bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparative Effectiveness Analysis of Early Steroid Withdrawal in Black Kidney Transplant Recipients
Authors: Taber David J. , Hunt Kelly J. , Gebregziabher Mulugeta , Srinivas Titte , Chavin Kenneth D. , Baliga Prabhakar K. , Egede Leonard E. 
Published: December 2016

Background and objectives
There is continued debate whether early steroid withdrawal is safe to use in high–immunologic risk patients, such as blacks. The goal of this study was to use comparative effectiveness methodology to elucidate the safety of early steroid withdrawal in blacks with kidney transplants.

Design, setting, participants, & measurements
Our cohort study used United Network of Organ Sharing data including all adult black kidney transplant recipients from 2000 to 2009 followed through 2014. Propensity score matching was used to equalize baseline risk between continued steroid and early steroid withdrawal groups. Interaction terms were used to assess if the effect of early steroid withdrawal on outcomes varied by baseline and post-transplant factors. Of 26,582 eligible black patients with kidney transplants (5825 [21.9%] with early steroid withdrawal), 5565 patients with early steroid withdrawal were matched to 5565 blacks on continued steroid use.

Results
Black patients with early steroid withdrawal had similar risk of graft loss (hazard ratio, 0.98; 95% confidence interval, 0.92 to 1.04; P=0.42) and lower risk of death (hazard ratio, 0.91; 95% confidence interval, 0.84 to 0.99; P=0.02), primarily driven by a late mortality advantage (>4 years post-transplant). Delayed graft function, cytolytic induction, tacrolimus, and mycophenolate significantly modified the effect of early steroid withdrawal on outcomes (P<0.05). Acute rejection rates were slightly higher in the continued steroid group (13.0% versus 11.3%, respectively; P<0.01), but this was not associated with graft or patient survival.

Conclusions
Overall, early steroid withdrawal in black kidney transplant recipients was not associated with graft loss but seemed to be associated with better long–term patient survival. Early steroid withdrawal in blacks not receiving cytolytic induction, tacrolimus, and mycophenolate or those with delayed graft function was associated with higher risk of graft loss and death.
Trust and Professional Skepticism in the Relationship between Auditors and Clients: Overcoming the Dichotomy Myth
Authors: Aschauer Ewald , Fink Matthias , Moro Andrea , van Bakel-Auer Katharina , Warming-Rasmussen Bent 
Published: December 2016

ABSTRACT
This study empirically investigates the relationship between auditors' identification-based trust in client firms' managers (CEOs/CFOs) and their perceptions of auditors' professional skepticism. We employ a multimethod approach broken down into two studies. First, in Study 1, we approached auditors and clients using narrative interviews in order to identify the working definitions of interpersonal trust and professional skepticism and also to develop an empirical and testable hypothesis against the backdrop of the current literature. Second, in Study 2, an ordinary least squares regression based on data collected from 233 real auditor-client dyads in Germany reveals that auditors' identification-based trust is positively associated with their clients' perception of the auditors' professional skepticism. The identified coexistence of trust and professional skepticism in auditor-client dyads implies that regulatory measures that impede the evolution of trust between auditors and their clients will fail to enhance professional skepticism. Instead, regulations should give auditors and their clients sufficient leeway to establish identification-based trust.
JEL Classifications: M42.
Predicting Which Children with Juvenile Idiopathic Arthritis Will Have a Severe Disease Course: Results from the ReACCh-Out Cohort
Authors: Guzman Jaime , Henrey Andrew , Loughin Thomas , Berard Roberta A. , Shiff Natalie J. , Jurencak Roman , Benseler Susanne M. , Tucker Lori B. 
Published: December 2016

