bluuebunny/crossref_metadata_2025 huggingface dataset:
Mobility balance in the light-emitting layer governs the polaron accumulation and operational stability of organic light-emitting diodes
Authors: Kim Jae-Min , Lee Chang-Heon , Kim Jang-Joo
Published: November 2017

Organic light-emitting diode (OLED) displays are lighter and more flexible, have a wider color gamut, and consume less power than conventional displays. Stable materials and the structural design of the device are important for OLED longevity. Control of charge transport and accumulation in the device is particularly important because the interaction of excitons and polarons results in material degradation. This research investigated the charge dynamics of OLEDs experimentally and by drift-diffusion modeling. Parallel capacitance–voltage measurements of devices provided knowledge of charge behavior at different driving voltages. A comparison of exciplex-forming co-host and single host structures established that the mobility balance in the emitting layers determined the amount of accumulated polarons in those layers. Consequently, an exciplex-forming co-host provides a superior structure in terms of device lifetime and efficiency because of its well-balanced mobility. Minimizing polaron accumulation is key to achieving long OLED device lifetimes. This is a crucial aspect of device physics that must be considered in the device design structure.
Tuning domain wall velocity with Dzyaloshinskii-Moriya interaction
Authors: Ajejas Fernando , Křižáková Viola , de Souza Chaves Dayane , Vogel Jan , Perna Paolo , Guerrero Ruben , Gudin Adrian , Camarero Julio , Pizzini Stefania
Published: November 2017

We have studied a series of Pt/Co/M epitaxial trilayers, in which Co is sandwiched between Pt and a nonmagnetic layer M (Pt, Ir, Cu, and Al). Using polar magneto-optical Kerr microscopy, we show that the field-induced domain wall speeds are strongly dependent on the nature of the top layer, increase going from M = Pt to lighter top metallic overlayers, and can reach several 100 m/s for Pt/Co/Al. The domain wall (DW) dynamics is consistent with the presence of chiral Néel walls stabilized by the interfacial Dzyaloshinskii-Moriya interaction (DMI) whose strength increases going from Pt to Al top layers. This is explained by the presence of DMI with opposite signs at the Pt/Co and Co/M interfaces, the latter increasing in strength going towards heavier atoms, possibly due to the increasing spin-orbit interaction. This work shows that in non-centrosymmetric trilayers, the domain wall dynamics can be finely tuned by engineering the DMI strength, in view of efficient devices for logic and spintronic applications.
Seeking an accurate generalized-gradient approximation functional for high pressure molecular fluids
Authors: Dubois Vincent , Desbiens N. , Clérouin J.
Published: November 2017

We propose to assess the performance of density functional theory calculations to predict the properties of CO2, H2O, and N2 fluids under high pressure (up to 40 GPa), which are representatives of not only detonation products but also giant planet interiors. Twenty-two generalized-gradient approximation functionals, presently in the ABINIT code, have been compared to molecular data and experimental equations of state of supercritical fluids. We found that the Perdew, Burke, and Ernzerhof (PBE) functional with Grimme's dispersion correction (D3) gives the best results. The residual error of PBE-D3 on pressure is estimated around 15%.
Transition of EMRIs through resonance: Corrections to higher order in the on-resonance flux modification
Authors: Mihaylov Deyan P. , Gair Jonathan R.
Published: November 2017

Extreme-mass-ratio inspirals are candidate events for gravitational wave detection in the millihertz band (by detectors like Laser Interferometer Space Antenna (lisa)). These events involve a stellar-mass black hole, or a similar compact object, descending in the gravitational field of a supermassive black hole, eventually merging with it. Properties of the inspiralling trajectory away from resonance are well known and have been studied extensively; however, little is known about the behaviour of these binary systems at resonance, when the radial and lateral frequencies of the orbit become commensurate. We describe the two existing models: the instantaneous frequency approach used by Gair, Bender, and Yunes and the standard two-time scale approach implemented by Flanagan and Hinderer. In both cases, the exact treatment depends on the modeling of the gravitational self-force, which is currently not available. We extend the results from the work of Gair, Bender, and Yunes to higher order in the on-resonance flux modification and argue that the instantaneous frequency approach is also a valid treatment of the resonance problem. The non-linear differential equations which arise in treating resonances are interesting from a mathematical view point. We present our algorithm for perturbative solutions and the results to third order in the infinitesimal parameter and discuss the scope of this approach.
Persistence property in a two-species chemotaxis system with two signals
Authors: Zheng Pan , Mu Chunlai , Hu Xuegang
Published: November 2017

This paper deals with a two-species chemotaxis system with two different signals under homogeneous Neumann boundary conditions in a bounded convex domain with the non-negative initial data. This system is a generalization of the classical Keller-Segel chemotaxis models to the case of two species which are attracted by two different chemical signals. Under suitable conditions, it is proved that for any non-negative global classical solutions, the masses of two species do not extinct at any time.
Mathematical modelling and simulation of a solar water heater for an aviculture unit using MATLAB/SIMULINK
Authors: Yousef Nezhad Mohammad Esmaeil , Hoseinzadeh Siamak
Published: November 2017

