bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disc-damage Likelihood Scale (DDLS) as a Clinical Indicator of the Presence of a Relative Afferent Pupillary Defect (RAPD)
Authors: Zhang Alice Y. , Lu Lan , Ali Mohsin , Rutnin Nont , Faria Bruno M. , Guzel Huseyin , Liang Liang , Martinez Patricia , Tawfik Mike , Spaeth George L. 
Published: April 2016

Purpose:
To evaluate clinical parameters and their relationship to the presence of a relative afferent pupillary defect (RAPD).

Materials and Methods:
Retrospective chart review of 672 consecutive patients who presented to the Glaucoma Service at Wills Eye Hospital from January 1 through May 29, 2012. Swinging flashlight method (SFM) was used to test for RAPDs. Records of visual acuity, intraocular pressure (IOP), disc-damage likelihood scale (DDLS), cup/disc (C/D) ratio, visual field mean deviation (MD), optical coherence tomography (OCT), and Heidelberg retinal tomography (HRT) asymmetries were examined. We measured the prevalence of RAPDs as clinical asymmetries increase, calculated cut-off points for clinical asymmetries that optimized sensitivity and specificity in detecting RAPDs, and determined values of clinical asymmetries above which a RAPD always exists.

Results:
Upon exclusion, we studied 409 patients, 175 (42.8%) with RAPDs and 234 (57.2%) without. Age, visual acuity, IOP, DDLS, C/D ratio, MD, retina nerve fiber layer thickness by OCT, HRT C/D, and HRT rim area asymmetries all correlated with RAPD status (OCT and HRT parameters did not include enough patients for multivariable analysis or cut-off determination). Multivariable analysis indicated that IOP, DDLS, and MD asymmetries were significantly correlated with RAPD status (P-value<0.05). Although the optimal cut-off values for the variables retained in the final multivariable model had low sensitivity and moderate specificity, DDLS had the highest specificity of 0.86.

Conclusions:
IOP, DDLS, and MD asymmetries had the best correlation with RAPD status, and increased asymmetries in these parameters were associated with higher likelihood of RAPDs. DDLS score had the highest specificity in predicting a RAPD, and DDLS asymmetry scores ≥6 identified all cases of RAPDs.
Inadequate Bowel Cleansing Efficacy of Split-dose Polyethylene Glycol for Colonoscopy in Type 2 Diabetic Patients
Authors: Kim Young Hwan , Seo Eun Hee , Lee Jae Seung , Lee Seung Heon , Park Hee Seung , Choi Sung Ho , Park Ja Young , Lee Chang Won 
Published: April 2016

Background/Aims:
Split-dose polyethylene glycol (PEG) is considered a standard bowel preparation regimen for colonoscopy in the general population. However, it is not clear whether the regimen is optimal for colonoscopy in diabetic patients. The aim of this study was to compare the efficacy and tolerability of split-dose PEG for diabetic versus nondiabetic patients.

Methods:
This is a single-center, prospective, investigator-blinded study. A total of 55 consecutive nondiabetic and 50 diabetic patients ingested 2 L PEG solution on the day before the procedure and then 2 L of the solution on the day of colonoscopy. The quality of bowel preparation was graded using the Ottawa scale.

Results:
There was a significant difference in bowel preparation quality, with a worse preparation except for mid colon in diabetic group (total score: 7.06±1.69 vs. 5.54±1.97, P<0.001; right colon: 2.28±0.57 vs. 1.81±0.72, P<0.001; mid colon: 1.70±0.54 vs. 1.56±0.66, P=0.253; rectosigmoid colon: 1.70±0.76 vs. 1.14±0.62, P<0.001; fluid volume: 1.38±0.53 vs. 1.01±0.59, P=0.001). About 70% of nondiabetic patients had an adequate preparation compared with only 40% of diabetic patients (P=0.003). Diabetic group had longer cecal intubation time (6.4±3.6 vs. 4.5±2.4, P=0.002) and total procedure time (22.1±7.6 vs. 18.1±8.5, P=0.015). Compliance and adverse events were not significantly different. In diabetic group, inadequate bowel preparation had a significant association with higher fasting plasma glucose (136.9±21.8 vs. 121.8±19.4 mg/dL, P=0.016).

