bluuebunny/crossref_metadata_2025_split huggingface dataset:
Palliative Care Problem Severity Score: Reliability and acceptability in a national study
Authors: Masso Malcolm , Allingham Samuel Frederic , Johnson Claire Elizabeth , Pidgeon Tanya , Yates Patsy , Currow David , Eagar Kathy 
Published: October 2015

Background: The Palliative Care Problem Severity Score is a clinician-rated tool to assess problem severity in four palliative care domains (pain, other symptoms, psychological/spiritual, family/carer problems) using a 4-point categorical scale (absent, mild, moderate, severe). Aim: To test the reliability and acceptability of the Palliative Care Problem Severity Score. Design: Multi-centre, cross-sectional study involving pairs of clinicians independently rating problem severity using the tool. Setting/participants: Clinicians from 10 Australian palliative care services: 9 inpatient units and 1 mixed inpatient/community-based service. Results: A total of 102 clinicians participated, with almost 600 paired assessments completed for each domain, involving 420 patients. A total of 91% of paired assessments were undertaken within 2 h. Strength of agreement for three of the four domains was moderate: pain (Kappa = 0.42, 95% confidence interval = 0.36 to 0.49); psychological/spiritual (Kappa = 0.48, 95% confidence interval = 0.42 to 0.54); family/carer (Kappa = 0.45, 95% confidence interval = 0.40 to 0.52). Strength of agreement for the remaining domain (other symptoms) was fair (Kappa = 0.38, 95% confidence interval = 0.32 to 0.45). Conclusion: The Palliative Care Problem Severity Score is an acceptable measure, with moderate reliability across three domains. Variability in inter-rater reliability across sites and participant feedback indicate that ongoing education is required to ensure that clinicians understand the purpose of the tool and each of its domains. Raters familiar with the patient they were assessing found it easier to assign problem severity, but this did not improve inter-rater reliability.
The number of optic neuritis attacks is a potential confounder when comparing patients with NMO vs. controls by voxel-based neuroimaging analysis
Authors: Sánchez-Catasús Carlos A , Cabrera-Gomez José , Almaguer Melián William , Bosch Bayard Jorge , Rodríguez Rojas Rafael , Valdes-Sosa Pedro 
Published: October 2015

Background Voxel-based morphometric (VBM) studies in neuromyelitis optica (NMO) have shown limited reproducibility. A previous study suggests that the number of optic neuritis (ON) attacks may be a confounding factor when comparing NMO patients with controls if it is not taken into account during VBM analysis. Purpose To investigate the potential confounding effect of the number of ON attacks, for both tissue volumes and perfusion by voxel-based statistical analysis. Material and Methods Volumetric magnetic resonance imaging (MRI) and perfusion SPECT were obtained from 15 controls and two patient subgroups: subgroup I was composed of nine patients with one or two ON attacks; and subgroup II of six patients with three or four ON attacks. We performed non-parametric voxel-based comparison of tissue volumes and perfusion between controls versus the two patient subgroups and for the whole patient group. Results Subgroup I presented no volume reductions, contrary to subgroup II that showed unequivocal reduction. We also found hypoperfusion in different brain regions in different subgroups. The results were quite different for the whole patient group. Conclusion These findings highlight the confounding effect of the number of ON attacks, providing a new methodological insight that could explain the limited reproducibility of previous VBM studies in NMO.
Virtual stenting of intracranial aneurysms: application of hemodynamic modification analysis
Authors: Song Yunsun , Choe Jooae , Liu Hairi , Park Kye Jin , Yu HyungBin , Lim Ok Kyun , Kim Hyoweon , Park Darlene , Ge Jiajia , Suh Dae Chul 
Published: October 2015

Background Practical application of hemodynamic modification analysis based on computational fluid dynamics (CFD) in intracranial aneurysms is still under study. Purpose To determine the clinical applicability of virtual stenting of aneurysms by comparing the simulated results with clinical outcome of real stenting. Material and Methods Three-dimensional (3D) digital subtraction angiography (DSA) images were imported to a dedicated integrated prototypic CFD platform (Siemens Healthcare GmbH) which allows all necessary steps of 3D models for CFD analysis. The results of CFD simulation with virtual implantation of a stent can be visualized in the same platform for qualitative comparisons on a color-coded volume visualization window. Five small intracranial aneurysms with and without virtual stenting were analyzed and assessed on a qualitative level. Expert rating were performed for evaluating the simulated results, and comparing those to the long-term follow-up outcomes of real stenting. Results CFD simulation after virtual stenting was feasible in five differently located aneurysms and corresponded to the long-term changes of stented aneurysms by showing alteration in flow pattern. There was no significant difference ( P = 0.5) between the simulated hemodynamic changes after virtual stenting and the angiographic changes after stenting in four aneurysms except one. There was good agreement regarding the assessment of the changes by two raters (kappa = 0.657). Conclusion CFD analysis using patient-specific virtual stenting of the CFD platform may be used as a simple and less time-consuming test tool predicting the involution of aneurysms after stent placement by analyzing the vector visualization of the flow changes.
The influence of genetic constitution on migraine drug responses
Authors: Christensen Anne Francke , Esserlind Ann-Louise , Werge Thomas , Stefánsson Hreinn , Stefánsson Kári , Olesen Jes 
Published: October 2015

