bluuebunny/crossref_metadata_2025_split huggingface dataset:
A qualitative study of adolescents with medically unexplained symptoms and their parents. Part 2: How is healthcare perceived?
Authors: Moulin V. , Akre C. , Rodondi P.‐Y. , Ambresin A.‐E. , Suris J.‐C. 
Published: October 2015

ABSTRACTMedically unexplained symptoms (MUS) are common among adolescents and an important cause of clinical visits. This study sought to understand the experiences with, and perceptions of, the healthcare of adolescents who have MUS and their parents. Using a qualitative approach, six focus groups and two individual interviews were conducted with a total of ten adolescents and sixteen parents. The participants were recruited in a university hospital in Switzerland. A thematic analysis was conducted in accordance with the Grounded Theory. Six main themes emerged: needing a label for the symptoms, seeking an etiology to explain the symptoms, negotiating the medical system, medication and treatments, interactions with doctors, and the inclusion of parents during consultations. Transcending these themes, however, was the need for good communication between the adolescents, their parents and the clinicians. When explaining the symptoms, clinicians should make sure to discuss the results, investigations and lack of organic origin.
Differential genetic and environmental influences on developmental trajectories of antisocial behavior from adolescence to young adulthood
Authors: Zheng Yao , Cleveland H. Harrington 
Published: October 2015

ABSTRACTLittle research has investigated differential genetic and environmental influences on different developmental trajectories of antisocial behavior. This study examined genetic and environmental influences on liabilities of being in life‐course‐persistent (LCP) and adolescent‐limited (AL) type delinquent groups from adolescence to young adulthood while considering nonviolent and violent delinquency subtypes and gender differences. A genetically informative sample (n = 356, 15–16 years) from the first three waves of In‐Home Interview of the National Longitudinal Study of Adolescent to Adult Health was used, with 94 monozygotic and 84 dizygotic pairs of same‐sex twins (50% male). Biometric liability threshold models were fit and found that the male‐specific LCP type class, chronic, showed more genetic influences, while the AL type classes, decliner and desister, showed more environmental influences. Genetic liability and shared environment both influence the persistence of antisocial behavior. The development of female antisocial behavior appears to be influenced more by shared environment.
Lifestyle intervention for gestational diabetes mellitus prevention: A cluster‐randomized controlled study
Authors: Wang Shuang , Ma Jing‐Mei , Yang Hui‐Xia 
Published: October 2015

AbstractObjectiveThe study was to examine whether gestational diabetes mellitus (GDM) can be prevented by early trimester lifestyle counseling in a high‐risk population.MethodsFrom September 2012 to January 2013, 1664 pregnancies in the Department of Obstetrics and Gynecology of First Hospital of Peking University were enrolled in the study during their first prenatal care visit before the 8 gestational weeks visit and asked to fill out a questionnaire on GDM risk evaluation. According to the questionnaire and medical records, those with at least one risk factor of GDM were included in the intervention study and randomly allocated to two groups, intervention group and control group. Routine prenatal care was offered, while standardized two‐step lifestyle intervention was provided to the intervention group during 6–8 gestational weeks, and at 12–13 gestational weeks, enforcement intervention based on maternal anthropometrics were offered. Both groups were followed until 75 g oral glucose tolerance test (OGTT) testing at 24–28 gestational weeks. The weight gain after intervention and the prevalence of GDM were used to evaluate the effect.Results(1) According to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria, the positive rate of GDM for the intervention group was 17.16% (23/134), lower than the control group which was 23.91% (33/138), P = 0.168. (2) The weight gain during the first and second trimester for the intervention group was (1.38 ± 2.34) kg and (5.51 ± 2.18) kg, lower than in the control group which was (1.41 ± 2.58) kg and (5.66 ± 2.25) kg, (P = 0.905, P = 0.567). (3) Positive rate of GDM for those fasting plasma glucose (FPG) ≥5.1 mmol/L during early pregnancy was 11/36 (30.55%) for the intervention group that was lower than 17/37 (45.95%) for the control group, but the statistical difference was not significant (P = 0.076).ConclusionThe positive rate of GDM could be reduced by a certain amount lifestyle intervention from the beginning of pregnancy. More validated effective intervention should be explored in the high‐risk pregnant women.
Keap1–Nrf2 pathway: A promising target towards lung cancer prevention and therapeutics
Authors: Tong Ying‐Hui , Zhang Bo , Fan Yun , Lin Neng‐Ming 
Published: October 2015

