bluuebunny/crossref_metadata_2025_split huggingface dataset:
A new vision of actinic keratosis beyond visible clinical lesions
Authors: Malvehy J. 
Published: December 2014

AbstractIn actinic keratosis (AK), clinical and subclinical lesions coexist across large areas of sun‐exposed skin resulting in field cancerization. The lesions are part of a disease continuum which can progress into invasive squamous cell carcinoma (SCC). Conventional biopsy sampling together with histopathological analysis of the excised tissue is still the gold standard for differentially diagnosing AK from invasive SCC and identifying the characteristic pathophysiological features of these lesions. Given that biopsy sampling is invasive and not suited to the investigation of disease across large fields of skin, several imaging technologies have been applied to non‐invasively investigate AK. Widely available imaging technologies such as cross‐polarized light, fluorescence and dermoscopy can assist the dermatologist in diagnosing AK and in identifying different types of AK lesions. Modern imaging technologies such as reflectance confocal microscopy (RCM) and high‐definition optical coherence tomography (HD‐OCT) provide high‐resolution images of the skin. These techniques can be used to image the histological changes that characterize AK and so can be used to diagnose the disease and its severity. They can also identify the presence of subclinical lesions and non‐invasively monitor the effects of AK treatments on both subclinical and clinical lesions over time. Both RCM and HD‐OCT have revealed a new vision of AK by visualizing in detail the cellular and histological changes that characterize both clinical and subclinical lesions, and confirming that the disease affects the entire sun‐exposed field. As a consequence of these findings, the target for the treatment of AK now needs to be the detection and clearance of all clinical and subclinical lesions across the entire sun‐exposed field.
Interdisciplinary workshop in the philosophy of medicine: medical knowledge, medical duties
Authors: Bullock Emma , Kingma Elselijn 
Published: December 2014

AbstractOn 27 September 2013, the Centre for the Humanities and Health (CHH) at King's College London hosted a 1‐day workshop on ‘Medical knowledge, Medical Duties’. This workshop was the fifth in a series of five workshops whose aim is to provide a new model for high‐quality, open interdisciplinary engagement between medical professionals and philosophers. This report identifies the key points of discussion raised throughout the day and the methodology employed.
Determining differences in user performance between expert and novice primary care doctors when using an electronic health record (EHR)
Authors: Clarke Martina A. , Belden Jeffery L. , Kim Min Soon 
Published: December 2014

AbstractRationale, aims and objectivesThe goal of this study is to determine usability gaps between expert and novice primary care doctors when using an electronic health record (EHR).MethodsUsability tests using video analyses with triangular method approach were conducted to analyse usability gaps between 10 novice and seven expert doctors. Doctors completed 19 tasks, using think‐aloud strategy, based on an artificial but typical patient visit note. The usability session lasted approximately 20 minutes. The testing room consisted of the participant and the facilitator. Mixed methods approach including four sets of performance measures, system usability scale (SUS), and debriefing session with participants was used.ResultsWhile most expert doctors completed tasks more efficiently, and provided a higher SUS score than novice doctors (novice 68, expert 70 out of 100 being perfect score), the result of ‘percent task success rate’ were comparable (74% for expert group, 78% for novice group, P = 0.98) on all 19 tasks.ConclusionThis study found a lack of expertise among doctors with more experience using the system demonstrating that although expert doctors have been using the system longer, their proficiency did not increase with EHR experience. These results may potentially improve the EHR training programme, which may increase doctors' performance when using an EHR. These results may also assist EHR vendors in improving the user interface, which may aid in reducing errors caused from poor usability of the system.
Association of weight gain since age 20 with non‐alcoholic fatty liver disease in normal weight individuals
Authors: Kimura Takeshi , Deshpande Gautam A , Urayama Kevin Y , Masuda Katsunori , Fukui Tsuguya , Matsuyama Yutaka 
Published: December 2014

