bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Autologous Breast Reconstruction on Body Mass Index Patterns in Breast Cancer Patients: A Propensity-Matched Analysis
Authors: Cho Eugenia H. , Shammas Ronnie L. , Glener Adam D. , Greenup Rachel A. , Hwang E. Shelley , Hollenbeck Scott T.
Published: November 2017

Background:

Weight gain is common in breast cancer patients and increases the risk of recurrence and mortality. The authors assessed the impact of autologous breast reconstruction on body mass index patterns after diagnosis in mastectomy patients.

Methods:

Women undergoing therapeutic mastectomy at the authors’ institution from 2008 to 2010 were identified. Patients undergoing no breast reconstruction or autologous breast reconstruction were propensity-matched by age at diagnosis, baseline obesity, mastectomy laterality, and adjuvant therapies. Multivariable regression was used to estimate covariate associations with percentage body mass index change and percentage body mass index change greater than 5.0 percent at 1 to 4 years after diagnosis.

Results:

Of 524 total patients, 80 propensity-matched pairs were identified. In multivariable regression, women undergoing immediate autologous breast reconstruction had reduced body mass index changes after diagnosis, compared with nonreconstruction patients, at 1 year (β = −5.25 percent; p < 0.01), 2 years (β = −8.78 percent; p < 0.01), and 3 years (β = −7.21 percent; p < 0.01). After 4 years, all autologous reconstruction was predictive of reduced body mass index changes (β = −3.54 percent; p = 0.02). Higher body mass index increases were observed among women who were leaner at diagnosis (p < 0.01 at 1 year) and received chemotherapy (p = 0.02 at 3 years; p = 0.04 at 4 years).

Conclusions:

Women undergoing autologous breast reconstruction gained less weight after diagnosis than nonreconstruction patients. Normal baseline body mass index and chemotherapy were predictive of greater body mass index increases. These findings may guide targeted weight management strategies in high-risk patients to maximize survival rates.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
Is Postoperative Intensive Care Unit Care Necessary following Cranial Vault Remodeling for Sagittal Synostosis?
Authors: Wolfswinkel Erik M. , Howell Lori K. , Fahradyan Artur , Azadgoli Beina , McComb J. Gordon , Urata Mark M.
Published: November 2017

Background:

Of U.S. craniofacial and neurosurgeons, 94 percent routinely admit patients to the intensive care unit following cranial vault remodeling for correction of sagittal synostosis. This study aims to examine the outcomes and cost of direct ward admission following primary cranial vault remodeling for sagittal synostosis.

Methods:

An institutional review board–approved retrospective review was undertaken of the records of all patients who underwent primary cranial vault remodeling for isolated sagittal craniosynostosis from 2009 to 2015 at a single pediatric hospital. Patient demographics, perioperative course, and outcomes were recorded.

Results:

One hundred ten patients met inclusion criteria with absence of other major medical problems. Average age at operation was 6.7 months, with a mean follow-up of 19.8 months. Ninety-eight patients (89 percent) were admitted to a general ward for postoperative care, whereas the remaining 12 (11 percent) were admitted to the intensive care unit for preoperative or perioperative concerns. Among ward-admitted patients, there were four (3.6 percent) minor complications; however, there were no major adverse events, with none necessitating intensive care unit transfers from the ward and no mortalities. Average hospital stay was 3.7 days. The institution’s financial difference in cost of intensive care unit stay versus ward bed was $5520 on average per bed per day. Omitting just one intensive care unit postoperative day stay for this patient cohort would reduce projected health care costs by a total of $540,960 for the study period.

Conclusion:

Despite the common practice of postoperative admission to the intensive care unit following cranial vault remodeling for sagittal craniosynostosis, the authors suggest that postoperative care be considered on an individual basis, with only a small percentage requiring a higher level of care.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
Prospective Controlled Study of Chin Augmentation by Means of Fat Grafting
Authors: Basile Filipe V. , Basile Antonio R.
Published: November 2017

Background:

Although fat grafting is a valuable tool for different areas of plastic surgery, its use in the chin area has never been evaluated. A variety of methods are available for adjusting suboptimal chin morphology, and they each present drawbacks.

Methods:

A prospective controlled study was performed to evaluate whether fat grafting increases the chin volume and sagittal projection and to determine the magnitude and nature of the observed changes. Forty-two consecutive patients underwent chin augmentation by means of fat grafting between October of 2014 and January of 2016. All patient images were analyzed using a software program (Fiji package of ImageJ), which creates a three-dimensional version of the chin that is used to produce reliable estimates of the volume and gain in sagittal projection.

Results:

All 42 patients showed an increase in the sagittal projection and total volume at 4 weeks and 6 months after surgery. The sagittal projection increased from 4 mm to 12 mm (average, 8.9 mm) and from 3 mm to 11 mm (average, 7 mm) after 4 weeks and 6 months, respectively. The total volume increase ranged from 3 to 11 ml (average, 8 ml) after 4 weeks and from 3 to 8 ml (average, 7.4 ml) after 6 months.

Conclusion:

Fat grafting to the chin area is a reliable method for improving chin volumes (to a maximum of approximately 10 cc in our study) and sagittal projections (to a maximum of approximately 11 mm in our study).

