bluuebunny/crossref_metadata_2025 huggingface dataset:
Implizite Assoziationen mit dem Tod: Erste Validierung einer deutschen Version des Impliziten Assoziationstests für Suizidalität (Suizid-IAT)
Authors: Rath Dajana , Hallensleben Nina , Glaesmer Heide , Spangenberg Lena , Strauss Maria , Kersting Anette , Teismann Tobias , Forkmann Thomas
Published: June 2017

Nock, Park, Finn, et al. 1 entwickelten einen impliziten Assoziationstest für Suizid (Suizid-IAT), der die Stärke der Assoziation zwischen den Kategorien ‚Tod‘ und ‚Ich‘ misst. Sie konnten zeigen, dass Patienten mit einem Suizidversuch eine stärkere Assoziation zwischen ‚Tod‘ und ‚Ich‘ als zwischen ‚Leben‘ und ‚Ich‘ zeigten im Vergleich zu Patienten ohne Suizidversuch. Ziel dieser Studie ist die Vorstellung einer deutschen Version des IATs für Suizid von Nock, Park, Finn, et al. 1 sowie dessen Validierung an einer Stichprobe aus 16 Patienten mit einer depressiven Störung und Suizidgedanken sowie 16 nicht depressiven Kontrollprobanden ohne Suizidgedanken. Außerdem untersuchen wir Zusammenhänge zwischen dem IAT und Suizidgedanken, -verhalten, bekannten Risikofaktoren für Suizidalität wie Depressivität und Hoffnungslosigkeit sowie den zentralen Konzepten der Interpersonalen Theorie suizidalen Verhaltens und Erlebens nach Joiner 2, Thwarted Belongingness und Perceived Burdensomeness. Es zeigte sich, dass Patienten ‚Tod‘ und ‚Ich‘ stärker assoziieren als Kontrollprobanden. Darüber hinaus fanden wir bedeutsame Zusammenhänge impliziter Assoziationen zwischen ‚Tod‘ und ‚Ich‘ mit expliziten Auskünften zu suizidalem Verhalten – über Depressivität, Hoffnungslosigkeit und Suizidgedanken hinaus. Die Ergebnisse sprechen für die Validität dieser deutschen Version des Suizid-IATs und werden im Licht der Theorie suizidalen Verhaltens sowie der aktuellen Suizidforschung diskutiert.
Low-Intensity Cognitive Behavioral Therapy (LI-CBT) – Eine Einführung in Konzepte und Rahmenbedingungen
Authors: Wabnitz Pascal , Löhr Michael , Nienaber André , Hemkendreis Bruno , Kronmüller Klaus , Schulz Michael
Published: June 2017

Die Bezeichnung Low-Intensity Cognitive Behavioral Therapie (LI-CBT) (in der Übersetzung etwa „niedrigintensive kognitive Verhaltenstherapie“) beschreibt Versorgungsangebote, die das Ziel verfolgen, den Zugang zu evidenzbasierten psychologischen Therapien zu verbessern. Dies wird erreicht indem (1) die Kontaktzeit zwischen Therapeut und Patient reduziert wird, (2) Fachkräfte mit speziellem Training aber ohne langjährige psychotherapeutische Qualifikation und (3) Interventionen mit variabler Intensität eingesetzt werden. Gestufte (Stepped-care) und berufsgruppen-vernetzende (Collaborative-care) Versorgungsstrukturen bilden den strukturellen Rahmen für eine erfolgreiche Umsetzung von LI-CBT. Während sich international großangelegte Forschungs- und Praxisprojekte diesem Thema widmen, liegt die Entwicklung in Deutschland deutlich zurück. Gerade vor dem Hintergrund wachsender Bedarfe und Inanspruchnahmen sowie der Zielsetzung von politischer Seite, neue Versorgungsformen zu entwickeln, stellte das Konzept LI-CBT daher einen vielversprechenden Ansatz dar.
Die Eignung der HoNOS (Health of the Nation Outcome Scales) zur Erfassung des Verlaufs und des Schweregrads depressiver Symptomatik im stationären Setting
Authors: Fankhauser Sonja , Hochstrasser Barbara , Sievers Marcus , Soyka Michael
Published: June 2017

Ziel Diese Studie untersuchte die Eignung der „Health of the Nation Outcome Scales“ (HoNOS) zur Erfassung des Verlaufs depressiver Symptomatik und des Schweregrads der Depression im stationären Setting.

