bluuebunny/crossref_metadata_2025 huggingface dataset:
Sulfur Hexafluoride 20% Versus Air 100% for Anterior Chamber Tamponade in DMEK: A Meta-Analysis
Authors: Marques Raquel Esteves , Guerra Paulo Silva , Sousa David Cordeiro , Ferreira Nuno Pinto , Gonçalves Ana Inês , Quintas Ana Miguel , Rodrigues Walter
Published: March 2018

Purpose:

To compare intracameral 20% sulfur hexafluoride (SF6) versus 100% air as tamponade for graft attachment in Descemet membrane endothelial keratoplasty (DMEK).

Methods:

Using an electronic database search on MEDLINE and CENTRAL from inception to December 2017, we performed a literature review and meta-analysis including all comparative studies of SF6 at a 20% concentration (20% SF6) versus pure air (100% air) for anterior chamber tamponade in DMEK. The primary outcome was the rebubbling rate at the final observation. The secondary outcomes were 1) the graft detachment rate, 2) mean difference (MD) in best-corrected visual acuity (BCVA), 3) manifest refraction spherical equivalent, 4) central corneal thickness (CCT), 5) percentage of endothelial cell loss (ECL), and 6) rate of pupillary block by the final observation. Statistical analysis was performed using RevMan5.3 software.

Results:

Five retrospective studies were included, assessing 1195 eyes (SF6 277; air 918). The main indication for surgery was Fuchs endothelial dystrophy (SF6 85.2%; air 86.2%) and bullous keratopathy (SF6 10.8%; air 10.0%). Overall, studies were of moderate to good methodological quality. Patients in the SF6 group required 58% less rebubbling procedures (risk ratio 0.42, 95% confidence interval (CI), 0.31–0.56, P < 0.0001). No differences were found regarding BCVA improvement (MD 0.03, 95% CI, −0.05 to 0.11, P = 0.49). SF6 was associated with a minor hyperopic shift (MD 0.37 D, 95% CI, −0.95 to −0.21, P = 0.21). No differences were found regarding CCT, ECL, and rate of pupillary block (P > 0.05).

Conclusions:

In DMEK, 20% SF6 tamponade and longer postoperative time supine were associated with 58% fewer rebubbling procedures, and an ECL not statistically different from using 100% air.
Is Patient Knowledge of Glaucoma Improved by Using a Glaucoma Logbook?
Authors: Daly Rebecca , Agarwal Pankaj Kumar
Published: March 2018

Aims:

Patient-held records are becoming more commonly used in health care, particularly in chronic diseases like glaucoma. There is a lack of evidence to support their use, however. This study examines the change in knowledge scores within a group following the introduction of a newly designed glaucoma logbook.

Methods:

This analysis uses a test and retest method where patients undergoing treatment for glaucoma or ocular hypertension were assessed using a validated knowledge questionnaire. They were then given a personalized glaucoma logbook and their knowledge scores retested after 4 to 8 weeks. The change in knowledge score was examined using a Wilcoxon signed-rank test.

Results:

A total of 56 patients were recruited and 35 completed both questionnaires equating to a 62.5% retention rate. The analysis showed a significant increase in the knowledge score attained following introduction of the questionnaire (Z=−4.176, P<0.001).

Conclusions:

In this format, the glaucoma logbook has a positive impact on patient knowledge. Further research will be necessary to show if this result is maintained in a larger sample group and to investigate whether this improvement in knowledge is associated with any improvement in long-term structural and functional outcomes.
The Impact of Clinical Pathways on Antibiotic Prescribing for Acute Otitis Media and Pharyngitis in the Emergency Department
Authors: Dona Daniele , Baraldi Maura , Brigadoi Giulia , Lundin Rebecca , Perilongo Giorgio , Hamdy Rana F. , Zaoutis Theoklis , Da Dalt Liviana , Giaquinto Carlo
Published: March 2018

Background:

Although Italian pediatric antimicrobial prescription rates are among the highest in Europe, little action has been taken to improve the appropriateness of antimicrobial prescriptions. The primary aim of this study was to assess changes in antibiotic prescription before and after acute otitis media (AOM) and group A streptococcus (GAS) pharyngitis Clinical Pathway (CP) implementation; secondary aims were to compare treatment failures and to assess change in the total antibiotics costs before and after CP implementation.

Methods:

Pre-post quasi-experimental study comparing the 6-month period before CP implementation (baseline period: October 15, 2014, through April 15, 2015) to the 6 months after intervention (postintervention: October 15, 2015, through April 15, 2016).

Results:

Two hundred ninety-five pre- and 278 postintervention emergency department visits were associated with AOM. After CP implementation, there was an increase in “wait and see” approach and a decrease in overall prescription of broad-spectrum antibiotics from 53.2% to 32.4% (P < 0.001). One hundred fifty-one pre- and 166 postimplementation clinic visits were associated with GAS pharyngitis, with a decrease in broad-spectrum prescription after CP implementation (46.4% vs. 6.6%; P < 0.001). For both conditions, no difference was found in treatment failure, and total antibiotics cost was significantly reduced after CP implementation, with a decrease especially in broad-spectrum antibiotics costs.