Objective.We studied an inception cohort of children with juvenile idiopathic arthritis (JIA) to (1) identify distinct disease courses based on changes over 5 years in 5 variables prioritized by patients, parents, and clinicians; and (2) estimate the probability of a severe disease course for each child at diagnosis.Methods.Assessments of quality of life, pain, medication requirements, patient-reported side effects, and active joint counts were scheduled at 0, 6, 12, 18, 24, 36, 48, and 60 months. Patients who attended at least 6 assessments were included. Multivariable cluster analysis, r2, and silhouette statistics were used to identify distinct disease courses. One hundred candidate prediction models were developed in random samples of 75% of the cohort; their reliability and accuracy were tested in the 25% not used in their development.Results.Four distinct courses were identified in 609 subjects. They differed in prioritized variables, disability scores, and probabilities of attaining inactive disease and remission. We named them Mild (43.8% of children), Moderate (35.6%), Severe Controlled (9%), and Severe Persisting (11.5%). A logistic regression model using JIA category, active joint count, and pattern of joint involvement at enrollment best predicted a severe disease course (Controlled + Persisting, c-index = 0.87); 91% of children in the highest decile of risk actually experienced a severe disease course, compared to 5% of those in the lowest decile.Conclusion.Children in this JIA cohort followed 1 of 4 disease courses and the probability of a severe disease course could be estimated with information available at diagnosis.
Reading and understanding an antibiogram
Authors: Tascini Carlo , Sozio Emanuela , Viaggi Bruno , Meini Simone 
Published: December 2016

In recent years, we have been facing a significant increase in antimicrobial resistance and complex enzymatic mechanisms. The challenge of antibiotic resistance is becoming dramatic. Among gram-positive it is spreading resistance to glycopeptides, reducing the possibility to use these drugs empirically. Among gram-negative rods, beside the spreading of extended-spectrum β-lactamases, there is an increased diffusion of carbapenemases. In order to administer the correct antibiotic therapy, physicians need a rapid and correct interpretation with non-automated tests to implement appropriate therapeutic strategies. The automated reporting systems do not always provide complete and accurate information on antimicrobial resistance phenotype, making it difficult to interpret. Recently, the European Committee of Antimicrobial Susceptibility Testing (EUCAST) has proposed a new breakpoint system to be adopted by European countries. An interpretative reading of an antibiogram aims to analyze the overall susceptibility pattern, not just the result for an individual antibiotic, and so to predict the underlying resistance mechanisms. The purpose of this work is to guide physicians in reading and understanding antibiograms through an attempt of phenotypic interpretation of resistance mechanism.
Cardiorespiratory Fitness in Internal Medicine Residents: Are Future Physicians Becoming Deconditioned?
Authors: Daneshvar Farshid , Weinreich Michael , Daneshvar Danial , Sperling Michael , Salmane Chadi , Yacoub Harout , Gabriels James , McGinn Thomas , Smith Marianne C. 
Published: December 2016

ABSTRACT

Background
Previous studies have shown a falloff in physicians' physical activity from medical school to residency. Poor fitness may result in stress, increase resident burnout, and contribute to mortality from cardiovascular disease and other causes. Physicians with poor exercise habits are also less likely to counsel patients about exercise. Prior studies have reported resident physical activity but not cardiorespiratory fitness age.

Objective
The study was conducted in 2 residency programs (3 hospitals) to assess internal medicine residents' exercise habits as well as their cardiorespiratory fitness age.

Methods
Data regarding physical fitness levels and exercise habits were collected in an anonymous cross-sectional survey. Cardiopulmonary fitness age was determined using fitness calculator based on the Nord-Trøndelag Health Study (HUNT).

Results
Of 199 eligible physicians, 125 (63%) responded to the survey. Of respondents, 11 (9%) reported never having exercised prior to residency and 45 (36%) reported not exercising during residency (P &lt; .001). In addition, 42 (34%) reported exercising every day prior to residency, while only 5 (4%) reported exercising daily during residency (P &lt; .001), with 99 (79%) participants indicating residency obligations as their main barrier to exercise. We found residents' calculated mean fitness age to be 5.6 years higher than their mean chronological age (P &lt; .001).

