bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Narrative Review of the Evidence on the Efficacy of Dexamethasone on Postoperative Analgesic Consumption
Authors: Batistaki Chrysanthi , Kaminiotis Evagelia , Papadimos Thomas , Kostopanagiotou Georgia 
Published: February 2017

Objectives:
The effect of dexamethasone on analgesic consumption has not been adequately studied. The aim of this review was to investigate recent literature regarding the possible effect of dexamethasone on postoperative analgesic consumption.

Methods:
Critical review of randomized trials and prospective consecutive studies investigating the postoperative analgesic effect of dexamethasone was performed. Only studies published during 2006 to 2015 were included.

Results:
Forty-one studies met the inclusion criteria; 33 in adults and 8 in children (9 in general surgery, 8 in gynecologic/breast surgery, 8 in orthopedic/spinal surgery, 8 in head/neck surgery, 7 in children’s tonsillectomy, and 1 in children’s orchiopexy). Literature review demonstrated that dexamethasone can decrease analgesic requirements in patients undergoing laparoscopic cholecystectomies, laparoscopic gynecologic and breast surgery; whereas there is no consensus regarding orthopedic procedures, with positive evidence mostly regarding spinal surgeries. The efficacy of dexamethasone during head and neck surgery is not conclusive; however, its use before thyroid surgery may be beneficial. In children a beneficial impact of dexamethasone administration was revealed on posttonsillectomy reduction of analgesic needs. Studies on other kinds of operations in children are lacking.

Conclusions:
Dexamethasone administered at a dose of 8 mg before surgical incision may be beneficial in laparoscopic cholecystectomies, thyroid, laparoscopic gynecologic and breast surgery, and tonsillectomies in children. Dexamethasone’s potential impact on reducing postoperative analgesic requirements should be investigated in more detail in a systematic manner, to support its use in other kinds of operations.
Gray Matter Abnormalities Associated With Chronic Back Pain
Authors: Yuan CongHu , Shi HaiCun , Pan PingLei , Dai ZhenYu , Zhong JianGuo , Ma HaiRong , Sheng LiQin 
Published: February 2017

Background:
Studies employing voxel-based morphometry have reported inconsistent findings on the association of gray matter (GM) abnormalities with chronic back pain (CBP). We, therefore, performed a meta-analysis of available studies to identify the most consistent GM regions associated with CBP.

Methods:
The PubMed, Embase, and Web of Science databases were searched from January 2000 to May 29, 2016. Comprehensive meta-analyses of whole-brain voxel-based morphometry studies to identify the most robust GM abnormalities in CBP were conducted using the Seed-based d Mapping software package.

Results:
A total of 10 studies, comprising 293 patients with CBP and 624 healthy controls, were included in the meta-analyses. The most robust findings of regional GM decreases in patients with CBP compared with healthy controls were identified in the bilateral medial prefrontal cortex extending to the anterior cingulate cortex, the right medial prefrontal cortex extending to the orbitofrontal cortex. Regional GM decreases in the left anterior insula were less robustly observed.

Conclusions:
The present study demonstrates a pattern of GM alterations in CBP. These data further advance our understanding of the pathophysiology of CBP.
The Untapped Potential of Patient and Family Engagement in the Organization of Critical Care
Authors: Haines Kimberley J. , Kelly Phillipa , Fitzgerald Peter , Skinner Elizabeth H. , Iwashyna Theodore J. 
Published: February 2017

Objective:
There is growing interest in patient and family participation in critical care—not just as part of the bedside, but as part of educational and management organization and infrastructure. This offers tremendous opportunities for change but carries risk to patients, families, and the institution. The objective is to provide a concise definitive review of patient and family organizational participation in critical care as a high-risk population and other vulnerable groups. A pragmatic, codesigned model for critical care is offered as a suggested approach for clinicians, researchers, and policy-makers.

Data Sources:
To inform this review, a systematic search of Ovid Medline, PubMed, and Embase was undertaken in April 2016 using the MeSH terms: patient participation and critical care. A second search was undertaken in PubMed using the terms: patient participation and organizational models to search for other examples of engagement in vulnerable populations. We explicitly did not seek to include discussions of bedside patient-family engagement or shared decision-making.