Conclusions:

A reduction in broad-spectrum antibiotic prescriptions and a reduction in the total cost of antibiotics for AOM and GAS pharyngitis along with an increase in “wait and see” prescribing for AOM indicate effectiveness of CP for antimicrobial stewardship in this setting.
Effect of Coadministration of Lidocaine on the Pain and Pharmacokinetics of Intramuscular Amikacin in Children With Multidrug-Resistant Tuberculosis: A Randomized Crossover Trial
Authors: Garcia-Prats Anthony J. , Rose Penelope C. , Draper Heather R. , Seddon James A. , Norman Jennifer , McIlleron Helen M. , Hesseling Anneke C. , Schaaf H. Simon
Published: March 2018

Background:

Currently recommended treatment for multidrug-resistant (MDR) tuberculosis (TB) includes 4–8 months of an injectable medication, which is poorly tolerated. We evaluated the impact of coadministering lidocaine on pain and pharmacokinetics of intramuscular injections of amikacin in children with MDR-TB.

Methods:

Children 8–18 years of age, receiving amikacin for MDR-TB treatment in Cape Town, South Africa, were eligible for this randomized crossover trial. Participants received a 15 mg/kg dose of intramuscular amikacin with and without additional lidocaine (0.2–0.4 mg/kg) on different days and were randomized to the order of the treatments (the sequence). Participants and staff completing evaluations were blinded to sequence. Samples were drawn predose, and at 1, 2, 4, 6 and 8 hours postdose for measurement of plasma amikacin concentrations. Pain was assessed by participants using the Wong Baker FACES pain scale (0–5) predose, immediately after the injection and then at 30 and 60 minutes. Pharmacokinetic measures were calculated using noncompartmental analysis.

Results:

Twelve children were included, median age 11.5 years (interquartile range [IQR], 9.9–13.4 years). Participant-reported pain scores immediately after the amikacin injection were lower when lidocaine was coadministered: 1.0 (IQR, 0.5–2.0) with lidocaine versus 2.5 (1.0–4.0) without lidocaine (P = 0.004). The median area under the concentration time curve0–8 and median maximum plasma concentration of amikacin were 109.0 μg × h/mL (IQR, 84.7–121.3) and 36.7 μg/mL (IQR, 34.1–40.5) with lidocaine compared with 103.3 μg × h/mL (IQR, 81.7–135.0; P = 0.814) and 34.1 μg/mL (IQR, 35.6–46.4; P = 0.638) without lidocaine, respectively.

Conclusions:

The coadministration of lidocaine resulted in reduced pain immediately after the injection and did not alter amikacin area under the concentration time curve or maximum plasma concentration.
Thirty-Day Readmissions After Upper and Lower Gastrointestinal Hemorrhage
Authors: Patel Smit D. , Desai Rupak , Patel Upenkumar , Singh Sandeep , Patel Zinal , Patel Neel , Zhang Allan , Panwala Amruta H. , Khan Vinshi N. , Singh Gagandeep , Shah Nihar
Published: March 2018

Background:

Upper gastrointestinal hemorrhage (UGIH) and lower gastrointestinal hemorrhage (LGIH) are 2 of the most common reasons for hospital admissions across the United States. The 30-day readmission after index admission poses a major burden on the health care infrastructure, and thus, it is important to assess the causes of 30-day readmission for patients with UGIH and LGIH.

Methods:

The study cohort was derived from the 2013 National Readmission Database. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) Volume 3 diagnosis codes were utilized to identify UGIH and LGIH patients from this data set. Patients who were readmitted to the hospital within 30 days within the same calendar year were further analyzed. Categorical variables and continuous variables were assessed by the χ2 test and the student t test, respectively. The independent predictors of unplanned 30-day readmissions were recognized by multivariate logistic regression, adjusting for stratified cluster design of National Readmission Database. SAS 9.4 (SAS Institute Inc., Cary, NC) was used for data analysis.

Results:

The number of index admissions identified from the National Readmission Data 2013 were 82,290 for UGIH and 133,114 for LGIH. All-cause 30-day readmission rate for UGIH versus LGIH was 14.6% (readmitted N=12,046; 56.64% age 65 y and above) versus 14.4% (readmitted N=19,128; 70.21% age 65 y and above and 49.61% men). Gastrointestinal causes were most common (33.9% vs. 39.6%), followed by cardiac (13.3% vs. 15.3%), infectious (10.4% vs. 9.1%), and respiratory causes (7.8% vs. 7.1%) for 30-day readmission for UGIH and LGIH. Significant predictors of increased 30-day readmission (odds ratio, 95% confidence interval, P-value) included metastatic disease (2.15, 1.75-2.64, P<0.001), discharge against medical advice (1.85, 1.55-2.22, P<0.001), and length of stay >3 days (1.50, 1.38-1.63, P<0.001). Predictors for 30-day readmission for LGIH included metastatic disease (1.75, 1.48-2.06, P<0.001), liver disease (1.59, 1.49-1.71, P<0.001), and drug abuse (1.38, 1.21-1.58, P<0.001).