AbstractBackground and AimsInterventions for lifestyle diseases including non‐alcoholic fatty liver disease (NAFLD) have focused on overweight and obese populations. The impact of adult weight gain on NAFLD development among normal weight individuals remains unclear.MethodsIn this cross‐sectional study, we collected data from participants presenting to a health check‐up program. Ultrasound‐diagnosed NAFLD prevalence was examined over 1‐kg increments of weight change since age 20. Relative risks were calculated in men and women stratified by current weight (normal, overweight, and obese). Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) adjusting for potential confounders.ResultsAmong 21 496 participants, 3498 cases of NAFLD (16.3%) were observed. Prevalence of NAFLD increased with weight gain since age 20; among the 10.1–11.0 kg weight gain group, 41.6% of men and 24.8% of women had NAFLD. Multivariate analysis by quartiles showed that weight change was significantly associated with NAFLD risk in men and women. Risk of NAFLD associated with weight change (10‐kg increments) was significantly higher in normal weight individuals (men: OR 7.53, 95% CI: 4.99–11.36, women: OR 12.20, 95% CI: 7.45–19.98) than overweight (men: OR 1.61, 95% CI: 0.91–2.85, women: OR 2.90, 95% CI: 0.99–8.54) and obese (men: OR 4.0, 95% CI: 2.97–5.39, women: OR 2.68, 95% CI: 2.00–3.60).ConclusionsNAFLD is robustly associated with weight change since age 20. This effect appears particularly strong in individuals at normal weight, suggesting an important role for early and longitudinal weight monitoring, even among healthy individuals at normal weight.
Small intestinal bacterial overgrowth as an uncommon cause of false positive lactose hydrogen breath test among patients with diarrhea‐predominant irritable bowel syndrome in Asia
Authors: Wang Yilin , Xiong Lishou , Gong Xiaorong , Li Weimin , Zhang Xiangsong , Chen Minhu 
Published: December 2014

AbstractBackground and AimIt has been reported that small intestinal bacterial overgrowth (SIBO) may lead to false positive diagnoses of lactose malabsorption (LM) in irritable bowel syndrome patients. The aim of this study was to determine the influence of SIBO on lactose hydrogen breath test (HBT) results in these patients.MethodsDiarrhea‐predominant irritable bowel syndrome patients with abnormal lactose HBTs ingested a test meal containing 99mTc and lactose. The location of the test meal and the breath levels of hydrogen were recorded simultaneously by scintigraphic scanning and lactose HBT, respectively. The increase in hydrogen concentration was not considered to be caused by SIBO if ≥ 10% of 99mTc accumulated in the cecal region at the time or before of abnormal lactose HBT.ResultsLM was present in 84% (31/37) of irritable bowel syndrome patients. Twenty of these patients agreed to measurement of oro‐cecal transit time. Only three patients (15%) with abnormal lactose HBT might have had SIBO. The median oro‐cecal transit time between LM and lactose intolerance patients were 75 min and 45 min, respectively (Z = 2.545, P = 0.011).ConclusionsMost of irritable bowel syndrome patients with an abnormal lactose HBT had LM. SIBO had little impact on the interpretation of lactose HBTs. The patients with lactose intolerance had faster small intestinal transit than LM patients.
Anatomy of the proximal tibiofibular joint and interosseous membrane, and their contributions to joint kinematics in below‐knee amputations
Authors: Burkhart Timothy A. , Asa Benjamin , Payne Michael W. C. , Johnson Marjorie , Dunning Cynthia E. , Wilson Timothy D. 
Published: December 2014

AbstractA result of below‐knee amputations (BKAs) is abnormal motion that occurs about the proximal tibiofibular joint (PTFJ). While it is known that joint morphology may play a role in joint kinematics, this is not well understood with respect to the PTFJ. Therefore, the purposes of this study were: (i) to characterize the anatomy of the PTFJ and statistically analyze the relationships within the joint; and (ii) to determine the relationships between the PTFJ characteristics and the degree of movement of the fibula in BKAs. The PTFJ was characterized in 40 embalmed specimens disarticulated at the knee, and amputated through the mid‐tibia and fibula. Four metrics were measured: inclination angle (angle at which the fibula articulates with the tibia); tibial and fibular articular surface areas; articular surface concavity and shape. The specimens were mechanically tested by applying a load through the biceps femoris tendon, and the degree of motion about the tibiofibular joint was measured. Regression analyses were performed to determine the relationships between the different PTFJ characteristics and the magnitude of fibular abduction. Finally, Pearson correlation analyses were performed on inclination angle and surface area vs. fibular kinematics. The inclination angle measured on the fibula was significantly greater than that measured on the tibia. This difference may be attributed to differences in concavity of the tibial and fibular surfaces. Surface area measured on the tibia and fibula was not statistically different. The inclination angle was not statistically correlated to surface area. However, when correlating fibular kinematics in BKAs, inclination angle was positively correlated to the degree of fibular abduction, whereas surface area was negatively correlated. The characteristics of the PTFJ dictate the amount of fibular movement, specifically, fibular abduction in BKAs. Predicting BKA complications based on PTFJ characteristics can lead to recommendations in treatment.
A CONDITIONALLY PARAMETRIC PROBIT MODEL OF MICRODATA LAND USE IN CHICAGO
Authors: McMillen Daniel , Soppelsa Maria Edisa 
Published: December 2014