In this study, a MATLAB/SIMULINK model of a solar water heater has been developed and simulated for an aviculture building in Tehran, Iran. The thermal behavior of the subsystems, such as temperature changes of the collector, heat exchanger, and storage tank, etc., has been determined. Three different simulation approaches have been considered. The thermal performance of the system was evaluated by proposing two auxiliary heaters within the storage tank and using them in three different cases. The results showed that the collector surface area has a great impact on the absorber plate average temperature. Also, a greater amount of auxiliary heating would cause the inlet and outlet of the heat exchanger to be equal for a much longer time and thus reduce the heat exchanger efficiency.
Introgression of allelic diversity from genetically distinct variants of Brassica rapa into Brassica napus canola and inheritance of the B. rapa alleles
Authors: Attri Rohit , Rahman Habibur
Published: November 2017

Broadening of genetic diversity in spring oilseed Brassica napus L. (AACC, 2n = 38) canola is important for continued improvement of this crop. For this, the vast allelic diversity of the A genome of Brassica rapa L. (AA, 2n = 20) can be utilised. We investigated the prospect of developing canola-quality euploid B. napus lines carrying the alleles of B. rapa from F2 and BC1 (F1 × B. napus) populations of three B. napus × B. rapa interspecific crosses involving one B. napus and three genetically distinct B. rapa parents. In meiosis, the F1 AAC hybrid was expected to show normal segregation for the A genome chromosomes, whereas a range of C chromosomes from zero to nine was expected to be included in the gametes due to random segregation of this haploid set of chromosomes. Subsequent self-pollination, theoretically, should have eliminated the unpaired C chromosomes and resulted in a majority of B. rapa type. However, no B. rapa-type progeny were detected, and all progeny in the F8 conformed to be B. napus type. Correlation between parent and offspring generation, grown in greenhouse or field, was weak to moderate for seed glucosinolate content; however, the simpler genetic control of this trait, involving only the A genome loci, allowed the development of low-glucosinolate lines from this interspecific cross. Of the theoretical number of simple sequence repeat (SSR) marker alleles of B. rapa expected to be present in F4 and F8 populations, about 45% were detected in these populations, suggesting that the loss of these marker alleles occurred prior to the F4 generation. Loss of several SSR loci was also detected in these populations, which probably resulted from homoeologous pairing and rearrangements of the chromosomes of the A and C genomes. Genetic diversity analysis performed on the F8 progeny of two crosses showed that the two populations clustered into distinct groups, which demonstrates that they inherited SSR B. rapa alleles unique to each B. rapa parent. We conclude that B. rapa alleles from diverse sources can be readily incorporated into B. napus progeny by this interspecific crossing method.
Socioeconomic status and genetic influences on cognitive development
Authors: Figlio David N. , Freese Jeremy , Karbownik Krzysztof , Roth Jeffrey
Published: November 2017

Significance

A prominent hypothesis in the study of intelligence is that genetic influences on cognitive abilities are larger for children raised in more advantaged environments. Evidence to date has been mixed, with some indication that the hypothesized pattern may hold in the United States but not elsewhere. We conducted the largest study to date using matched birth and school administrative records from the socioeconomically diverse state of Florida, and we did not find evidence for the hypothesis.
RSK2 phosphorylates T-bet to attenuate colon cancer metastasis and growth
Authors: Yao Ke , Peng Cong , Zhang Yuwen , Zykova Tatyana A. , Lee Mee-Hyun , Lee Sung-Young , Rao Enyu , Chen Hanyong , Ryu Joohyun , Wang Lei , Zhang Yi , Gao Ge , He Wei , Ma Wei-Ya , Liu Kangdong , Bode Ann M. , Dong Ziming , Li Bing , Dong Zigang
Published: November 2017

Significance

Many patients with colorectal cancer die because of metastases in distant organs such as the liver and lungs, rather than from the primary tumor. A better molecular understanding of colorectal cancer has allowed for improved patient prognosis and the launching of precision medicine for treating metastatic colorectal cancer. Here we demonstrate that a deficiency of ribosomal S6 kinase 2 (RSK2) can result in dramatically decreased IFNγ secretion through an inappropriate phosphorylation status of T-bet, a modulator of IFNγ expression. Decreased IFNγ levels can lead to immune suppression, accelerating colon cancer-mediated liver and lung metastasis. We found that RSK2-mediated phosphorylation of T-bet at serines 498 and 502 is required for the inhibition of colon cancer metastasis and growth, through a positive regulation of RSK2/T-bet/IFNγ signaling.
Mechanism of SOA formation determines magnitude of radiative effects
Authors: Zhu Jialei , Penner Joyce E. , Lin Guangxing , Zhou Cheng , Xu Li , Zhuang Bingliang
Published: November 2017

Significance

Secondary organic aerosol (SOA) forms via a variety of processes and plays a key role in climate change and air quality. Recent measurements indicate that most SOA exists as an internal mixture with other aerosols. This study examines the radiative effect of using a mixing state for SOA that depends on the process of formation, based on an explicit mechanism for the chemical production of SOA. The radiative forcing of SOA in the future is estimated using this approach. A surprising result is that the contribution of SOA to radiative forcing increases substantially (becomes more negative) in the future even though the increase of its burden is slight.
Adaptive benefits from small mutation supplies in an antibiotic resistance enzyme
Authors: Salverda Merijn L. M. , Koomen Jeroen , Koopmanschap Bertha , Zwart Mark P. , de Visser J. Arjan G. M.
Published: November 2017