Methode Die Stichprobe umfasste 132 depressive Patienten (F32: n=102; F33: n=30). Die HoNOS wurden mittels bivariaten Korrelationen mit der selbstbeurteilten (BDI) und fremdbeurteilten Depressivität (HAMD) verglichen. Die prädiktive Validität wurde mit linearen Regressionsanalysen untersucht.

Ergebnisse Die HoNOS differenzierten zwischen Patienten mit einer mittelgradigen versus schweren Depression (p<0,05) und korrelierten mit der Veränderung der fremdbeurteilten (r=0,25, p<0,008), jedoch nicht mit derjenigen der selbstbeurteilten Depressivität (r=0,19, p>0,008). Die HoNOS sagten die Depressivität bei Austritt nicht voraus (β=0,03, p>0,05).

Schlussfolgerung Da die HoNOS den Verlauf und Schweregrad depressiver Symptomatik nur teilweise erfassen, sollten sie nur kombiniert mit anderen depressionsspezifischen Messinstrumenten angewendet werden.
Deutschsprachige Kurzskalen zur Erfassung auffälligen Essverhaltens
Authors: Richter Felicitas , Strauß Bernhard , Berger Uwe
Published: June 2017

Die Entwicklung von Kurzskalen ist in den letzten Jahren zu einem wichtigen Teilbereich klinisch-psychologischer Diagnostik geworden. Kurzskalen bieten auf Grund ihrer wenigen Items und der schnellen und einfachen Handhabung wesentliche Vorteile für Anwender und Anwenderinnen. Jedoch wird häufig die psychometrische Güte im Rahmen der Entwicklung und Validierung der Verfahren zweitrangig behandelt. Die folgende Übersichtsarbeit stellt 6 Kurzskalen zur Diagnostik von auffälligem Essverhalten und Essstörungen vor: Eating Attitudes Test 8 (EAT-8) Eating Disorder Examination-Questionnaire 8 (EDE-Q8) mit der dazugehörigen Version für Kinder (ChEDE-Q8), ICD-10-Symptom-Rating Subskala Essstörungen (ISR-E), SCOFF-Fragebogen und Short Evaluation of Eating Disorders (SEED). Es wird ein Überblick über die aktuellen Validierungsstudien der deutschen Versionen gegeben. Da nicht jede Kurzskala für jeden Anwendungsbereich und jede Population validiert ist, sollten Anwender und Anwenderinnen bei der Auswahl des Verfahrens auf die Eignung und psychometrische Güte der Kurzskala achten. Ziel der Übersichtsarbeit ist es, die Auswahl und Anwendung eines geeigneten Verfahrens für verschiedene Einsatzgebiete zu erleichtern.
Tanz mit Spitzenschuhen: Besonderheiten, körperliche Voraussetzungen und Tauglichkeitskriterien
Authors: Wanke Eileen , Exner-Grave Elisabeth
Published: June 2017

Das Training mit Spitzenschuhen ist ein fester Bestandteil des klassischen und neoklassischen Tanzes, im professionellen Ausbildungs- sowie im ambitionierten Hobbytanzbereich. Der vor über 100 Jahren entwickelte – und seither nicht grundlegend veränderte dafür notwendige Spitzenschuh – ist hochspezifisch und ein Kompromiss zwischen Ästhetik, Funktion, Sicherheit und Gesundheit. Vor jedem Trainingsbeginn sollte daher eine Überprüfung der Eignung stehen. Mit dieser Fragestellung werden regelmäßig auf dem Gebiet der Medizin tätige Fachkräfte konfrontiert. Für eine Spitzentanz-Eignung (SST) müssen besondere anatomische, sich an der Tanztechnik orientierende allgemeine konditionelle und koordinative sowie spezifische tanztechnische Voraussetzungen erfüllt sein, um sowohl das akute Verletzungsrisiko als auch die Entstehung langfristiger Schäden möglichst gering zu halten. Dafür stehen neben einer (Trainings-)Anamnese mittlerweile verschiedene Testverfahren zur Verfügung, die im Verlauf einer Beratung eine zuverlässige Entscheidung für oder gegen den Spitzentanz ermöglichen. Unter Berücksichtigung der Zielgruppen professioneller Bühnentanz und Hobbytanz liefert dieser Beitrag Grundlagen und strukturierte Handlungsempfehlungen für Spitzentanz-Tauglichkeitsuntersuchungen (SST-TEST).
DNA Barcoding for Industrial Quality Assurance
Authors: Sgamma Tiziana , Lockie-Williams Claire , Kreuzer Marco , Williams Sarah , Scheyhing Ulrike , Koch Egon , Slater Adrian , Howard Caroline
Published: June 2017