ABSTRACTSpatial data sets pose challenges for discrete choice models because the data are unlikely to be independently and identically distributed. A conditionally parametric spatial probit model is amenable to very large data sets while imposing far less structure on the data than conventional parametric models. We illustrate the approach using data on 474,170 individual lots in the City of Chicago. The results suggest that simple functional forms are not appropriate for explaining the spatial variation in residential land use across the entire city.
Sequential keratinocytic differentiation and maturation in a three‐dimensional model of human artificial oral mucosa
Authors: Viñuela‐Prieto J. M. , Sánchez‐Quevedo M. C. , Alfonso‐Rodríguez C. A. , Oliveira A. C. , Scionti G. , Martín‐Piedra M. A. , Moreu G. , Campos A. , Alaminos M. , Garzón I. 
Published: December 2014

Background and ObjectiveOral mucosa shortage may limit or condition some clinical approaches in maxillofacial, periodontal and implant treatment. The availability of a human oral mucosa model generated by tissue engineering could help clinicians to address the lack of oral mucosa. In this work, we carried out a sequential maturation and differentiation study of the epithelial cell layer of an artificial human oral mucosa substitute based on fibrin–agarose biomaterials with fibroblasts and keratinocytes.Material and MethodsHistological, immunohistochemical and gene expression analyses were carried out in artificial human oral mucosa models developed and cultured for 1, 2 and 3 wk.ResultsArtificial oral mucosa models showed expression of tight junction proteins and cytokeratins from the first week of in vitro development. Mature samples of 3 wk of development subjected to air–liquid conditions showed signs of epithelial differentiation and expressed specific RNAs and proteins corresponding to adherent and gap junctions and basement lamina. Moreover, these mature samples overexpressed some desmosomal and tight junction transcripts, with gap junction components being downregulated.ConclusionThese results suggest that bioengineered human oral mucosa substitutes form a well‐developed epithelial layer that was very similar to human native tissues. In consequence, the epithelial layer could be fully functional in these oral mucosa substitutes, thus implying that these tissues may have clinical usefulness.
Optimizing Location and Capacity for Multiple Types of Locomotive Maintenance Shops
Authors: Xie Weijun , Ouyang* Yanfeng , Somani Kamalesh 
Published: December 2014

AbstractThousands of locomotives run in the North America railroad network and each of them must receive periodic maintenance service; meanwhile, the locomotives may break down during shipment operations and demand repair. Maintenance shops are characterized by the types of locomotives they can handle and the level of service they can provide. This article formulates a mixed‐integer program model to optimize location and capacity of locomotive maintenance shops. The objective is to minimize the sum of the costs for building new (or shutting down existing) maintenance shops, the costs for capacity expansion (or reduction), and the costs for shipping broken locomotives to a suitable shop. A Lagrangian‐relaxation‐based heuristic algorithm is proposed to solve the shop location and capacity planning problem. The model and solution techniques are applied to a full‐scale real‐world case study, while the computational results show that the current maintenance shops are overly built and recommend that two maintenance shops should be closed and an amount of capacities should be reduced from the existing shops. A series of numerical sensitivity analyses are also conducted to draw managerial insights.
Constipation is not associated with colonic diverticula: a multicenter study in Japan
Authors: Yamada E. , Inamori M. , Watanabe S. , Sato T. , Tagri M. , Uchida E. , Tanida E. , Izumi M. , Takeshita K. , Fujisawa N. , Komatsu K. , Hamanaka J. , Kanesaki A. , Matsuhashi N. , Nakajima A. 
Published: December 2014

