bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incorporating Inflammation into Mortality Risk in Pediatric Acute Respiratory Distress Syndrome
Authors: Zinter Matt S. , Orwoll Benjamin E. , Spicer Aaron C. , Alkhouli Mustafa F. , Calfee Carolyn S. , Matthay Michael A. , Sapru Anil 
Published: March 2017

Objectives:
In pediatric acute respiratory distress syndrome, lung injury is mediated by immune activation and severe inflammation. Therefore, we hypothesized that patients with elevated pro- and anti-inflammatory cytokines would have higher mortality rates and that these biomarkers could improve risk stratification of poor outcomes.

Design:
Multicenter prospective observational study.

Setting:
We enrolled patients from five academic PICUs between 2008 and 2015.

Patients:
Patients were 1 month to 18 years old, used noninvasive or invasive ventilation, and met the American European Consensus Conference definition of acute respiratory distress syndrome.

Interventions:
Eight proinflammatory and anti-inflammatory cytokines were measured on acute respiratory distress syndrome day 1 and correlated with mortality, ICU morbidity as measured by survivor Pediatric Logistic Organ Dysfunction score, and biomarkers of endothelial injury, including angiopoietin-2, von Willebrand Factor, and soluble thrombomodulin.

Measurements and Main Results:
We measured biomarker levels in 194 patients, including 38 acute respiratory distress syndrome nonsurvivors. Interleukin-6, interleukin-8, interleukin-10, interleukin-18, and tumor necrosis factor-R2 were each strongly associated with all-cause mortality, multiple markers of ICU morbidity, and endothelial injury. A multiple logistic regression model incorporating oxygenation index, interleukin-8, and tumor necrosis factor-R2 was superior to a model of oxygenation index alone in predicting the composite outcome of mortality or severe morbidity (area under the receiver operating characteristic, 0.77 [0.70–0.83] vs 0.70 [0.62–0.77]; p = 0.042).

Conclusions:
In pediatric acute respiratory distress syndrome, pro- and anti-inflammatory cytokines are strongly associated with mortality, ICU morbidity, and biochemical evidence of endothelial injury. These cytokines significantly improve the ability of the oxygenation index to discriminate risk of mortality or severe morbidity and may allow for identification and enrollment of high-risk subgroups for future studies.
RANIBIZUMAB FOR RETINAL VEIN OCCLUSION
Authors: Chatziralli Irini , Theodossiadis George , Chatzirallis Alexandros , Parikakis Efstratios , Mitropoulos Panagiotis , Theodossiadis Panagiotis 
Published: March 2017

Purpose:
The purpose of the study was to evaluate the long-term anatomical and functional outcomes in patients with retinal vein occlusion (RVO), either central retinal vein occlusion or branch retinal vein occlusion, treated with intravitreal ranibizumab and to determine the predictive factors of the final visual outcome.

Methods:
This retrospective study included 54 treatment-naive patients with macular edema due to RVO (25 with central retinal vein occlusion and 29 with branch retinal vein occlusion), who were treated with intravitreal ranibizumab (3 monthly injections and pro re nata). Predictive factors for visual outcome were assessed. In addition, the best-corrected visual acuity change and the percentage of patients with edema resolution were evaluated.

Results:
The mean follow-up time was 47.4 ± 11.1 months. At the end of the follow-up, patients with central retinal vein occlusion gained +6.9 letters (∼1 Snellen line), whereas patients with branch retinal vein occlusion gained +15.1 letters (3 Snellen lines). Forty-eight percent of patients in central retinal vein occlusion group and 69.0% in branch retinal vein occlusion group presented resolution of macular edema. Negative predictive factors for the final visual outcome were found to be increasing age, increasing macular thickness, the presence of intraretinal fluid, the duration of RVO >3 months, the ischemic type of RVO, the cystoid type of edema, and the external limiting membrane and ellipsoid zone disruption.