Significance

Breeding protocols in biotechnology focus on fast short-term responses by selecting extreme phenotypes from maximally diverse pools of heritable variants. However, when interactions among alleles are unpredictable, optimizing long-term responses may require intermediate stages with low or modest improvement. By subjecting mutant libraries of an antibiotic-degrading enzyme of different sizes to selection with a new antibiotic, we find support for this prediction: despite slower initial improvement due to limited genetic variation, the final alleles from two small libraries reached the highest antibiotic-resistance levels overall due to a broader exploration of the adaptive landscape. Our results present a cautionary tale for “greedy” adaptation protocols in biotechnology and call for quantitative data on mutation supplies in the clinical evolution of antibiotic resistance.
Closed-loop control of targeted ultrasound drug delivery across the blood–brain/tumor barriers in a rat glioma model
Authors: Sun Tao , Zhang Yongzhi , Power Chanikarn , Alexander Phillip M. , Sutton Jonathan T. , Aryal Muna , Vykhodtseva Natalia , Miller Eric L. , McDannold Nathan J.
Published: November 2017

Significance

Focused ultrasound is currently the only method of reversible blood–brain barrier disruption for targeted drug delivery without incision or radiation. A significant challenge for its clinical translation is a lack of reliable real-time treatment control. Here a closed-loop, real-time control paradigm is shown capable of sustaining stable microbubble oscillations at a preset level while minimizing microbubble behavior that may result in vascular damage. Tested at clinically relevant frequency in healthy and tumor-bearing rats, our approach enables targeted delivery of predefined drug concentrations within a therapeutically effective range in both normal tissue and glioma, while maintaining a safe exposure level. It can be readily implemented clinically for delivering chemotherapeutics or other agents and potentially applied to other cavitation-enhanced ultrasound therapies.
Matter wave speckle observed in an out-of-equilibrium quantum fluid
Authors: Tavares Pedro E. S. , Fritsch Amilson R. , Telles Gustavo D. , Hussein Mahir S. , Impens François , Kaiser Robin , Bagnato Vanderlei S.
Published: November 2017

Significance

In recent years, significant progress concerning matter–wave creation and manipulation has been achieved. Fresnel diffraction, atom lasers, and nonlinear matter wave phenomena are just a few examples of recent interesting research topics. There have also been numerous studies related to the propagation of matter waves interacting with disordered potentials, but not as many concerning the disorder existing into the matter wave itself. In the present study, we analyze the disorder imprinted into a Bose–Einstein condensate (BEC) and its characteristic spatial evolution afterward. We performed careful analyses and traced a few analogies that led us to the conclusion that the perturbed BECs evolve very much in a speckle-like manner, in close analogy with a traveling-light (optical) speckle.
Correlating kinetic and structural data on ubiquinone binding and reduction by respiratory complex I
Authors: Fedor Justin G. , Jones Andrew J. Y. , Di Luca Andrea , Kaila Ville R. I. , Hirst Judy
Published: November 2017

Significance

Respiratory complex I, a redox-coupled proton pumping enzyme, is central to aerobic metabolism in mammalian mitochondria and implicated in many neuromuscular disorders. One of its substrates, ubiquinone-10, binds in an unusually long and narrow channel, which is at the intersection of the enzyme’s electron and proton transfer modules and a hotspot for disease-causing mutations. Here, we use a minimal, self-assembled respiratory chain to study complex I catalyzing with ubiquinones of different isoprenoid chain lengths. We show that the channel enhances the affinity of long-chain quinones, assists in their transfer along the channel, and organizes them for product release. Finally, we discuss how efficient binding and dissociation processes may help to link redox catalysis to proton pumping for energy conversion.
Normalized value coding explains dynamic adaptation in the human valuation process
Authors: Khaw Mel W. , Glimcher Paul W. , Louie Kenway
Published: November 2017

Significance

Relative processing is a ubiquitous feature of neural and cognitive function. In perception, a prominent example of relative processing is adaptation, in which both sensory neural responses and resulting percepts depend on the history of past stimuli. Neurons in decision-related brain areas also adapt, representing value information relative to previous rewards, but whether adaptive value coding affects behavior is unknown. Here, we show adaptation in the subjective valuation process of human subjects, with values consistently dependent on the recent history of presented values. This adaptive valuation can be explained by divisive normalization, a canonical neural computation widely observed in sensory processing, offering a unifying biological mechanism for temporal context effects in perception and decision making.
Aging and the Social Ecology of Everyday Interpersonal Perception: What is Perceived, in Whom, and Where?
Authors: Castro Vanessa L , Isaacowitz Derek M
Published: November 2017

Objectives

Despite a proliferation of research in interpersonal perception and aging, no research has identified the nature of the social and emotional perceptions made by aging individuals in everyday life. In this study, we aimed to identify the social ecological features that characterize everyday interpersonal perception across the adult lifespan.

