bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dynamic Slow Motion Video Endoscopy as an Adjunct to Impedance Audiometry in the Assessment of Eustachian Tube Function
Authors: Sanu Sanoop , Divakaran Shilpa , Vijayakumar Sabarinath , Saxena Sunil , Alexander Arun , Gopalakrishnan Suryanarayanan 
Published: June 2017

Introduction Eustachian tube (ET) dysfunction plays an important role not only in the pathophysiology of various middle ear disorders, but also in predicting the outcome of the treatment. As there is no single test that assesses both the anatomic and physiological functions of the ET, a combination of tympanometry and dynamic slow motion video endoscopy may improve the sensitivity of ET function assessment.
Objective To find out if there is any correlation between dynamic slow motion nasal video endoscopy and impedance audiometry in assessing ET function in patients with middle ear diseases.
Methods Ours was a descriptive study performed with 106 patients attending the Ear, Nose and Throat (ENT) Outpatient Department of a tertiary care center in South India with features suggestive of middle ear disease. All patients underwent impedance audiometry and dynamic slow motion nasal video endoscopy, and were graded based on the severity of the ET pathology.
Results A total of 47 out of 97 patients with abnormal endoscopy findings also had abnormal impedance audiometry. The correlation was greater among the patients with higher grades of ET dysfunction. The endoscopy findings of 106 cases, when correlated with middle ear manometry, revealed that 56 cases showed complete agreement, and 50 cases showed disagreement. The nasal endoscopy results, when correlated with middle ear manometry studies by using McNemar's chi-squared (χ2) test, showed a significant association between the 2 tests (p = 0.017).
Conclusion There is a significant alteration in middle ear pressure as the severity of the ET tube dysfunction increases. Impedance audiometry and nasal endoscopy provide a better measure of ET function.
Prevalence of Substance use among Middle School–Aged E-Cigarette users Compared with Cigarette Smokers, Nonusers, and Dual Users: Implications for Primary Prevention
Authors: Kristjansson Alfgeir L. , Mann Michael J. , Smith Megan L. 
Published: June 2017

Background The objective of this study was to compare the prevalence of substance use in e-cigarette (EC)-only users with combustible cigarette (CC)-only users, dual users, and nonusers in a large sample of middle school–aged adolescents. Methods Population-based cross-sectional school survey conducted in 15 middle schools in 3 counties in West Virginia in the United States between October and December of 2015 ( N = 6547, girls = 49.6%; response rate 84.7%). Results Approximately 4.3% of participants had used EC only, 4.5% had used CC only, and around 5.5% were dual users. Nonusers had the lowest prevalence of all 9 forms of substance use assessed in the study (i.e., chewing tobacco, any alcohol, drunkenness, marijuana, sniffing, prescription drugs, hallucinogens, synthetic marijuana, and bath salts), followed by EC and CC users. Dual users had the highest prevalence of 8 of 9 forms of substance use. Multinomial logistic regression models showed that EC-only users had significantly greater odds over nonusers of using 8 of 9 types of substances included in the study. Conversely, EC-only users had significantly lower odds of using 7 of 9 types of substances when compared with dual users. However, EC-only users did not differ from CC-only users in odds of use in any of the 9 substances included in this analysis. Conclusions Among middle school–aged adolescents, EC-only users do not differ from CC-only users in odds for other forms of substance use. Primary prevention programs should consider EC use initiation as a pathway to greater risk of other licit and illicit substances among young adolescents.
Brain monoamine oxidase B and A in human parkinsonian dopamine deficiency disorders
Authors: Tong Junchao , Rathitharan Gausiha , Meyer Jeffrey H , Furukawa Yoshiaki , Ang Lee-Cyn , Boileau Isabelle , Guttman Mark , Hornykiewicz Oleh , Kish Stephen J 
Published: June 2017