Conclusion:
The various predictive factors that determine the visual outcome and possibly define the patients' prognosis after ranibizumab treatment in RVO have been studied. The long follow-up period showed that ranibizumab seems to be safe and effective in the treatment of the disease.
A Context-oriented Communication Algorithm for Advance Care Planning
Authors: Kim JinShil , Kim Shinmi , Shin Mi-Seung , Jin Jae Ok , Kim Yunmi , Lee Mee-Ok 
Published: March 2017

Background:Access to consultation or referral for decisions about advance care planning (ACP) is limited, particularly for nonmalignant models pertinent to palliative care in heart failure (HF).Objectives:The aim of this study was to solicit professional opinions about the feasibility of using an exemplary context-oriented communication algorithm for ACP discussions.Methods:Using a panel of expert physicians and nurses in cardiovascular care, a 3-round Delphi study was conducted to evaluate the proposed model.Results:A consensus was determined based on a content validity ratio (CVR) of 0.318 or greater, a critical value for selection of an item scored as important (≥4 on a 5-point Likert scale). A total of 50, 44, and 38 experts in Korea completed each round, respectively. Item evaluation did not differ across rounds (Friedman χ2>P= .05), except for timing of the ACP discussion. A lack of consensus was observed on the issue of after HF diagnosis for right timing of the ACP discussion across rounds (CVRs from −0.80 to −0.83); consensus was reached on the expectation of a terminal state (CVRs from 0.60 to 0.78). Content validity ratios were moderately high for Korean advance directive, ranging from 0.59 to 0.91. Experts also reached consensus about each of 5 steps of a communication model—patients’ determination of decisional capacity (CVR, 0.72–1.0), awareness (CVR, 0.95–1.0), willingness for advance care planning (CVR, 0.76–0.84), family dynamics (CVR, 0.92–1.0) and patient readiness for advance care planning (CVR, 0.76–0.95).Conclusions:A context-oriented communication model could be used to facilitate the decision-making process for palliative care and continuity of care in HF.
Radiofrequency ablation treatment for aldosterone-producing adenomas
Authors: Sacks Barry A. , Sacks Ari C. , Faintuch Salomao 
Published: March 2017

Purpose of review
To review the current status of radiofrequency ablation as a primary treatment for hyperfunctioning adrenal nodules, predominantly aldosterone-producing adenomas (APAs).

Recent findings
Radiofrequency ablation is an established treatment for focal benign and malignant lesions, including metastatic disease to the adrenal gland. Hyperaldosteronism is the leading cause of secondary hypertension with up to 80% due to APA, statistically the most common functioning adrenal nodule. Although surgery remains the recommended treatment of choice for confirmed unilateral functioning adrenal nodules, radiofrequency ablation offers a less-invasive approach, with results comparable with surgery.

Summary
Radiofrequency ablation of functioning adrenal nodules is a newer application of a technology in use for almost 2 decades. Although limited, reports to date suggest that results are comparable with those of laparoscopic adrenalectomy, but with advantages including being a less-invasive outpatient procedure with lower morbidity, faster recovery, and lower cost. However, the current data are all retrospective, the number of patients treated is small, and reported long-term results are limited.
Specific Etiologies Associated With the Multiple Organ Dysfunction Syndrome in Children: Part 2
Authors: Upperman Jeffrey S. , Bucuvalas John C. , Williams Felicia N. , Cairns Bruce A. , Cox Charles S. , Doctor Allan , Tamburro Robert F. 
Published: March 2017

Objective:
To describe a number of conditions and therapies associated with multiple organ dysfunction syndrome presented as part of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Multiple Organ Dysfunction Workshop (March 26–27, 2015). In addition, the relationship between burn injuries and multiple organ dysfunction syndrome is also included although it was not discussed at the workshop.

Data Sources:
Literature review, research data, and expert opinion.

Study Selection:
Not applicable.

Data Extraction:
Moderated by an expert from the field, issues relevant to the association of multiple organ dysfunction syndrome with a variety of conditions and therapies were presented, discussed, and debated with a focus on identifying knowledge gaps and the research priorities.