Method

Three studies were conducted. Study 1 identified and compared the targets and locations of young, middle-age, and older adults’ everyday interpersonal perceptions; these perceptions were categorized into types in Study 2. Study 3 applied these categorizations to identify and compare the social ecology surrounding aging individuals’ interpersonal perceptions.

Results

Everyday interpersonal perceptions were directed toward familiar others and occurred in familiar locations, although the specific familiar targets and locations sometimes varied significantly with age. However, the types of perceptions made in everyday life did not vary significantly between age groups.

Discussion

Aging individuals make similar types of interpersonal judgments, but the targets and locations of these judgments may change with age. Future studies on interpersonal perception and aging will need to account for these features of the aging individual’s social ecology to provide an accurate assessment of the aging process.
Strategic leadership capacity building for Sub-Saharan African health systems and public health governance: a multi-country assessment of essential competencies and optimal design for a Pan African DrPH
Authors: Agyepong Irene Akua , Lehmann Uta , Rutembemberwa Elizeus , Babich Suzanne M , Frimpong Edith , Kwamie Aku , Olivier Jill , Teddy Gina , Hwabamungu Boroto , Gilson Lucy
Published: November 2017

Leadership capacity needs development and nurturing at all levels for strong health systems governance and improved outcomes. The Doctor of Public Health (DrPH) is a professional, interdisciplinary terminal degree focused on strategic leadership capacity building. The concept is not new and there are several programmes globally–but none within Africa, despite its urgent need for strong strategic leadership in health. To address this gap, a consortium of institutions in Sub-Saharan Africa, UK and North America have embarked on a collaboration to develop and implement a pan-African DrPH with support from the Rockefeller Foundation. This paper presents findings of research to verify relevance, identify competencies and support programme design and customization. A mixed methods cross sectional multi-country study was conducted in Ghana, South Africa and Uganda. Data collection involved a non-exhaustive desk review, 34 key informant (KI) interviews with past and present health sector leaders and a questionnaire with closed and open ended items administered to 271 potential DrPH trainees. Most study participants saw the concept of a pan-African DrPH as relevant and timely. Strategic leadership competencies identified by KI included providing vision and inspiration for the organization, core personal values and character qualities such as integrity and trustworthiness, skills in adapting to situations and context and creating and maintaining effective change and systems. There was consensus that programme design should emphasize learning by doing and application of theory to professional practice. Short residential periods for peer-to-peer and peer-to-facilitator engagement and learning, interspaced with facilitated workplace based learning, including coaching and mentoring, was the preferred model for programme implementation. The introduction of a pan-African DrPH with a focus on strategic leadership is relevant and timely. Core competencies, optimal design and customization for the sub-Saharan African context has broad consensus in the study setting.
Lessons to learn from epidemiologic studies in ARDS
Authors: McNicholas Bairbre A. , Rooney Grainne M. , Laffey John G.
Published: November 2017

Purpose of review

Recent advances in our understanding of the epidemiology of ARDS has generated key insights into the incidence, risk factors, demographics, management and outcomes from this devastating clinical syndrome.

Recent findings

ARDS occurs in 10% of all ICU patients, in 23% of all mechanically ventilated patients, with 5.5 cases per ICU bed each year. Although some regional variation exists regarding ARDS incidence, this may be less than previously thought. Subphenotypes are increasingly identified within the ARDS cohort, with studies identifying a ‘hyperinflammatory’ or ‘reactive’ subgroup that has a higher mortality, and may respond differently to therapeutic interventions. Demographic factors, such as race, may also affect the therapeutic response. Although mortality in ARDS is decreasing in clinical trials, it remains unchanged at approximately 40% in major observational studies. Modifiable ventilatory management factors, including PEEP, airway pressures, and respiratory rate are associated with mortality in ARDS. Hospital and ICU organizational factors play a role in outcome, whereas socioeconomic status is independently associated with survival in patients with ARDS. The Kigali adaptation of the Berlin ARDS definition may provide useful insights into the burden of ARDS in the developing world.

ARDS exerts a substantial disease burden, with 40% of patients dying in hospital. Diverse factors, including patient-related factors such as age and illness severity, country level socioeconomic status, and ventilator management and ICU organizational factors each contribute to outcome from ARDS. Addressing these issues provides opportunities to improve outcome in patients with ARDS.
Environmental and epigenetic regulation of postprandial lipemia
Authors: Parnell Laurence D. , Ordovas Jose M. , Lai Chao-Qiang
Published: November 2017

Purpose of review

Postprandial lipemia (PPL), the prolonged increase in plasma triglyceride-rich lipoproteins following food consumption, is an independent risk factor for cardiovascular disease. Genetic variation, environment and the interplay between these direct an individual's postprandial lipid response. From such interplay, inducible and reversible epigenetic changes arise. Increasing evidence suggests epigenetic variation contributes to postprandial response in lipids and risk.

Recent findings

Diet and exercise are central agents affecting postprandial lipemia - triglyceride, but heterogeneity of the findings warrant more and larger studies. Several epigenetic loci identified from a human intervention study account for a substantial proportion of PPL phenotype variation, but the burden to conduct an intervention study of postprandial responses likely limits translation to personalized nutrition.