Conclusions:

Most common reason for UGIH and LGIH readmission was related to gastrointestinal disease, followed by cardiac, infectious, and respiratory etiologies. By addressing these etiologies for readmission, it may be possible to reduce adverse outcomes.
Metabolic Syndrome, Anxiety and Depression in a Sample of Italian Primary Care Patients
Authors: Mattei Giorgio , Padula Maria Stella , Rioli Giulia , Arginelli Lodovico , Bursi Roberto , Bursi Serena , Epifani Antonio Matteo , Pingani Luca , Rigatelli Marco , Rosato Francesca Maria , Sacchetti Andrea , Galeazzi Gian Maria , Ferrari Silvia
Published: March 2018

This cross-sectional study aimed at measuring the correlation and association of anxiety, depression and comorbid anxiety-depression symptoms with metabolic syndrome (MetS) in a sample of Italian primary care patients who attended their General Practitioner clinics over a 1-month period in 2013. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depressive symptoms. The sample was made up of 129 patients (57% women; mean age, 61 ± 12 years). The prevalence of MetS varied from 40% (Adult Treatment Panel III-Revised criteria) to 48% (International Diabetes Federation criteria). The prevalence of symptoms of anxiety, depression and comorbid anxiety and depression was, respectively, 26%, 2%, and 15%. MetS (defined according to Adult Treatment Panel III-Revised criteria) was associated with comorbid anxiety-depressive symptoms (odds ratio [OR] = 3.84, 95% confidence interval [CI] = 1.26–11.71), but not with anxiety or depressive symptoms only. Out of the individual components of MetS, enlarged waist circumference was associated with anxiety symptoms (OR = 4.22, 95% CI = 1.56–11.44).
Effects of Thickness on Corneal Biomechanical Properties Using Optical Coherence Elastography
Authors: Vantipalli Srilatha , Li Jiasong , Singh Manmohan , Aglyamov Salavat R. , Larin Kirill V. , Twa Michael D.
Published: March 2018

SIGNIFICANCE

Measured corneal biomechanical properties are driven by intraocular pressure, tissue thickness, and inherent material properties. We demonstrate tissue thickness as an important factor in the measurement of corneal biomechanics that can confound short-term effects due to UV riboflavin cross-linking (CXL) treatment.

PURPOSE

We isolate the effects of tissue thickness on the measured corneal biomechanical properties using optical coherence elastography by experimentally altering the tissue hydration state and stiffness.

METHODS

Dynamic optical coherence elastography was performed using phase-sensitive optical coherence tomography imaging to quantify the tissue deformation dynamics resulting from a spatially discrete, low-force air pulse (150-μm spot size; 0.8-millisecond duration; <10 Pa [<0.08 mmHg]). The time-dependent surface deformation is characterized by a viscoelastic tissue recovery response, quantified by an exponential decay constant—relaxation rate. Ex vivo rabbit globes (n = 10) with fixed intraocular pressure (15 mmHg) were topically instilled every 5 minutes with 0.9% saline for 60 minutes and 20% dextran for another 60 minutes. Measurements were made after every 20 minutes to determine the central corneal thickness (CCT) and the relaxation rates. Cross-linking treatment was performed on another 13 eyes, applying isotonic riboflavin (n = 6) and hypertonic riboflavin (n = 7) every 5 minutes for 30 minutes, followed by UV irradiation (365 nm, 3 mW/cm2) for 30 minutes while instilling riboflavin. Central corneal thickness and relaxation rates were obtained before and after CXL treatment.

RESULTS

Corneal thickness was positively correlated (R
2 = 0.9) with relaxation rates. In the CXL-treated eyes, isotonic riboflavin did not affect CCT and showed a significant increase in relaxation rates (+10%; P = .01) from 2.29 ms−1 to 2.53 ms−1. Hypertonic riboflavin showed a significant CCT decrease (−31%; P = .01) from 618 μm to 429 μm but showed little change in relaxation rates after CXL treatment.

CONCLUSIONS

Corneal thickness and stiffness are correlated positively. A higher relaxation rate implied stiffer material properties after isotonic CXL treatment. Hypertonic CXL treatment results in a stiffness decrease that offsets the stiffness increase with CXL treatment.
Individuals' Perspectives on Coping with Vision Loss from Diabetic Retinopathy
Authors: Sturrock Bonnie A. , Rees Gwyneth , Lamoureux Ecosse L. , Wong Tien Y. , Holloway Edith , Fenwick Eva K.
Published: March 2018

SIGNIFICANCE

People with vision loss from diabetic retinopathy (DR) and diabetic macular edema (DME) use problem-focused and emotion-regulation strategies that may influence their short- and longer-term adaptation and psychological outcomes. Our findings can assist the development of models of adjustment to DR/DME–related vision loss and treatments focused on adaptation.

PURPOSE

To qualitatively determine the coping strategies used by participants with vision loss resulting from DR/DME.

METHODS

Fifty-seven participants with DR/DME engaged in one of eight focus groups or one of 18 semistructured interviews. Participants were mostly older than 55 years (mean, 58.7 years) and male (68%) and had type 2 diabetes (74%; median duration, 17 years). Almost 50% had proliferative DR, 95% had undergone laser treatment, and 42% had DME; 68%, 14% and 14% had none, mild (<0.3 logarithm of the minimum angle of resolution ≤ 0.48), and moderate-severe vision impairment (>0.48 logarithm of the minimum angle of resolution) in the better eye. Focus groups/interviews were transcribed verbatim and iteratively analyzed using the constant comparative method. Qualitative software NVivo 2008 was used to sort/store the data. Our top-down and bottom-up approach to conceptualize the data was informed by the Transactional Model of Stress and Coping.