Data Synthesis:
Summary of presentations and discussion supported and supplemented by relevant literature.

Conclusions:
Sepsis and trauma are the two conditions most commonly associated with multiple organ dysfunction syndrome both in children and adults. However, many other pathophysiologic processes may result in multiple organ dysfunction syndrome. In this article, we discuss conditions such as liver failure and pancreatitis, pathophysiologic processes such as ischemia and hypoxia, and injuries such as trauma and burns. Additionally, therapeutic interventions such as medications, blood transfusions, transplantation may also precipitate and contribute to multiple organ dysfunction syndrome. The purpose of this article is to describe the association of multiple organ dysfunction syndrome with a variety of conditions and therapies in an attempt to identify similarities, differences, and opportunities for therapeutic intervention.
Precision Medicine With Point-of-Care Ultrasound
Authors: Kessler David , Ng Lorraine , Tessaro Mark , Fischer Jason 
Published: March 2017

Abstract
The Precision Medicine Initiative spearheaded by the National Institute of Health has pioneered a new model of health care focused on health care delivery that is tailored to an individual. Medical advances have already provided clinicians with the tools to better predict treatment outcomes based on the individual needs of each patient's disease process. Three-dimensional printing allows medical devices and implants to be custom made-to-order. Technological advances in preoperative imaging have augmented the ability for surgeons to plan a specific surgical approach for each patient. In a similar vein, point-of-care ultrasound offers the emergency care provider an opportunity to move beyond protocols and provide precise medical care tailored to the acute needs of each ill or injured emergent patient. In this article, we explore several cutting-edge applications of point-of-care ultrasound that can help providers develop a personalized approach to resuscitation and emergent procedures in pediatrics.
Family-Based Crisis Intervention With Suicidal Adolescents
Authors: Wharff Elizabeth A. , Ginnis Katherine B. , Ross Abigail M. , White Erina M. , White Matthew T. , Forbes Peter W. 
Published: March 2017

Objective
In current practice, treatment as usual (TAU) for suicidal adolescents includes evaluation, with little or no intervention provided in the emergency department (ED), and disposition, usually to an inpatient psychiatry unit. The family-based crisis intervention (FBCI) is an emergency psychiatry intervention designed to sufficiently stabilize suicidal adolescents within a single ED visit so that they may return home safely with their families. The objective of this article is to report efficacy outcomes related to FBCI for suicidal adolescents and their families.

Methods
A total of 142 suicidal adolescents (age, 13–18 years) and their families presenting for psychiatric evaluation to a large pediatric ED were randomized to receive FBCI or TAU. Patients and caregivers completed self-report measures of suicidality, family empowerment, and satisfaction with care provided at pretest, posttest, and 3 follow-up time points over a 1-month period.

Results
Patients randomized to FBCI were significantly more likely to be discharged home with outpatient follow-up care compared with their TAU counterparts (P < 0.001). Families randomized to the FBCI condition reported significantly higher levels of family empowerment and client satisfaction with care at posttest compared with their TAU counterparts. Gains were maintained over the follow-up period. No completed suicides were reported during the study period in either condition.

Conclusions
Family-based crisis intervention is a model of care for suicidal adolescents that may be a viable alternative to traditional ED care that involves inpatient psychiatric hospitalization.
A Rare Case of Candida Epiglottitis in an Immunocompetent Child
Authors: Beil Elizabeth P. , Sole David P. 
Published: March 2017

Abstract
We present a case of acute Candida epiglottitis in an otherwise healthy and Haemophilus influenzae type B–immunized 4-year-old child. A query of the literature reveals this disease to be commonly found in patients who are immunocompromised by problems including human immunodeficiency virus disease and lymphoma and leukemia. However, there are no published reports of acute Candida epiglottitis in immunocompetent and vaccinated patients. Our case should emphasize to the emergency physician the need to remain vigilant for subtle and atypical presentations of airway-destabilizing diseases.
The Effectiveness of Structured Group Education on Ankylosing Spondylitis Patients
Authors: Kasapoglu Aksoy Meliha , Birtane Murat , Taştekin Nurettin , Ekuklu Galip 
Published: March 2017

Background
Ankylosing spondylitis (AS) is a common inflammatory rheumatic disease that affects the axial skeleton which can lead to structural and functional impairments. It has a negative impact on the person's daily life activities. Early diagnosis, exercise and patient education are factors playing a major role on prognosis.