AbstractObjectivesDrugs for targeted therapy have become a new strategy of adjuvant therapy for treatment of lung cancer. The Keap1 (kelch‐like ECH‐associated protein 1)–Nrf2 (nuclear factor erythroid 2‐related factor 2) pathway is recognized to be critical in regulating genes related to the cellular protective response and protecting cells from oxidative damages and toxic insult.MethodsPubmed, Embase, OVID, and the Cochrane Library databases were searched from the beginning of each database without any limitations to the date of publication. Search terms were “Nrf2” or “Keap1” and “Lung cancer”.ResultsThe upregulation of Nrf2 had been closely related to tumor protection and drug resistance. The aberrant state of Keap1 or Nrf2 that were frequently found in lung cancer conferred a poor prognosis. Nrf2 could prevent cells from undergoing oncogenesis as a tumor suppressor, while it could also promote cancer progression and resistance to chemotherapeutic drugs as an oncogene, depending on the different stages of tumor progression. Target Nrf2 signaling by specific chemicals showed it could prevent tumor growth or combat chemoresistance.ConclusionsIncreasing evidence has demonstrated the dual roles of the Keap1–Nrf2 pathway in tumor initiation and progression. In this paper, we provide a comprehensive overview of the potency of the Keap1–Nrf2 pathway as an antitumor target, and the current status of Nrf2 activators or inhibitors for therapeutic approaches. Further studies are required to clarify the role of Nrf2 in lung cancer at different tumor stages, in order to maximize the efficacy of Keap1–Nrf2 targeting agents.
Differential impacts of duration of untreated psychosis (DUP) on cognitive function in first-episode schizophrenia according to mode of onset
Authors: Ito S. , Nemoto T. , Tsujino N. , Ohmuro N. , Matsumoto K. , Matsuoka H. , Tanaka K. , Nishiyama S. , Suzuki M. , Kinoshita H. , Ozawa H. , Fujita H. , Shimodera S. , Kishimoto T. , Matsumoto K. , Hasegawa T. , Mizuno M. 
Published: October 2015

AbstractBackgroundThe mode of onset and the course of schizophrenia illness exhibit substantial individual variations. Previous studies have pointed out that the mode of onset affects the duration of untreated psychosis (DUP) and clinical outcomes, such as cognitive and social functioning. This study attempted to clarify the association between the DUP and clinical features, taking the different modes of onset into consideration, in a prospective longitudinal study examining patients with first-episode schizophrenia.MethodsThis study was conducted in six areas of Japan. Patients with first-episode schizophrenia were followed for over 18 months. Cognitive function, psychopathology, and social functioning were assessed at baseline and at 6, 12, and 18-month follow-up points.ResultsWe identified 168 patients and sufficient information was available to determine the DUP and the mode of onset for 156 patients (92.9%): 79 had an acute onset, and 77 had an insidious onset. The DUP was significantly associated with quality of life (QOL), social functioning, and cognitive function at most of the follow-up points in the insidious-onset group. The DUP and negative symptoms at baseline were significant predictors of cognitive function at the 18-month follow-up in the insidious-onset group.ConclusionsThe present results further support the hypothesis that the DUP affects QOL, social functioning, and cognitive function over the course of illness, especially in patients with an insidious onset. Effective strategies for detecting and caring for individuals with insidious onset early during the course of schizophrenia will be essential for achieving a full patient recovery.
Clinical and prognostic value of combined measurement of cytokines and vascular cell adhesion molecule‐1 in premature rupture of membranes
Authors: Wang Ying , Wang Hong‐Ling , Chen Jie , Sun Jing‐Xia 
Published: October 2015