The impact of both DNA methylation patterns and environmental factors such as diet, exercise, sleep and medication on PPL is multifaceted. Discovery of interactions that modify the association between CpG (oligodeoxydinucleotide) methylation and postprandial phenotypes is unfolding.
Why we do not expect dispersal probability density functions based on a single mechanism to fit real seed shadows
Authors: Cousens Roger D. , Hughes Barry D. , Mesgaran Mohsen B.
Published: November 2017

Bullock et al. (Journal of Ecology105:6‐19, 2017) have suggested that the theory behind the Wald Analytical Long Distance (WALD) model for wind dispersal from a point source needs to be re‐examined. This is on the basis that an inverse Gaussian probability density function (pdf) does not provide the best fit to seed shadows around individual source plants known to be dispersed by wind.

We present two reasons why we would not necessarily expect any of the standard mechanistically derived pdfs to fit real seed shadows any better than empirical functions.

Firstly, the derivation of “off‐the‐shelf” pdfs such as the Gaussian, exponential and inverse Gaussian involves only one of the processes and factors that together generate a real seed shadow. It is implausible to expect that a single‐process model, no matter how sophisticated in detail, will capture the behaviour of an entire, complex system, which may involve a number of sequential random processes, or a superposition of parallel random processes, or both.

Secondly, even if there is only one process involved and we have a perfect model for that process, the basic parameters of the model would be difficult to pin down precisely. Moreover, these parameters are unlikely to remain constant over a dispersal season, so that effectively we observe the outcome of a linear combination of dispersal events with different parameter values, constituting a form of averaging over the parameters of the distribution. Simple examples show that averaging a pdf over its parameters can lead to a pdf from an entirely different class.

Synthesis. The failure of the inverse Gaussian model to fit seed shadow data is not in itself a reason to doubt the validity of theWald Analytical Long Distancemodel for movement of particles through the air under specified environmental conditions. A greater awareness is needed of the differences between theWald Analytical Long Distanceand the inverse Gaussian (or Wald) and the purposes for which they are used. The complexity of dispersing populations of seeds means that any of the standard mechanistically derived pdfs will actually be merely empirical in this context. Shape and flexibility of a pdf is far more important for adequately describing data than some perceived higher status.
Medicare Advantage and Fee‐for‐Service Performance on Clinical Quality and Patient Experience Measures: Comparisons from Three Large States
Authors: Timbie Justin W. , Bogart Andy , Damberg Cheryl L. , Elliott Marc N. , Haas Ann , Gaillot Sarah J. , Goldstein Elizabeth H. , Paddock Susan M.
Published: November 2017

Objective

To compare performance between Medicare Advantage (MA) and Fee‐for‐Service (FFS) Medicare during a time of policy changes affecting both programs.

Data Sources/Study Setting

Performance data for 16 clinical quality measures and 6 patient experience measures for 9.9 million beneficiaries living in California, New York, and Florida.

Study Design

We compared MA and FFS performance overall, by plan type, and within service areas associated with contracts between CMS and MA organizations. Case mix‐adjusted analyses (for measures not typically adjusted) were used to explore the effect of case mix on MA/FFS differences.

Data Collection/Extraction Methods

Performance measures were submitted by MA organizations, obtained from the nationwide fielding of the Medicare Consumer Assessment of Healthcare Providers and Systems (MCAHPS) Survey, or derived from claims.

Principal Findings

Overall, MA outperformed FFS on all 16 clinical quality measures. Differences were large for HEDIS measures and small for Part D measures and remained after case mix adjustment. MA enrollees reported better experiences overall, but FFS beneficiaries reported better access to care. Relative to FFS, performance gaps were much wider for HMOs than PPOs. Excluding HEDIS measures, MA/FFS differences were much smaller in contract‐level comparisons.

Conclusions

Medicare Advantage/Fee‐for‐Service differences are often large but vary in important ways across types of measures and contracts.
Effects of Guideline and Formulary Changes on Statin Prescribing in the Veterans Affairs
Authors: Markovitz Adam A. , Holleman Rob G. , Hofer Timothy P. , Kerr Eve A. , Klamerus Mandi L. , Sussman Jeremy B.
Published: November 2017

Objective

To compare the effects of two sequential policy changes—the addition of a high‐potency statin to the Department of Veterans Affairs (VA) formulary and the release of the American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guidelines—on VA provider prescribing.

Data Sources/Study Setting

Retrospective analysis of 1,100,682 VA patients, 2011–2016.

Study Design

Interrupted time‐series analysis of changes in prescribing of moderate‐to‐high‐intensity statins among high‐risk patients and across high‐risk subgroups. We also assessed changes in prescribing of atorvastatin and other statin drugs. We estimated marginal effects (ME) of formulary and guideline changes by comparing predicted and observed statin use.

Data Collection/Extraction Methods

Data from VA Corporate Data Warehouse.

Principal Findings

The use of moderate‐to‐high‐intensity statins increased by 2 percentage points following the formulary change (ME, 2.4, 95% confidence interval [CI], 2.2 to 2.6) and less than 1 percentage point following the guideline change (ME, 0.8, 95% CI, 0.6 to 0.9). The formulary change led to approximately a 12 percentage‐point increase in the use of moderate‐to‐high‐intensity atorvastatin (ME, 11.5, 95% CI, 11.3 to 11.6). The relatively greater provider response to the formulary change occurred across all patient subgroups.

