in septic mice after Fn14 blockade. Similarly, ICAM-1 and MCP-1 levels were attenuated after Fn14 blockade or knockdown in lungs or human pulmonary microvascular endothelial cells (HPMECs). Furthermore, Fn14 silencing reduced Caspase-3 levels and upregulated the transendothelial electrical resistance level in TNF-like weak inducer of apoptosis-treated HPMECs. In addition, the degree of lung fibrosis was ameliorated and the survival of CLP mice was improved significantly after Fn14 blockade. In conclusion, Fn14 on PMVECs plays an important role in the progress of septic ALI. Fn14 blockade may prove to be an innovative lung-protective strategy for the treatment of septic ALI.
Impact of Critical Care Air Transport Team (CCATT) ventilator management on combat mortality
Authors: Maddry Joseph K. , Mora Alejandra G. , Savell Shelia C. , Perez Crystal A. , Mason Phillip E. , Aden James K. , Bebarta Vikhyat S. 
Published: May 2017

BACKGROUND
Aeromedical evacuation platforms such as Critical Care Air Transport Teams (CCATTs) play a vital role in the transport and care of critically injured and ill patients in the combat theater. Mechanical ventilation is used to support patients with failing respiratory function and patients requiring high levels of sedation. Mechanical ventilation, if not managed appropriately, can worsen or cause lung injury and contribute to increased morbidity. The purpose of this study was to evaluate the impact of ARDSNet protocol compliance during aeromedical evacuation of ventilated combat injured patients.

METHODS
We performed a retrospective chart review of combat injured patients transported by CCATTs from Afghanistan to Landstuhl Regional Medical Center (LRMC) in Germany between January 2007 and January 2012. After univariate analyses, we performed regression analyses to assess compliance and post-flight outcomes. Cox proportional hazard models were used to evaluate associations between the risk factor of non-compliance with increased number of ventilator, ICU, or hospital days. Nominal logistic regression models were performed to evaluate the association between non-compliance and mortality.

RESULTS
Sixty-two percent (n = 669) of 1,086 patients required mechanical ventilation during transport. A total of 650 patients required volume-controlled mechanical ventilation and were included in the analysis. Of the 650 subjects, 62% (n = 400) were non-compliant per tidal volume and ARDSNet table recommendations. The groups were similar in all demographic variables, except the Non-compliant group had a higher Injury Severity Score compared to the Compliant group. Subjects in the Compliant group were less likely to have an incidence of acute respiratory distress, acute respiratory failure, and ventilator-associated pneumonia when combing the variables (2% vs. 7%, p < 0.0069). The Non-compliant group had an increased incidence of in-flight respiratory events, required more days on the ventilator and in the ICU, and had a higher mortality rate.

CONCLUSIONS
Compliance with the ARDSNet guidelines was associated with a decrease in ventilator days, ICU days, and 30-day mortality.

LEVEL OF EVIDENCE
Therapeutic/care management, level IV.
Early infectious outcomes after addition of fluoroquinolone or aminoglycoside to posttrauma antibiotic prophylaxis in combat-related open fracture injuries
Authors: Lloyd Bradley A. , Murray Clinton K. , Shaikh Faraz , Carson M. Leigh , Blyth Dana M. , Schnaubelt Elizabeth R. , Whitman Timothy J. , Tribble David R. 
Published: May 2017

BACKGROUND
We examined combat-related open extremity fracture infections as a function of whether posttrauma antimicrobial prophylaxis included expanded Gram-negative (EGN) coverage.

METHODS
Military personnel with open extremity fractures sustained in Iraq and Afghanistan (2009–2014) who transferred to participating hospitals in the United States were assessed. The analysis was restricted to patients with a U.S. hospitalization period of ≥7 days. Prophylaxis was classified as narrow (e.g., IV cefazolin, clindamycin, and/or amoxicillin-clavulanate) or EGN, if the prophylactic regimen included fluoroquinolones and/or aminoglycosides.

RESULTS
The study population included 1,044 patients, of which 585 (56%) and 459 (44%) received narrow and EGN coverage, respectively (p < 0.001). Skin and soft-tissue infections (SSTIs) were more common among patients who received narrow prophylaxis compared to EGN coverage (28% vs. 22%; p = 0.029), whereas osteomyelitis rates were comparable between regimens (8%). Similar findings were noted when endpoints were measured at 2 and 4 weeks postinjury. There was no significant difference related to length of hospitalization between narrow and EGN regimens (median: 34 and 32 days, respectively) or operating room visits (median: 5 and 4). A higher proportion of EGN coverage patients had Gram-negative organisms isolated that were not susceptible to fluoroquinolones and/or aminoglycosides (49% vs. 40%; p < 0.001). In a Cox proportional model, narrow prophylaxis was independently associated with an increased risk of extremity SSTIs (hazard ratio: 1.41; 95% confidence interval: 1.09–1.83).

DISCUSSION
Despite seeing a small benefit with EGN coverage related to a reduction of SSTIs, it does not decrease the risk of osteomyelitis, and there seems to be a cost of increased antibiotic resistance associated with use. Overall, our findings support the current post-combat trauma antibiotic prophylaxis guidelines, which recommend the use of cefazolin or clindamycin with open fractures.