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Correlates of Linkage to HIV Preexposure Prophylaxis Among HIV-Testing Clients
Authors: Flash Charlene A. , Adegboyega Oluwatobi O. , Yu Xiaoying , Avalos Carmen , Johnson Syundai , Mayer Kenneth H. , Giordano Thomas P.
Published: November 2017

Background:

Publicly funded HIV-testing sites can identify HIV preexposure prophylaxis (PrEP) candidates and provide PrEP linkage.

Setting:

Harris Health System's HIV clinic, HIV-testing program, and HIV-prevention program (HPP) in Houston, TX, a high HIV-incidence city.

Methods:

A prospective assessment of individuals aged 18 years and older recruited from walk-in HIV testing from December 2013 to April 2015 included risk assessment, HIV testing, and self-administered survey, with follow-up surveys at 6 and 12 months and medical record review.

Results:

The mean age of our sample (n = 300) was 38.3 ± 11.7 years. Men constituted 63.1% of the sample and 53.7% were black non-Hispanic, 26.3% Hispanic, and 14.7% white non-Hispanic. Most were uninsured (63.5%). Only 27% always used condoms, although 67% perceived personal HIV risk. Of 300 participants, 64 (21.3%) linked to PrEP care and 49 (16.3%) took PrEP. In multivariable analysis, compared with heterosexual men, women [adjusted OR (aOR) 4.1, 95% CI: 1.5 to 11.1] and MSM (aOR 10.2, 95% CI: 3.4 to 31.0) were more likely to attend HPP and to take PrEP (aOR 3.0, 95% CI: 1.6 to 15.1 and 3.0, 95% CI: 1.1 to 8.3, respectively). Serodiscordance and PrEP interest correlated with program attendance (aOR 14.0, 95% CI: 6.1 to 32.3 and aOR 6.7, 95% CI: 1.8 to 25.4) and taking PrEP (aOR 13.1, 95% CI: 5.2 to 32.8 and 14.4, 95% CI: 1.8 to 166.9), respectively.

Conclusions:

Preexposure prophylaxis interest, being female or MSM, and serodiscordance correlated with PrEP linkage. Safety-net health systems can facilitate PrEP access in marginalized populations, but the PrEP initiation rates remain low.
Influence of Injection Drug Use–Related HIV Acquisition on CD4 Response to First Antiretroviral Therapy Regimen Among Virally Suppressed Individuals
Authors: Calkins Keri L. , Lesko Catherine R. , Chander Geetanjali , Moore Richard D. , Lau Bryan
Published: November 2017

Background:

The inflammatory effects of injection drug use (IDU) may result in an impaired immune response to antiretroviral therapy (ART). We examined CD4 response to first ART regimen among individuals in routine HIV care, stratified by IDU-related HIV acquisition.

Setting:

Cohort study including patients who initiated ART between 2000 and 2015 in the Johns Hopkins HIV Clinic.

Methods:

We followed individuals from ART initiation until death, loss to follow-up, loss of viral load suppression (<500 copies/mL), or administrative censoring. We described CD4 trajectories after ART initiation using inverse probability weighted quantile regression models with restricted cubic splines for time. Weights accounted for differences in baseline characteristics of persons comparing those with IDU-related HIV acquisition to those with other HIV acquisition risks (non-IDU) and possible nondifferential censoring due to death, loss to follow-up, or loss of viral load suppression. We also examined CD4 response by strata of CD4 at ART initiation (≤200, 201–350, >350).

Results:

Of 1244 patients initiating ART, 30.4% were IDU. Absolute CD4 cell difference at the 50th percentile comparing IDU with non-IDU was −25 cells [95% confidence interval (CI): −63 to 35], −66 cells (95% CI: −141 to 16), and −91 cells (95% CI: −190 to −5) at 2, 4, and 6 years after ART initiation, respectively. Results were similar (non-IDU with slightly higher CD4 count, but not statistically significant differences) at other percentiles and stratified by baseline CD4.

Conclusions:

CD4 recovery after ART initiation was similar for IDU and non-IDU, conditional on consistent viral load suppression.
Effect of Home Care Nursing on Patients Discharged From Hospital With Self-Reported Signs of Constipation
Authors: Konradsen Hanne , Rasmussen Marie Louise Thiese , Noiesen Eline , Trosborg Ingelise
Published: November 2017

Constipation is a common health problem in relation to hospitalization. This randomized controlled trial aimed to investigate whether advice from a home care nurse after discharge had an effect on self-reported signs of constipation. A total of 59 patients were included in the study on the basis of their self-reported signs of constipation evaluated using the Constipation Assessment Scale. Advice from the home care nurses was given on the intake of fiber and liquid and mobilization related to scorings on the Constipation Risk Assessment Scale, the administration of laxatives, and referral to a physician when needed. Results showed a tendency toward the visits being effective, but a more complex intervention might be needed.
Debriefing to Improve Student Ability to Assess and Plan for the Care of Persons With Disability
Authors: Takeda Mikiko Y. , Smith Mark J. , Cone Catherine J.
Published: November 2017

Introduction

Although recent literature suggests that students should be trained in the care of persons with disability (PWDs) as a form of cultural sensitivity (CS), healthcare professionals may receive limited experience during their formal training. After pharmacy students in 2 previous years of testing failed to adequately assess and plan for the care of a standardized patient’s chief complaint and disability in an Objective Structured Clinical Examination (OSCE), the investigators added debriefing to the OSCE to determine if it would improve student’s ability to assess and plan for the care of PWD.