Conclusions

Addition of a high‐potency statin to formulary affected provider prescribing more than the ACC/AHA guidelines.
Geographic Disparities in Access to Nursing Home Services: Assessing Fiscal Stress and Quality of Care
Authors: Park Young Joo , Martin Erika G.
Published: November 2017

Objective

We test whether nursing homes serving predominately low‐income and racial minority residents (compositional explanation) or located in neighborhoods with higher concentrations of low‐income and racial minority residents (contextual explanation) have worse financial outcomes and care quality.

Data Sources

Healthcare Cost Report Information System, Nursing Home Compare, Online Survey Certification and Reporting Certification, and American Community Survey.

Study Design

A cross‐sectional study design of nursing homes within U.S. metropolitan areas.

Data Collection/Extraction Methods

Data were obtained from Centers for Medicare & Medicaid Services and U.S. Census Bureau.

Principal Findings

Medicaid‐dependent nursing homes have a 3.5 percentage point lower operating ratio. Those serving primarily racial minorities have a 2.64‐point lower quality rating. A 1 percent increase in the neighborhood population living in poverty is associated with a 1.20‐point lower quality rating, on a scale from 10 to 50, and a 1 percent increase in the portion of neighborhood black residents is associated with a 0.8 percentage point lower operating ratio and a 0.37 lower quality rating.

Conclusions

Medicaid dependency (compositional effect) and concentration of racial minority residents in neighborhoods (contextual effect) are associated with higher fiscal stress and lower quality of care, indicating that nursing homes’ geographic location may exacerbate long‐term care inequalities.
Bovine Milk Allergens: A Comprehensive Review
Authors: Villa Caterina , Costa Joana , Oliveira Maria Beatriz P.P. , Mafra Isabel
Published: November 2017

Cow milk allergy is one of the most common food allergies in early childhood and often persists through adult life, forcing an individual to a complete elimination diet. Milk proteins are present in uncounted food products, such as cheese, yogurt, or bakery item, exposing allergic persons to a constant threat. Many efforts have been made to overcome this global problem and to improve the life quality of allergic individuals. First, proper and reliable food labeling is fundamental for consumers, but the verification of its compliance is also needed, which should rely on accurate and sensitive analytical methods to detect milk allergens in processed foods. At the same time, strategies to reduce milk allergenicity, such as immunotherapy or the use of food processing techniques to modify allergen structure, have to be extensively studied. Recent research findings on the applicability of food processing, such as heat treatment, fermentation, or high pressure, have revealed great potential in reducing milk allergenicity. In this review, significant research advances on cow milk allergy are explored, focusing on prevalence, diagnosis, and therapy. Molecular characterization of cow milk allergens and cross‐reactivity with other nonbovine milk species are described, as well as the effects of processing, food matrix, and digestibility on milk allergenicity. Additionally, analytical methods for the detection of milk allergens in food are described, from immunoassays and mass spectrometry methods for protein analysis to real‐time polymerase chain reaction for DNA analysis.
Does buyer heterogeneity steepen or flatten quantity discounts?
Authors: Conlon John R.
Published: November 2017

This article argues that as the distribution of a firm's buyers becomes more heterogeneous, the firm's profit‐maximizing quantity‐discount schedule becomes less steep. First, we note that one measure of heterogeneity is the slope of the hazard function, expressed in terms of a simple crossing condition. We then show that marginal price schedules, for distributions of buyers which are more heterogeneous by this measure, are less negatively sloped in that they cross schedules for more homogeneous distributions from below. Intuitively, quantity discounts are a response to an individual buyer's declining marginal utilities, and buyer heterogeneity interferes with this response.
The accuracy of hospital merger screening methods
Authors: Garmon Christopher
Published: November 2017

This article analyzes the accuracy of various prospective hospital merger screening methods used by antitrust agencies and the courts. The predictions of the screening methods calculated with pre‐merger data are compared with the actual post‐merger price changes of 28 hospital mergers measured relative to controls. The evaluated screening methods include traditional structural measures (e.g., Herfindahl‐Hirschman Index), measures derived from hospital competition models (e.g., diversion ratios, willingness‐to‐pay, and upward pricing pressure), and hospital merger simulation. Willingness‐to‐pay and upward pricing pressure are found to be more accurate at flagging potentially anticompetitive mergers for further investigation than traditional methods.
Using multi‐response models to investigate pathogen coinfections across scales: Insights from emerging diseases of amphibians
Authors: Stutz William E. , Blaustein Andrew R. , Briggs Cheryl J. , Hoverman Jason T. , Rohr Jason R. , Johnson Pieter T. J.
Published: November 2017

Associations among parasites affect many aspects of host–parasite dynamics, but a lack of analytical tools has limited investigations of parasite correlations in observational data that are often nested across spatial and biological scales.

Here we illustrate how hierarchical, multiresponse modelling can characterize parasite associations by allowing for hierarchical structuring, offering estimates of uncertainty and incorporating correlational model structures. After introducing the general approach, we apply this framework to investigate coinfections among four amphibian parasites (the trematodesRibeiroia ondatraeandEchinostomaspp., the chytrid fungusBatrachochytrium dendrobatidisand ranaviruses) and among >2,000 individual hosts, 90 study sites and five amphibian host species.