Conclusions:
Diabetic patients had a worse preparation quality and longer cecal intubation and total procedure time compared with nondiabetic patients. These data suggest that split-dose PEG preparation regimen is not sufficient for optimal bowel preparation in diabetic patients undergoing colonoscopy.
Short-Term Public Health Impact of the July 22, 2011, Terrorist Attacks in Norway: A Nationwide Register-Based Study
Authors: Strand Linn Beate , Mukamal Kenneth J. , Halasz Jozsef , Vatten Lars J. , Janszky Imre 
Published: April 2016

ABSTRACT

Objectives
To examine increases in several health outcomes after the July 22, 2011 terrorist attacks in Norway.

Methods
Retrospective analysis of nationwide registers (n = 4,953,000) where incidences of schizophrenia/psychosis hospitalizations, suicides, acute myocardial infarctions, and preterm births after the terrorist attacks were compared with corresponding periods the previous 3 years.

Results
Compared with the same period the preceding 3 years, the observed number of hospitalizations from schizophrenia/psychosis was 14% higher during the first 4 weeks after the terrorist attack (incidence ratio [IR] = 1.14, 95% confidence interval [CI] = 1.07–1.21). The corresponding IRs for the first 3 days and the first week were 1.26 (95% CI = 0.99–1.58) and 1.10 (95% CI = 0.96–1.24). The observed number of suicides was increased by 45% the first 4 weeks (IR = 1.45, 95% CI = 1.12–1.86), 163% the first 3 days (IR = 2.63, 95% CI = 1.15–5.20), and 105% the first week (IR = 2.05, 95% CI = 1.14–3.42). For acute myocardial infarction, there was an increase of 5% the first 4 weeks. There were also more births the 4 weeks (IR = 1.04, 95% CI = 1.01–1.07, but this increase was not seen in preterm births of less than 37 weeks of gestation (IR = 0.93, 95% CI = 0.83–1.04).

Conclusions
We observed a general nationwide increase of health outcomes investigated in this study the first 4 weeks after the terrorist attacks. These results may contribute to the growing body of evidence on the adverse health outcomes that may accompany national stressors.
Subgenual Cingulate Cortex Functional Connectivity in Relation to Depressive Symptoms and Cognitive Functioning in Type 1 Diabetes Mellitus Patients
Authors: van Duinkerken Eelco , Ryan Christopher M. , Schoonheim Menno M. , Barkhof Frederik , Klein Martin , Moll Annette C. , Diamant Michaela , IJzerman Richard G. , Snoek Frank J. 
Published: April 2016

ABSTRACT

Objectives
Patients with Type 1 diabetes mellitus (T1DM) are at an increased risk for major depression, but its underlying mechanisms are still poorly understood. In nondiabetic participants, mood disturbances are related to altered subgenual cingulate cortex (SGC) resting-state functional connectivity. We tested for SGC connectivity alterations in T1DM, whether these alterations were related to depressive symptoms, and if depressive symptoms were associated with cognition.

Methods
A bilateral SGC seed-based resting-state functional magnetic resonance imaging analysis was performed in 104 T1DM patients and 49 controls without known psychiatric diagnosis or treatment. Depressive symptoms were self-reported using the Center for Epidemiological Studies Depression scale. Cognition was assessed with a battery of standardized tests.

Results
In patients versus controls, SGC to right inferior frontal gyrus and frontal pole connectivity was decreased (52 voxels, z valuepeak = 3.56, p
cluster-FWE = .002), whereas SGC to bilateral precuneus (33 voxels, z valuepeak = 3.34, p
cluster-FWE = .04) and left inferior parietal lobule (50 voxels, z valuepeak = 3.50, p
cluster-FWE = .003) connectivity was increased. In all participants, increased depressive symptoms was related to lower SGC to inferior frontal gyrus and frontal pole connectivity (β = −0.156, p = .053), and poorer general cognitive ability (β = −0.194, p = .023), information processing speed (β = −0.222, p = .008), and motor speed (β = −0.180, p = .035).

Conclusions
T1DM patients showed a pattern of SGC connectivity that is characterized by lower executive control and higher default mode network connectivity. Depressive symptoms are partially related to these alterations and seem to exacerbate T1DM-related cognitive dysfunction. Future studies should detail the effect of diagnosed major depressive disorder in this population and establish what alterations are diabetes specific.
Complex molecular mixtures under cycling gradients as basis for life’s origins
Authors: Spitzer Jan , Poolman Bert 
Published: April 2016