Study Selection:
Two reviewers screened citations independently. Included studies either actively partnered with patients and families or described a model of engagement in critical care and other vulnerable populations.

Data Extraction:
Data or description of how patient and family engagement occurred and/or description of model were extracted into a standardized form.

Data Synthesis:
There was limited evidence of patient and family engagement in critical care although key recommendations can be drawn from included studies. Patient and family engagement is occurring in other vulnerable populations although there are few described models and none which address issues of risk.

Conclusions:
A model of patient and family engagement in critical care does not exist, and we propose a pragmatic, codesigned model that takes into account issues of psychologic safety in this population. Significant opportunity exists to document processes of engagement that reflect a changing paradigm of healthcare delivery.
Methodology and Reporting of Mobile Health and Smartphone Application Studies for Schizophrenia
Authors: Torous John , Firth Joseph , Mueller Nora , Onnela J. P. , Baker Justin T. 
Published: February 2017

Abstract
The increasing prevalence of mobile devices among patients of all demographic groups has the potential to transform the ways we diagnose, monitor, treat, and study mental illness. As new tools and technologies emerge, clinicians and researchers are confronted with an increasing array of options both for clinical assessment, through digital capture of the essential behavioral elements of a condition, and for intervention, through formalized treatments, coaching, and other technology-assisted means of patient communication. And yet, as with any new set of tools for the assessment or treatment of a medical condition, establishing and adhering to reporting guidelines—that is, what works and under what conditions—is an essential component of the translational research process. Here, using the recently published World Health Organization mHealth Evaluation, Reporting and Assessment guidelines for evaluating mobile health applications, we review the methodological strengths and weaknesses of existing studies on smartphones and wearables for schizophrenia. While growing evidence supports the feasibility of using mobile tools in severe mental illness, most studies to date failed to adequately report accessibility, interoperability, costs, scalability, replicability, data security, usability testing, or compliance with national guidelines or regulatory statutes. Future research efforts addressing these specific gaps in the literature will help to advance our understanding and to realize the clinical potential of these new tools of psychiatry.
AGE-RELATED CHANGES IN CHOROIDAL VASCULAR DENSITY OF HEALTHY SUBJECTS BASED ON IMAGE BINARIZATION OF SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY
Authors: Ruiz-Medrano Jorge , Ruiz-Moreno José M. , Goud Abhilash , Vupparaboina Kiran Kumar , Jana Soumya , Chhablani Jay 
Published: February 2017

Purpose:
To analyze the vascular density of the choroid in a healthy population using swept-source optical coherence tomography.

Methods:
A cross-sectional, noninterventional study. Inclusion criteria: best-corrected visual acuity between 20/20 and 20/25, spherical equivalent between ±3 diopters, no systemic or ocular diseases, and ages ranging between 3 and 85 years. One hundred and thirty-six eyes from 136 subjects were analyzed, 86 eyes (63.2%) were from male and 50 eyes (36.8%) from female subjects. The eyes were divided into different age groups to analyze the possible age-related changes. Twelve-millimeter horizontal, fovea-centered B-scans were used. Choroidal stroma and vessel area analysis involved automated segmentation and binarization using validated algorithms.

Results:
Mean age was 33.1 ± 24.5 years. Mean choroidal area was 0.5554 ± 0.1377 mm2. Mean stromal area was 0.2524 ± 0.0762 mm2, and mean vascular region area was 0.3029 ± 0.0893 mm2. The percentage of choroidal vascularity (vascular area/total area) was 54.40 ± 8.35%. Choroid area, vascular region, and percentage of choroidal vascular density were statistically higher in the <18-year-old group versus the >18-year-old group (P < 0.001). The stromal region was not different (P = 0.46). In the same way, choroid area, vascular region, and percentage of choroidal vascular density between the 5 age groups were statistically different (P < 0.001), showing larger figures in the 0 to 10-year-old group, but not stromal region (P = 0.71). There were no gender-related differences.

Conclusion:
The luminal area and the percentage of vascular/total area decrease with increasing age, while the stromal area remains stable.
Is there still a role for hypothermia in neurocritical care?
Authors: Frank Florian , Broessner Gregor 
Published: February 2017

Purpose of review
Therapeutic hypothermia (i.e. induced body core temperature ≈ 33–35°C) in neurological patients with cerebrovascular disease and traumatic brain injury is a controversially discussed issue in the literature. In this review, we have included the most recently published research covering the use of therapeutic hypothermia and targeted temperature management in neurologic diseases and translated the results into a clinical decision support for the professional healthcare community.

