bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endothelial permeability, LDL deposition, and cardiovascular risk factors—a review
Authors: Mundi Santa , Massaro Marika , Scoditti Egeria , Carluccio Maria Annunziata , van Hinsbergh Victor W M , Iruela-Arispe Marial Luisa , De Caterina Raffaele 
Published: December 2017

AbstractEarly atherosclerosis features functional and structural changes in the endothelial barrier function that affect the traffic of molecules and solutes between the vessel lumen and the vascular wall. Such changes are mechanistically related to the development of atherosclerosis. Proatherogenic stimuli and cardiovascular risk factors, such as dyslipidaemias, diabetes, obesity, and smoking, all increase endothelial permeability sharing a common signalling denominator: an imbalance in the production/disposal of reactive oxygen species (ROS), broadly termed oxidative stress. Mostly as a consequence of the activation of enzymatic systems leading to ROS overproduction, proatherogenic factors lead to a pro-inflammatory status that translates in changes in gene expression and functional rearrangements, including changes in the transendothelial transport of molecules, leading to the deposition of low-density lipoproteins (LDL) and the subsequent infiltration of circulating leucocytes in the intima. In this review, we focus on such early changes in atherogenesis and on the concept that proatherogenic stimuli and risk factors for cardiovascular disease, by altering the endothelial barrier properties, co-ordinately trigger the accumulation of LDL in the intima and ultimately plaque formation.
Etiology and Impact of Coinfections in Children Hospitalized With Community-Acquired Pneumonia
Authors: Nolan Vikki G , Arnold Sandra R , Bramley Anna M , Ampofo Krow , Williams Derek J , Grijalva Carlos G , Self Wesley H , Anderson Evan J , Wunderink Richard G , Edwards Kathryn M , Pavia Andrew T , Jain Seema , McCullers Jonathan A 
Published: December 2017

AbstractBackgroundRecognition that coinfections are common in children with community-acquired pneumonia (CAP) is increasing, but gaps remain in our understanding of their frequency and importance.MethodsWe analyzed data from 2219 children hospitalized with CAP and compared demographic and clinical characteristics and outcomes between groups with viruses alone, bacteria alone, or coinfections. We also assessed the frequency of selected pairings of codetected pathogens and their clinical characteristics.ResultsA total of 576 children (26%) had a coinfection. Children with only virus detected were younger, more likely to be black, and more likely to have comorbidities such as asthma, compared with children infected with typical bacteria alone. Children with virus-bacterium coinfections had a higher frequency of leukocytosis, consolidation on chest radiography, parapneumonic effusions, intensive care unit admission, and need for mechanical ventilation and an increased length of stay, compared with children infected with viruses alone. Virus-virus coinfections were generally comparable to single-virus infections, with the exception of the need for oxygen supplementation, which was higher during the first 24 hours of hospitalization in some virus-virus pairings.ConclusionsCoinfections occurred in 26% of children hospitalized for CAP. Children with typical bacterial infections, alone or complicated by a viral infection, have worse outcomes than children infected with a virus alone.
Characterization and photometric performance of the Hyper Suprime-Cam Software Pipeline
Authors: Huang Song , Leauthaud Alexie , Murata Ryoma , Bosch James , Price Paul , Lupton Robert , Mandelbaum Rachel , Lackner Claire , Bickerton Steven , Miyazaki Satoshi , Coupon Jean , Tanaka Masayuki 
Published: December 2017