Objective
The purpose of the study was to compare the structured theoretical and exercise educational program with routine clinic educational efforts on the parameters of the disorder over a 3 month follow up.

Materials and Methods
This randomized, educational intervention study was performed on 41 AS patients. A 5 day structured education and exercise program was applied to the first group of patients (Group 1) in subgroups consisting 4–5 patients each. Patients had group exercises throughout the education program. The second group followed routine clinical care. The effectiveness of the treatment was assessed by Bath ankylosing spondylitis functional (BASFI), Bath ankylosing spondylitis disease activity (BASDAI), Bath ankylosing spondylitis global (BAS-G), Bath ankylosing spondylitis metrology indices (BASMI), chest expansion, short form-36 (SF-36), ankylosing spondylitis quality of life scale (ASQoL) and laboratory parameters in all patients. Patients were evaluated on initiation and after 3 months.

Results
Significant improvements in BASFI, BASDAI and BAS-G, chest expansion, SF-36 and ASQoL indices were observed in Group 1 No difference could be found in BASMI and chest expansion.

Conclusion
A structured educational and exercise intervention had a positive effect on the functional status,disease activity, and general well-being and quality of life. It also, shows that education programs should be within the routine treatment program for AS.
Mixed Connective Tissue Disease and Epitope Spreading
Authors: Escolà-Vergé Laura , Pinal-Fernandez Iago , Fernandez-Codina Andreu , Callejas-Moraga Eduardo L. , Espinosa Juan , Marin Ana , Labrador-Horrillo Moises , Selva-O’Callaghan Albert 
Published: March 2017

Objectives
Mixed connective tissue disease (MCTD) is characterized by the presence of anti-U1-snRNP autoantibodies and a variable set of associated clinical features. Some MCTD patients test positive over time to autoantibodies against Sm, proteins spatially related with U1-snRNP. This situation has been attributed to expanding of the autoimmune response by a phenomenon known as epitope spreading. Our aim was to study the frequency of this phenomenon in MCTD patients and the specific clinical features of those with epitope spreading.

Methods
All anti-U1-RNP-positive patients (2010–2015) were retrospectively reviewed, and those meeting the MCTD criteria were included in the study. Patients showing epitope spreading were compared with the remainder of the MCTD cohort. In addition, the clinical features of patients with epitope spreading were compared before and after the phenomenon occurred.

Results
Among 72 anti-U1-RNP-positive patients, 40 (37 women) were diagnosed with MCTD. Thirteen MCTD patients (43%) presented epitope spreading, mainly during the first 2 years after the diagnosis of the disease (median, 1.4 years). Patients with epitope spreading had a significantly lower prevalence of skin sclerosis (0% vs. 44%, P = 0.004) and a greater prevalence of interstitial lung disease (46% vs. 15%, P = 0.05) than those without. Arthritis (92% vs. 25%, P = 0.02) and muscle involvement (67% vs. 17%, P = 0.02) were less frequent after epitope spreading had occurred.