AbstractObjective: To evaluate whether levels of interleukin 6 (IL‐6), interleukin 8 (IL‐8), and vascular cell adhesion molecule‐1 (VCAM‐1) in women with premature rupture of membranes (PROM) differ from those in women without PROM. Methods: An observational study of full‐term primiparous pregnant women with PROM (PROM group) and those undergoing elective cesarean delivery (control group) was performed at a center in Yangzhou, China, between January 2003 and July 2006. IL‐6, IL‐8, and VCAM‐1 levels were measured in maternal blood, cord blood, and amniotic fluid. A pathologic examination of fetal membranes was conducted. Results: The IL‐6, IL‐8, and VCAM‐1 levels in maternal serum, amniotic fluid, and cord blood were significantly higher in the PROM group (n = 58) than in the control group (n = 38; P < 0.05 for all comparisons). In the PROM group, the levels increased with duration of membrane rupture (P < 0.05 for all). Women with chorioamnionitis had significantly higher levels than women without chorioamnionitis (P < 0.05 for all), and women with PROM whose newborns had low Apgar score (≤ 7) had higher levels than those whose newborns had a higher Apgar score (P < 0.05 for all). Conclusion: Combined measurements of IL‐6, IL‐8, and VCAM‐1 might help to improve early diagnosis of PROM and chorioamnionitis, and to evaluate the prognosis of newborns.
Randomized double‐blind placebo‐controlled trial of buccal misoprostol to reduce the need for additional uterotonic drugs during cesarean delivery
Authors: Hernández‐Castro Flavio , López‐Serna Norberto , Treviño‐Salinas Emilio M , Soria‐López Juan A , Sordia‐Hernández Luis H , Cárdenas‐Estrada Eloy 
Published: October 2015

AbstractObjectiveTo determine whether buccal misoprostol during cesarean delivery in conjunction with active management of the third stage of labor reduces the need for additional uterotonic drugs.MethodA double‐blind, randomized, placebo‐controlled trial was performed in Monterrey, Mexico, between February 2008 and December 2013. Eligible women had risk factors for uterine atony and were to undergo cesarean delivery under epidural block. Using a computer‐generated sequence and blocks of six, patients were randomly assigned to receive 400 μg misoprostol or 800 μg placebo buccally after cord clamping. Both groups received an intravenous oxytocin infusion. The primary outcome was the need for additional uterotonic drugs. Analyses were performed per protocol. Patients, investigators, and data analysts were masked to group assignment.ResultsA total of 120 women were included in analyses (60 in each group). At least one additional uterotonic drug was required in 24 (40%) women in the placebo group versus 6 (10%) women in the misoprostol group (relative risk 0.16; 95% confidence interval 0.06–0.44). No adverse effects due to misoprostol were recorded.ConclusionBuccal misoprostol during cesarean delivery reduced the need for additional uterotonic drugs to treat uterine atony.ClinicalTrials.gov: NCT01733329
Development of a novel set of criteria to select methodology for designing product service systems
Authors: Tran Tuananh , Park Joon Young 
Published: October 2015

Abstract
This paper proposes eight groups of twenty nine scoring criteria that can help designers and practitioners to compare and select an appropriate methodology for a certain problem in designing product service system (PSS). PSS has been researched for more than a decade and is now becoming more and more popular in academia as well as industry. Despite that fact, the adoption of PSS is still limited for its potential. One of the main reasons is that designing PSS itself is a challenge. Designers and developers face difficulties in choosing appropriate PSS design methodologies for their projects so that they can design effective PSS offerings. By proposing eight groups of twenty nine scoring criteria, this paper enables a “step by step” process to identify the most appropriate design methodology for a company's PSS problem. An example is also introduced to illustrate the use of the proposed scoring criteria and provide a clear picture of how different design methodologies can be utilized at their best in terms of application.
Highlights This paper proposes eight groups of twenty nine scoring criteria that can help designers and practitioners to compare and select an appropriate methodology for a certain problem in designing product service system (PSS). This paper enables a “step by step” process to identify the most appropriate design methodology for a company's PSS problem. An example is also introduced to illustrate the use of the proposed scoring criteria and provide a clear picture of how different design methodologies can be utilized at their best in terms of application. An example is also introduced to illustrate the use of the proposed scoring criteria and provide a clear picture of how different design methodologies can be utilized at their best in terms of application.
Conversion to stem‐cell state in response to microenvironmental cues is regulated by balance between epithelial and mesenchymal features in lung cancer cells
Authors: Andriani Francesca , Bertolini Giulia , Facchinetti Federica , Baldoli Erika , Moro Massimo , Casalini Patrizia , Caserini Roberto , Milione Massimo , Leone Giorgia , Pelosi Giuseppe , Pastorino Ugo , Sozzi Gabriella , Roz Luca 
Published: October 2015