Abstract
The Subaru Strategic Program (SSP) is an ambitious multi-band survey using the Hyper Suprime-Cam (HSC) on the Subaru telescope. The Wide layer of the SSP is both wide and deep, reaching a detection limit of i ∼ 26.0 mag. At these depths, it is challenging to achieve accurate, unbiased, and consistent photometry across all five bands. The HSC data are reduced using a pipeline that builds on the prototype pipeline for the Large Synoptic Survey Telescope. We have developed a Python-based, flexible framework to inject synthetic galaxies into real HSC images, called SynPipe. Here we explain the design and implementation of SynPipe and generate a sample of synthetic galaxies to examine the photometric performance of the HSC pipeline. For stars, we achieve 1% photometric precision at i ∼ 19.0 mag and 6% precision at i ∼ 25.0 in the i band (corresponding to statistical scatters of ∼0.01 and ∼0.06 mag respectively). For synthetic galaxies with single-Sérsic profiles, forced CModel photometry achieves 13% photometric precision at i ∼ 20.0 mag and 18% precision at i ∼ 25.0 in the i band (corresponding to statistical scatters of ∼0.15 and ∼0.22 mag respectively). We show that both forced point spread function and CModel photometry yield unbiased color estimates that are robust to seeing conditions. We identify several caveats that apply to the version of HSC pipeline used for the first public HSC data release (DR1) that need to be taking into consideration. First, the degree to which an object is blended with other objects impacts the overall photometric performance. This is especially true for point sources. Highly blended objects tend to have larger photometric uncertainties, systematically underestimated fluxes, and slightly biased colors. Secondly, &gt;20% of stars at 22.5 &lt; i &lt; 25.0 mag can be misclassified as extended objects. Thirdly, the current CModel algorithm tends to strongly underestimate the half-light radius and ellipticity of galaxy with i &gt; 21.5 mag.
Crisis Management Simulation: Establishing a Dual Neurosurgery and Anesthesia Training Experience
Authors: Ciporen Jeremy , Gillham Haley , Noles Michele , Dillman Dawn , Baskerville Mark , Haley Caleb , Spight Donn , Turner Ryan C. , Lucke-Wold Brandon P. 
Published: December 2017

Background:
Simulation training has been shown to be an effective teaching tool. Learner management of an intraoperative crisis such as a major cerebrovascular bleed requires effective teamwork, communication, and implementation of key skill sets at appropriate time points. This study establishes a first of a kind simulation experience in a neurosurgery/anesthesia resident (learners) team working together to manage an intraoperative crisis.

Methods:
Using a cadaveric cavernous carotid injury perfusion model, 7 neurosurgery and 6 anesthesia learners, were trained on appropriate vascular injury management using an endonasal endoscopic technique. Learners were evaluated on communication skills, crisis management algorithms, and implementation of appropriate skill sets at the right time. A preanatomic and postanatomic examination and postsimulation survey was administered to neurosurgery learners. Anesthesia learners provided posttraining evaluation through a tailored realism and teaching survey.

Results:
Neurosurgery learners’ anatomic examination score improved from presimulation (33.89%) to postsimulation (86.11%). No significant difference between learner specialties was observed for situation awareness, decision making, communications and teamwork, or leadership evaluations. Learners reported the simulation realistic, beneficial, and highly instructive.

Conclusions:
Realistic, first of kind, clinical simulation scenarios were presented to a neurosurgery/anesthesia resident team who worked together to manage an intraoperative crisis. Learners were effectively trained on crisis management, the importance of communication, and how to develop algorithms for future implementation in difficult scenarios. Learners were highly satisfied with the simulation training experience and requested that it be integrated more consistently into their residency training programs.
Human Immunodeficiency Virus (HIV)– and Non-HIV–Associated Immunosuppression and Risk of Cervical Neoplasia
Authors: Silverberg Michael J. , Leyden Wendy A. , Chi Aileen , Gregorich Steven , Huchko Megan J. , Kulasingam Shalini , Kuppermann Miriam , Seto Anna , Smith-McCune Karen K. , Sawaya George F. 
Published: December 2017

OBJECTIVE:
To estimate the risk of cervical intraepithelial neoplasia grade 2, 2–3, 3, adenocarcinoma in situ, or cancer (CIN 2 or worse) among women with human immunodeficiency virus (HIV)– and non-HIV–associated immunosuppression.

METHODS:
We performed a case–control study of 20,146 women with incident CIN 2 or worse and 5:1 age-matched, incidence-density selected women in a control group (n=100,144) enrolled in an integrated health care system from 1996 to 2014. Adjusted rate ratios (RRs) from conditional logistic regression were obtained for HIV status (stratified by CD4+ T-cells), solid organ transplant history, and immunosuppressive medication use.