AbstractBackgroundThe association of diverticula with bowel habits is unclear. We therefore analyzed the association between diverticula and bowel habits in over 1000 Japanese individuals.MethodsJapanese subjects who underwent total colonoscopies at seven centers in Japan from June to September 2013 were analyzed. Bowel habits were evaluated using the Gastrointestinal Symptom Rating Scale, and stool form was assessed using a part of the Bristol Scale and Rome ΙΙΙ criteria. Diverticula were diagnosed by colonoscopy with a transparent soft‐short hood.Key ResultsThe study evaluated 1066 subjects, 648 males and 418 females (ratio, 1.55 : 1), of mean age 63.9 ± 13.0 years. After adjusting for age and sex, the presence of constipation was associated with a significantly reduced likelihood of diverticula (odds ratio [OR] = 0.70, 95% confidence interval [CI] 0.52–0.93). When assessed according to the location of diverticula, the presence of constipation was associated with a significantly decreased likelihood of left‐sided (OR = 0.39, 95% CI 0.16–0.93), but not right‐sided (OR = 1.10, 95% CI 0.48–2.53), diverticula. Furthermore, stool form was unrelated with the presence or absence of diverticula.Conclusions & InferencesThe wide‐spread hypothesis that constipation was associated with colonic diverticula was not supported. Rather, we found that the absence of diverticula was associated with constipation, suggesting the need to reassess the etiology of colonic diverticula.
Predictors of Conversion of Recent‐Onset Atrial Fibrillation Treated with Vernakalant
Authors: COSTABEL JUAN P. , LAMBARDI FLORENCIA , ARAGÓN MARTIN , CAMPOS ROBERTO , URDAPILLETA MARCELA , ARIZNAVARRETA PAULA , VERGARA JUAN M. , CONDE DIEGO 
Published: December 2014

BackgroundVernakalant is an available drug for the treatment of recent‐onset atrial fibrillation, producing conversion between 55% and 87% of the patients treated. In this sense, little is known about the predictors of conversion with this agent. The aim of our study was to analyze the predictors of conversion in our 2‐year experience using vernakalant for the treatment of recent‐onset atrial fibrillation.MethodsOne hundred twenty‐one patients with recent‐onset atrial fibrillation without hemodynamic impairment received pharmacological treatment with vernakalant. Clinical variables, history of cardiovascular diseases, and echocardiographic data were recorded.ResultsMean age was 58.1 ± 13.9 years and 13.4% of patients had structural heart disease. Conversion to sinus rhythm was achieved in 84.5% of patients, and 46% required the second dose of vernakalant. After analyzing the predictors of conversion, the presence of structural heart disease was significantly larger in the group without conversion (35.3 vs 9.7%; P = 0.02). The mean ejection fraction in the group with conversion was 61.05 ± 5.7% versus 54.9 ± 8.4% in the group without conversion (P = 0.016). After dichotomizing the variable ejection fraction, patients with ejection fraction <55% had a lower conversion rate (P = 0.001).ConclusionIn our study, the absence of any kind of structural heart disease and preserved systolic function were associated with greater conversion rate with vernakalant.
Optimizing Radiofrequency Ablation of Paroxysmal and Persistent Atrial Fibrillation by Direct Catheter Force Measurement—A Case‐Matched Comparison in 198 Patients
Authors: SIGMUND ELISABETH , PUERERFELLNER HELMUT , DERNDORFER MICHAEL , KOLLIAS GEORGIOS , WINTER SIEGMUND , AICHINGER JOSEF , NESSER HANS‐JOACHIM , MARTINEK MARTIN 
Published: December 2014

BackgroundSufficient electrode‐tissue contact is crucial for adequate lesion formation in radiofrequency catheter ablation (RFCA).ObjectiveWe assessed the impact of direct catheter force measurement on acute procedural parameters and outcome of RFCA for paroxysmal and persistent atrial fibrillation (AF).MethodsNinety‐nine consecutive patients (70% men) with paroxysmal (63.6%) or persistent AF underwent left atrial RFCA using a 3.5‐mm open‐irrigated‐tip (OIT) catheter with contact force measurement capabilities (group 1). For comparison a case‐matched cohort with standard OIT catheters was used (99 patients; group 2). Case matching included gender, type of AF, number or RFCA procedures, and type of procedure.ResultsProcedural data showed a significant decline in radiofrequency ablation time from 52 ± 20 to 44 ± 16 minutes (P = 0.003) with a remarkable mean reduction in overall procedure time of 34 minutes (P = 0.0001; 225.8 ± 53.1 vs 191.9 ± 53.3 minutes). In parallel, the total fluoroscopy time could be significantly reduced from 28.5 ± 11.0 to 19.9 ± 9.3 minutes (P = 0.0001) as well as fluoroscopy dose from 74.1 ± 58.0 to 56.7 ± 38.9 Gy/cm2 (P = 0.016). Periprocedural complications were similar in both groups.ConclusionsThe use of contact force sensing technology is able to significantly reduce ablation, procedure, and fluoroscopy times as well as dose in RFCA of AF in a mixed case‐matched group of paroxysmal and persistent AF. Energy delivery is substantially reduced by avoiding radiofrequency ablation in positions with insufficient surface contact. Additionally 12‐month outcome data showed increased efficacy. Such time saving and equally safe technology may have a relevant impact on laboratory management and increased cost effectiveness.
A novel and fully scalable Agrobacterium spray‐based process for manufacturing cellulases and other cost‐sensitive proteins in plants
Authors: Hahn Simone , Giritch Anatoli , Bartels Doreen , Bortesi Luisa , Gleba Yuri 
Published: December 2014