Abstract
See Jellinger (doi:10.1093/awx190) for a scientific commentary on this article.
The enzyme monoamine oxidases (B and A subtypes, encoded by MAOB and MAOA, respectively) are drug targets in the treatment of Parkinson’s disease. Inhibitors of MAOB are used clinically in Parkinson’s disease for symptomatic purposes whereas the potential disease-modifying effect of monoamine oxidase inhibitors is debated. As astroglial cells express high levels of MAOB, the enzyme has been proposed as a brain imaging marker of astrogliosis, a cellular process possibly involved in Parkinson’s disease pathogenesis as elevation of MAOB in astrocytes might be harmful. Since brain monoamine oxidase status in Parkinson’s disease is uncertain, our objective was to measure, by quantitative immunoblotting in autopsied brain homogenates, protein levels of both monoamine oxidases in three different degenerative parkinsonian disorders: Parkinson’s disease (n = 11), multiple system atrophy (n = 11), and progressive supranuclear palsy (n = 16) and in matched controls (n = 16). We hypothesized that if MAOB is ‘substantially’ localized to astroglial cells, MAOB levels should be generally associated with standard astroglial protein measures (e.g. glial fibrillary acidic protein). MAOB levels were increased in degenerating putamen (+83%) and substantia nigra (+10%, non-significant) in multiple system atrophy; in caudate (+26%), putamen (+27%), frontal cortex (+31%) and substantia nigra (+23%) of progressive supranuclear palsy; and in frontal cortex (+33%), but not in substantia nigra of Parkinson’s disease, a region we previously reported no increase in astrocyte protein markers. Although the magnitude of MAOB increase was less than those of standard astrocytic markers, significant positive correlations were observed amongst the astrocyte proteins and MAOB. Despite suggestions that MAOA (versus MAOB) is primarily responsible for metabolism of dopamine in dopamine neurons, there was no loss of the enzyme in the parkinsonian substantia nigra; instead, increased nigral levels of a MAOA fragment and ‘turnover’ of the enzyme were observed in the conditions. Our findings provide support that MAOB might serve as a biochemical imaging marker, albeit not entirely specific, for astrocyte activation in human brain. The observation that MAOB protein concentration is generally increased in degenerating brain areas in multiple system atrophy (especially putamen) and in progressive supranuclear palsy, but not in the nigra in Parkinson’s disease, also distinguishes astrocyte behaviour in Parkinson’s disease from that in the two ‘Parkinson-plus’ conditions. The question remains whether suppression of either MAOB in astrocytes or MAOA in dopamine neurons might influence progression of the parkinsonian disorders.
Superior Prognostic Value of Cumulative Intracranial Tumor Volume Relative to Largest Intracranial Tumor Volume for Stereotactic Radiosurgery-Treated Brain Metastasis Patients
Authors: Hirshman Brian R , Wilson Bayard , Ali Mir Amaan , Proudfoot James A , Koiso Takao , Nagano Osamu , Carter Bob S , Serizawa Toru , Yamamoto Masaaki , Chen Clark C 
Published: June 2017

Abstract

BACKGROUND
Two intracranial tumor volume variables have been shown to prognosticate survival of stereotactic-radiosurgery-treated brain metastasis patients: the largest intracranial tumor volume (LITV) and the cumulative intracranial tumor volume (CITV).

OBJECTIVE
To determine whether the prognostic value of the Scored Index for Radiosurgery (SIR) model can be improved by replacing one of its components—LITV—with CITV.

METHODS
We compared LITV and CITV in terms of their survival prognostication using a series of multivariable models that included known components of the SIR: age, Karnofsky Performance Score, status of extracranial disease, and the number of brain metastases. Models were compared using established statistical measures, including the net reclassification improvement (NRI > 0) and integrated discrimination improvement (IDI). The analysis was performed in 2 independent cohorts, each consisting of ∼3000 patients.

RESULTS
In both cohorts, CITV was shown to be independently predictive of patient survival. Replacement of LITV with CITV in the SIR model improved the model's ability to predict 1-yr survival. In the first cohort, the CITV model showed an NRI > 0 improvement of 0.2574 (95% confidence interval [CI] 0.1890-0.3257) and IDI of 0.0088 (95% CI 0.0057-0.0119) relative to the LITV model. In the second cohort, the CITV model showed a NRI > 0 of 0.2604 (95% CI 0.1796-0.3411) and IDI of 0.0051 (95% CI 0.0029-0.0073) relative to the LITV model.