Methods

Two sequentially enrolled second-year pharmacy school student cohorts participated in this study (control n = 90; intervention n = 82). During the OSCE, students interviewed and examined a standardized patient with a simulated physical disability and other chronic disease states. Students were then instructed to develop a care plan considering the patient’s disability and other disease states. The intervention cohort received debriefing; the control did not. Students documented the care plan in a subjective, objective, assessment, and plan (SOAP) note. Investigators assessed SOAP note score (general ability of students to write a SOAP note) and CS score (specific ability to care for PWD) to determine the effectiveness of the debriefing.

Results

The intervention group showed a significantly higher percent mean CS score than the control group (93.6% ± 19% and 61.1% ± 30.7%, respectively, P < 0.001), translating to a mean of 56.2/60 points earned for the intervention group and 36.7/60 points earned for the control group. Scores ranged from 0 to 60 points for both intervention and control groups. Students in the intervention group had an absolute improvement in pass rates (those students scoring ≥70% on the OSCE) of 59.4% with 92.7% of the students passing in the intervention group versus 33.3% of the students passing in the control group (P < 0.001). The overall SOAP note scores were no different between the 2 cohorts (P = 0.353).

Conclusions

Debriefing added to an OSCE improved students’ performance in developing care plans for disabled patients. Ideally, longitudinal studies should be completed to determine if these skills transfer from debriefings to clinical practice. Development of effective training and assessment methods is essential for students to obtain adequate skills and knowledge to care for persons with disabilities.
Successful Desensitization of T cell Flow Cytometry Crossmatch Positive Renal Transplant Recipients Using Plasmapheresis and Super High-Dose Intravenous Immunoglobulin
Authors: Kakuta Yoichi , Satoh Shigeru , Watarai Yoshihiko , Aikawa Atsushi , Tanabe Kazunari , Harada Hiroshi , Yagisawa Takashi , Ishida Hideki , Okumi Masayoshi , Takahara Shiro
Published: November 2017

Background

High-dose IVIG (2 g/kg) alone or low-dose IVIG (100 mg/kg) in conjunction with plasma exchange is typically administered as a renal transplantation desensitization therapy. Herein, we monitored changes in T cell and B cell flow cytometry crossmatch (FCXM) to assess the effects of short-term super high-dose IVIG (4 g/kg) administration with plasmapheresis before living-donor renal transplantation.

Methods

Seventeen patients, each showing positive T cell FCXM (median ratio, ≥ 1.4) after 2 rounds of double-filtration plasmapheresis, received 4-day regimens of IVIG (1 g/kg per day) over 1-week periods. T cell and B cell FCXM determinations were obtained after every IVIG dose and again up to 4 weeks after initiating IVIG to ascertain negative conversion of T cell FCXM (median ratio < 1.4). The primary study endpoint was the percentage of patients achieving T cell FCXM-negative status after the 4-dose IVIG regimen.

Results

Upon completion (4 g/kg total) or discontinuation of IVIG administration, 8 (47.1%) of 17 patients displayed negative T cell FCXM. Based on Kaplan-Meier estimates, the cumulative T cell FCXM-negative conversion rate 4 weeks after IVIG administration initiation was 60.3%. The T cell FCXM-negative conversion rates after cumulative doses of 1, 2, 3, and 4 g/kg IVIG were 29.4%, 35.3%, 56.3%, and 46.7%, respectively.

Conclusions

Desensitization of donor-specific antibody-positive renal transplant recipients seems achievable in only a subset of recipients through IVIG dosing (1 g/kg × 4) within 1 week after double-filtration plasmapheresis. The T cell FCXM-negative conversion rate resulting from a cumulative IVIG dose of 3 g/kg or greater surpassed that attained via conventional single-dose IVIG (2 g/kg) protocol. This short-term high-dose IVIG desensitization protocol may be an alternative to conventional protocols for recipients with donor-specific antibody.
Retinal Ganglion Cell Topography in Patients With Visual Pathway Pathology
Authors: Zehnder Simon , Wildberger Hannes , Hanson James V. M. , Lukas Sebastian , Pelz Stefan , Landau Klara , Wichmann Werner , Gerth-Kahlert Christina
Published: November 2017

Background:

To investigate and quantify the impact of intracranial lesions at different locations within the visual pathway on the ganglion cell layer–inner plexiform layer (GCL–IPL) complex and the retinal nerve fiber layer (RNFL).

Methods:

Patients with intracranial lesions affecting the optic chiasm (Group I) or the optic tract and/or lateral geniculate nucleus (Group II) were included. All patients received kinetic visual field assessment and underwent spectral domain optical coherence tomography. Peripapillary and papillomacular bundle (PMB) RNFL and macular GCL–IPL thickness in 4 perifoveal areas were measured and compared with normal values derived from 52 age-matched healthy control subjects. Z-scores for each parameter of every patient were calculated and compared with the normative data. Z-scores less than −2.0 (e.g., −2.5) were considered as being statistically significant.