Ninety‐two percent of sites and 80% of hosts supported two or more pathogen species. Our results revealed strong correlations between parasite pairs that varied by scale (from among hosts to among sites) and classification (microparasite versus macroparasite), but were broadly consistent across taxonomically diverse host species. At the host‐scale, infection by the trematodeR. ondatraecorrelated positively with the microparasites,B. dendrobatidisand ranavirus, which were themselves positively associated. However, infection by a second trematode (Echinostomaspp.) correlated negatively withB. dendrobatidisand ranavirus, both at the host‐ and site‐level scales, highlighting the importance of differential relationships between micro‐ and macroparasites.

Given the extensive number of coinfecting symbiont combinations inherent to natural systems, particularly across multiple host species, multiresponse modelling of cross‐sectional field data offers a valuable tool to identify a tractable number of hypothesized interactions for experimental testing while accounting for uncertainty and potential sources of co‐exposure. For amphibians specifically, the high frequency of co‐occurrence and coinfection among these pathogens—each of which is known to impair host fitness or survival—highlights the urgency of understanding parasite associations for conservation and disease management.
Macroinvertebrate‐based bioassessment of rivers in Addis Ababa, Ethiopia
Authors: Desalegne Solomon A.
Published: November 2017

Chemical‐based studies have shown pollution of rivers in Addis Ababa, Ethiopia. However, as bioassessment is not a component of the river assessment and monitoring programmes, information on the ecological status of the rivers is limited. The study assessed the ecological status of the Little and Greater Akaki Rivers using macroinvertebrates. Macroinvertebrates were collected from twelve sites twice in the dry and wet seasons. There was abundance of few tolerant, collector‐gatherer taxa with a loss of most sensitive taxa that used to be part of the river systems. Macroinvertebrate communities from upper and lower reaches showed complete differentiation on the nonmetric multidimensional scaling (NMS) ordination graph with upstream reaches composed of relatively sensitive taxa while the lower reaches dominated by tolerant taxa. Multiresponse permutation procedure (MRPP) showed significant difference between the two reaches. Macroinvertebrate communities from the dry and wet seasons did not show differentiation on the NMS ordination graph and MRPP did not show significant difference. Both rivers scored low in the South African Scoring System (SASS 5) and ETHbios, indicating ecological degradation. The results suggest that several decades of environmental degradation might have led to impoverished regional species pool, consisting mainly tolerant and generalist taxa constant throughout the year.
The Changing Role of a Bank's Treasury
Authors: Roszkowska Paulina , Prorokowski Lukasz
Published: November 2017

This study investigates the contemporary role of banks’ treasuries and shows how the treasury function is being transformed across the banking sector. Using a sample of international surveys of banks representing both emerging and advanced markets (with 35% of banks representing the Asia–Pacific region), we analyze the current and future challenges faced by treasuries. Including the Asia–Pacific banks in the analysis enables comparison of how the treasury departments differ in their search of revenue diversification under the conditions of tighter credit and liquidity, and what are the problems associated with treasury products offering as part of the revised strategies.
Stage of diagnosis of prostate, breast and colorectal cancer in farm residents compared with other rural and urban residents in New South Wales
Authors: Depczynski Julie , Dobbins Timothy , Armstrong Bruce , Lower Tony
Published: November 2017

Objective

To determine if stage at diagnosis of prostate, breast and colorectal cancers differs between farm, rural non‐farm and urban residents.

Design

Data linkage of baseline survey information from a large cohort study, with state cancer registry records from 2006 to 2009.

Setting

New South Wales, Australia.

Participants

New South Wales residents enrolled in the 45 and Up Study cohort.

Main outcome measures

Adjusted odds ratio of non‐localised cancer stage was modelled using binary logistic regression, controlling for commonly known cancer risk factors.

Results

Overall differences in the odds ratios for later stage prostate, breast and colorectal cancer diagnosis in farm men and women compared with rural non‐farm and urban counterparts were not statistically significant, although farm men had twice the odds of either group of being diagnosed at later stage colorectal cancer. The odds of later stage prostate cancer for farm and urban men were similar, but rural non‐farm men were significantly less likely than urban men to be diagnosed at later stage. Higher household income was associated with later stage breast and prostate cancer; and private health insurance with extras was negatively associated with later stage prostate cancer.

Conclusions

Differences in stage of cancer diagnosis, particularly between farm and rural non‐farm men, remain unexplained but were not statistically significant. Farm men may be at higher risk of later stage colorectal cancer diagnosis, which if confirmed has implications for research on possible reasons, and for the delivery of appropriate cancer diagnostic services in rural areas.
Quality of life is significantly impaired in nonallergic rhinitis patients
Authors: Segboer C. L. , Terreehorst I. , Gevorgyan A. , Hellings P. W. , van Drunen C. M. , Fokkens W. J.
Published: November 2017

Background

In contrast to the well‐known significant impairment of quality of life (QoL) in allergic rhinitis (AR), the degree of impairment in QoL in nonallergic rhinitis (NAR) remained unknown for a long time, due to a lack of a validated questionnaire to assess QoL in the NAR patient group. In this study, a validation of the mini‐RQLQ questionnaire in NAR patients was performed, followed by an assessment of QoL in NAR patients compared to AR and healthy controls. Secondly, use of medication and treatment satisfaction in AR and NAR was assessed.