DNA barcoding methods originally developed for the identification of plant specimens have been applied to the authentication of herbal drug materials for industrial quality assurance. These methods are intended to be complementary to current morphological and chemical methods of identification. The adoption of these methods by industry will be accelerated by the introduction of DNA-based identification techniques into regulatory standards and monographs. The introduction of DNA methods into the British Pharmacopoeia is described, along with a reference standard for use as a positive control for DNA extraction and polymerase chain reaction (PCR). A general troubleshooting chart is provided to guide the user through the problems that may be encountered during this process. Nevertheless, the nature of the plant materials and the demands of industrial quality control procedures mean that conventional DNA barcoding is not the method of choice for industrial quality control. The design of DNA barcode-targeted quantitative PCR and high resolution melt curve tests is one strategy for developing rapid, robust, and reliable protocols for high-throughput screening of raw materials. The development of authentication tests for wild-harvested Rhodiola rosea L. is used as a case study to exemplify these relatively simple tests. By way of contrast, the application of next-generation sequencing to create a complete profile of all the biological entities in a mixed herbal drug is described and its potential for industrial quality assurance discussed.
Anti-inflammatory and Anti-HIV Compounds from Swertia bimaculata
Authors: Dong Miao , Quan Li-Qiu , Dai Wei-Feng , Yan Shi-Li , Chen Chin-Ho , Chen Xuan-Qin , Li Rong-Tao
Published: June 2017

Three new compounds (1 – 3), including a sesterterpenoid, aspterpenacid C (1), with an unusual 5/3/7/6/5 pentacyclic skeleton, together with seven known ones (4 – 10), were isolated from the ethanol extract of the traditional Chinese medicinal plant Swertia bimaculata. Their structures were elucidated on the basis of the methods of spectroscopic NMR, MS, and computational chemistry. The structure of 1 was further confirmed by single-crystal X-ray diffraction analysis. Compounds 1 – 10 were tested for activities on the inhibition of nitric oxide production and HIV-1 replication in vitro. Compound 1 exhibited moderate activity in inhibiting nitric oxide production (IC50 = 16.1 µM) and HIV-1 replication (EC50 = 1.35 µM).
Conductance modulation in Weyl semimetals with tilted energy dispersion without a band gap
Authors: Yesilyurt Can , Siu Zhuo Bin , Tan Seng Ghee , Liang Gengchiau , Jalil Mansoor B. A.
Published: June 2017

We investigate the tunneling conductance of Weyl semimetal with tilted energy dispersion by considering electron transmission through a p-n-p junction with one-dimensional electric and magnetic barriers. In the presence of both electric and magnetic barriers, we found that a large conductance gap can be produced with the aid of tilted energy dispersion without a band gap. The origin of this effect is the shift of the electron wave-vector at barrier boundaries caused by (i) the pseudo-magnetic field induced by electrical potential, i.e., a newly discovered feature that is only possible in the materials possessing tilted energy dispersion, (ii) the real magnetic field induced by a ferromagnetic layer deposited on the top of the system. We use a realistic barrier structure applicable in current nanotechnology and analyze the temperature dependence of the tunneling conductance. The new approach presented here may resolve a major problem of possible transistor applications in topological semimetals, i.e., the absence of normal backscattering and gapless band structure.
A class of integral-difference operators in a plane: Spectral analysis and application to thin films relaxation in an attractive field
Authors: Melnikov Yuri B.
Published: June 2017

We use a recently developed technique to study in detail a model of thin film relaxation processes in a field. We consider the spectral structure of the operators underlying the dynamics of such processes and provide spectral estimates. Specific attention is paid to centre-symmetric attractive fields, located in circular domains.
A refined understanding of compressibility effects on the stability of drift ballooning modes
Authors: Rhee T. , Park G. Y. , Jhang Hogun , Kim S. S. , Singh R.
Published: June 2017