Objective Specific acute treatments of migraine are 5HT1B/D receptor agonists; triptans and ergotamine, but only two-thirds of patients respond well without side effects. No migraine-prophylactic drugs are specific to migraine. Prophylactic drugs are selected by time-consuming “trial and error.” Personalized treatment is therefore much needed. The objective of this study was to test the effect of 12 single nucleotide polymorphisms (SNPs) significantly associated with migraine on migraine drug responses. Methods Semi-structured migraine interviews including questions on drug responses, blood samples and genotyping were performed on 1806 unrelated migraine cases recruited from the Danish Headache Center. Association analyses were carried out using logistic regression, assuming an additive model for the genetic effect. The effect on drug responses was tested for a combined genetic score and for each of the 12 SNPs. Significant findings were subsequently tested in an independent replication sample of 392 unrelated Danish migraine cases. Results A single risk variant, rs2651899 in PRDM16, was significantly associated with efficacy of triptans with an odds ratio (OR) of treatment success of 1.3, and a higher combined genetic score was significantly associated with efficacy of triptans with an OR of success of up to 2.6. A number of SNPs showed nominal preferential association with the efficacy of triptans and others with prophylactic drugs. Analyses of triptans and ergotamine complemented each other and gave a stronger signal when analyzed together. The associations between response to triptans and genetic load and rs2651899 were partially confirmed in the independent sample. Conclusion We show for the first time an association between genetic constitution and migraine drug response. This is a first step toward future individualized medicine.
The Association between Discrimination and Psychological and Social Well-being
Authors: Castaneda Anu E. , Rask Shadia , Koponen Päivikki , Suvisaari Jaana , Koskinen Seppo , Härkänen Tommi , Mannila Simo , Laitinen Kari , Jukarainen Pirjo , Jasinskaja-Lahti Inga 
Published: October 2015

Background Discrimination is known to negatively affect the psychological well-being of migrants. Less is known on the association between discrimination and social well-being. Aim We examined the association between experienced discrimination and psychological (mental health, quality of life) and social well-being (loneliness, feelings of safety, trust towards society) in Russian, Somali and Kurdish migrants in Finland. Methods We used data from the Finnish Migrant Health and Wellbeing Study (Maamu). The participants comprised 1795 persons of Russian, Somali or Kurdish origin aged 18–64 years. Experiences of discrimination, loneliness, safety and trust towards society were measured using interview questions. Mental health symptoms were measured using the HSCL-25 and quality of life using EUROHIS-QOL. Logistic regression analyses were conducted to investigate the associations between discrimination and psychological and social well-being, separately for the three ethnic groups. Results Discrimination increased the odds for mental health symptoms and decreased the odds for quality of life among Russian and Kurdish migrants, but not Somalis. Discrimination was associated with feeling unsafe and decreased trust towards society among all migrants. Among Kurds, discrimination increased the odds also for loneliness. Conclusions Discrimination is an essential threat to the psychological and social well-being of Russian, Somali or Kurdish migrants.
‘Welcoming the Other’: psychodrama in an acute inpatient unit
Authors: Michael Lorraine 
Published: October 2015

Objective: In this article, the author uses the leitmotifs inherent in a critically acclaimed film and in the philosophy of Emmanuel Levinas as a backdrop for discussion around how we encounter the humanity in the Other and its particular relevance for psychiatry. She proceeds to describe the existential underpinnings of psychodrama and demonstrates how she has been directing a psychodrama group, ‘Theatre of Life’, which has been operating for well over a decade within a public mental health system, acute inpatient unit. Through the ensuing discussion, she illustrates how the humanistic ethic of ‘welcoming the Other’ is actualised in the ‘here-and now’ of the psychodrama group psychotherapy process. Conclusions: A thematic analysis derived from group-members’ evaluation of each session illuminates their felt sense depicting the ethic in action.
Spin echo transverse relaxation and atrophy in multiple sclerosis deep gray matter: A two-year longitudinal study
Authors: Uddin Md Nasir , Lebel R Marc , Seres Peter , Blevins Gregg , Wilman Alan H 
Published: October 2015