Conclusion
Epitope spreading is common in MCTD, occurring early after the diagnosis. The clinical manifestations in patients with this phenomenon differ from those without, and their clinical features change after the immunological phenomenon has occurred.
High quality frozen extracts ofXenopus laeviseggs reveal size-dependent control of metaphase spindle micromechanics
Authors: Takagi Jun , Shimamoto Yuta 
Published: March 2017

AbstractCell-free extracts from unfertilizedXenopus laeviseggs offer the opportunity for a variety of biochemical assays for analyzing essential cell cycle events, such as metaphase spindle assembly. However, extracts’ utility is often hampered by their short storage-stability duration and high quality variation. Here, we report a simple two-step method for preparing frozen egg extracts that retain spindle assembly activity levels that are close to those of freshly prepared extracts. Extract degradation associated with the freeze-thaw process can be substantially reduced by using centrifugal filter-based dehydration and slow sample cooling. Large amounts of frozen extract stocks from single batch preparations allowed us to collect a large number of data in micromanipulation experiments that are intrinsically low-throughput and, hence, clarify correlations between metaphase spindle size and stiffness. We anticipate that our method provides an assay platform with minimized biological heterogeneity and makes egg extracts more accessible to researchers as distributable material.SummaryThe authors describe a method for preparing frozen extracts ofXenopus laeviseggs that retain spindle assembly activity levels that are close to those of freshly prepared extracts. This allowed for clarifying the correlation between spindle size and stiffness.
Pan-cancer scale landscape of simple somatic mutations
Authors: Zhou Nan , Gallego Blanca , Bao Jinku , Tsafnat Guy 
Published: March 2017

AbstractGenome is the carrier of somatic mutations during the development of cancer. The catalogue of simple somatic mutations (SSM) is a subgroup of somatic mutations. It includes single base substitutions, small deletions and insertions of <= 200 bp, and multiple base substitutions of <= 200 bp. The comprehensive landscape of SSM has not been studied. After analysed 46,692,922 SSM of 10,878 samples, we proposed a pan-cancer scale landscape of SSM for 60 cancer projects in ICGC. In addition, the whole genome sequencing (WGS) and whole exome sequencing (WXS) techniques were compared according to the landscape of SSM. The result indicates numbers of SSM vary dramatically in different cancers. WGS can detect 10 times more single base substitutions and insertions than WXS. In terms of WXS, it called 10 times more deletions than insertions. Multiple base substitutions have not been well studied so they were just observed in a few cancer projects. Cancers generally show high prevalence of C > T substitutions at NpCpG trinucleotide contexts. Skin cancer showed distinct mutational spectra. Breast cancer, bladder cancer, and cervical cancer were found to have similar mutational spectra. Acute myeloid leukemia and lung cancer from South Korea, and colorectal cancer from China show high density of single base substitutions per mega base in chromosome Y. To sum up, our study and findings will be thought provoking in studying SSM in cancer.
Allopatric divergence, local adaptation, and multiple Quaternary refugia in a long-lived tree (Quercus spinosa) from subtropical China
Authors: Feng Li , Zhang Yan-Ping , Chen Xiao-Dan , Yang Jia , Zhou Tao , Bai Guo-Qing , Yang Jiao , Li Zhong-Hu , Peng Ching-I , Zhao Gui-Fang 
Published: March 2017

SummaryThe complex geography and climatic changes occurring in subtropical China during the Tertiary and Quaternary might have provided substantial opportunities for allopatric speciation. To gain further insight into these processes, we reconstruct the evolutionary history ofQuercus spinosa,a common evergreen tree species mainly distributed in this area.Forty-six populations were genotyped using four chloroplast DNA regions and 12 nuclear microsatellite loci to assess genetic structure and diversity, which was supplemented by divergence time and diversification rate analyses, environmental factor analysis, and ecological niche modeling of the species distributions in the past and at present.The genetic data consistently identified two lineages: the western Eastern Himalaya-Hengduan Mountains lineage and the eastern Central-Eastern China lineage, mostly maintained by populations’ environmental adaptation. These lineages diverged through climate/orogeny-induced vicariance during the Neogene and remained separated thereafter. Genetic data strongly supported the multiple refugia (per se, interglacial refugia) or refugia within refugia hypotheses to explainQ. spinosaphylogeography in subtropical China.Q. spinosapopulation structure highlighted the importance of complex geography and climatic changes occurring in subtropical China during the Neogene in providing substantial opportunities for allopatric divergence.