A study is conducted on the impact of plasma compressibility on the stability of drift ballooning modes. The two-fluid and four-field model developed by Hazeltine et al. [Phys. Fluids 28, 2466 (1985)] is employed in this study. Results of linear numerical simulations show that finite compressibility destabilizes ballooning modes which are otherwise stable due to the ion diamagnetic drift effect. A systematic study reveals that the parallel compressibility originating from the two-fluid effect, rather than the drift-acoustic wave coupling suggested by Hastie et al. [Phys. Plasmas 10, 4405 (2003)], plays the most important role in destabilizing the ballooning modes. An analytic evaluation of the dispersion relation underpins the strong sensitivity of this parallel compressibility term in the ballooning mode stability. The potential impact of this new understanding on the physics of small edge localized modes is discussed.
Enhancement of intensity in a periodically layered metal-dielectric waveguide with magnetized plasma
Authors: Hasanbeigi A. , Ashrafi A. , Mehdian H.
Published: June 2017

Recently, a periodically layered metal-dielectric structure was introduced as a new type of tunable radiation source by Adamo et al. [Phys. Rev. Lett. 103, 113901 (2009); J. Opt. 12, 024012 (2010)]. It is anticipated that the proposed structure forms an important part of future THz systems. In this paper, the effect of plasma, as an extra controlling parameter, on this radiation source has been investigated. The results of the numerical calculations show that the presence of plasma can lead to a significant increase in the output power, and therefore, the device can be tuned over a wide frequency range by changing the plasma density.
Investigation of Tritron as a high power microwave oscillator
Authors: Wu Y.
Published: June 2017

In order to improve the conversion efficiency of the dual cavity oscillator named Bitron, a new type of triple cavity oscillator named Tritron is proposed and investigated in this paper. An intermediate cavity is introduced into the device to enhance the beam modulation depth and the conversion efficiency. The theoretical study shows that the fundamental harmonic current modulation coefficient could exceed 1.16 when the modulated electron beam enters the intermediate cavity at an optimized phase. Accordingly, the maximum theoretical efficiency could exceed the efficiency of the Bitron of 58%. Moreover, an S-band Tritron is designed and verified by the particle-in-cell simulation. An output power of 2.6 GW with a frequency of 2.42 GHz is obtained in the simulation. Compared with the efficiency of 22.2% obtained in the Bitron, the efficiency of the Tritron increases to 41.3%.
Hydrographic characteristics and community structure of epipelagic mesozooplankton in the Dongsha (Pratas) Atoll, South China Sea
Authors: Hsieh Hung-Yen , Hung Jia-Jang , Wang Yu-Huai , Lo Wen-Tseng
Published: June 2017

The relationship between hydrographic features and the community structure of epipelagic mesozooplankton was examined among 10 stations of the water body within the Dongsha (Pratas) Atoll during April (spring), July (summer) and October (autumn) 2011. The hydrographic conditions of the Dongsha Atoll were likely influenced by air temperature and rainfall due to the semi-enclosed topography. Surface water was warm and less saline, particularly in autumn, apparently due to the passage of Typhoon Nalgae. The highest mean (±s.d.) abundance of mesozooplankton was recorded in spring (1204 ± 336individualsm–3) and the lowest was recorded in autumn (45 ± 9individualsm–3). Twenty-six major mesozooplankton groups were observed across the samples collected. Mesozooplankton communities were dominated by calanoid copepods, crab zoea, fish eggs and foraminiferans, which together comprised 86.01% of the total zooplankton catch. The absence of significant correlation between mesozooplankton abundance and chlorophyll-a concentration indicated that the temporal pattern of the mesozooplankton community seems to be more dependent on physical variables than on primary production.
Ionic CD3−Lck interaction regulates the initiation of T-cell receptor signaling
Authors: Li Lunyi , Guo Xingdong , Shi Xiaoshan , Li Changting , Wu Wei , Yan Chengsong , Wang Haopeng , Li Hua , Xu Chenqi
Published: June 2017

Significance

Antigen-induced phosphorylation of T-cell receptor (TCR) is the first signaling event in T cells that determines the functional outcome of antigen stimulation. Here, we report a key regulatory mechanism of the initiation of TCR phosphorylation. Using biochemical and biophysical tools, we find that a basic residue-rich sequence in CD3ε subunit of TCR can efficiently recruit Lck via ionic interaction to initiate TCR phosphorylation. The mechanism reported here can aid in the design of better T-cell therapies such as the Chimeric Antigen Receptor T-cell therapies.
ATM loss leads to synthetic lethality in BRCA1 BRCT mutant mice associated with exacerbated defects in homology-directed repair
Authors: Chen Chun-Chin , Kass Elizabeth M. , Yen Wei-Feng , Ludwig Thomas , Moynahan Mary Ellen , Chaudhuri Jayanta , Jasin Maria
Published: June 2017