RESULTS

Coping efforts were mostly problem focused (64%) with seven subthemes: problem solving, passive coping, changing activities to suit a new ability level, active coping, rehearsing alternative outcomes, maintaining independence, and information seeking. Emotion-regulation strategies were distraction, acceptance, alternative adaptive thinking, avoidance, expressing emotions, denial, and changing emotions. Meaning-based coping strategies included mindfulness and engaging in meaningful activities. Themes relating to adaptation and moderators to coping (e.g., dispositional optimism) are outlined.

CONCLUSIONS

Participants described a variety of ways to cope. Some strategies are likely to improve functioning and decrease distress, whereas others are expected to reduce immediate distress while perpetuating this in the longer term. Our findings may assist researchers to develop models of adjustment to DR/DME-related vision loss and psychosocial/educational interventions focused on adaptation.
Autoimmune Sequelae Following Rituximab Therapy
Authors: Kersh Anna E. , Feldman Ron J.
Published: March 2018

Rituximab is an anti-CD20 antibody used to deplete B lymphocytes in lymphoma and autoimmune disease. Case reports in the literature describe patients who paradoxically develop autoimmune disease in response to rituximab therapy. We review the reports of autoimmune pathology in response to rituximab treatment and the proposed mechanisms of this reaction. These autoimmune diseases manifest in various organ systems, most frequently the skin and lungs, and involve distinct mechanisms of pathogenesis mediated by potential alterations in B and T lymphocytes, innate immune system, and specific environmental factors. Those clinicians utilizing rituximab should be aware of this unusual phenomenon.
Cyclophosphamide Versus Mycophenolate Versus Rituximab in Lupus Nephritis Remission Induction
Authors: Goswami Rudra Prosad , Sircar Geetabali , Sit Hiramanik , Ghosh Alakendu , Ghosh Parasar
Published: March 2018

Objective

We report comparative efficacy between high-dose cyclophosphamide (HDCyC), low-dose cyclophosphamide (LDCyC), mycophenolate mofetil (MMF) and rituximab in patients with lupus nephritis (LN).

Methods

We analyzed comparative efficacy of 4 induction regimens of biopsy-proven LN: LDCyC: 500 mg fortnightly, HDCyC: 750 to 1200 mg monthly, MMF: 1.5 to 3 g/d, and rituximab. Outcomes of 4 groups were analyzed at the sixth month.

Results

Among a total 222 patients, 26 received LDCyC (3-g total dose), 113 received HDCyC (mean, 5.1-g total dose), 61 received MMF (mean, 2.2 g/d), and 22 received rituximab (mean, 1.9-g total dose). Relapsing/refractory LN was 11 in HDCyC, 1 in LDCyC, 10 in MMF, and 14 in the rituximab group. Overall 16.2% had no improvement of proteinuria, 18% had partial response, and 65.8% (146/222) had complete response. Renal response (RR) was higher in HDCyC (90.3%) and rituximab (90.9%) groups compared with LDCyC (73%) and MMF (72%) groups. Rituximab was effective in relapsing disease (100% RR). Infection was highest with the HDCyC, followed by LDCyC and rituximab (p = 0.15), whereas the MMF group had a higher incidence of gastrointestinal adverse effects (p < 0.001). The following predictors of RR were identified: rituximab (odds ratio [OR], 20.4; 95% confidence interval [CI], 1.9–215.7; p = 0.012), renal Baseline Systemic Lupus Erythematosus Disease Activity Index at baseline (OR, 0.86; 95% CI, 0.75–0.99; p = 0.034), and duration of disease (OR, 0.98; 95% CI, 0.97–0.99; p = 0.009).

Conclusions

High-dose cyclophosphamide and rituximab were the most effective therapeutic strategies in patients with LN, especially in the Indian context. Rituximab was highly effective in relapsing disease.
Does Mixed Conventional/Piezosurgery Implant Site Preparation Affect Implant Stability?
Authors: Alattar Abrar Nizar , Bede Salwan Yousif Hanna
Published: March 2018

The aim of this study was to compare the effect of conventional implant site preparation technique and a combination of conventional/piezosurgery preparation on implant stability measured at different time intervals, insertion torque, and preparation time. A randomized controlled study was designed, it included 26 patients who received 54 dental implants randomly assigned to 2 groups; in the control group, implants were installed after conventional preparation with drills whereas the study group received implants after mixed conventional/piezosurgery preparation. The outcome variables included: implant stability measured immediately after implant insertion, at 8 weeks and 16 weeks postoperatively, insertion torque and preparation time. All the investigated variables were analyzed statistically using 1 sample Kolmogrov–Simirenov test, Mann–Whitney U test, paired and unpaired Student t test, the Pearson χ
2 test, Fisher exact test, and analysis of variance (1-way ANOVA). The differences were considered significant at P ≤ 0.05. Implant stability showed a similar pattern in both the groups which consists of a statistically significant decrease in implant stability quotient values at the 8th week followed by a statistically significant increase at the 16th week, where the implant stability quotient values return close to those of primary stability. The 2 groups revealed a statistically not significant difference in insertion torque and implant stability changes throughout the study period, whereas the preparation time was significantly longer in the study group than the control group. The mixed conventional/piezosurgery method of implant site preparation offers no additional advantage over the conventional drilling method in terms of values of insertion torque and patterns of implant stability change throughout the healing period.
The Modified Socket Shield Technique
Authors: Han Chang-Hun , Park Kwang-Bum , Mangano Francesco Guido
Published: March 2018

Objective:

In the anterior regions, the resorption of the buccal bone after tooth extraction leads to a contraction of the overlying soft tissues, resulting in an esthetic problem, particularly with immediate implant placement. In the socket shield technique, the buccal root section of the tooth is maintained, to preserve the buccal bone for immediate implant placement. The aim of this prospective study was to investigate the survival, stability, and complication rates of implants placed using a “modified” socket shield technique.