CONCLUSION
After accounting for covariates within the SIR model, CITV offers superior prognostic value relative to LITV for stereotactic radiosurgery-treated brain metastasis patients.
Predictors of Unplanned Hospitalization in Patients Receiving Outpatient Parenteral Antimicrobial Therapy Across a Large Integrated Healthcare Network
Authors: Schmidt Monica , Hearn Bevin , Gabriel Michael , Spencer Melanie D. , McCurdy Lewis 
Published: June 2017

Abstract

Background
Outpatient parenteral antimicrobial therapy (OPAT) prescribing has increased along with the trend toward early discharge of hospitalized patients who have infections. There is limited literature that assesses unplanned hospitalizations during OPAT. This study aims to elucidate the predictors of unplanned hospitalization in OPAT patients after discharge from acute-care facilities within Carolinas HealthCare System (CHS). Understanding these predictors may inform future interventions to improve treatment efficacy and patient outcomes.

Methods
The study cohort included hospitalized patients aged &gt;19 years who initiated OPAT in an acute-care facility within CHS in 2014–2015. Patients who had OPAT prescribed at an ambulatory-care facility were excluded. The primary outcome was unplanned hospitalization anytime during the at-risk time from discharge through 90 days.

Results
The unplanned hospitalization rate for the cohort was 18.5%. In adjusted analysis, having OPAT delivered at a skilled nursing facility was associated with a 46% (incident risk ratio = 1.46; 95% confidence interval = 1.04–2.06) increased risk of an unplanned hospitalization compared with patients receiving OPAT at home after adjustment for demographics, comorbidities, indication, treatment duration, and antimicrobial prescribed. Infusion, dialysis, and rehabilitation centers had the lowest rates of unplanned hospitalizations.

Conclusions
These results suggest that the location of OPAT delivery is associated with unplanned hospitalizations and that older patients need additional support during OPAT.
Statin and Its Association With Delirium in the Medical ICU*
Authors: Mather Jeffrey F. , Corradi John P. , Waszynski Christine , Noyes Adam , Duan Yinghui , Grady James , Dicks Robert 
Published: June 2017

Objectives:
To examine the association between statin use and the risk of delirium in hospitalized patients with an admission to the medical ICU.

Design:
Retrospective propensity-matched cohort analysis with accrual from September 1, 2012, to September 30, 2015.

Setting:
Hartford Hospital, Hartford, CT.

Patients:
An initial population of patients with an admission to a medical ICU totaling 10,216 visits were screened for delirium by means of the Confusion Assessment Method. After exclusions, a population of 6,664 was used to match statin users and nonstatin users. The propensity-matched cohort resulted in a sample of 1,475 patients receiving statin matched 1:1 with control patients not using statin.

Interventions:
None.

Measurements and Main Results:
Delirium defined as a positive Confusion Assessment Method assessment was the primary end point. The prevalence of delirium was 22.3% in the unmatched cohort and 22.8% in the propensity-matched cohort. Statin use was associated with a significant decrease in the risk of delirium (odds ratio, 0.47; 95% CI, 0.38–0.56). Considering the type of statin used, atorvastatin (0.51; 0.41–0.64), pravastatin (0.40; 0.28–0.58), and simvastatin (0.33; 0.21–0.52) were all significantly associated with a reduced frequency of delirium.

Conclusions:
The use of statins was independently associated with a reduction in the risk of delirium in hospitalized patients. When considering types of statins used, this reduction was significant in patients using atorvastatin, pravastatin, and simvastatin. Randomized trials of various statin types in hospitalized patients prone to delirium should validate their use in protection from delirium.
Single-Case Design, Analysis, and Quality Assessment for Intervention Research
Authors: Lobo Michele A. , Moeyaert Mariola , Baraldi Cunha Andrea , Babik Iryna 
Published: June 2017

Background and Purpose:
The purpose of this article is to describe single-case studies and contrast them with case studies and randomized clinical trials. We highlight current research designs, analysis techniques, and quality appraisal tools relevant for single-case rehabilitation research.

Summary of Key Points:
Single-case studies can provide a viable alternative to large group studies such as randomized clinical trials. Single-case studies involve repeated measures and manipulation of an independent variable. They can be designed to have strong internal validity for assessing causal relationships between interventions and outcomes, as well as external validity for generalizability of results, particularly when the study designs incorporate replication, randomization, and multiple participants. Single-case studies should not be confused with case studies/series (ie, case reports), which are reports of clinical management of a patient or a small series of patients.