Results:

Twenty-two patients (Group I and II: 13 and 9, respectively) were included. Ten of 13 patients in Group I showed significant binasal GCL–IPL thinning, with associated temporal sector thinning in 8 patients. In Group II, all 9 patients showed significant reduction of the GCL–IPL corresponding to the homonymous visual field defect, but only 4 demonstrated RNFL thinning. Contralateral RNFL thinning within the PMB clinically similar to bow-tie atrophy was evident in all patients in Group II. GCL–IPL and RNFL thinning varied in severity from mild (isolated PMB RNFL thickness reduction) to severe (bilateral asymmetrical reduction of PMB RNFL associated with asymmetric, predominantly nasal reduction of GCL–IPL) in Group I.

Conclusion:

Clinical abnormalities in patients with visual pathway lesions are more likely to demonstrate abnormalities of GCL–IPL than global peripapillary RNFL thickness. However, PMB thickness measurement appears to be a valuable tool to detect abnormalities of the anterior visual pathways. If peripapillary RNFL measurements are performed in such patients, PMB thickness should be considered the most useful quantitative parameter.
Instructive starPEG-Heparin biohybrid 3D cultures for modeling human neural stem cell plasticity, neurogenesis, and neurodegeneration
Authors: Papadimitriou Christos , Cosacak Mehmet I. , Mashkaryan Violeta , Celikkaya Hilal , Bray Laura , Bhattarai Prabesh , Hollak Heike , Chen Xin , He Shuijin , Antos Christopher L. , Thomas Alvin K. , Friedrichs Jens , Dahl Andreas , Zhang Yixin , Freudenberg Uwe , Werner Carsten , Kizil Caghan
Published: November 2017

Three-dimensional models of human neural development and neurodegeneration are crucial when exploring stem-cell-based regenerative therapies in a tissue-mimetic manner. However, existing 3D culture systems are not sufficient to model the inherent plasticity of NSCs due to their ill-defined composition and lack of controllability of the physical properties. Adapting a glycosaminoglycan-based, cell-responsive hydrogel platform, we stimulated primary and induced human neural stem cells (NSCs) to manifest neurogenic plasticity and form extensive neuronal networks in vitro. The 3D cultures exhibited neurotransmitter responsiveness, electrophysiological activity, and tissue-specific extracellular matrix (ECM) deposition. By whole transcriptome sequencing, we identified that 3D cultures express mature neuronal markers, and reflect the in vivo make-up of mature cortical neurons compared to 2D cultures. Thus, our data suggest that our established 3D hydrogel culture supports the tissue-mimetic maturation of human neurons. We also exemplarily modeled neurodegenerative conditions by treating the cultures with Aβ42 peptide and observed the known human pathological effects of Alzheimer’s disease including reduced NSC proliferation, impaired neuronal network formation, synaptic loss and failure in ECM deposition as well as elevated Tau hyperphosphorylation and formation of neurofibrillary tangles. We determined the changes in transcriptomes of primary and induced NSC-derived neurons after Aβ42, providing a useful resource for further studies. Thus, our hydrogel-based human cortical 3D cell culture is a powerful platform for studying various aspects of neural development and neurodegeneration, as exemplified for Aβ42 toxicity and neurogenic stem cell plasticity.

Significance

Neural stem cells (NSC) are reservoir for new neurons in human brains, yet they fail to form neurons after neurodegeneration. Therefore, understanding the potential use of NSCs for stem cell-based regenerative therapies requires tissue-mimetic humanized experimental systems. We report the adaptation of a 3D bio-instructive hydrogel culture system where human NSCs form neurons that later form networks in a controlled microenvironment. We also modeled neurodegenerative toxicity by using Amyloid-beta4 peptide, a hallmark of Alzheimer’s disease, observed phenotypes reminiscent of human brains, and determined the global gene expression changes during development and degeneration of neurons. Thus, our reductionist humanized culture model will be an important tool to address NSC plasticity, neurogenicity, and network formation in health and disease.
Comparison of reprogramming factor targets reveals both species-specific and conserved mechanisms in early iPS cells
Authors: Fu Kai , Chronis Constantinos , Soufi Abdenour , Bonora Giancarlo , Edwards Miguel , Smale Steve , Zaret Kenneth S. , Plath Kathrin , Pellegrini Matteo
Published: November 2017

Both human and mouse fibroblasts can be reprogrammed to pluripotency with Oct4, Sox2, Klf4, and c-Myc (OSKM) transcription factors. While both systems generate pluripotency, human reprogramming takes considerably longer than mouse. To assess additional similarities and differences, we sought to compare the binding of the reprogramming factors between the two systems. In human fibroblasts, the OSK factors initially target many more closed chromatin sites compared to mouse. Despite this difference, the intra- and intergenic distribution of target sites, target genes, primary binding motifs, and combinatorial binding patterns between the reprogramming factors are largely shared. However, while many OSKM binding events in early mouse cell reprogramming occur in syntenic regions, only a limited number is conserved in human. In summary, these findings suggest similar general effects of OSKM binding across these two species, even though the detailed regulatory networks have diverged significantly.
Deferiprone, an Iron Chelator, is Preventive and Therapeutic in Experimental Crescentic Glomerulonephritis
Authors: Chen Tai-Di , Ko Jeong-Hun , Prendecki Maria , McAdoo Stephen P. , Pusey Charles D. , Terence Cook H. , Behmoaras Jacques
Published: November 2017