Methods:

Over a 2-year period, all patients referred to a dental clinic for treatment with oral implants were considered for inclusion in this study. Inclusion criteria were healthy adult patients who presented nonrestorable single teeth with intact buccal periodontal tissues in the anterior regions of both jaws. Exclusion criteria were teeth with present/past periodontal disease, vertical root fractures on the buccal aspect, horizontal fractures below bone level, and external/internal resorptions. The buccal portion of the root was retained to prevent the resorption of the buccal bone; the shield was 1.5 mm thick with the most coronal portion at the bone crest level. All patients then underwent immediate implants. In the patient with a gap between the implant and shield, no graft material was placed. All implants were immediately restored with single crowns and followed for 1 year. The main outcomes were implant survival, stability, and complications.

Results:

Thirty patients (15 males, 15 females; mean age was 48.2 ± 15.0 years) were enrolled in the study and installed with 40 immediate implants. After 1 year, all implants were functioning, for a survival rate of 100%; excellent implant stability was reported (mean implant stability quotient at placement: 72.9 ± 5.9; after 1 year: 74.6 ± 2.7). No biologic complications were reported, and the incidence of prosthetic complications was low (2.5%).

Conclusions:

The “modified” socket shield technique seems to be a successful procedure when combined with immediate implant placement, because the root fragment does not interfere with osseointegration and may be beneficial for the esthetics, protecting the buccal bone from resorption.
Prosthetic Complications Affecting Single-Tooth Morse-Taper Connection Implants
Authors: Mangano Francesco , Lucchina Alberta Greco , Brucoli Matteo , Migliario Mario , Mortellaro Carmen , Mangano Carlo
Published: March 2018

Purpose:

To evaluate the long-term cumulative implant survival rate (CISR%) and cumulative implant-crown success rate (CICSR%) of single-tooth Morse–taper connection implants, with particular attention to documenting the incidence of prosthetic complications.

Methods:

The customized records of all patients who had been treated with single-tooth Morse-taper connection implants in 2 dental centers during the period between January 2002 and December 2012 were revisited. These records included patient-related (gender, age at surgery, smoking, bruxism), implant-related (date of insertion, site/location, and length/diameter of the implant, previous/concomitant bone regeneration), and restoration-related (date of delivery of the provisional and final crown) information. In addition, these records contained information about any implant failure and biologic and/or prosthetic complication that occurred during the follow-up period as well as the radiographic documentation. The follow-up period comprised between 5 and 15 years. The main outcomes were CISR% and CICSR%, with the latter being defined as the condition in which no complication had affected the surviving implant-supported crown during the entire follow-up. Life-table analysis was used for the analysis of CISR% and CICSR%. Peri-implant marginal bone resorption (PIMBR) at 5, 10, and 15 years was a secondary outcome of this study.

Results:

In total, 578 patients who had received 612 implants were included in this study. The overall CISR% at 15 years was 94.8% (94.2% maxilla, 95.3% mandible). Among the surviving crowns, the overall CICSR% at 15 years was 94.5% (93.1% and 94.9% for anterior and posterior crowns, respectively), and the incidence of prosthetic complications was low (1.5%). The PIMBL amounted to 0.38 ± 0.29 mm, 0.49 ± 0.35 mm, and 0.94 ± 0.58 mm at the 5-, 10-, and 15-year follow-ups, respectively.

Conclusion:

Morse-taper connection implants represent a reliable treatment procedure for the restoration of single-tooth gaps in the long term, with high CISR% (94.8%) at 15 years, a very low incidence of complications, and a high CICSR% (94.5%).
Poor Patient and Graft Outcome After Induction Treatment by Antithymocyte Globulin in Recipients of a Kidney Graft After Nonrenal Organ Transplantation
Authors: Mai Hoa Le , Treilhaud Michèle , Ben-Arye Shani Leviatan , Yu Hai , Perreault Hélène , Ang Evelyn , Trébern-Launay Katy , Laurent Julie , Malard-Castagnet Stéphanie , Cesbron Anne , Nguyen Thi Van Ha , Brouard Sophie , Rostaing Lionel , Houssel-Debry Pauline , Legendre Christophe , Girerd Sophie , Kessler Michèle , Morelon Emmanuel , Sicard Antoine , Garrigue Valérie , Karam Georges , Chen Xi , Giral Magali , Padler-Karavani Vered , Soulillou Jean Paul
Published: March 2018

Background

End-stage renal failure occurs in a substantial number of patients having received a nonrenal transplantation (NRT), for whom a kidney transplantation is needed. The medical strategy regarding the use of immunosuppression (IS) for a kidney graft in patients after an NRT is not well established. The prekidney grafts long-term IS advocates for a mild induction, such as using anti-IL-2R antibodies, whereas addition of new incompatibilities and anti-HLA preimmunization may suggest using stronger IS such as induction by polyclonal antithymocyte globulins (ATG).