Cancer cells within a tumor are functionally heterogeneous and specific subpopulations, defined as cancer initiating cells (CICs), are endowed with higher tumor forming potential. The CIC state, however, is not hierarchically stable and conversion of non‐CICs to CICs under microenvironment signals might represent a determinant of tumor aggressiveness. How plasticity is regulated at the cellular level is however poorly understood. To identify determinants of plasticity in lung cancer we exposed eight different cell lines to TGFβ1 to induce EMT and stimulate modulation of CD133+ CICs. We show that response to TGFβ1 treatment is heterogeneous with some cells readily switching to stem cell state (1.5–2 fold CICs increase) and others being unresponsive to stimulation. This response is unrelated to original CICs content or extent of EMT engagement but is tightly dependent on balance between epithelial and mesenchymal features as measured by the ratio of expression of CDH1 (E‐cadherin) to SNAI2. Epigenetic modulation of this balance can restore sensitivity of unresponsive models to microenvironmental stimuli, including those elicited by cancer‐associated fibroblasts both in vitro and in vivo. In particular, tumors with increased prevalence of cells with features of partial EMT (hybrid epithelial/mesenchymal phenotype) are endowed with the highest plasticity and specific patterns of expression of SNAI2 and CDH1 markers identify a subset of tumors with worse prognosis. In conclusion, here we describe a connection between a hybrid epithelial/mesenchymal phenotype and conversion to stem‐cell state in response to external stimuli. These findings have implications for current endeavors to identify tumors with increased plasticity.
Comparative Sensitivity of Intraoperative Motor Evoked Potential Monitoring in Predicting Postoperative Neurologic Deficits: Nondegenerative versus Degenerative Myelopathy
Authors: Clark Aaron J. , Safaee Michael , Chou Dean , Weinstein Philip R. , Molinaro Annette M. , Clark John P. , Mummaneni Praveen V. 
Published: October 2015

Study Design Retrospective review. Objective Intraoperative motor evoked potential (MEP) monitoring in spine surgery may assist surgeons in taking corrective measures to prevent neurologic deficits. The efficacy of monitoring MEPs intraoperatively in patients with myelopathy from nondegenerative causes has not been quantified. We compared the sensitivity and specificity of intraoperative MEP monitoring in patients with myelopathy caused by nondegenerative processes to patients with degenerative cervicothoracic spondylotic myelopathy (CSM). Methods We retrospectively reviewed our myelopathy surgical cases during a 1-year period to identify patients with degenerative CSM and CSM of nondegenerative causes and collected data on intraoperative MEP changes and postoperative new deficits. Categorical variables were analyzed by Fisher exact test. Receiver operator curves assessed intraoperative MEP monitoring performance in the two groups. Results In all, 144 patients were identified: 102 had degenerative CSM and 42 had CSM of nondegenerative causes (24 extra-axial tumors, 12 infectious processes, 5 traumatic fractures, and 1 rheumatoid arthritis). For degenerative CSM, there were 11 intraoperative MEP alerts and 7 new deficits ( p < 0.001). The corresponding sensitivity was 71% and the specificity was 94%. In the nondegenerative group, there were 11 intraoperative MEP alerts and 3 deficits, which was not significant ( p > 0.99). The sensitivity (33%) and specificity (74%) were lower. Among patients with degenerative CSM, the model performed well for predicting postoperative deficits (area under the curve [AUC] 0.826), which appeared better than the nondegenerative group, although it did not reach statistical significance (AUC 0.538, p = 0.16). Conclusions Based on this large retrospective analysis, intraoperative MEP monitoring in surgery for nondegenerative CSM cases appears to be less sensitive to cord injury and less predictive of postoperative deficits when compared with degenerative CSM cases.
BGT: efficient and flexible genotype query across many samples
Authors: Li Heng 
Published: October 2015