SummaryTransient transfection of plants by vacuum infiltration of Agrobacterium vectors represents the state of the art in plant‐based protein manufacturing; however, the complexity and cost of this approach restrict it to pharmaceutical proteins. We demonstrated that simple spraying of Nicotiana plants with Agrobacterium vectors in the presence of a surfactant can substitute for vacuum inoculation. When the T‐DNA of Agrobacterium encodes viral replicons capable of cell‐to‐cell movement, up to 90% of the leaf cells can be transfected and express a recombinant protein at levels up to 50% of total soluble protein. This simple, fast and indefinitely scalable process was successfully applied to produce cellulases, one of the most volume‐ and cost‐sensitive biotechnology products. We demonstrate here for the first time that representatives of all hydrolase classes necessary for cellulosic biomass decomposition can be expressed at high levels, stored as silage without significant loss of activity and then used directly as enzyme additives. This process enables production of cellulases, and other potential high‐volume products such as noncaloric sweetener thaumatin and antiviral protein griffithsin, at commodity agricultural prices and could find broad applicability in the large‐scale production of many other cost‐sensitive proteins.
Pigment patterns in adult fish result from superimposition of two largely independent pigmentation mechanisms
Authors: Ceinos Rosa M. , Guillot Raúl , Kelsh Robert N. , Cerdá‐Reverter José M. , Rotllant Josep 
Published: December 2014

SummaryDorso‐ventral pigment pattern differences are the most widespread pigmentary adaptations in vertebrates. In mammals, this pattern is controlled by regulating melanin chemistry in melanocytes using a protein, agouti‐signalling peptide (ASIP). In fish, studies of pigment patterning have focused on stripe formation, identifying a core striping mechanism dependent upon interactions between different pigment cell types. In contrast, mechanisms driving the dorso‐ventral countershading pattern have been overlooked. Here, we demonstrate that, in fact, zebrafish utilize two distinct adult pigment patterning mechanisms – an ancient dorso‐ventral patterning mechanism, and a more recent striping mechanism based on cell–cell interactions; remarkably, the dorso‐ventral patterning mechanism also utilizes ASIP. These two mechanisms function largely independently, with resultant patterns superimposed to give the full pattern.
Quantification of Mirafiori lettuce big‐vein virus and its vector, Olpidium virulentus, from soil using real‐time PCR
Authors: Momonoi K. , Mori M. , Matsuura K. , Moriwaki J. , Morikawa T. 
Published: December 2014

Big vein disease of lettuce (Lactuca sativa) is an economically important disease transmitted through soil by Olpidium virulentus, and has occurred in most production areas worldwide. The disease is assumed to be caused by Mirafiori lettuce big‐vein virus (MiLBVV). To understand the dynamics of the virus and its vector, MiLBVV and O. virulentus were directly detected in soil. DNA and RNA were extracted from 5 g soil using a bead beating method, followed by purification using adsorption to a column. Detection and quantification were performed using real‐time PCR and a TaqMan probe that was prepared based on the CP region of MiLBVV and the rDNA‐ITS region of O. virulentus, respectively. Furthermore, using a visual assessment of the incidence rate of big vein disease on lettuce in agricultural fields, the Ct values of MiLBVV and O. virulentus from soil were also determined using real‐time PCR. The results showed that MiLBVV concentrations in the soil were high in the field, as also determined by a visual assessment of the incidence rate of big vein disease on lettuce. However, the amount of O. virulentus in soil was not directly correlated with the incidence of MiLBVV. From these results, it is suggested that the risk of lettuce crops developing big vein disease can be estimated using an index of the amount of MiLBVV in the soil.