RESULTS:
Risk of CIN 2 or worse was increased among women with HIV (n=36 women in the case group and 79 women in the control group; adjusted RR 2.0, 95% CI 1.3–3.0) compared with those without HIV and in solid organ transplant recipients (n=51 women in the case group and 68 women in the control group; RR 3.3, 95% CI 2.3–4.8) compared with women without a prior transplant. The highest risks were among women with HIV and less than 200 CD4+ T-cells/microliter (n=9 women in the case group and eight women in the control group; RR 5.6, 95% CI 2.1–14.7) compared with those without HIV and in solid organ transplant recipients prescribed three or greater immunosuppressive medication classes (n=32 women in the case group and 33 women in the control group; RR 4.1, 95% CI 2.5–6.8) compared with women without a prior transplant and zero medication classes. No increased risks were observed for women with HIV and 500 or greater CD4+ T-cells/microliter (n=9 women in the case group and 43 women in the control group; RR 0.8, 95% CI 0.4–1.7) compared with those without HIV or women without prior solid organ transplantation prescribed two or fewer immunosuppressive medication classes (n=1,262 women in the case group and 6,100 women in the control group; RR 0.95, 95% CI 0.89–1.01) compared with women without and a prior transplant and zero medication classes.

CONCLUSION:
Risk of CIN 2 or worse is increased in women with a prior solid organ transplant or who have HIV and CD4+ cells/microliter less than 500 but not in women with HIV and higher CD4+ levels or in women without a prior solid organ transplant but who are prescribed only one or two immunosuppressive medication classes.
Liposomal Bupivacaine During Robotic Colpopexy and Posterior Repair
Authors: Yeung Jennifer , Crisp Catrina C. , Mazloomdoost Donna , Kleeman Steven D. , Pauls Rachel N. 
Published: December 2017

OBJECTIVE:To evaluate the effect of liposomal bupivacaine on postoperative pain among patients undergoing robotic sacrocolpopexy with posterior repair.METHODS:This was a randomized, patient-blinded, placebo-controlled trial of women undergoing robotic sacrocolpopexy with posterior repair. Liposomal bupivacaine or normal saline placebo was injected into laparoscopic and vaginal incisions at completion of surgery. Perioperative care was standardized. Visual analog scales were collected at 4, 18, and 24 hours postoperatively in hospital. Starting on postoperative day 1, participants completed twice-daily pain scales and a pain medication diary up until the evening of postoperative day 3. The primary outcome was a 20-mm change in the visual analog scale 18 hours postoperatively. Secondary measures included additional pain scores, satisfaction, and narcotic use. Sample size calculation revealed that 32 patients per arm were required to detect the 20-mm difference with 90% power and an α of 0.05. To allocate for dropout, a goal of 70 was set.RESULTS:Between March 2015 and April 2016, 100 women were screened and 70 women were enrolled: 35 women were randomized to liposomal bupivacaine and 35 to placebo, of whom 64 (91%) were included in the final analysis: 33 liposomal bupivacaine and 31 placebo. No difference in demographics, surgical data, or satisfaction between groups was noted. Median VAS at 18 hours after surgery was not statistically different in those who received liposomal bupivacaine compared with normal saline (15 mm compared with 20 mm;P=.52). Other pain scales and total morphine equivalents were also similar (P=.90).CONCLUSION:In this study of robotic sacrocolpopexy with posterior repair, there were no differences in pain scores or narcotic use between liposomal bupivacaine and placebo injected into laparoscopic and vaginal incisions. Given its lack of clinical benefit, routine use of liposomal bupivacaine is not supported for this surgical intervention.CLINICAL TRIAL REGISTRATION:ClinicalTrials.gov, NCT02449915.
Angiogenic Factor Profiles in Pregnant Women With a History of Early-Onset Severe Preeclampsia Receiving Low-Molecular-Weight Heparin Prophylaxis
Authors: Lecarpentier Edouard , Gris Jean Christophe , Cochery-Nouvellon Eva , Mercier Erick , Touboul Cyril , Thadhani Ravi , Karumanchi S. Ananth , Haddad Bassam 
Published: December 2017

OBJECTIVE:
To evaluate whether daily low-molecular-weight (LMW) heparin prophylaxis during pregnancy alters profile of circulating angiogenic factors that have been linked with the pathogenesis of preeclampsia and fetal growth restriction.

METHODS:
This is a planned ancillary study of the Heparin-Preeclampsia trial, a randomized trial in pregnant women with a history of severe early-onset preeclampsia (less than 34 weeks of gestation). In the parent study, all women were treated with aspirin and then randomized to receive LMW heparin or aspirin alone. In this study, we measured serum levels of circulating angiogenic factors (soluble fms-like tyrosine kinase-1, placental growth factor, and soluble endoglin by immunoassay) at the following gestational windows: 10–13 6/7 weeks, 14–17 6/7 weeks, 18–21 6/7 weeks, 22–25 6/7 weeks, 26–29 6/7 weeks, 30–33 6/7 weeks, and 34–37 6/7 weeks.