Background: Deep gray matter (DGM) is affected in relapsing–remitting multiple sclerosis (RRMS) and may be studied using short-term longitudinal MRI. Objective: To investigate two-year changes in spin-echo transverse relaxation rate (R2) and atrophy in DGM, and its relationship with disease severity in RRMS patients. Methods: Twenty six RRMS patients and 26 matched controls were imaged at 4.7 T. Multiecho spin-echo R2 maps and atrophy measurements were obtained in DGM at baseline and two-year follow-up. Differences between MRI measures and correlations to disease severity were examined. Results: After two years, mean R2 values in the globus pallidus and pulvinar increased by ~4% ( p<0.001) in patients and <1.7% in controls. Two-year changes in R2 showed significant correlation to disease severity in the globus pallidus, pulvinar, substantia nigra, and thalamus. Multiple regression of the two-year R2 difference using these four DGM structures as variables, yielded high correlation with disease severity ( r=0.83, p<0.001). Two-year changes in volume and R2 showed significant correlation only for the globus pallidus in multiple sclerosis (MS) ( p<0.05). Conclusions: Two-year difference R2 measurements in DGM correlate to disease severity in MS. R2 mapping and atrophy measurements over two years can be used to identify changes in DGM in MS.
Interleukin-27: a novel biomarker in predicting bacterial infection among the critically ill
Authors: Hanna William J. , Berrens Zachary , Langner Travis , Lahni Patrick , Wong Hector R. 
Published: October 2015

Abstract
Introduction
A continued need exists for effective diagnostic biomarkers in bacterial sepsis among critically ill patients, despite increasing use of available biomarkers such as procalcitonin (PCT). Interleukin-27 (IL-27) has shown early promise in a recent preliminary study, exhibiting high specificity and positive predictive values for bacterial infection in critically ill children. This validation study was performed to assess the value of IL-27 in predicting bacterial infection among patients admitted to the pediatric intensive care unit and to compare its performance with that of PCT.

Methods
A single-center (n = 702) prospective study was performed comparing both IL-27 and PCT levels between bacterially infected and uninfected cohorts in the pediatric intensive care unit. Infected status was determined by a chart review by an intensivist blinded to biomarker results. Formal performance comparisons included calculations of receiver operating characteristic (ROC) curves for IL-27 and PCT individually in addition to a combination strategy using a decision tree generated by classification and regression tree (CART) methodology. Secondary analysis focusing on subjects with documented bloodstream infections was performed.

Results
The overall infection rate was 27 %. ROC curves for the primary analysis yielded areas under the curve (AUCs) of 0.64 (0.59 to 0.68) for IL-27 and 0.61 (0.56 to 0.65) for PCT. Secondary analysis defining infected status exclusively through positive blood cultures yielded AUCs of 0.75 (0.68 to 0.81) for IL-27 and 0.64 (0.57 to 0.71) for PCT, with a specificity of 95 % (92 % to 97 %) for the prior established IL-27 cut-point value of at least 5.0 ng/ml. Similar AUCs were found for the subset of immunocompromised patients. In a CART-derived analysis taking immunocompromised status into consideration, a combination of IL-27 and PCT yielded an AUC of 0.81 (0.75 to 0.86), statistically improved from either IL-27 or PCT alone.

Conclusions
Despite having a modest predictive value for infection independent of source, IL-27 may serve as a useful biomarker in estimating risk of bacterial infection among critically ill pediatric patients with bloodstream infections. In particular, among immunocompromised subjects, this diagnostic biomarker may be helpful either alone or using a combination strategy with other available biomarkers.
Biomarkers from distinct biological pathways improve early risk stratification in medical emergency patients: the multinational, prospective, observational TRIAGE study
Authors: Schuetz Philipp , Hausfater Pierre , Amin Devendra , Amin Adina , Haubitz Sebastian , Faessler Lukas , Kutz Alexander , Conca Antoinette , Reutlinger Barbara , Canavaggio Pauline , Sauvin Gabrielle , Bernard Maguy , Huber Andreas , Mueller Beat ,   for the TRIAGE Study group
Published: October 2015

Abstract
Introduction
Early risk stratification in the emergency department (ED) is vital to reduce time to effective treatment in high-risk patients and to improve patient flow. Yet, there is a lack of investigations evaluating the incremental usefulness of multiple biomarkers measured upon admission from distinct biological pathways for predicting fatal outcome and high initial treatment urgency in unselected ED patients in a multicenter and multinational setting.