Recent findings
Recent findings from large multicenter studies investigating therapeutic hypothermia in patients with various acute neurologic diseases have revealed that although short-term and long-term temperature modulation on different temperature levels is feasible with the latest device technology, the effect on outcome is controversial.

Summary
There is overwhelming evidence that fever is an independent predictor of morbidity and mortality in patients with acute severe neurologic diseases. Although therapeutic hypothermia has been proven to be a potent neuroprotective measure acting on various levels in animal models, many questions such as optimal depth of target temperature, speed of rewarming, duration of cooling and management of side-effects accompanying therapeutic hypothermia are unresolved in human. Therefore, the application of therapeutic hypothermia outside of strictly supervised clinical trials must be carefully considered.
Diagnosis of a malignant adrenal mass: the role of urinary steroid metabolite profiling
Authors: Bancos Irina , Arlt Wiebke 
Published: February 2017

Purpose of review
Adrenal masses are highly prevalent, found in 5% of the population. Differentiation of benign adrenocortical adenoma from adrenocortical carcinoma is currently hampered by the poor specificity and limited evidence base of imaging tests. This review summarizes the results of studies published to date on urine steroid metabolite profiling for distinguishing benign from malignant adrenal masses.

Recent findings
Three studies have described cohorts of at least 100 patients with adrenal tumors showing significant differences between urinary steroid metabolite excretions according to the nature of the underlying lesion, suggesting significant value of steroid metabolite profiling as a highly accurate diagnostic test.

Summary
Steroid profiling is emerging as a powerful novel diagnostic tool with a significant potential for improving the management for patients with adrenal tumors. Although the current studies use gas chromatography–mass spectrometry for proof of concept, widespread use of the method in routine clinical care will depend on transferring the approach to high-throughput tandem mass spectrometry platforms. The use of computational data analysis in conjunction with urine steroid metabolite profiling, that is, steroid metabolomics, adds accuracy and precision.
Clinical significance of 11-oxygenated androgens
Authors: Turcu Adina F. , Auchus Richard J. 
Published: February 2017

Purpose of review
The adrenal gland is considered a source of weak androgens, such as dehydroepiandrosterone, dehydroepiandrosterone sulfate, and androstenedione. Emerging evidence proposes a set of 11-oxygenated 19-carbon (11oxC19) adrenal-derived steroids as clinically important androgens. Such steroids include 11β-hydroxyandrostenedione, 11-ketoandrostenedione, 11β-hydroxytestosterone, and 11-ketotestosterone. The present review will discuss the synthesis, androgenic activity, and clinical implications of the 11oxC19 steroids.

Recent findings
The clinical relevance of the 11oxC19 steroids resides in two key characteristics: the synthesis of all 11oxC19 originates predominantly in the adrenal cortex, and 11-ketotestosterone and its 5α-reduced metabolite, 11-ketodihydrotestosterone are potent agonists of the human androgen receptor, similar to the classic androgens testosterone and dihydrotestosterone, respectively. Recent studies have demonstrated higher than normal circulating levels of 11oxC19 steroids in patients with 21-hydroxylase deficiency and in polycystic ovary syndrome. The 11oxC19 steroids are also thought to contribute to castration-resistant prostate cancer progression. In addition, the 11oxC19 steroids might have clinical implications in adrenarche and postmenopausal women.

Summary
Future prospective studies are needed to establish the clinical utility of the 11oxC19 steroids for individualized patient care. Preliminary data suggest that these biomarkers hold promise to improve the evaluation and management of androgen excess disorders.
Chronic Health Outcomes and Prescription Drug Copayments in Medicaid
Authors: Kostova Deliana , Fox Jared 
Published: February 2017

Background:
Prescription drug copayments and cost-sharing have been linked to reductions in prescription drug use and expenditures. However, little is known about their effect on specific health outcomes.

Objective:
To evaluate the association between prescription drug copayments and uncontrolled hypertension, uncontrolled hypercholesterolemia, and prescription drug utilization among Medicaid beneficiaries with these conditions.