RESULTS:
Samples were available from 185 patients: LMW heparin+aspirin (n=92) and aspirin alone (n=93). The two groups had comparable baseline characteristics and had similar adverse composite outcomes (35/92 [38.0%] compared with 36/93 [38.7%]; P=.92). There were no significant differences in serum levels of soluble fms-like tyrosine kinase-1, placental growth factor, and soluble endoglin in the participants who received LMW heparin and aspirin compared with those who received aspirin alone regardless of gestational age period. Finally, women who developed an adverse composite outcome at less than 34 weeks of gestation demonstrated significant alterations in serum angiogenic profile as early as 10–13 6/7 weeks that was most dramatic 6–8 weeks preceding delivery.

CONCLUSION:
Prophylactic LMW heparin therapy when beginning from before 14 weeks of gestation with aspirin during pregnancy is not associated with an improved angiogenic profile. This may provide a molecular explanation for the lack of clinical benefit noted in recent trials.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT00986765.
Misoprostol With Foley Bulb Compared With Misoprostol Alone for Cervical Ripening
Authors: Al-Ibraheemi Zainab , Brustman Lois , Bimson Brianne E. , Porat Natalie , Rosenn Barak 
Published: December 2017

OBJECTIVE:
To test the hypothesis that cervical ripening using a combination of misoprostol and a transcervical Foley bulb leads to delivery within a shorter time compared with misoprostol alone.

METHODS:
This randomized controlled trial was offered to women admitted for cervical ripening. Inclusion criteria were gestational age 37 weeks or greater with intact membranes, singleton fetus, cephalic presentation, and Bishop score 6 or less. Exclusion criteria included, among others, prior uterine surgery, ruptured membranes, and any contraindication to vaginal delivery. Patients were randomized to cervical ripening using misoprostol and a transcervical Foley bulb simultaneously or misoprostol alone. Primary outcome was time from placement of the misoprostol to delivery. Secondary outcomes included time to active phase, time from active phase to delivery, cesarean delivery rate, uterine tachysystole, estimated blood loss, chorioamnionitis, cord pH, 5-minute Apgar score, and neonatal intensive care unit admission. Sample size calculation revealed that 94 participants were required in each group to detect a 3-hour difference with 80% power and α error of 0.05. Intention-to-treat analysis was performed.

RESULTS:
From September 2015 to July 2016, a total of 200 patients were randomized, 100 to each group. There were no differences between groups with respect to parity, body mass index, gestational age, Bishop score, birth weight, or indication for induction. Time to delivery was significantly shorter in the combined misoprostol–transcervical Foley group: 15.0 (11.0–21.8) hours (median [interquartile range]) vs 19.0 (14.0–27.3) hours in the misoprostol-only group (P=.001). This time difference remained significant after subanalysis by parity or after excluding cesarean deliveries. There was no difference between groups with respect to the rate or indication for cesarean delivery, estimated blood loss, rate of tachysystole, chorioamnionitis, or neonatal outcomes.

CONCLUSION:
Cervical ripening using misoprostol in combination with a transcervical Foley bulb is an effective method to shorten the course of labor compared with misoprostol alone.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT02566005.
Term Elective Induction of Labor and Pregnancy Outcomes Among Obese Women and Their Offspring
Authors: Gibbs Pickens Cassandra M. , Kramer Michael R. , Howards Penelope P. , Badell Martina L. , Caughey Aaron B. , Hogue Carol J. 
Published: December 2017

OBJECTIVE:
To evaluate whether elective induction of labor between 39 through 41 weeks of gestation, as compared with expectant management, is associated with reduced cesarean delivery and other adverse outcomes among obese women and their offspring.

METHODS:
We conducted a retrospective cohort study using the 2007–2011 California Linked Patient Discharge Data–Birth Cohort File of 165,975 singleton, cephalic, nonanomalous deliveries to obese women. For each gestational week (39–41), we used multivariable logistic regression models, stratified by parity, to assess whether elective induction of labor or expectant management was associated with lower odds of cesarean delivery and other adverse outcomes.