Method
We included consecutive, adult, medical patients seeking ED care into this observational, cohort study in Switzerland, France and the USA. We recorded initial clinical parameters and batch-measured prognostic biomarkers of inflammation (pro-adrenomedullin [ProADM]), stress (copeptin) and infection (procalcitonin).

Results
During a 30-day follow-up, 331 of 7132 (4.6 %) participants reached the primary endpoint of death within 30 days. In logistic regression models adjusted for conventional risk factors available at ED admission, all three biomarkers strongly predicted the risk of death (AUC 0.83, 0.78 and 0.75), ICU admission (AUC 0.67, 0.69 and 0.62) and high initial triage priority (0.67, 0.66 and 0.58). For the prediction of death, ProADM significantly improved regression models including (a) clinical information available at ED admission (AUC increase from 0.79 to 0.84), (b) full clinical information at ED discharge (AUC increase from 0.85 to 0.88), and (c) triage information (AUC increase from 0.67 to 0.83) (p <0.01 for each comparison). Similarly, ProADM also improved clinical models for prediction of ICU admission and high initial treatment urgency. Results were robust in regard to predefined patient subgroups by center, main diagnosis, presenting symptoms, age and gender.

Conclusions
Combination of clinical information with results of blood biomarkers measured upon ED admission allows early and more adequate risk stratification in individual unselected medical ED patients. A randomized trial is needed to answer the question whether biomarker-guided initial patient triage reduces time to initial treatment of high-risk patients in the ED and thereby improves patient flow and clinical outcomes.

Trial registration
ClinicalTrials.gov NCT01768494. Registered January 9, 2013.
Genomic information of the arsenic-resistant bacterium Lysobacter arseniciresistens type strain ZS79T and comparison of Lysobacter draft genomes
Authors: Liu Lin , Zhang Shengzhe , Luo Meizhong , Wang Gejiao 
Published: October 2015

AbstractLysobacter arseniciresistens ZS79T is a highly arsenic-resistant,rod-shaped, motile, non-spore-forming, aerobic, Gram-negative bacterium. In this study, four Lysobacter type strains were sequenced and the genomic information of L. arseniciresistens ZS79T and the comparative genomics results of the Lysobacter strains were described. The draft genome sequence of the strain ZS79T consists of 3,086,721 bp and is distributed in 109 contigs. It has a G+C content of 69.5 % and contains 2,363 protein-coding genes including eight arsenic resistant genes.
Intensive Multiagent Therapy, Including Dose-Compressed Cycles of Ifosfamide/Etoposide and Vincristine/Doxorubicin/Cyclophosphamide, Irinotecan, and Radiation, in Patients With High-Risk Rhabdomyosarcoma: A Report From the Children's Oncology Group
Authors: Weigel Brenda J. , Lyden Elizabeth , Anderson James R. , Meyer William H. , Parham David M. , Rodeberg David A. , Michalski Jeff M. , Hawkins Douglas S. , Arndt Carola A.S. 
Published: October 2015

Purpose Patients with metastatic rhabdomyosarcoma (RMS), except those younger than 10 years with embryonal RMS, have an estimated long-term event-free survival (EFS) of less than 20%. The main goal of this study was to improve outcome of patients with metastatic RMS by dose intensification with interval compression, use of the most active agents determined in phase II window studies, and use of irinotecan as a radiation sensitizer. Patients and Methods Patients with metastatic RMS received 54 weeks of therapy: blocks of therapy with vincristine/irinotecan (weeks 1 to 6, 20 to 25, and 47 to 52), interval compression with vincristine/doxorubicin/cyclophosphamide alternating with etoposide/ifosfamide (weeks 7 to 19 and 26 to 34), and vincristine/dactinomycin/cyclophosphamide (weeks 38 to 46). Radiation therapy occurred at weeks 20 to 25 (primary) but was also permitted at weeks 1 to 6 (for intracranial or paraspinal extension) and weeks 47 to 52 (for extensive metastatic sites). Results One hundred nine eligible patients were enrolled, with a median follow-up of surviving patients of 3.8 years (3-year EFS for all patients, 38% [95% CI, 29% to 48%]; survival, 56% [95% CI, 46% to 66%]). Patients with one or no Oberlin risk factor (age > 10 years or < 1 year, unfavorable primary site of disease, ≥ three metastatic sites, and bone or bone marrow involvement) had a 3-year EFS of 69% (95% CI, 52% to 82%); high-risk patients with two or more risk factors had a 3-year EFS of 20% (95% CI, 11% to 30%). Toxicity was similar to that on prior RMS studies. Conclusion Patients with metastatic RMS with one or no Oberlin risk factor had an improved 3-year EFS of 69% on ARST0431 compared with an historical cohort from pooled European and US studies; those with two or more risk factors have a dismal prognosis, and new approaches are needed for this very-high-risk group.
Importance of Adult Dmbx1 in Long-Lasting Orexigenic Effect of Agouti-Related Peptide
Authors: Hirono Seiichiro , Lee Eun Young , Kuribayashi Shunsuke , Fukuda Takahiro , Saeki Naokatsu , Minokoshi Yasuhiko , Iwanaga Toshihiko , Miki Takashi 
Published: October 2015