Significance

The tumor suppressors BRCA1 and ATM have both been implicated in the early steps of homologous recombination, also termed homology-directed repair (HDR). However, how ATM genetically interacts with BRCA1 in this process is unclear. In mice carrying a breast cancer-derived mutation in the BRCA1 C-terminal (BRCT) domain, we find that ATM becomes essential for supporting the residual levels of HDR necessary to repair a DNA break. ATM-mediated HDR is not affected by the status of 53BP1, an antagonizing factor of BRCA1. ATM loss is associated with synthetic lethality of BRCT mutant mice, which provides insight into the therapeutic potential of utilizing ATM kinase inhibitors in combination with PARP-inhibitor therapy for certain BRCA1-deficient tumors.
Multimodal language use in Savosavo
Authors: Bressem Jana , Stein Nicole , Wegener Claudia
Published: June 2017

Departing from a short overview on pragmatic gestures specialized for the expression of refusal and negation, the article presents first results of a study on those gestures in Savosavo, a Papuan language spoken in the Solomon Islands in the Southwest Pacific. The paper focuses on two partly conventionalized gestures (sweeping and holding away) and shows that speakers of Savosavo use the gestures in a very similar way as speakers of German, English or French, for example. The article shows how a linguistic and semiotic analysis might serve to uncover proto-morpho-semantic structures in a manual mode of communication and contributes to a better understanding of the conventional nature and cross-linguistic distribution of gestures. Moreover, by examining partly conventionalized gestures in a small, little known and endangered language, it presents a particular approach to the analysis of multimodality in the field of language documentation.
Turkish students and their experiences during a short-term summer visit to the U.S.
Authors: Güvendir Emre
Published: June 2017

This study examined the language-related experiences of Turkish students during their time in the U.S., and how these experiences related to their perceptions about learning English in an English-speaking community and interacting with host community members. The study also examined why Turkish students preferred a native speaker environment such as the U.S. as a venue for learning English. The participants of the study included 31 Turkish students who took English classes in a short-term summer study program in the U.S. The study used face-to-face interviews for data collection and content analysis to categorize students’ experiences. Findings show that although the majority of the students benefited from their stay in the U.S., they faced various challenges that limited their interaction with the host community and restricted their access to language input.
Technology, translation and society
Authors: Olohan Maeve
Published: June 2017

Translation studies and social theories of translation tend not to deal adequately with questions regarding the role of technology in translation and have neglected the ways in which technologies, as non-human entities, embody and materialize hegemonic and power relations. This paper seeks to address this shortcoming by looking to science and technology studies (STS) for conceptual frameworks to help us to understand and articulate (a) how popular, deterministic perceptions of translation technology are perpetuated through the discourses of hegemonic actors, (b) how decisions regarding design and use of translation technologies may be studied with reference to their construction and interpretation by relevant social groups, and (c) how a critical theory of technology and an analytical focus on practices can help to focus our attention on the exercise of hegemonic control in the translation sector.
Visualizing and comparing circular genomes using the CGView family of tools
Authors: Stothard Paul , Grant Jason R , Van Domselaar Gary
Published: June 2017

Graphical genome maps are widely used to assess genome features and sequence characteristics. The CGView (Circular Genome Viewer) software family is a popular collection of tools for generating genome maps for bacteria, organelles and viruses. In this review, we describe the capabilities of the original CGView program along with those of subsequent companion applications, including the CGView Server and the CGView Comparison Tool. We also discuss GView, a graphical user interface-enabled rewrite of CGView, and the GView Server, which offers several integrated analyses for identifying shared or unique genome regions relative to a collection of comparison genomes. We conclude with some remarks about our current development efforts related to CGView aimed at adding new functionality while increasing ease of use.
Carbon-ion radiotherapy for patients with advanced stage non–small-cell lung cancer at multicenters
Authors: Karube Masataka , Yamamoto Naoyoshi , Shioyama Yoshiyuki , Saito Junichi , Matsunobu Akira , Okimoto Tamaki , Ohno Tatsuya , Tsuji Hiroshi , Nakano Takashi , Kamada Tadashi
Published: June 2017