RESULTS:
At 39 and 40 weeks of gestation, cesarean delivery was less common in obese nulliparous women who were electively induced compared with those who were expectantly managed (at 39 weeks of gestation, frequencies were 35.9% vs 41.0%, respectively [P<.05]; adjusted odds ratio [OR] 0.82, 95% CI 0.77–0.88). Severe maternal morbidity was less frequent among electively induced obese nulliparous patients (at 39 weeks of gestation, 5.6% vs 7.6% [P<.05]; adjusted OR 0.75, 95% CI 0.65–0.87). Neonatal intensive care unit admission was less common among electively induced obese nulliparous women (at 39 weeks of gestation, 7.9% vs 10.1% [P<.05]; adjusted OR 0.79, 95% CI 0.70–0.89). Patterns were similar among obese parous women at 39 weeks of gestation (crude frequencies and adjusted ORs [95% CIs] were as follows: for cesarean delivery, 7.0% vs 8.7% [P<.05] and 0.79 [0.73–0.86]; for severe maternal morbidity, 3.3% vs 4.0% [P<.05] and 0.83 [0.74–0.94]; for neonatal intensive care unit admission: 5.3% vs 7.4% [P<.05] and 0.75 [0.68–0.82]). Similarly, elective induction at 40 weeks of gestation was associated with reduced odds of cesarean delivery, maternal morbidity, and neonatal intensive care unit admission among both obese nulliparous and parous patients.

CONCLUSION:
Elective labor induction after 39 weeks of gestation was associated with reduced maternal and neonatal morbidity among obese women. Further prospective investigation is necessary.
Improving Patient-reported Pain During Radiotherapy Through Nurse Involvement and Patient Education
Authors: Holtzman Adam L. , Williams Jodie P. , Hutchinson Debra F. , Morris Christopher G. , Yeung Anamaria R. 
Published: December 2017

Objectives:
Pain management during radiotherapy helps assess quality of care. By establishing an intervention to address pain during on-treatment visits (OTVs), we aim to lower patient-reported pain scores.

Methods:
A total of 171 patients were included in the analysis: 58 were retrospectively reviewed to provide a control and 113 were prospectively enrolled and evaluated after the intervention. The intervention included (1) a pain management in-service performed with the resident physician and nurses, (2) distribution of pain management educational materials, and (3) nurse consultation for patients with a pain score ≥5 within 2 days of the in-service. Study aims were to reduce the number of pain scores ≥5 by 30% and increase the number of pain scores documented during every OTV to >90%.

Results:
Median patient age was 65 years. Before the intervention, the average DVPRS score at initial consultation was 2 (range, 0 to 9) and 98% of patients had scores documented during OTVs. Overall, 26% (44/171) of OTV scores measured ≥5. Following the intervention, average DVPRS score at initial consultation was 2 (range, 0 to 10) and 99% of scores were documented during OTVs. About 14% (49/341) of patient-reported scores were ≥5, representing an ~50% relative reduction (P=0.023). The number of patients with 2+ pain scores ≥5 was reduced from 21% (12/58) before the intervention to 11% (12/109) after the intervention (P=0.1068).

Conclusion:
Involving nursing staff in the education and follow-up of patients with uncontrolled pain during radiotherapy led to an ~50% relative reduction in patient-reported DVPRS scores of 5+ during weekly OTVs.
CUTICULAR DRUSEN IN AN INDIGENOUS AUSTRALIAN
Authors: Cunningham William J. , Balaratnasingam Chandrakumar , Chen Yi , Chen Fred K. 
Published: December 2017

Background/Purpose:
To report a case of cuticular drusen in an indigenous Australian.

Methods:
A 37-year-old indigenous (aboriginal) Australian woman from a remote Western Australian town presented with a 2-month history of vision loss. Clinical history, examination, and multimodal retinal imaging data from spectral domain optical coherence tomography, fundus autofluorescence, fluorescein angiography, and indocyanine green angiography were analyzed.

Results:
Multimodal imaging confirmed cuticular drusen complicated by a right choroidal neovascularization with pigment epithelial detachment and a left foveal vitelliform lesion. An unusual “negative-staining” pattern was noted on late phase indocyanine green angiography and this spared the regions affected by cuticular drusen.

Conclusion:
To the best of our knowledge, this is the first published report of cuticular drusen in an indigenous Australian. We hypothesize that this may be secondary to ancestral mixing of the gene pool. An unusual staining pattern witnessed on indocyanine green angiography suggests widespread disturbance of lipoprotein deposition in the Bruch membrane.