Methods

We performed Cox multivariate and propensity score analysis of our validated transplant database to study the impact of the type of induction therapy on kidney graft survival of recipients of a kidney graft after NRT.

Results

We report here that kidney transplantation after NRT treated with an ATG induction has a poorer outcome (kidney and recipient survival) than that with an anti–IL-2R induction. After accounting for potential baseline differences with a multivariate Cox model, or by adjusting on a propensity score, we found that despite patients having received ATG cumulate more risk factors, ATG appears independently involved. As animal-derived biotherapeutics induce antiglycan antibodies and particularly anti–N-glycolylneuraminic acid (Neu5Gc) IgGs which may activate endothelial cells in patients and grafts, we also investigated the magnitude and the nature of the anti-Neu5Gc elicited by the induction and showed that induction was associated with a shift in anti-Neu5Gc IgG repertoire. Possible reasons and mechanisms of a deleterious ATG usage in these patients are discussed.

Conclusions

Our study suggests that ATG induction after a kidney transplantation in recipients already under maintenance IS for a NRT should be used cautiously.
Measles outbreak response decision-making under uncertainty: a retrospective analysis
Authors: Fonnesbeck Christopher J. , Shea Katriona , Carran Spencer , Cassio de Moraes Jose , Gregory Christopher , Goodson James L. , Ferrari Matthew J.
Published: March 2018

Resurgent outbreaks of vaccine-preventable diseases that have previously been controlled or eliminated have been observed in many settings. Reactive vaccination campaigns may successfully control outbreaks but must necessarily be implemented in the face of considerable uncertainty. Real-time surveillance may provide critical information about at-risk population and optimal vaccination targets, but may itself be limited by the specificity of disease confirmation. We propose an integrated modelling approach that synthesizes historical demographic and vaccination data with real-time outbreak surveillance via a dynamic transmission model and an age-specific disease confirmation model. We apply this framework to data from the 1996–1997 measles outbreak in São Paulo, Brazil. To simulate the information available to decision-makers, we truncated the surveillance data to what would have been available at 1 or 2 months prior to the realized interventions. We use the model, fitted to real-time observations, to evaluate the likelihood that candidate age-targeted interventions could control the outbreak. Using only data available prior to the interventions, we estimate that a significant excess of susceptible adults would prevent child-targeted campaigns from controlling the outbreak and that failing to account for age-specific confirmation rates would underestimate the importance of adult-targeted vaccination.
Crossing the front: contrasting storm-forced dispersal dynamics revealed by biological, geological and genetic analysis of beach-cast kelp
Authors: Waters Jonathan M. , King Tania M. , Fraser Ceridwen I. , Craw Dave
Published: March 2018

The subtropical front (STF) generally represents a substantial oceanographic barrier to dispersal between cold-sub-Antarctic and warm-temperate water masses. Recent studies have suggested that storm events can drastically influence marine dispersal and patterns. Here we analyse biological and geological dispersal driven by two major, contrasting storm events in southern New Zealand, 2017. We integrate biological and physical data to show that a severe southerly system in July 2017 disrupted this barrier by promoting movement of substantial numbers of southern sub-Antarctic
Durvillaea
kelp rafts across the STF, to make landfall in mainland NZ. By contrast, a less intense easterly storm (Cyclone Cook, April 2017) resulted in more moderate dispersal distances, with minimal dispersal between the sub-Antarctic and mainland New Zealand. These quantitative analyses of approximately 200 freshly beach-cast kelp specimens indicate that storm intensity and wind direction can strongly influence marine dispersal and landfall outcomes.
Population cycles: generalities, exceptions and remaining mysteries
Authors: Myers Judith H.
Published: March 2018

Population cycles are one of nature's great mysteries. For almost a hundred years, innumerable studies have probed the causes of cyclic dynamics in snowshoe hares, voles and lemmings, forest Lepidoptera and grouse. Even though cyclic species have very different life histories, similarities in mechanisms related to their dynamics are apparent. In addition to high reproductive rates and density-related mortality from predators, pathogens or parasitoids, other characteristics include transgenerational reduced reproduction and dispersal with increasing-peak densities, and genetic similarity among populations. Experiments to stop cyclic dynamics and comparisons of cyclic and noncyclic populations provide some understanding but both reproduction and mortality must be considered. What determines variation in amplitude and periodicity of population outbreaks remains a mystery.
A natural adaptive syndrome as a model for the origins of cereal agriculture
Authors: Wood David , Lenné Jillian M.
Published: March 2018

A novel explanation of the origin of cereal agriculture is proposed, based on the ecology and adaptive morphology of wild cereals ancestral to our founder cereals (einkorn, emmer and barley). Wild cereals are unusually large-seeded. A natural evolutionary-ecological syndrome relates
l
arge seed,
a
wns and
m
onodominance (LAM). Awns bury attached seeds in the soil, protecting seed from fire; buried seed needs to be large to emerge on germination; large seeds, growing without competition from small-seeded plants, will produce monodominant vegetation. Climatic and edaphic instability at the Pleistocene–Holocene boundary would have provided an impetus for the spread of annual ruderal grasses. LAM grassland provided an obvious natural model for the origins of cereal agriculture. Subsequent field management would mimic the natural niche (MNN). The fact that monodominance is a long-standing character of the natural LAM syndrome validates cereal monocultures (now producing most of our food). An alternative explanation of crop domestication, by auditioning a great range of species for a human-constructed niche (NCT), is rejected.
A proteome-based design of bitter peptide digestion regime to attenuate bone soup bitterness: comparison with a rainbow trout extract-mediated bitter taste masking approach
Authors: Han Ying , Guo Changlu , Yan Zhengyu , Jin Feng , Jiang Jie , Zhang Zhizhou
Published: March 2018