Crescentic glomerulonephritis represents the most severe form of antibody-mediated glomerulonephritis. It is an important cause of renal dysfunction worldwide and there is a need for more effective treatment. Deferiprone, an orally active iron chelator, is widely used in patients with thalassemia. Here we present the preventive and therapeutic effects of deferiprone in experimental crescentic glomerulonephritis. Nephrotoxic nephritis was induced in Wistar Kyoto rats, and preventive treatment with deferiprone substantially lowered glomerular crescent formation by 84%, with 70% reduction in proteinuria. In established glomerulonephritis, deferiprone treatment effectively halted glomerular inflammation, reversed progression of proteinuria, and prevented deterioration of renal function. Deferiprone reduced glomerular inflammatory cell proliferationin vivo.It was internalised by monocyte/macrophages and inhibited their proliferationin vitro,without showing cellular toxicity. Interestingly, deferiprone showed a neutralizing effect on superoxide anions, and prevented the expression of monocyte chemoattractant protein-1 and matrix metalloproteinase 9, 12 and 14, by primary macrophages. These results suggest that deferiprone partly exerts its renal protective effect through inhibition of monocyte/macrophage proliferation and function by iron-chelating and anti-oxidant properties, respectively. We conclude that deferiprone is an effective treatment in a severe and reproducible model of antibody-mediated glomerular inflammation that resembles human crescentic glomerulonephritis, indicating its therapeutic potential.
Prioritized memory access explains planning and hippocampal replay
Authors: Mattar Marcelo G. , Daw Nathaniel D.
Published: November 2017

To make decisions, animals must evaluate outcomes of candidate choices by accessing memories of relevant experiences. Yet little is known about which experiences are considered or ignored during deliberation, which ultimately governs choice. Here, we propose a normative theory to predict which memories should be accessed at each moment to optimize future decisions. Using nonlocal “replay” of spatial locations in hippocampus as a window into memory access, we simulate a spatial navigation task where an agent accesses memories of locations sequentially, ordered by utility: how much extra reward would be earned due to the computation enabling better choices. This prioritization balances two desiderata: the need to evaluate imminent choices, vs. the gain from propagating newly encountered information to predecessor states. We show that this theory offers a unifying account of a range of hitherto disconnected findings in the place cell literature such as the balance of forward and reverse replay, biases in the replayed content, and effects of experience. Accordingly, various types of nonlocal events during behavior and rest are re-interpreted as instances of a single choice evaluation operation, unifying seemingly disparate proposed functions of replay including planning, learning and consolidation, and whose dysfunction may underlie pathologies like rumination and craving.
Frequency-dependent Maternal Effects across Species and Environments
Authors: Germain Rachel M. , Grainger Tess N. , Jones Natalie T. , Gilbert Benjamin
Published: November 2017

Maternal provisioning of offspring in response to environmental conditions (“maternal environmental effects”) has been argued as ‘the missing link’ in plant life histories. Although empirical evidence suggests that maternal responses to abiotic conditions are common, there is little understanding of the prevalence of maternal provisioning in competitive environments.

We tested how competition in two soil moisture environments affects maternal provisioning of offspring seed mass. Specifically, we varied conspecific frequency from 90% (intraspecific competition) to 10% (interspecific competition) for 15 pairs of annual plant species that occur in California.

We found that conspecific frequency affected maternal provisioning (seed mass) in 48% of species, and that these responses included both increased (20%) and decreased (24%) seed mass. In contrast, 68% of species responded to competition through changes in per capita fecundity (seed number), which generally decreased as conspecific frequency increased. The direction and magnitude of frequency-dependent seed mass depended on the identity of the competitor, even among species in which fecundity was not affected by competitor identity.

Synthesis. Our research demonstrates how species responses to different competitive environments manifest through maternal provisioning, and that these responses alter previous estimates of environmental maternal effects and reproductive output; future study is needed to understand their combined effects on population and community dynamics.
Learning to read the imprints of consciousness on global brain dynamics: an application to intra-operative monitoring of anesthesia
Authors: Alonso Leandro M. , Solovey Guillermo , Yanagawa Toru , Proekt Alex , Cecchi Guillermo A. , Magnasco Marcelo O.
Published: November 2017

In daily life, in the operating room and in the laboratory, the operational way to assess wakefulness and consciousness is through responsiveness. A number of studies suggest that the awake, conscious state is not the default behavior of an assembly of neurons, but rather a very special state of activity that has to be actively maintained and curated to support its functional properties. Thus responsiveness is a feature that requires active maintenance, such as a homeostatic mechanism to balance excitation and inhibition. In this work we developed a method for monitoring such maintenance processes, focusing on a specific signature of their behavior derived from the theory of dynamical systems: stability analysis of dynamical modes. When such mechanisms are at work, their modes of activity are at marginal stability, neither damped (stable) nor exponentially growing (unstable) but rather hovering in between. We have previously shown that, conversely, under induction of anesthesia those modes become more stable and thus less responsive, then reversed upon emergence to wakefulness. We take advantage of this effect to build a single-trial classifier which detects whether a subject is awake or unconscious achieving high performance. We show that our approach can be developed into a mean for intra-operative monitoring of the depth of anesthesia, an application of fundamental importance to modern clinical practice.
Crystal structures of threeortho-substitutedN-acylhydrazone derivatives
Authors: Purandara H. , Foro Sabine , Thimme Gowda B.
Published: November 2017