AbstractWe consider life as a cyclic physicochemical process that makes heredity and Darwinian evolution observable through living cells. We elaborate four principles that constrain current speculations about life’s emergence to natural processes driven by diurnal physicochemical gradients, primarily of temperature, water activity and electromagnetic radiation. First, Earth’s prebiotic chemical evolution is historically continuous with Darwinian evolution; second, cycling energies of solar radiation are primary drivers of chemical evolution; third, environmental molecular complexity must be high at the origin of life; and fourth, non-covalent molecular forces determine molecular recognition and cellular organization. Under normal physiological conditions of high ionic strength and high macromolecular crowding, hydration interactions (hydrogen bonding), screened electrostatic forces and excluded volume repulsions act over acommensuratedistance of about one nanometer. This intermolecular distance governs chemical coevolution of proto-biomacromolecular surfaces (nucleic acids, proteins and membranes) toward Darwinian thresholds and living states. The above physicochemical principles of life’s emergence are consistent with the second law of thermodynamics, and with the current facts of molecular microbiology and planetary sciences. New kinds of experimentation with crowded molecular mixtures under oscillating temperature gradients - a PCR-like mechanism of life’s origins - can further illuminate how living states come about.Graphical abstractLife’s emergence follows from chemical and Darwinian evolution, a high degree of molecular complexity and a high crowdedness, and non-covalent molecular forces that determine molecular recognition and cellular organization. The macromolecules divide the cytoplasm into dynamically crowded macromolecular regions and topologically complementary electrolyte pools. Small ions and ionic metabolites are transported vectorially between the electrolyte pools and through the (semi-conducting) electrolyte pathways of the crowded macromolecular regions.
LINES between species: Evolutionary dynamics of LINE-1 retrotransposons across the eukaryotic tree of life
Authors: Ivancevic Atma M. , Kortschak R. Daniel , Bertozzi Terry , Adelson David L. 
Published: April 2016

AbstractLINE-1 (L1) retrotransposons are dynamic elements. They have the potential to cause great genomic change due to their ability to ‘jump’ around the genome and amplify themselves, resulting in the duplication and rearrangement of regulatory DNA. Active L1, in particular, are often thought of as tightly constrained, homologous and ubiquitous elements with well-characterised domain organisation. For the past 30 years, model organisms have been used to define L1s as 6-8kb sequences containing a 5’-UTR, two open reading frames working harmoniously incis, and a 3’-UTR with a polyA tail.In this study, we demonstrate the remarkable and overlooked diversity of L1s via a comprehensive phylogenetic analysis of over 500 species from widely divergent branches of the tree of life. The rapid and recent growth of L1 elements in mammalian species is juxtaposed against their decline in plant species and complete extinction in most reptiles and insects. In fact, some of these previously unexplored mammalian species (e.g. snub-nosed monkey, minke whale) exhibit L1 retrotranspositional ‘hyperactivity’ far surpassing that of human or mouse. In contrast, non-mammalian L1s have become so varied that the current classification system seems to inadequately capture their structural characteristics. Our findings illustrate how both long-term inherited evolutionary patterns and random bursts of activity in individual species can significantly alter genomes, highlighting the importance of L1 dynamics in eukaryotes.
How strongly does appetite counter weight loss? Quantification of the homeostatic control of human energy intake
Authors: Polidori David , Sanghvi Arjun , Seeley Randy , Hall Kevin D. 
Published: April 2016