Subjects:
Select adults aged 20–64 from NHANES 1999–2012 in 18 states.

Measures:
Uncontrolled hypertension, uncontrolled hypercholesterolemia, and taking medication for each of these conditions.

Research Design:
A differencing regression model was used to evaluate health outcomes among Medicaid beneficiaries in 4 states that introduced copayments during the study period, relative to 2 comparison groups—Medicaid beneficiaries in 14 states unaffected by shifts in copayment policy, and a within-state counterfactual group of low-income adults not on Medicaid, while controlling for individual demographic factors and unobserved state-level characteristics.

Results:
Although uncontrolled hypertension and hypercholesterolemia declined among all low-income persons during the study period, the trend was less pronounced in Medicaid beneficiaries affected by copayments. After netting out concurrent trends in health outcomes of low-income persons unaffected by Medicaid copayment changes, we estimated that introduction of drug copayments in Medicaid was associated with an average rise in uncontrolled hypertension and uncontrolled hypercholesterolemia of 7.7 and 13.2 percentage points, respectively, and with reduced drug utilization for hypercholesterolemia.

Conclusions:
As Medicaid programs change in the years following the Affordable Care Act, prescription drug copayments may play a role as a lever for controlling hypertension and hypercholesterolemia at the population level.
Defining Potentially Preventable Adverse Outcomes in Medicare Elective Lung Resections
Authors: Fry Donald E. , Pine Michael , Nedza Susan M. , Locke David G. , Reband Agnes M. , Pine Gregory 
Published: February 2017

Objective
The aims of the study were to develop risk-adjusted models and apply them for comparisons of hospital performance to define potentially preventable adverse outcomes (OAs) in Medicare lung resection surgery.

Methods
The Medicare Limited Data Set for 2010–2012 was used to design predictive risk models for the four OAs of inpatient deaths, prolonged length-of-stay outliers, 90-day postdischarge deaths without hospital readmission, and 90-day readmissions after removal of unrelated readmission events. The probability of adverse events for each hospital was used to compute the hospital-specific standard deviation (SD) tailored to patient risk profiles. Observed versus predicted adverse events divided by the hospital-specific SD identified the z score for each hospital. Risk-adjusted OA rates were then computed for comparing hospital performance.

Results
A total of 39,405 lung resection patients from 739 hospitals had 768 inpatient deaths (1.9%), 3147 had prolonged LOS (8.0%), 514 had 90-day postdischarge deaths without readmission (1.3 %), and 7701 had one or more 90-day readmissions (19.5%); 10,924 patients (27.7%) had one or more of these OAs. Twenty-six hospitals were two SDs better than predicted and 34 hospitals were two SDs poorer than predicted. When evaluated by deciles of risk-adjusted OAs, the top performing decile of hospitals had rates of 14.3% and the poorest performing decile had OA rates of 41.0%.

Conclusions
The differences in risk-adjusted comparative outcomes between top- and suboptimal-performing hospitals in lung resections define the potential opportunities for care improvement. Identification of risk factors associated with OAs and causes for readmissions provides direction for specific areas of care redesign for improvement.
Lowering Perfusate Temperature From 37°C to 32°C Diminishes Function in a Porcine Model of Ex Vivo Kidney Perfusion
Authors: Adams Thomas D. , Patel Meeta , Hosgood Sarah A. , Nicholson Michael L. 
Published: February 2017

Background
Ex vivo perfusion (EVP) is a novel method of preservation. However, optimal perfusion conditions remain undetermined. Reducing the temperature of the perfusate to subnormothermia may be beneficial during EVP and improve early graft function. The aim of this study was to investigate whether subnormothermia would influence the conditioning effect of EVP when compared with normothermic perfusion, and standard cold static storage (CS).

Methods
Porcine kidneys underwent static CS for 23 hours followed by 1 hour of EVP using leukocyte-depleted blood at a mean temperature of 32°C or 37°C. After this, kidneys were reperfused with whole autologous blood at 37°C for 3 hours to assess renal function and injury. These were compared with a control group that underwent 24 hours CS.