Carbon-ion radiation therapy (CIRT) for advanced non–small-cell lung cancer (NSCLC) has not been well studied to date. This paper aimed to analyze a retrospective multicenter survey for detecting problems with the use of CIRT for Stage II and III NSCLC (7th UICC TNM Staging System). Inclusion was restricted to patients with Stage II and III NSCLC who received CIRT from November 2003 to December 2014. We gathered the data from three CIRT operating centers on July 2015. Patients with radiotherapy history, patients with cancers other than lung cancer, and those receiving palliative therapies were excluded. The patient characteristics, prescribed dose/fraction, survival rates, and adverse effects were analyzed. The total number of patients was 64 (male: 49, female: 15). Of these, 53 patients were medically inoperable. The median age was 76 years (range 46–91), and the median follow-up period was 18.5 months (range 3.2–121.5). The clinical staging consisted of 10 Stage IIA, 30 Stage IIB, 23 Stage IIIA and 1 Stage IIIB. The median prescribed dose was 72.0 Gy (RBE) (range 52.8–72.0) in 16 fractions (range 4–16). The 2-year overall survival, progression-free survival, and local control rates were 62.2% [confidence interval (CI): 47.5–76.9], 42.3% (CI: 28.8–55.8) and 81.8% (CI: 69.9–94.0), respectively. There were no higher than Grade 2 adverse effects observed. CIRT for inoperable Stage II and III NSCLC could be implemented without severe adverse effects, but the clinical staging (including lymph node status) was inhomogeneous. In addition, the prescribed dose and fractionation were not standardized. Further data accumulation and a multiple centers prospective trial for evaluating clinical stage–based results are required.
Efficacy and Safety of Combination Therapy of Shenfu Injection and Postresuscitation Bundle in Patients With Return of Spontaneous Circulation After In-Hospital Cardiac Arrest: A Randomized, Assessor-Blinded, Controlled Trial*
Authors: Zhang Qian , Li Chunsheng , Shao Fei , Zhao Lianxing , Wang Miaomiao , Fang Yingying
Published: June 2017

Objectives:

Postresuscitation care bundle treatment after return of spontaneous circulation in patients experiencing in-hospital cardiac arrest can improve patients’ survival and quality of life. The aim of the study was to evaluate the efficacy and safety of combined therapy of Shenfu injection and postresuscitation care bundle in these patients.

Design:

Prospective, randomized, controlled clinical study.

Setting:

Fifty hospitals in China.

Patients:

Adult patients had experienced in-hospital cardiac arrest between 2012 and 2015.

Interventions:

Based on the standardized postresuscitation care bundle treatment, patients were randomized to a Shenfu injection group (Shenfu injection + postresuscitation care bundle) or control group (postresuscitation care bundle) for 14 days or until hospital discharge. In the Shenfu injection group, 100 mL Shenfu injection was additionally administered via continuous IV infusion, bid.

Measurements and Main Results:

The primary outcome was 28-day survival after randomization. The secondary outcomes included 90-day survival as well as the duration of mechanical ventilation and the hospital stay and the total cost of hospitalization. Of 1,022 patients enrolled, a total of 978 patients were allocated to the two groups: the control (n= 486) and Shenfu injection (n= 492) groups. The Shenfu injection group had a significantly greater 28-day survival rate (42.7%) than the control group (30.1%). Also, the Shenfu injection group had a significantly higher survival rate at 90 days (39.6%) than the control group (25.9%). Compared with patients in the control group, patients in the Shenfu injection group had lower risks of 28-day mortality (hazard ratio, 0.61; 95% CI, 0.43–0.89;p= 0.009) and 90-day mortality (hazard ratio, 0.55; 95% CI, 0.38–0.79;p= 0.002). In the Shenfu injection group, the duration of mechanical ventilation (8.6 ± 3.2 vs 12.7 ± 7.9 d;p< 0.001) and the hospital stay (8.7 ± 5.9 vs 13.2 ± 8.1 d;p< 0.001) were significantly less than in the control group. Irreversible brain damage was the main cause of death in both groups. No serious drug-related adverse event was recorded.