Methods

The study was an observational cohort study in 287 AR and 160 NAR patients. Patients with symptoms of rhinitis were recruited from a tertiary care outpatient clinic of the Otorhinolaryngology Department. Allergic rhinitis (AR) was defined as one or more positive results on skin prick testing and clinically relevant symptoms of rhinitis related to their sensitization. Nonallergic rhinitis (NAR) was defined as clinically relevant symptoms of rhinitis but without positive results on skin prick testing. The mini‐RQLQ was successfully validated in this study for NAR patients.

Results

Quality of life (QoL) in NAR patients was equally—and for some aspects even more—impaired compared to AR. More than half of both AR and NAR patients were unsatisfied with treatment.

Conclusion

These results demonstrate a significant impairment in both AR and NAR patients in their QoL combined with a low treatment satisfaction, emphasizing the need for adequate treatment, especially in the NAR patient group.
Impact of web‐based clinical practice guidelines on paediatric fracture clinics
Authors: Camp Mark W. , Barnes James R. , Damany Mohita , Donnan Leo T.
Published: November 2017

Background

In an effort to standardize management and reduce over‐treatment of uncomplicated paediatric fractures, the Victorian Pediatric Orthopaedic Network and the Royal Children's Hospital, Melbourne, created publically available web‐based paediatric fracture pathways. The aim of this study was to determine the impact of web‐based fracture pathways on the clinic volume at a tertiary‐care paediatric fracture clinic.

Methods

A comparative retrospective review was performed at a large, urban, tertiary‐care children's hospital. Fracture clinic data from two 12‐week periods before and after implementation of the fracture pathways were compared. For each study period, data collected included: total number of emergency department visits, number of fracture clinic visits, number of fracture clinic visits for patients that presented with upper extremity fractures for which web‐based fracture pathways were available, number of radiology department visits for X‐rays, and number of fracture clinic visits for patients requiring orthopaedic intervention in the operating room (closed or open reductions).

Results

The number of fracture clinic visits for patients with upper extremity fractures decreased 12% post‐pathway implementation, from 954 visits to 842 visits. The number of radiology department visits for patients with upper extremity fractures decreased 24% post‐pathway implementation, from 714 to 544 visits.

Conclusion

The implementation of web‐based fracture pathways for upper extremity paediatric fractures was associated with a decrease in clinic resource utilization at a tertiary‐care children's hospital.
Current evidence for the use of N‐acetylcysteine following liver resection
Authors: Kemp Richard , Mole Jonathan , Gomez Dhanny ,   on behalf of the Nottingham HPB Surgery Group
Published: November 2017

Background

N‐acetylcysteine (NAC) has many uses in medicine; notable in the management of paracetamol toxicity, acute liver failure and liver surgery. The aim of this review was to critically appraise the published literature for the routine use of NAC in liver resection surgery.

Methods

An electronic search was performed of EBSCOhost (Medline and CINAHL database), PubMed and the Cochrane Library for the period 1990–2016. MeSH headings: ‘acetyl‐cysteine’, ‘liver resection’ and ‘hepatectomy’ were used to identify all relevant articles published in English.

Results

Following the search criteria used, three articles were included. Two of these studies were randomized controlled trials. All the studies collated data on morbidity and mortality. All three studies did not show a significant difference in overall complications rates in patients that underwent hepatic resection that had NAC infusion compared with patients that did not. In one study, NAC administration was associated with a higher frequency of grade A post‐hepatectomy liver failure. In another study, a significantly higher incidence of delirium was observed in the NAC group, which led to the trial to be terminated early.

Conclusion

The current published data do not support the routine use of NAC following liver resection.
Effects of supplementary amino acids on available energy of soybean meal determined by difference and regression methods fed to growing pigs
Authors: Zhao Jinbiao , Shi Chuanxin , Li Zhongchao , Wang Ji , Liu Ling , Li Defa , Zhang Shuai
Published: November 2017

This study was conducted to evaluate effects of inclusion level and supplementary amino acids (AAs) on digestible energy (DE) and metabolizable energy (ME) values of soybean meal (SBM) fed to growing pigs, determined by difference and regression methods. Sixty pigs were fed 10 diets according to a 5 × 2 factorial arrangement. Two control diets contained 97.34% corn without supplementary AAs or 95.61% corn with supplementary AAs. Eight diets were formulated by replacing corn and AAs in control diets with 8%, 15%, 25% and 31% SBM. There was no difference in DE and ME values of SBM determined by difference method as inclusion level of SBM increased or crystalline AAs were added. No difference was observed in DE and ME values of SBM determined by the two methods in diets without supplementary AAs, but the values determined by the difference method were greater (P < 0.05) than those determined by regression method when crystalline AAs were added in diets. In conclusion, inclusion level and supplementary AAs did not affect DE and ME values of SBM calculated by difference or regression methods. There were differences in DE and ME values of SBM determined by the difference method and the regression method when crystalline AAs were added in diets.