Recommendations for Clinical Practice:
When rigorously designed, single-case studies can be particularly useful experimental designs in a variety of situations, such as when research resources are limited, studied conditions have low incidences, or when examining effects of novel or expensive interventions. Readers will be directed to examples from the published literature in which these techniques have been discussed, evaluated for quality, and implemented.
A Classification System to Guide Physical Therapy Management in Huntington Disease: A Case Series
Authors: Fritz Nora E. , Busse Monica , Jones Karen , Khalil Hanan , Quinn Lori 
Published: June 2017

Background and Purpose:
Individuals with Huntington disease (HD), a rare neurological disease, experience impairments in mobility and cognition throughout their disease course. The Medical Research Council framework provides a schema that can be applied to the development and evaluation of complex interventions, such as those provided by physical therapists. Treatment-based classifications, based on expert consensus and available literature, are helpful in guiding physical therapy management across the stages of HD. Such classifications also contribute to the development and further evaluation of well-defined complex interventions in this highly variable and complex neurodegenerative disease. The purpose of this case series was to illustrate the use of these classifications in the management of 2 individuals with late-stage HD.

Case Description:
Two females, 40 and 55 years of age, with late-stage HD participated in this case series. Both experienced progressive declines in ambulatory function and balance as well as falls or fear of falling. Both individuals received daily care in the home for activities of daily living.

Intervention:
Physical therapy Treatment–Based Classifications for HD guided the interventions and outcomes. Eight weeks of in-home balance training, strength training, task-specific practice of functional activities including transfers and walking tasks, and family/carer education were provided.

Outcomes:
Both individuals demonstrated improvements that met or exceeded the established minimal detectible change values for gait speed and Timed Up and Go performance. Both also demonstrated improvements on Berg Balance Scale and Physical Performance Test performance, with 1 of the 2 individuals exceeding the established minimal detectible changes for both tests. Reductions in fall risk were evident in both cases.

Discussion:
These cases provide proof-of-principle to support use of treatment-based classifications for physical therapy management in individuals with HD. Traditional classification of early-, mid-, and late-stage disease progression may not reflect patients' true capabilities; those with late-stage HD may be as responsive to interventions as those at an earlier disease stage.

Video Abstract available for additional insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A172).
Uptake of Home-Based Syphilis and Human Immunodeficiency Virus Testing Among Male Partners of Pregnant Women in Western Kenya
Authors: Mark Jennifer , Kinuthia John , Roxby Alison C. , Krakowiak Daisy , Osoti Alfred , Richardson Barbra A. , Gone Molly Ann , Asila Victor , Parikh Saloni , Farquhar Carey 
Published: June 2017

Background
Few men are tested for syphilis or human immunodeficiency virus (HIV) during their partner’s pregnancy, a high-risk period for HIV and syphilis transmission. Offering home-based rapid testing of syphilis to couples during pregnancy can support prevention efforts to reduce transmission of sexually transmitted diseases and adverse pregnancy outcomes.

Methods
We assessed men’s uptake of paired (separate tests, single blood draw) point-of-care syphilis and HIV tests within a randomized controlled trial of pregnant women who received clinic or home partner HIV testing. We evaluated acceptance of paired HIV-syphilis testing during pregnancy or at 6 months postpartum, and evaluated whether addition of syphilis testing affected the uptake of HIV testing among men.

Results
Of 601 women, we were unable to meet 101 male partners, and 180 tested before syphilis tests were available. Paired syphilis and HIV testing was offered at home to 80 men during pregnancy and to 230 men postpartum. For syphilis, 93% of men agreed to test during pregnancy and 98% agreed postpartum. For paired syphilis and HIV testing, 91% of men tested for both during pregnancy and 96% tested postpartum. Before syphilis test introduction, 96% of men accepted HIV testing, compared with 95% of men who accepted HIV testing when paired testing was offered.

Conclusions
Uptake of syphilis and HIV testing was high among male partners offered couple testing at home. Introducing syphilis testing did not adversely affect HIV testing among men. Point-of-care diagnostics outside facilities can increase testing of male partners who rarely accompany women to antenatal clinics.
Elevated Central Venous to Arterial Co 2 Difference Is Not Associated With Poor Clinical Outcomes After Cardiac Surgery With Cardiopulmonary Bypass in Children
Authors: Akamatsu Takaaki , Inata Yu , Tachibana Kazuya , Hatachi Takeshi , Takeuchi Muneyuki 
Published: June 2017

Objective:
To investigate whether elevated central venous to arterial Co
2 difference is associated with delayed extubation and prolonged ICU stay in children after cardiac surgery with cardiopulmonary bypass.