Conclusions
Internal medicine residents reported significant decreases in physical activity and fitness. Residents attributed time constraints due to training as a key barrier to physical activity.
Demonstration of reticulin fibres in the epididymis of adult male wistar rats (Rattus norvegicus)
Authors: Ukwenya V. , Ashaolu O. , Alese O. , Oluyemi K. , Ojo G. , Ashamu E. 
Published: December 2016

Abstract
Introduction: The epididymis is a tube of smooth muscle lined by a pseudostratified epithelium; the duct is lined by smooth muscle and the stroma is made up of connective tissue. Reticulin fibres are fine fibres that contain primarily collagen type III that are secreted by reticular cells and are traditionally thought to be present only in soft blood-forming tissues such as kidney, liver, bone marrow and organs of the lymphatic system such as thymus. Methods: This work demonstrates for the first time the presence of reticulin fibres in the epididymis of adult male Wistar rats using silver impregnation method. Results: The results show reticulin fibres around the peritubular ductal walls and in the connective tissue stroma. Conclusion: The presence of reticulin fibres within the epididymal connective tissue may have effect on contractility, assisting the movement of sperms from the caput portion of the duct to the caudal part.
Anatomical variation of the alveolar inferior nerve: a case report
Authors: Azeredo R. , Cesconetto L. , Torres L. 
Published: December 2016

Abstract
Introduction: The mandibular nerve is the third and inferior division of the trigeminal nerve. One of its branches, the inferior alveolar nerve, is one among the three branches of the posterior division of the mandibular nerve, it supplies the lower jaw and teeth. However, variations of the inferior alveolar nerve branches have been of major concern in the performance of surgical procedure and anesthesia in dental and maxillofacial practice. Method and Results: A variant branch arising from the alveolar inferior nerve before it enters in the mandibular foramen were discovered during a dissection routine. The branch can be described as a variation referring to inferior alveolar nerve as a recurrent branch towards superior, posterior and medial entering in the lateral pterygoid muscle, leaving inferior alveolar nerve before the nerve for mylohyoid muscle. The nerve were found in the in both infratemporal fossa. Conclusion: Knowledge of the variations of the mandibular nerve, its branches and communications are clinically important especially for dental surgeons to understand the effectiveness of the nerve block and complications following regional anesthesia.
Are rodlet cells reliable biomarkers in Fundulus heteroclitus (L.)?
Authors: Kramer C. , Hongach S. , Antonov K. , Qama E. 
Published: December 2016

AbstractTwo populations of killifish, Fundulus heteroclitus (L.) were studied, one from a high environmentally impacted site (Saw Mill Creek) exposed to pollutants, heavy metals and infected with parasites, the other from a habitat that was far less affected (Lemon Creek), on Staten Island, New York. The rodlet cell counts in the gills of each population were compared and correlated with the number of gill parasites. A comparison of rodlet cell numbers was also made between mature males and females within each population. Although the parasite infestation was significantly higher in the Saw Mill Creek population, the rodlet cell counts did not differ between the two groups. There was no statistical correlation between the parasite number and number of rodlet cells or between standard length and rodlet cells in each population. Also, the number of rodlet cells did not differ between males and females in either group. Furthermore, EM observations showed no difference in the activity of these cells. Our findings suggest that in F. heteroclitus, rodlet cells are not dependable biomarkers for evaluating the fish's response to parasites and environmental stressors. In addition, the sexual status of the fish does not appear to affect the number of rodlet cells.
Secularism, Islamism, and Sectarianism: The Inevitable Linkage
Authors: Susser Asher 
Published: December 2016

Abstract
Through the lens of three notable intellectuals, this article explores several different explanations for the limited success of secularism in the Middle East. The “Arab Spring” of recent years, far more than it has been a struggle between the forces of democracy and the forces of autocracy, as portrayed by so many, was in fact yet another clash between the forces of modernity and the traditionalists. Most Western scholars and observers failed to identify the centrality of the forces of tradition, ignoring the social and political undercurrents of Arab societies, especially the importance of religion as a critical marker of collective identity. Middle Eastern societies were “not just like us.” Culture mattered.
The Ethics of Deception in Biblical Narrative
Authors: Weiss Shira 
Published: December 2016

Abstract
Is it ever moral to lie or deceive? Despite biblical prohibitions against lying, the Bible rarely offers an evaluation of its characters or their conduct, thus leaving the moral ambiguity regarding the Bible's attitude toward the ethical nature of deception open to interpretation by the reader. This article uses contemporary moral debate to elucidate the ethical problems that arise from morally ambiguous biblical narratives depicting deception. Did Abram, and later Isaac, act ethically when they identified their wives as their sisters? Were Simeon and Levi morally justified in their deception and ambush of the inhabitants of Shechem? Philosophical analysis of the biblical stories, in light of arguments advanced by Immanuel Kant and Benjamin Constant, support different interpretations that contribute to an enhanced understanding of the biblical text and a more informed evaluation by its readers.
Whose Womb and Whose Ethics? Surrogacy in Israel and in Jewish Ethics
Authors: Raucher Michal 
Published: December 2016