AbstractObjectiveTo quantify the homeostatic feedback control of energy intake in response to long-term covert manipulation of energy balance in free-living humans.MethodsWe used a validated mathematical method to calculate energy intake changes during a 52 week placebo-controlled trial in 153 patients treated with canagliflozin, a sodium glucose co-transporter inhibitor that increases urinary glucose excretion thereby resulting in weight loss without patients being directly aware of the energy deficit. We analyzed the relationship between the body weight time course and the calculated energy intake changes using principles from engineering control theory.ResultsWe discovered that weight loss leads to a proportional homeostatic drive to increase energy intake above baseline by ~100 kcal/day per kg of lost weight – an amount more than 3-fold larger than the corresponding energy expenditure adaptations.ConclusionsWhile energy expenditure adaptations are often thought to be the main reason for slowing of weight loss and subsequent regain, feedback control of energy intake plays an even larger role and helps explain why long-term maintenance of a reduced body weight is so difficult.FundingThis research was supported by the Intramural Research Program of the NIH, National Institute of Diabetes & Digestive & Kidney Diseases, using data from a study sponsored by Janssen Research & Development, LLC.DisclosureD.P. is a full-time employee of Janssen Research & Development, LLC. K.D.H. reports patent pending on a method of personalized dynamic feedback control of body weight (US Patent Application No. 13/754,058; assigned to the NIH) and has received funding from the Nutrition Science Initiative to investigate the effects of ketogenic diets on human energy expenditure. R.S. is a paid consultant for Janssen, Novo Nordisk, Takeda, Daichii Sankyo, Novartis, Pfizer, Nestle, Circuit Therapeutics and Ethicon. R.S., also has received research support from Novo Nordisk, Ethicon, Sanofiand Boehringer Ingelheim. A.S. reports no conflicts of interest.What is already known about this subject?Human body weight is believed to be regulated by homeostatic feedback control of both energy intake and energy expenditure.Adaptations of energy expenditure to weight loss have been well-established, but the homeostatic control of energy intake has yet to be quantified.What this study addsWe provide the first quantification of the homeostatic control of energy intake in free-living humans.The increase in energy intake per kg of weight lost is several-fold larger than the known energy expenditure adaptations.Homeostatic control of energy intake is likely the primary reason why it is difficult to achieve and sustain large weight losses.
Comparison of the analgesic effect of patient‐controlled oxycodone and fentanyl for pain management in patients undergoing colorectal surgery
Authors: Jung Kyeo‐Woon , Kang Hyeon‐Wook , Park Chan‐Hye , Choi Byung‐Hyun , Bang Ji‐Yeon , Lee Soo‐Han , Lee Eun‐Kyung , Choi Byung‐Moon , Noh Gyu‐Jeong 
Published: April 2016

SummaryOxycodone is a μ‐opioid receptor agonist and is generally indicated for the relief of moderate to severe pain. The aim of this study was to compare the analgesic efficacy of patient‐controlled oxycodone and fentanyl for postoperative pain in patients undergoing colorectal surgery. Patients scheduled to undergo elective colorectal surgery (n=82) were allocated to receive oxycodone (n=41, concentration of 1 mg/mL) or fentanyl (n=41, concentration of 15 μg/mL) for postoperative pain management. After the operation, pain using a numerical rating scale (NRS), delivery to demand ratio, infused dose of patient‐controlled analgesia (PCA), side effects, and sedation levels were evaluated. Median (25%–75%) cumulative PCA dose of oxycodone group at 48 hours (66.9, 58.4–83.7 mL) was significantly less than that of fentanyl group (80.0, 63.4–103.3 mL, P=.037). Six hours after surgery, the mean (SD) NRS scores of the oxycodone and fentanyl groups were 6.2 (2.4) and 6.8 (1.9), respectively (P=.216). The mean equianalgesic potency ratio of oxycodone to fentanyl was 55:1. The groups did not differ in postoperative nausea, vomiting, and level of sedation. Patient‐controlled oxycodone provides similar effects for pain relief compared to patient‐controlled fentanyl in spite of less cumulative PCA dose. Based on these results, oxycodone can be a useful alternative to fentanyl for PCA in patients after colorectal surgery.
Lack of tumor necrosis factor alpha gene polymorphism ‐857c/t (rs1799724) association in Pakistani rheumatoid arthritis patients
Authors: Sadaf Tayyaba , John Peter , Bhatti Attya , Jahangir Sidrah , Kiani Aysha K. , Gill Farah A. , Malik Javed M. 
Published: April 2016

AbstractBackgroundRheumatoid arthritis (RA) is a common systemic autoimmune disease, influenced greatly by the pro‐inflammatory cytokine tumor necrosis factor‐ alpha (TNF‐α). Single nucleotide polymorphisms (SNPs) in regulatory regions of the TNF‐α gene play a significant role in disease development and pathogenesis. The aim of this study was to investigate the association of TNF‐α ‐857C/T (rs1799724) SNP with RA activity or severity in our Pakistani study group.MethodsThe study included 134 (116 women, 18 men) patients with RA and 134 ethnically matched healthy controls (108 women, 26 men). Each patient's disease activity was measured by Disease Activity Score of 28 joints. The genotypes were determined in all included individuals following allele‐specific polymerase chain reaction along with the prerequisite internal amplification controls. Statistical analysis including chi‐square/Fischer exact test and one‐way analysis of variance; nonparametric Kruskal–Wallis test was employed using Graphpad Prism 6 software for association study.ResultsThe prevalence of TNF‐α ‐857C/T (rs1799724) polymorphism was not differentially distributed between RA patients and controls in either allele frequency, with odds ratio (95% CI) of 0.9661 (0.6714–1.390) and P‐value of 0.8527, or genotype frequency with χ2 of 0.5015 and P‐value of 0.7782. Moreover, no correlation was found when genotype frequency distribution was analyzed with disease severity (P = 0.6321 and Kruskal–Wallis statistics of 1.098).ConclusionThe study demonstrated ‐857C/T (rs1799724) polymorphism may not have influenced RA susceptibility in our study group. However, investigations of genetic variability influence on disease outcome in large prospective cohorts are required, so the complicated interconnection of genetic and environmental elements can be emulated for better understanding.
Self‐assessment of skin tightness severity by scleroderma patients
Authors: Daungkum Kittikorn , Foocharoen Chingching , Mahakkanukrauh Ajanee , Suwannaroj Siraphop , Thinkhamrop Bandit , Nanagara Ratanavadee 
Published: April 2016