Design:
Retrospective review of medical records.

Setting:
PICU in a tertiary children’s hospital.

Patients:
Pediatric patients younger than 18 years old who underwent cardiac surgery with cardiopulmonary bypass between January 2014 and December 2014.

Interventions:
None.

Measurements and Main Results:
In total, 114 patients were included in this study. On ICU admission, blood samples were obtained simultaneously from an arterial line and a central venous line. There were no strong correlations between central venous to arterial Co
2 difference (median, 11.1 [8.4–13] mm Hg) and other commonly used variables for the assessment of oxygen delivery including arteriovenous oxyhemoglobin saturation difference (R
2 = 0.16) and blood lactate concentration (R
2 = 0.02). When the patients were divided into two groups, based on the Co
2 difference, the high group (difference ≥ 6 mm Hg; n = 103 [90%]) and the low group (difference < 6 mm Hg; n = 11 [10%]) showed no difference in the time to extubation (6 vs 5 hr, respectively; p = 0.80) or in the time to discharge from ICU (4 vs 5 d, respectively; p = 0.49). There was no mortality within 30 days of surgery.

Conclusions:
Elevation of central venous to arterial Co
2 difference on ICU admission in children after cardiac surgery with cardiopulmonary bypass does not appear to be associated with delayed extubation or prolonged ICU stay.
Purely entropic self-assembly of the bicontinuous Ia
3
d gyroid phase in equilibrium hard-pear systems
Authors: Schönhöfer Philipp W. A. , Ellison Laurence J. , Marechal Matthieu , Cleaver Douglas J. , Schröder-Turk Gerd E. 
Published: June 2017

We investigate a model of hard pear-shaped particles which forms the bicontinuous Ia

d structure by entropic self-assembly, extending the previous observations of Barmes
et al.
(2003
Phys. Rev. E
68
, 021708. (
doi:10.1103/PhysRevE.68.021708
)) and Ellison
et al.
(2006
Phys. Rev. Lett.
97
, 237801. (
doi:10.1103/PhysRevLett.97.237801
)). We specifically provide the complete phase diagram of this system, with global density and particle shape as the two variable parameters, incorporating the gyroid phase as well as disordered isotropic, smectic and nematic phases. The phase diagram is obtained by two methods, one being a compression–decompression study and the other being a continuous change of the particle shape parameter at constant density. Additionally, we probe the mechanism by which interdigitating sheets of pears in these systems create surfaces with negative Gauss curvature, which is needed to form the gyroid minimal surface. This is achieved by the use of Voronoi tessellation, whereby both the shape and volume of Voronoi cells can be assessed in regard to the local Gauss curvature of the gyroid minimal surface. Through this, we show that the mechanisms prevalent in this entropy-driven system differ from those found in systems which form gyroid structures in nature (lipid bilayers) and from synthesized materials (di-block copolymers) and where the formation of the gyroid is enthalpically driven. We further argue that the gyroid phase formed in these systems is a realization of a modulated splay-bend phase in which the conventional nematic has been predicted to be destabilized at the mesoscale due to molecular-scale coupling of polar and orientational degrees of freedom.
Identification of a novel interspecific hybrid yeast from a metagenomic spontaneously inoculated beer sample using Hi-C
Authors: Heil Caiti Smukowski , Burton Joshua N. , Liachko Ivan , Friedrich Anne , Hanson Noah A. , Morris Cody L. , Schacherer Joseph , Shendure Jay , Thomas James H. , Dunham Maitreya J. 
Published: June 2017

AbstractInterspecific hybridization is a common mechanism enabling genetic diversification and adaptation; however, the detection of hybrid species has been quite difficult. The identification of microbial hybrids is made even more complicated, as most environmental microbes are resistant to culturing and must be studied in their native mixed communities. We have previously adapted the chromosome conformation capture method Hi-C to the assembly of genomes from mixed populations. Here, we show the method’s application in assembling genomes directly from an uncultured, mixed population from a spontaneously inoculated beer sample. Our assembly method has enabled us to de-convolute 4 bacterial and 4 yeast genomes from this sample, including a putative yeast hybrid. Downstream isolation and analysis of this hybrid confirmed its genome to consist ofPichia membranifaciensand that of another related, but undescribed yeast. Our work shows that Hi-C-based metagenomic methods can overcome the limitation of traditional sequencing methods in studying complex mixtures of genomes.