Abstract
Through the comparison of Jewish ethical arguments about surrogacy and ethnographic data from surrogacy in Israel, this article argues that normative Jewish ethics does not respond to the contemporary lived experience of surrogacy. On the ground, some normative Jewish ethical concerns are resolved easily, and yet we will find that the lived experience raises issues not even addressed by Jewish ethicists. This article looks at questions of maternal identity and the exploitation of surrogates through the comparison of normative Jewish ethics with ethnographic data. In the conclusion it considers how to improve the methodology of Jewish ethics to better reflect the reality on the ground.
Risk factors for suicide in the Israeli army between the years 1992–2012: A case-control study
Authors: Shelef L. , Tomer G. , Tatsa-Laur L. , Kedem R. , Bonne O. , Fruchter E. 
Published: December 2016

AbstractObjectiveYoung age, availability of weapons, and stressful life events, increase the risk of suicide. The aim of the present study was to assess additional risk factors for suicide in the Israeli army.MethodsWe conducted a case-control study, to assess risk factors for suicide. The cases comprised soldiers who died by suicide during their military service (n = 462; 0.039% of all soldiers in the cohort). The control group consisted of soldiers who did not commit suicide but were in active service during the investigated period (n = 1,170,895; 99.96%). Predictor variables, including socio-demographic and psychiatric diagnoses, were considered.ResultsUsing a Generalized Linear Model with a Binary Logistic dependent variable to predict suicide, while controlling the effect of intervening variables, we found the following variables enhanced the risk for committing suicide: male (RR = 6.703; P < 0.001), country of origin: Ethiopia (RR = 4.555; P = 0.014), low socioeconomic status (RR = 1.448; P = 0.016) and low adjustment difficulties (RR = 2.324; P < 0.001). In addition, we found that in males only, Cluster B Personality Disorder (RR = 2.548; P = 0.027), low (RR = 1.657; P = 0.002), to average motivation to serve in a combat unit (RR = 1.322; P = 0.046) increased the risk for suicide.ConclusionsIDF Soldiers bearing a psychiatric diagnosis or severe adjustment difficulties remained tightly monitored through their military service, and were found to be at a lower risk for suicide. However, those enlisted with mild (low) difficulties, were found to be at greater risk for suicide, as well as soldiers whose country of origin is Ethiopia. Suicide prevention program should focus on monitoring soldiers with these risk factors, together with soldiers’ guidance regarding help seeking and de-stigmatizing suicide.
Objective and subjective scar aesthetics with topical Manuka honey post‐thyroidectomy: A randomized control study
Authors: Thamboo Andrew , Mulholland Graeme , Matthews Kathleen , Ayoub Noel , Anderson Donald 
Published: December 2016

ObjectiveLeptospermum Honey (Manuka honey) has proven to be effective in improving acute and chronic wound healing presumably due to its antibacterial and anti‐inflammatory properties. The aim is to determine if Manuka honey decreases scar formation and results in a cosmetically appealing scar.MethodsA prospective single‐blinded randomized control trial was performed. All patients received an 8 cm incision. Patients randomized to honey treatment were instructed to apply Manuka honey paste topically to the incision site once per day post surgery for 4 weeks. The patients' scar was then analyzed objectively by a blinded observer and subjectively at 4 and 8 weeks postoperatively. The primary outcome measure used was the Patient and Observer Scar Assessment Scale (POSAS).ResultsA total of 21 patients completed the entire scar analysis (honey treatment = 9, standard treatment = 12). There was no statistically significant difference between patient scar assessment scale and observer scar assessment scale at 4 and 8 weeks postoperatively.ConclusionDespite Leptospermum Honey's reported anti‐inflammatory and antibacterial properties, this study did not show a difference in scar appearance when applied.
Short Term Predictors of Unemployment in Multiple Sclerosis Patients
Authors: Busche K.D. , Fisk J.D. , Murray T.J. , Metz L.M. 
Published: December 2016