Abstract
Dmbx1 is a brain-specific homeodomain transcription factor expressed primarily during embryogenesis, and its systemic disruption (Dmbx1−/−) in the ICR mouse strain resulted in leanness associated with impaired long-lasting orexigenic effect of agouti-related peptide (AgRP). Because spatial and temporal expression patterns of Dmbx1 change dramatically during embryogenesis, it remains unknown when and where Dmbx1 plays a critical role in energy homeostasis. In the present study, the physiological roles of Dmbx1 were examined by its conditional disruption (Dmbx1loxP/loxP) in the C57BL/6 mouse strain. Although Dmbx1 disruption in fetal brain resulted in neonatal lethality, its disruption by synapsin promoter-driven Cre recombinase, which eliminated Dmbx1 expression postnatally, exempted the mice (Syn-Cre;Dmbx1loxP/loxP mice) from lethality. Syn-Cre;Dmbx1loxP/loxP mice show mild leanness and impaired long-lasting orexigenic action of AgRP, demonstrating the physiological relevance of Dmbx1 in the adult. Visualization of Dmbx1-expressing neurons in adult brain using the mice harboring tamoxifen-inducible Cre recombinase in the Dmbx1 locus (Dmbx1CreERT2/+ mice) revealed Dmbx1 expression in small numbers of neurons in restricted regions, including the lateral parabrachial nucleus (LPB). Notably, c-Fos expression in LPB was increased at 48 hours after AgRP administration in Dmbx1loxP/loxP mice but not in Syn-Cre;Dmbx1loxP/loxP mice. These c-Fos-positive neurons in LPB did not coincide with neurons expressing Dmbx1 or melanocortin 4 receptor but did coincide with those expressing calcitonin gene-related peptide. Accordingly, Dmbx1 in the adult LPB is required for the long-lasting orexigenic effect of AgRP via the neural circuitry involving calcitonin gene-related peptide neurons.
Inhibition of motor neuron death in vitro and in vivo by a p75 neurotrophin receptor intracellular domain fragment
Authors: Matusica Dusan , Alfonsi Fabienne , Turner Bradley J. , Butler Tim J. , Shepheard Stephanie R. , Rogers Mary-Louise , Skeldal Sune , Underwood Clare K. , Mangelsdorf Marie , Coulson Elizabeth J. 
Published: October 2015

ABSTRACT
The p75 neurotrophin receptor (p75NTR; also known as NGFR) can mediate neuronal apoptosis in disease or following trauma, and facilitate survival through interactions with Trk receptors. Here we tested the ability of a p75NTR-derived trophic cell-permeable peptide, c29, to inhibit p75NTR-mediated motor neuron death. Acute c29 application to axotomized motor neuron axons decreased cell death, and systemic c29 treatment of SOD1G93A mice, a common model of amyotrophic lateral sclerosis, resulted in increased spinal motor neuron survival mid-disease as well as delayed disease onset. Coincident with this, c29 treatment of these mice reduced the production of p75NTR cleavage products. Although c29 treatment inhibited mature- and pro-nerve-growth-factor-induced death of cultured motor neurons, and these ligands induced the cleavage of p75NTR in motor-neuron-like NSC-34 cells, there was no direct effect of c29 on p75NTR cleavage. Rather, c29 promoted motor neuron survival in vitro by enhancing the activation of TrkB-dependent signaling pathways, provided that low levels of brain-derived neurotrophic factor (BDNF) were present, an effect that was replicated in vivo in SOD1G93A mice. We conclude that the c29 peptide facilitates BDNF-dependent survival of motor neurons in vitro and in vivo.