BACKGROUND

The fresh bones (with some meat on them; frequently discarded as a large quantity of industry garbage) of marine fish such as cod and salmon are good materials for manufacture of food additives (taste adjusters). However, such fish-bone originated additives often have apparent bitter taste and need additional debittering regime.

RESULTS

In this study, 46 known bitter peptides in the cod proteome were targeted for specific protease digestion to eliminate bitter taste from the cod bone soup. Though the debittering effect was apparent, the bitter taste was not completely removed. However, the bitter taste can be removed by addition of trout extract to a complete extent. The strong debittering power of rainbow trout extract was further confirmed by the debittering experiments on salmon bone soup and bitter melon, both with perfect results.

CONCLUSION

These results indicated that the cod bone soup bitterness comes not only from bitter peptide but also from other substances that can be masked by trout extract. Considering the fact that trout proteome has more potential bitter peptides than cod, trout extract shall have a strong bitter masking substance to be determined in the future.
Lateral plasma membrane compartmentalization links protein function and turnover
Authors: Busto Jon V. , Elting Annegret , Haase Daniel , Spira Felix , Kuhlman Julian , Schäfer-Herte Marco , Wedlich-Söldner Roland
Published: March 2018

Biological membranes organize their proteins and lipids into nano- and microscale patterns. In the yeast plasma membrane (PM) constituents segregate into a large number of distinct domains. However, if and how this intricate patchwork contributes to biological functions at the PM is still poorly understood. Here, we reveal an elaborate interplay between PM compartmentalization, biochemical function and endocytic turnover. Using the methionine permease Mup1 as model system we demonstrate that this transporter segregates into PM clusters. Clustering requires sphingolipids, the tetraspanner Nce102 and TORC2 signaling. Importantly, we show that during substrate transport, a simple conformational change in Mup1 mediates rapid relocation into a unique disperse network at the PM. Clustered Mup1 is protected from turnover, whereas relocated Mup1 actively recruits the endocytic machinery thereby initiating its own turnover. Our findings suggest that lateral compartmentalization provides an important regulatory link between function and turnover of PM proteins.
Unmodified, autologous adipose-derived regenerative cells improve cardiac function, structure and revascularization in a porcine model of chronic myocardial infarction
Authors: Haenel Alexander , Ghosn Mohamad , Karimi Tahereh , Vykoukal Jody , Kettlun Claudia , Shah Dipan , Dave Amish , Valderrabano Miguel , Schulz Daryl , Azares Alon , Raizner Albert , Alt Eckhard
Published: March 2018

Numerous studies have investigated cell-based therapies for myocardial infarction (MI), with mixed results. In the present study the left anterior descending (LAD) artery of pigs was occluded for 180 min. Four weeks later, the mean left ventricular ejection fraction (LVEF) was shown to have been reduced to approximately 35%. At that time, 18×106 unmodified, autologous adipose-derived regenerative cells (UA-ADRCs) were delivered into the LAD vein (control: delivery of saline). Six weeks following UA-ADRCs/saline delivery, the mean LVEF had increased by 18% (p<0.01) after delivery of UA-ADRCs, but was unchanged after delivery of saline. This is among the best outcome ever reported in studies on porcine animal models of cell-based therapies for MI in which functional outcome was assessed with cardiac magnetic resonance imaging. The unique combination of the procedure used for isolating UA-ADRCs, the late cell delivery time and the uncommon cell delivery route applied in the present study may open new horizons for cell-based therapies for MI.
Distinct Functional Connectivity Mode during Viewing Natural Scenes Revealed by Principal Component Analysis
Authors: Demirtaş Murat , Ponce-Alvarez Adrian , Gilson Matthieu , Hagmann Patric , Mantini Dante , Betti Viviana , Romani Gian Luca , Friston Karl , Corbetta Maurizio , Deco Gustavo
Published: March 2018

A fundamental question in systems neuroscience is how spontaneous activity at rest is reorganized during task performance. Recent studies suggest a strong relationship between resting and task FC. Furthermore, the relationship between resting and task FC has been shown to reflect individual differences. Particularly, various studies have demonstrated that the FC has higher reliability and provides enhanced detection of individual differences while viewing natural scenes. Although the large-scale organization of FC during rest and movie-viewing conditions have been well studied in relation to individual variations, the re-organization of FC during viewing natural scenes have not been studied in depth. In this study, we used principal component analysis on FC during rest and movie-viewing condition to characterize the dimensionality of FC patterns across conditions and subjects. We found that the variations in FC patterns related to viewing natural scenes can be explained by a single component, which enables identification of the task over subjects with 100% accuracy. We showed that the FC mode associated to viewing natural scenes better reflects individual variations. Furthermore, we investigated the signatures of movie-viewing-specific functional modes in dynamic FC based on phase-locking values between brain regions. We found that the movie-specific functional mode is persistent across time; suggesting the emergence of a stable processing mode. To explain the reorganization of whole-brain FC through the changes in local dynamics, we appeal to a large-scale computational model. This modelling suggested that the reorganization of whole-brain FC is associated to the interaction between frontal-parietal and frontal-temporal activation patterns.
Co-leadership: public sector case studies using reciprocal expectations
Authors: Donnelly Mike , Graham Wayne
Published: March 2018

Purpose

The paper aims to introduce the reciprocal expectations (RE) approach to co-leadership and outlines the complex environments within which public services operate.