ABSTRACT:Background:Unemployment is common in people with multiple sclerosis (MS) and is associated with loss of income and impaired health related quality of life. This study determined variables associated with unemployment and risk factors for the development of unemployment in people with MS.Methods:Ninety-six patients who were under age 65 and participated in two previous studies to measure economic costs and health related quality of life in MS were included. The baseline employment rate and variables associated with unemployment at baseline were determined. The ability of these variables to predict unemployment over the next two and a half years was then evaluated.Results:At baseline 50.1% (50/96) of participants were employed. Two and a half years later only 40.6% (39/96) remained employed. This represents loss of employment for 22.0% (11/50) of those originally employed. Factors associated with unemployment at baseline included greater disability, progressive disease course, longer disease duration, and older age. Risk factors for loss of employment over the next 2.5 years included greater disability and older age.Conclusions:This study confirms the low employment rate among people with MS and confirms the association of several previously-reported factors with greater risk of unemployment. It is also the first study to confirm that some of these factors also increase the risk of future unemployment. People with MS who are over age 39 or have moderate disability and are still employed can now be identified as at risk for becoming unemployed over the next 2.5 years. They should be considered for interventions to maintain employment or to lessen the impact of unemployment.
QseC inhibition as an antivirulence approach for colitis-associated bacteria
Authors: Rooks Michelle G. , Veiga Patrick , Reeves Analise Z. , Lavoie Sydney , Yasuda Koji , Asano Yasunari , Yoshihara Kazufumi , Michaud Monia , Wardwell-Scott Leslie , Gallini Carey Ann , Glickman Jonathan N. , Sudo Nobuyuki , Huttenhower Curtis , Lesser Cammie F. , Garrett Wendy S. 
Published: December 2016

SignificanceBacteria use two-component quorum-sensing systems to communicate with each other and their hosts. Catecholamines are host stress signals that participate in this dialogue and drive bacterial growth and virulence. Evidence from a preclinical model of inflammatory bowel disease (IBD) revealed that Enterobacteriaceae and pathways linked to catecholamine-mediated bacterial virulence are enriched in active disease. Here we targeted the bacterial adrenergic sensor, quorum-sensingEscherichia coliregulator C (QseC) of the QseBC two-component system. Genetically inactivatingqseCin a pathogenic, IBD-associatedE. colistrain (LF82) reduced its virulence and ability to colonize a murine host. Furthermore, biochemically inhibiting QseC attenuated disease in multiple preclinical IBD models. This report demonstrates that QseC signaling influences IBD pathogenesis and identifies QseC blockade as a therapeutic strategy for colitis-associated bacteria.
The Emergence of the Syntactic Concept of Phrase in Comenius
Authors: Oniga Renato 
Published: December 2016

Summary
We owe the emergence of the linguistic idea of phrase to Jan Amos Comenius (1592–1670), in his Grammatica Latino-vernacula (Leszno 1649). He proposes to use the stylistic term ‘phrasis’ with a new linguistic meaning, in order to indicate a group of words arranged in a hierarchical structure, which is an intermediate syntactic unit between the word and the sentence. This idea allows us to back-date by a century the discovery of “groups of words”, which is usually ascribed to Gabriel Girard (1677–1774) in 1747.
Drawing Syntax before Syntactic Trees
Authors: Mazziotta Nicolas 
Published: December 2016

Summary
This contribution investigates the syntactic conceptions of, and the diagramming system introduced by, the American grammarian Stephen Watkins Clark (1810–1901), who introduced the first comprehensive syntactic diagramming system. The structure of the English sentence is illustrated by agglutinated ‘bubbles’ expressing the relations between words by the means of their relative position. The sentence consists of two or three horizontally aligned bubbles containing words that are called principal elements. These principal elements can be complemented with adjunct elements, that appear in bubbles attached below them. For grammatical words the conventions differ depending on whether the grammatical word is a preposition or a conjunction. Coordination is never named as such, but there is an orthogonal abstract relation that connects elements performing the same role in a “compound” construction. The system allows recursivity in two different ways: by wrapping bubbles into other bubbles, thus following a mereological logic (i.e., partwhole relations) close to IC analysis or by hierarchically aggregating bubbles that resemble dependency trees. Clark’s conceptions thus prefigure modern graphical formalizations.