To explore the effect of the nature of substitutions on the structural parameters and hydrogen-bond interactions inN-acylhydrazone derivatives, the crystal structures of threeortho-substitutedN-acylhydrazone derivatives, namely (E)-N-{2-[2-(2-chlorobenzylidene)hydrazinyl]-2-oxoethyl}-4-methylbenzenesulfonamide, C16H16ClN3O3S (I), (E)-N-{2-[2-(2-methylbenzylidene)hydrazinyl]-2-oxoethyl}-4-methylbenzenesulfonamide, C17H19N3O3S (II), and (E)-N-{2-[2-(2-nitrobenzylidene)hydrazinyl]-2-oxoethyl}-4-methylbenzenesulfonamide, C16H16N4O5S (III), have been determined. The structures of the three compounds display similar molecular conformations and hydrogen-bond patterns. The hydrazone part of the molecule, C—C—N—N=C, is almost planar in all the compounds, with the C—C—N—N and C—N—N=C torsion angles being 179.5 (3) and 177.1 (3)°, respectively, in (I), −179.4 (2) and −177.1 (3)° in (II) and −179.7 (2) and 173.4 (2)° in (III). The two phenyl rings on either side of the chain are approximately parallel to each other. In the crystal, the molecules are linked to each otherviaN—H...O hydrogen bonds, forming ribbons withR22(8) andR22(10) ring motifs. The introduction of electron-withdrawing groups (by a chloro or nitro group) to produce compounds (I) or (III) results in C—H...O hydrogen-bonding interactions involving the sulfonyl O atoms of adjacent ribbons, forming layers parallel to theabplane in (I) or a three-dimensional network in (III). In (III), one O atom of the nitro group is disordered over two orientations with refined occupancy ratio of 0.836 (12):0.164 (12).
Histological evaluations and inflammatory responses of different dental implant abutment materials: A human histology pilot study
Authors: Sampatanukul Teeratida , Serichetaphongse Pravej , Pimkhaokham Atiphan
Published: November 2017

Background

Improvements of soft tissue to the abutment surface results in more stable peri‐implant conditions, however, few human histological studies have compared soft tissue responses around different abutment materials.

Purpose

To describe the peri‐implant tissue around 3 abutment materials; titanium, zirconia, and gold alloy, over an 8‐week healing period.

Materials and Methods

Fifteen edentulous sites were treated with implants. Eight weeks later, peri‐implant tissue was harvested and processed using a nonseparation resin embedded technique. The tissue attachment characteristics were assessed at clinical stages using the gingival index (GI) score, surgical stage (surgical score), and histological stage (histological attachment percentage). Additionally, the inflammatory responses were evaluated using inflammatory extent and inflammatory cellularity grades. Nonparametrical statistics were used to describe the GI and surgical scores, and analytical statistics were used to analyze the histological attachment percentages as well as the inflammatory extent and cellularity grades amongst the 3 groups.

Results

There were no statistically significant differences among the groups for GI score (P = .071) and surgical score (P = .262). Titanium and zirconia exhibited nearly similar mean histological attachment percentages while gold alloy had a significantly lower percentage (P = .004). For the inflammatory extent and cellularity grades, the odds of being one grade higher for gold alloy abutment was 5.18 and 17.8 times that of titanium abutment, respectively. However, for the zirconia abutment, the odds were 0.87 and 7.5 times higher than the titanium group.

Conclusions

The tissue around the gold alloy abutments resulted in worse attachment conditions compared with the titanium and zirconia abutments. Inflammation tended to be higher in the tissue around the gold alloy abutments than the titanium and zirconia abutments.
An Examination of Meaning in Life, Satisfaction with Life, Self-Concept and Locus of Control among Teachers
Authors: Taş İbrahim , İskender Murat
Published: November 2017

The aim of this study is to examine meaning in life, satisfaction with life, self-concept and locus of control among teachers by several variables. The research group was composed of 363 teachers (114 [40%] women, 219 [60%] men) working in several districts of İstanbul. The data were collected with Meaning in Life Scale (MLS), Satisfaction with Life Scale (SWLS), Social Comparison Scale (SCS), and Rotter’s Locus of Control Scale (RLCS). Pearson’s Correlation Analysis, Independent Samples T-Test and Mann Whitney-U and Kruskal-Wallis H test were utilized. A positive relationship was found between experienced meaning in life and satisfaction with life and self-concept while a negative relationship was found between experienced meaning in life and locus of control. Expected meaning in life, satisfaction with life and locus of control were found to differ by gender. It was also determined that expected meaning in life and self-concept differed by marital status.
The Kodaira dimension of complex hyperbolic manifolds with cusps
Authors: Bakker Benjamin , Tsimerman Jacob
Published: November 2017