Abstract
Summary: BGT is a compact format, a fast command line tool and a simple web application for efficient and convenient query of whole-genome genotypes and frequencies across tens to hundreds of thousands of samples. On real data, it encodes the haplotypes of 32 488 samples across 39.2 million SNPs into a 7.4 GB database and decodes up to 420 million genotypes per CPU second. The high performance enables real-time responses to complex queries.
Availability and implementation: https://github.com/lh3/bgt
Contact: hengli@broadinstitute.org
The minimum evolution problem is hard: a link between tree inference and graph clustering problems
Authors: Bastkowski Sarah , Moulton Vincent , Spillner Andreas , Wu Taoyang 
Published: October 2015

AbstractMotivation: Distance methods are well suited for constructing massive phylogenetic trees. However, the computational complexity for Rzhetsky and Nei’s minimum evolution (ME) approach, one of the earliest methods for constructing a phylogenetic tree from a distance matrix, remains open.Results: We show that Rzhetsky and Nei’s ME problem is NP-complete, and so probably computationally intractable. We do this by linking the ME problem to a graph clustering problem called the quasi-clique decomposition problem, which has recently also been shown to be NP-complete. We also discuss how this link could potentially open up some useful new connections between phylogenetics and graph clustering.Contact: taoyang.wu@uea.ac.ukSupplementary information: Supplementary data are available at Bioinformatics online.
Provider variation in responses to warnings: do the same providers run stop signs repeatedly?
Authors: Beeler Patrick E , Orav E John , Seger Diane L , Dykes Patricia C , Bates David W 
Published: October 2015

AbstractObjective Variation in the use of tests and treatments has been demonstrated to be substantial between providers and geographic regions. This study assessed variation between outpatient providers in overriding electronic prescribing warnings.Methods Responses to warnings were prospectively logged. Random effects models were used to calculate provider-to-provider variation in the rates for the decisions to override warnings in 6 different clinical domains: medication allergies, drug-drug interactions, duplicate drugs, renal recommendations, age-based recommendations, and formulary substitutions.Results A total of 157 482 responses were logged. Differences between 1717 providers accounted for 11% of the overall variability in override rates, so that while the average override rate was 45.2%, individual provider rates had a wide range with a 95% confidence interval (CI) (13.7%-76.7% ). The highest variations between providers were observed in the categories age-based (25.4% of total variability; average override rate 70.2% [95% CI, 29.1%-100% ]) and renal recommendations (24.2%; average 70% [95% CI, 29.5%-100% ]), and provider responses within these 2 categories were most often clinically inappropriate according to prior work. Among providers who received at least 10 age-based recommendations, 64 of 238 (27%) overrode ≥ 90% of the warnings and 13 of 238 (5%) overrode all of them. Of those who received at least 10 renal recommendations, 36 of 92 (39%) overrode ≥ 90% of the alerts and 9 of 92 (10%) overrode all of them.Conclusions The decision to override prescribing warnings shows variation between providers, and the magnitude of variation differs among the clinical domains of the warnings; more variation was observed in areas with more inappropriate overrides.
Alert dwell time: introduction of a measure to evaluate interruptive clinical decision support alerts
Authors: McDaniel Robert B , Burlison Jonathan D , Baker Donald K , Hasan Murad , Robertson Jennifer , Hartford Christine , Howard Scott C , Sablauer Andras , Hoffman James M 
Published: October 2015

Abstract
Metrics for evaluating interruptive prescribing alerts have many limitations. Additional methods are needed to identify opportunities to improve alerting systems and prevent alert fatigue. In this study, the authors determined whether alert dwell time—the time elapsed from when an interruptive alert is generated to when it is dismissed—could be calculated by using historical alert data from log files. Drug–drug interaction (DDI) alerts from 3 years of electronic health record data were queried. Alert dwell time was calculated for 25,965 alerts, including 777 unique DDIs. The median alert dwell time was 8 s (range, 1–4913 s). Resident physicians had longer median alert dwell times than other prescribers ( P &lt;  .001). The 10 most frequent DDI alerts ( n =  8759 alerts) had shorter median dwell times than alerts that only occurred once ( P &lt;  .001). This metric can be used in future research to evaluate the effectiveness and efficiency of interruptive prescribing alerts.