AbstractAimsSkin tightness progression determines the severity and mortality of systemic sclerosis (SSc). The modified Rodnan skin score (mRSS) is a skin tightness assessment tool, albeit inter‐physician variability is a limitation. Our objectives were to evaluate the correlation and agreement of skin tightness assessment between patient self‐assessment and physician‐assessment.MethodsA descriptive study was conducted on the masked, self‐assessments of mRSS (at week 0, 4 and 12) by 23 Thai adult SSc patients seen at Srinagarind Hospital, KhonKaen University, between March 2014 and February 2015. Correlation between the physician and patient assessments was estimated using Pearson's. The intra‐class correlation coefficient (ICC) and limit of agreement by Bland‐Altman were determined.ResultsWe included 23 SSc patients (female to male ratio being 1.1:1). All had the diffuse cutaneous SSc subset. The skin thickness assessment correlation was moderate at baseline (Pearson's r = 0.68) and improved to a good correlation at week 4 and 12 (r = 0.78 and 0.86, respectively). The ICC showed good agreement (0.761) at week 0 and increased to excellent at week 4 (0.846) and 12 (0.910). The patient self‐assessment score was higher than the physician assessment, which slightly decreased over time: mean difference = 4.30 (95% LOA;−9.54 to 18.14) at week 0, then 3.78 (95% LOA,−10.20 to 17.77) at week 4, and 3.16 (95% LOA,−7.78 to 14.10) at week 12.ConclusionThe respective modified Rodnan skin score assessment by patient versus the physician was highly correlated with a high level of agreement. Validation of generalized patient self‐assessment needs to be confirmed.
Clinical characteristics of scleroderma overlap syndromes: comparisons with pure scleroderma
Authors: Foocharoen Chingching , Netwijitpan Sittichai , Mahakkanukrauh Ajanee , Suwannaroj Siraphop , Nanagara Ratanavadee 
Published: April 2016

AbstractBackgroundScleroderma with characteristics of other connective tissue diseases is called scleroderma overlap syndrome (SOV); the clinical features of which have yet to be investigated among Thai patients.ObjectiveTo determine the clinical differences between pure scleroderma and SOV.MethodsA historical cohort study was conducted among patients with pure scleroderma versus those with SOV. Subjects were over 18 years of age and followed up at Srinagarind Hospital, Khon Kaen University, Thailand, between January 2006 and December 2011.ResultsFour hundred and three medical records were included (276 female vs. 127 male). SOV was found in 68 cases (16.9%): (i) scleroderma–polymyositis overlap (SOV‐PM), the most common type of SOV (48 cases; 70.6%); (ii) scleroderma–systemic lupus erythematosus overlap (11 cases; 16.2%); and (iii) scleroderma–rheumatoid arthritis overlap (nine cases; 13.2%). Mean age at onset of non‐systemic sclerosis symptoms was 46.9 ± 11.8 years (range, 19.8–74.3). Characteristically, sufferers of SOV as against pure scleroderma were younger, had less frequent anti‐topoisomerase I (ATA) and needed moderate‐ to high‐dose steroid and immunosuppressant therapy during follow‐up. SOV‐PM presented the clinical features of scleroderma at onset and during follow‐up looks like pure scleroderma having vasculopathy, severity of skin tightness, and gastrointestinal, cardiopulmonary and renal involvement. Anti‐Ro52 was the most common serology among sufferers of SOV (31.6%). ATA was associated with pure scleroderma patients (P = 0.047).ConclusionsSOV rather than pure scleroderma presented in younger Thai scleroderma patients and SOV‐PM was the most common subtype and its clinical features were similar to those of pure scleroderma. ATA was strongly associated with the latter.