We prove a bound relating the volume of a curve near a cusp in a complex ball quotient$X=\mathbb{B}/\unicode[STIX]{x1D6E4}$to its multiplicity at the cusp. There are a number of consequences: we show that for an$n$-dimensional toroidal compactification$\overline{X}$with boundary$D$,$K_{\overline{X}}+(1-\unicode[STIX]{x1D706})D$is ample for$\unicode[STIX]{x1D706}\in (0,(n+1)/2\unicode[STIX]{x1D70B})$, and in particular that$K_{\overline{X}}$is ample for$n\geqslant 6$. By an independent algebraic argument, we prove that every ball quotient of dimension$n\geqslant 4$is of general type, and conclude that the phenomenon famously exhibited by Hirzebruch in dimension 2 does not occur in higher dimensions. Finally, we investigate the applications to the problem of bounding the number of cusps and to the Green–Griffiths conjecture.
Positive-tone crosslinked molecular resist based on acid-catalyzed depolymerization
Authors: Sharp Brandon L. , Narcross Hannah L. , Tolbert Laren M. , Henderson Clifford L.
Published: November 2017

Presented here is 1,1,1-tris(4-hydroxyphenyl) ethane (THPE)-2VE, a phenol-containing depolymerization resist that demonstrates a 248-nm deep ultraviolet sensitivity (dose-to-clear) of 3 mJ/cm2 as well as a contrast ratio of 7.2 when formulated with 5 mol. % triphenyl sulfonium hexafluoroantimonate as photoacid generator. The 100 keV e-beam contrast curve shows a sensitivity of 24 μC/cm2 for methyl isobutyl ketone (MIBK) development with a contrast ratio of 6.0. A sensitivity of 20 μC/cm2 for 0.26 N tetra methyl ammonium hydroxide (TMAH) development and a contrast ratio of 10.3 was observed for 0.26 N TMAH development. THPE-2VE has been demonstrated to resolve features down to at least 35 nm lines with doses of 48 μC/cm2 in MIBK development with a line edge roughness (LER) (3σ) value of 8.4 nm. In 0.26 N TMAH development, the material required an e-beam dose of 40 μC/cm2 to pattern roughly 35 nm lines with an LER (3σ) value of 8.2 nm. This material shows improved sensitivity and shelf life compared to other depolymerization resist designs previously reported by our group. THPE-2VE has been demonstrated to resolve some of the smallest features reported to date with crosslinked depolymerization resists.
Influence of discharge power and bias potential on microstructure and hardness of sputtered amorphous carbon coatings
Authors: Saringer Christian , Oberroither Christoph , Zorn Katrin , Franz Robert , Mitterer Christian
Published: November 2017

This work reports on the influence of the power density and bias potential on the structure-property relations of sputter deposited amorphous carbon coatings. Coatings were deposited at power densities between 4.4 and 28 W/cm2 in both Ar and Ne atmospheres at pressures of 1 and 1.25 Pa, respectively. Measurements of the substrate temperature during deposition indicate that the coating is subjected to a substantial thermal load during deposition, which leads to growth of the graphitic clusters at higher power densities. This change of the microstructure results in a drop of the hardness of up to 40% when the power density increased to 28 W/cm2. A high hardness of up to 30 GPa, however, can be achieved when either a bias potential of −100 V is applied or when Ne instead of Ar is used as process gas. This can be attributed to the high compressive stresses present as a result of an enhanced ion bombardment.
Long-Distance Triathletes’ Intentions to Manipulate Energy and Macronutrient Intake Over a Training Macrocycle
Authors: Kopetschny Hani , Rowlands David , Popovich David , Thomson Jasmine
Published: November 2017

This study explored the information sources long-distance triathletes used to inform their training and nutrition plans, and evaluated these plans over a training macrocycle. Seventy-four long-distance triathletes completed the online survey. Coaches were the most popular training information source (69%), whereas nonprofessional sources (internet 65%, other athletes 53%) were more popular than nutritionists (29%) for nutrition information. Attributes valued most in an information source were: source prior personal experience, individualized advice, breadth of knowledge, and credibility. Sixty-five percent of participants reported previously manipulating dietary intake to improve performance. Forty-three percent reported carbohydrate loading previously, but only 29% planned to carbohydrate load for their upcoming event. Thirty-six percent of participants planned to reduce carbohydrate intake at some point in training, predominantly early (28%) and toward the end (22%) of their macrocycles. Twenty percent of participants planned to maintain energy intake early, and increase (14%) or maintain energy intake (15%) mid-cycle. Triathletes’ training plans showed intentions for concurrent increases in volume and intensity, rather than a classical periodized training progression. Limitations of this study include the lack of diet intake and training data, quantitative comparison with dietary guidelines and high/low carbohydrate classification, and an overrepresentation of women in the study cohort. This research showed the popularity of the internet and other athletes to inform triathletes’ nutrition plans, and revealed intentions to reduce carbohydrate intakes alongside training load increases, contrary to professional guidelines. Understanding athletes’ intentions and sources of nutrition information is crucial to developing effective nutrition education strategies.
Rapid Weight Loss Is Not Associated With Competitive Success in Elite Youth Olympic-Style Boxers in Europe
Authors: Zubac Damir , Karnincic Hrvoje , Sekulic Damir
Published: November 2017