Results
During EVP, kidneys perfused at 37°C had a higher level of renal blood flow and oxygen consumption compared with EVP at 32°C (P = 0.001, 0.002). During reperfusion, 32°C EVP kidneys had lower creatinine clearance and urine output than control (P = 0.023, 0.011) and a higher fractional excretion of sodium, serum potassium, and serum aspartate transaminase than 37°C EVP kidneys (P = 0.01, 0.023, 0.009).

Conclusions
Tubular and renal functions were better preserved by a near-physiological temperature of 37°C during 1 hour of EVP, when compared to EVP at 32°C or cold storage.
Mobility as the purpose of postural control
Authors: Mouel Charlotte Le , Brette Romain 
Published: February 2017

AbstractCounteracting the destabilizing force of gravity is usually considered to be the main purpose of postural control. However, from the consideration of the mechanical requirements for movement, we argue that posture is adjusted in view of providing impetus for movement. Thus, we show that the posture that is usually adopted in quiet standing in fact allows torque for potential movement. Moreover, when performing a movement - either voluntarily or in response to an external perturbation - we show that the postural adjustments are organized both spatially and temporally so as to provide the required torque for the movement. Thus, when movement is performed skillfully, the force of gravity is not counteracted but actually used to provide impetus to movement. This ability to move one’s weight so as to exploit the torque of gravity seems to be dependent on development and skill learning, and is impaired in aging.
The recombinase protein is a torque sensitive molecular switch
Authors: Atwell Scott X. , Dupont Aurélie , Migliozzi Daniel , Viovy Jean-Louis , Cappello Giovanni 
Published: February 2017

AbstractHow a nano-searcher finds its nano-target isa general problem in non-equilibrium statistical physics. It becomesvital when the searcher is a damaged DNA fragmenttrying to find its counterpart on the intact homologous chromosome. If the two copies are paired, that intact homologous sequence serves as a template to reconstitute the damaged DNA sequence, enabling the cell to survive without genetic mutations. To succeed, the search must stop only when the perfect homology is found. The biological process that ensures such a genomic integrity is calledHomologous Recombinationand is promoted by the Recombinase proteins. In this article, we use torque-sensitive magnetic tweezers to measure the free-energy landscape of the human Recombinase hRad51 protein assembled a DNA fragment. Based on our measurements we model the hRad51/DNA complex as an out-of-equilibrium two-state system and provide a thermodynamical description of Homologous Recombination. With this dynamical two-state model, we suggest a mechanism by which the recombinase proteins discriminate between homologous and a nonhomologous sequences.
The Sequence of 1504 Mutants in the Model Rice Variety Kitaake Facilitates Rapid Functional Genomic Studies
Authors: Li Guotian , Jain Rashmi , Chern Mawsheng , Pham Nikki T. , Martin Joel A. , Wei Tong , Schackwitz Wendy S. , Lipzen Anna M. , Duong Phat Q. , Jones Kyle C. , Jiang Liangrong , Ruan Deling , Bauer Diane , Peng Yi , Barry Kerrie W. , Schmutz Jeremy , Ronald Pamela C. 
Published: February 2017

ABSTRACTThe availability of a whole-genome sequenced mutant population and the cataloging of mutations of each line at a single-nucleotide resolution facilitates functional genomic analysis. To this end, we generated and sequenced a fast-neutron-induced mutant population in the model rice cultivar Kitaake (Oryza sativa L. ssp. japonica), which completes its life cycle in 9 weeks. We sequenced 1,504 mutant lines at 45-fold coverage and identified 91,513 mutations affecting 32,307 genes, 58% of all rice genes. We detected an average of 61 mutations per line. Mutation types include single base substitutions, deletions, insertions, inversions, translocations, and tandem duplications. We observed a high proportion of loss-of-function mutations. Using this mutant population, we identified an inversion affecting a single gene as the causative mutation for the short-grain phenotype in one mutant line with a small segregating population. This result reveals the usefulness of the resource for efficient identification of genes conferring specific phenotypes. To facilitate public access to this genetic resource, we established an open access database called KitBase that provides access to sequence data and seed stocks, enabling rapid functional genomic studies of rice.One-sentence summaryWe have sequenced 1,504 mutant lines generated in the short life cycle rice variety Kitaake (9 weeks) and established a publicly available database, enabling rapid functional genomic studies of rice.