Design/methodology/approach

A case study of two government departments is undertaken to apply the RE approach within a public services context.

Findings

The application of the RE approach to co-leadership resulted in the mending of broken relationships, thereby providing the basis for stable, effective government, and restoring Ministerial confidence in the government departments.

Practical implications

Strong and effective co-leadership can be achieved when attributes of trust, honesty, and clear expectations are facilitated and mutually adopted.

Originality/value

The organizational context of elected and professional leaders in government is complex, unique, and requires special attention. The RE approach is original, and the case studies contribute to the knowledge of co-leadership and the benefits of the RE approach to good governance practice.
Investigating the relationship between service quality dimensions, customer satisfaction and loyalty in Turkish banking sector
Authors: Yilmaz Veysel , Ari Erkan , Gürbüz Hüseyin
Published: March 2018

Purpose

Using the attitudes of students toward ideal banking services, the purpose of this paper is to examine the structure of banking-related SERVQUAL service dimensions with first-order and second-order confirmatory factors analysis. Following this, a study model was suggested to describe the relationship between the perceptions of students regarding the services provided by their banks and their overall level of satisfaction with the bank.

Design/methodology/approach

The sample group for the study comprised students from the Faculty of Economics and Administrative Sciences of Eskisehir Osmangazi University. The sample included 441 students, and was designed according to a stratified and proportional distribution. The first-order and second order confirmatory factor model used to confirm the structure of the SERVQUAL service dimensions presented in the study was found to be suitable and compatible. The relationship of the SERVQUAL service dimensions based on the actual perception of banking services by the students with the students’ satisfaction and loyalty to their banks was investigated using a structural equation modeling (SEM) analysis.

Findings

Based on the study results, it was concluded that the confidence inspired by the banks, the reliability of their services, and the physical appearance and accessibility of the bank all have an effect in increasing customer satisfaction.

Originality/value

Conducting this study using university students, who represent a specific group, will help in determining whether the quality of banking services provided to students is, in itself, sufficient to make them prefer these banks. Furthermore, the study will also shed light on various other aspects, such as the banks’ efforts at reviewing and developing the services they provide to students.
Modeling credit risk in credit unions using survival analysis
Authors: Hassan M. Kabir , Brodmann Jennifer , Rayfield Blake , Huda Makeen
Published: March 2018

Purpose

The purpose of this paper is to investigate proprietary data from customers of a Southern Louisiana credit union. It analyzes the factors that contribute to an accelerated failure time (AFT) using information from customers’ credit applications as well as information provided in their credit report.

Design/methodology/approach

This paper investigates the factors that affect credit risk using survival analysis by employing two primary models – the AFT model and the Cox proportional hazard (PH) model. While several studies employ the Cox PH model, few use the AFT model. However, this paper concludes that the AFT model has superior predictive qualities.

Findings

This paper finds that the factors specific to borrowers and local factors play an important role in the duration of a loan.

Practical implications

This paper offers an easily interpretable model for determining the duration of a potential borrower. The marketing department of credit unions can then use this information to predict when a customer will default, thus allowing the credit union to intervene in a timely manner to prevent defaults. Further, the credit union can use this information to seek out customers who are less likely to default.

Originality/value

This study is different from the previous research due to its focus on credit unions, which have distinct characteristics. Compared to similar lending institutions, the charter of the credit union does not allow management to sell off loans to other investors.
Just how loyal are Islamic banking customers?
Authors: Ireland John J.
Published: March 2018

Purpose

The purpose of this paper is to determine the rate difference required to persuade Islamic banking customers to switch to conventional banks.

Design/methodology/approach

A choice-based conjoint analysis survey was administered to 300 UAE Islamic banking customers. Customer utilities for Islamic and conventional banks, products and prices were developed to test hypotheses while a market simulation estimated the impact of rate changes on choice shares.

Findings

Overall, Muslim customers of Islamic banks strongly preferred Islamic banks and products. However, 43 percent were willing to switch to conventional banks to obtain better rates. Indeed, the share choosing conventional banks rose from 25 percent when rates were the same to 68 percent when conventional products offered 2 percent better rates.

Research limitations/implications

This research requires replication and extension in appropriate contexts such as Malaysia and Indonesia. Moreover, the existence of price sensitivity tiers implies underlying benefit segments that should be studied.

Practical implications

As so many Islamic banking customers would switch to conventional banks for better rates, it seems that conventional banks compete with Islamic banks for most clients. Islamic banks should price accordingly.

Originality/value

This is the first study to quantify the loyalty of Islamic banking customers in terms of price and, consequently, the first to demonstrate the existence of price sensitivity tiers. It is also the first in this field to apply conjoint analysis and market modeling.