Purpose:To examine the influence of rapid weight loss (RWL) on competitive success in elite youth Olympic-style boxers. In addition, this study examined the practice and prevalence of weight reduction, weight-management protocols, and related symptoms in youth boxers from 12 European countries (N = 83, all males, mean [SD] age 17.1 [0.9] y).Methods:The data were collected using an extensive questionnaire on weight cutting and its associated protocols and symptoms prior to highest-level continental championships. Competition results were obtained at follow-up using a dichotomous variable: medal winning vs nonwinning at the European Championships.Results:Binary logistic regression analysis indicated that “boxing experience” was significantly related to the criterion competitive outcome (odds ratio = 1.33; 95% confidence interval, 1.06–1.66; NagelkerkeR2 = .11), with a higher likelihood of competitive success for more-experienced boxers. Of all the youth boxers, only 25% were included in the RWL group, irrespective of their weight-class stratification. More than 45% of all the youth boxers self-reported the simultaneous combination of different weight-cutting methods that are known to be serious health hazards. Finally, 33% of the boxers experienced muscle weakness as a consequence of RWL.Conclusions:Our study provided evidence of pathogenic weight-management protocols that are widely adopted by youth boxers, and yet the present outcomes showed that RWL did not translate into competitive success in these elite Olympic-style boxers in Europe. Therefore, the authors suggest a mandatory educational program that should simultaneously target all the mentioned issues including both health- and performance-threatening consequences.
Reactive Strength Index: A Poor Indicator of Reactive Strength?
Authors: Healy Robin , Kenny Ian C. , Harrison Andrew J.
Published: November 2017

Purpose:To assess the relationships between reactive strength measures and associated kinematic and kinetic performance variables achieved during drop jumps. A secondary aim was to highlight issues with the use of reactive strength measures as performance indicators.Methods:Twenty-eight national- and international-level sprinters, 14 men and 14 women, participated in this cross-sectional analysis. Athletes performed drop jumps from a 0.3-m box onto a force platform with dependent variables contact time (CT), landing time, push-off time, flight time, jump height (JH), reactive strength index (RSI, calculated as JH/CT), reactive strength ratio (RSR, calculated as flight time/CT), and vertical leg-spring stiffness recorded.Results:A Pearson correlation test found very high to near-perfect relationships between RSI and RSR (r = .91–.97), with mixed relationships between RSI, RSR, and the key performance variables (men:r = −.86 to −.71 between RSI/RSR and CT,r = .80–.92 between RSI/RSR and JH; women:r = −.85 to −.56 between RSR and CT,r = .71 between RSI and JH).Conclusions:The method of assessing reactive strength (RSI vs RSR) may be influenced by the performance strategies adopted, that is, whether athletes achieve their best reactive strength scores via low CTs, high JHs, or a combination. Coaches are advised to limit the variability in performance strategies by implementing upper and/or lower CT thresholds to accurately compare performances between individuals.
Associations Between Bicycling and Reduced Fall-Related Physical Performance in Older Adults
Authors: Harvey Stephen , Rissel Chris , Pijnappels Mirjam
Published: November 2017

Falls among older adults remain a significant public health issue. Bicycling positively influences falls risk factors including reduced balance, muscle weakness, and low self-perceived confidence in maintaining balance. However, this association has not been systematically examined. We recruited 107 community-dwelling participants aged 65 years and older in the Netherlands to determine the relationship between bicycling and falls risk factors. Participants completed three questionnaires on cycling behavior and balance confidence, and also undertook five falls-related physical performance tasks encompassing tests of balance, strength, gait, and endurance. On average, current bicyclists showed significantly better scores in all physical tasks and confidence compared with nonriders ranging from a 10% difference in 6-m walk time to a 141% difference in single-leg balance time (all ps = .01). Type of bike used and duration of bicycling displayed varied associations (.01 < ps < .79). Our findings suggest that bicycle riding warrants further prospective investigation for fall prevention and active aging.
Is there sufficient evidence regarding signage-based stair use interventions? A sequential meta-analysis
Authors: Bauman Adrian , Milton Karen , Kariuki Maina , Fedel Karla , Lewicka Mary
Published: November 2017

Objective

The proliferation of studies using motivational signs to promote stair use continues unabated, with their oft-cited potential for increasing population-level physical activity participation. This study examined all stair use promotional signage studies since 1980, calculating pre-estimates and post-estimates of stair use. The aim of this project was to conduct a sequential meta-analysis to pool intervention effects, in order to determine when the evidence base was sufficient for population-wide dissemination.

Design

Using comparable data from 50 stair-promoting studies (57 unique estimates) we pooled data to assess the effect sizes of such interventions.

Results

At baseline, median stair usage across interventions was 8.1%, with an absolute median increase of 2.2% in stair use following signage-based interventions. The overall pooled OR indicated that participants were 52% more likely to use stairs after exposure to promotional signs (adjusted OR 1.52, 95% CI 1.37 to 1.70). Incremental (sequential) meta-analyses using z-score methods identified that sufficient evidence for stair use interventions has existed since 2006, with recent studies providing no further evidence on the effect sizes of such interventions.

Conclusions

This analysis has important policy and practice implications. Researchers continue to publish stair use interventions without connection to policymakers' needs, and few stair use interventions are implemented at a population level. Researchers should move away from repeating short-term, small-scale, stair sign interventions, to investigating their scalability, adoption and fidelity. Only such research translation efforts will provide sufficient evidence of external validity to inform their scaling up to influence population physical activity.