LEVEL OF EVIDENCE
Prognostic/Epidemiological, Level II; Therapy, level IV.
Protein Evolution Depends on Multiple Distinct Population Size Parameters
Authors: Platt Alexander , Weber Claudia C , Liberles David A 
Published: May 2017

AbstractThat population size affects the fate of new mutations arising in genomes, modulating both how frequently they arise and how efficiently natural selection is able to filter them, is well established. It is therefore clear that these distinct roles for population size that characterize different processes should affect the evolution of proteins and need to be carefully defined. Empirical evidence is consistent with a role for demography in influencing protein evolution, supporting the idea that functional constraints alone do not determine the composition of coding sequences.Given that the relationship between population size, mutant fitness and fixation probability has been well characterized, estimating fitness from observed substitutions is well within reach with well-formulated models. Molecular evolution research has, therefore, increasingly begun to leverage concepts from population genetics to quantify the selective effects associated with different classes of mutation. However, in order for this type of analysis to provide meaningful information about the intra- and inter-specific evolution of coding sequences, a clear definition of concepts of population size, what they influence, and how they are best parameterized is essential.Here, we present an overview of the many distinct concepts that “population size” and “effective population size” may refer to, what they represent for studying proteins, and how this knowledge can be harnessed to produce better specified models of protein evolution.
The kinetic basis of CRISPR-Cas off-targeting rules
Authors: Klein Misha , Eslami-Mossallam Behrouz , Gonzalez Arroyo Dylan , Depken Martin 
Published: May 2017

ABSTRACTCas nucleases are popular tools for genome editing applications due to their ability to introduce DNA breaks at desired genomic locations. Such differential targeting is achieved through loading an RNA guide complimentary to the intended target sequence. As it turns out, sequences with only a partial match to the guide can also be cleaved. A large number of experiments have shed light on this off-targeting, outlining a number of rather peculiar empirical rules that detail the effect of mismatches at various positions and at various relative distances. We construct a kinetic model predicting on-target cleavage efficiency as well as off-target specificity. Our model explains a unified targeting rule for any target harboring mismatches, independent of their abundance and placing, and the observed decoupling between efficiency and specificity when protein-DNA interactions are weakened. We favorably compare our model to published experimental data from CRISPR-Cas9, CRISPR-Cpf1, CRISPR-Cascade, as well as to the human Argonaute 2 systems. Understanding the origins of off-targeting principles is important for the further development of CRISPR-Cas as a precise genome editing tool.
Conserved neural circuit structure acrossDrosophilalarval development revealed by comparative connectomics
Authors: Gerhard Stephan , Andrade Ingrid , Fetter Richard D. , Cardona Albert , Schneider-Mizell Casey M. 
Published: May 2017

AbstractThroughout an animal’s postembryonic development, neuronal circuits must maintain appropriate output even as the body grows. The contribution of structural adaptation — neuronal morphology and synaptic connectivity — to circuit development remains unclear. In a previous paper (Schneider-Mizellet al., 2016), we measured the detailed neuronal morphological structures subserving neuronal connectivity inDrosophila. Here, we examine how neuronal morphology and connectivity change across postembyronic development. Using new and existing serial section electron microscopy volumes, we reconstructed an identified nociceptive circuit in two larvae, one 1st instar and one 3rd instar. We found extremely consistent, topographically-arranged circuit structure. Five-fold increases in size of interneurons were associated with compensatory structural changes that maintained cell-type-specific synaptic input as a fraction of total inputs. An increase in number of synaptic contacts was accompanied with a disproportionate increase in the number of small dendritic terminal branches relative to other neuronal compartments. We propose that these precise patterns of structural growth act to conserve the computational function of a circuit, for example determining the location of a nociceptive stimulus.
Phylogenomic species delimitation in microendemic frogs of the Brazilian Atlantic Forest
Authors: Pie Marcio R. , Bornschein Marcos R. , Ribeiro Luiz F. , Faircloth Brant C. , McCormack John E. 
Published: May 2017

AbstractThe advent of next-generation sequencing allows researchers to use large-scale datasets for species delimitation analyses, yet one can envision an inflection point where the added accuracy of including more loci does not offset the increased computational burden. One alternative to including all loci could be to prioritize the analysis of loci for which there is an expectation of high informativeness, such as those with higher numbers of parsimony-informative sites. Here, we explore the issue of species delimitation and locus selection with species from two anuran genera:Melanophryniscus(Bufonidae) andBrachycephalus(Brachycephalidae). Montane species in these genera have been isolated in sky islands across the southern Brazilian Atlantic Forest, which led to the formation of a number of microendemic species. To delimit species, we obtained genetic data using target enrichment of ultraconserved elements from 32 populations (13 forMelanophryniscusand 19 forBrachycephalus), and we were able to create datasets that included over 800 loci with no missing data. We ranked loci according to their corresponding number of parsimony-informative sites, and we performed species delimitation analyses using BPP in each genus based on the top 10, 20, 40, 80, 160, 320, and 640 loci. We also conducted several additional analyses using 10 randomly sampled datasets containing the same numbers of loci to discriminate the relative contribution of increasing the number of loci from prioritizing those with higher informativeness. We identified three types of node: nodes with either consistently high or low support regardless of the number of loci or their informativeness, and nodes that were initially poorly supported, but their support became stronger with more data. Adding more loci had a stronger impact on model support than prioritizing loci for their informativeness, but this effect was less apparent in datasets with more than 160 loci. When viewed across all sensitivity analyses, our results suggest that the current species richness in both genera might have been underestimated. In addition, our results provide useful guidelines to the use of different sampling strategies to carry out species delimitation with phylogenomic datasets.