Conclusions:

This study demonstrates that Shenfu injection in combination with conventional postresuscitation care bundle treatment is effective at improving clinical outcomes in patients with return of spontaneous circulation after in-hospital cardiac arrest.
AGE-RELATED MACULAR DEGENERATION AND THE RISK OF ALL-CAUSE AND CARDIOVASCULAR MORTALITY
Authors: Xin Xueling , Sun Yongye , Li Shiru , Xu Hui , Zhang Dongfeng
Published: June 2017

Purpose:

We evaluated the association between age-related macular degeneration (AMD) and the risk of all-cause and cardiovascular mortality by meta-analyses of data from prospective studies.

Methods:

A literature search was performed in PubMed, Web of Science, Embase, Cocharne Library, and China National Knowledge Infrastructure for relevant articles published up to December 2016. We estimated hazard ratios with 95% confidence intervals with fixed-effect models and conducted meta-regression to explore the potential sources of heterogeneity. Small-study effect was estimated by Egger's test and funnel plot.

Results:

We identified 13 population-based prospective cohort studies that examined the relationship between AMD and all-cause and cardiovascular mortality. Overall, the hazard ratios (95% confidence intervals) of all-cause mortality and cardiovascular mortality associated with any AMD were 1.15 (1.05–1.27) and 1.05 (95% confidence intervals: 0.87–1.26), respectively. The risk of all-cause mortality and cardiovascular mortality associated with early AMD were 1.08 (1.00–1.18) and 1.05 (0.89–1.24), and the associations with late AMD were 1.23 (1.11–1.36) and 1.28 (1.04–1.57), respectively. No evidence of small-study effect was found.

Conclusion:

This meta-analysis indicated that AMD, especially late AMD, was associated with increased risk of all-cause mortality and cardiovascular mortality based on comparisons with people who did not have AMD and who were of similar age and sex.
THE RELATIONSHIP BETWEEN FOVEAL AVASCULAR ZONE AREA, VESSEL DENSITY, AND CYSTOID CHANGES IN DIABETIC RETINOPATHY
Authors: Tarassoly Kia , Miraftabi Arezoo , Soltan Sanjari Mostafa , Parvaresh Mohammad Mehdi
Published: June 2017

Purpose:

To measure the foveal avascular zone (FAZ) areas and vessel densities of patients with diabetic retinopathy and to study their relationship with diabetic cystoid changes and retinal thickness.

Methods:

Prospective case series of 51 eyes of 31 patients with diabetic retinopathy. The eyes were grouped based on the presence or absence of cystoid edema and evaluated using optical coherence tomography angiography. The FAZ areas and vessel density were compared.

Results:

The FAZ area at the superficial capillary plexus level was equal between the eyes with and without cystoid edema. Vessel density did not differ as well. There was no correlation with retinal thickness. In eyes with cystoid changes, FAZ area changes at the deep capillary plexus level were difficult to interpret.

Conclusion:

The FAZ area and vessel density at the superficial capillary plexus level are reproducible and independent of the presence of cystoid edema.
MOLECULAR PROGNOSTICS FOR UVEAL MELANOMA
Authors: Seider Michael I. , Mruthyunjaya Prithvi
Published: June 2017

Purpose:

To review laboratory methods, currently available commercial tests, caveats and clinical tips regarding prognostic analysis of uveal melanoma tissue.

Methods:

A review of the literature was performed focused on the genetic abnormalities found in uveal melanoma cells, their correlation to the development of metastases, the validity of various laboratory approaches in their detection, and the existing commercially available tests for uveal melanoma prognostication.

Results:

Numerous laboratory methods exist for analyzing genetic material obtained from uveal melanoma cells. Older tests have been gradually replaced with contemporary methods that are simpler with greater accuracy. Two commercially available assays exist which have not been directly compared—a gene expression profiling test has been validated directly through a large, prospective multicenter study and a DNA-based test which uses laboratory methods supported by extensive historical data.

Conclusion:

There are myriad laboratory methods for prognostic analysis of uveal melanoma tissue. These tests were historically only available to those with access to an outfitted laboratory. Newer commercially available assays have increased the accessibility of prognostic biopsy for uveal melanoma. The various caveats that exist when considering and performing prognostic biopsy of uveal melanoma are discussed.
Computer-Based Cognitive Rehabilitation Interventions for Traumatic Brain Injury: A Critical Review of the Literature
Authors: Fetta Joseph , Starkweather Angela , Gill Jessica M.
Published: June 2017

Background: Computer-based interventions have been developed to improve cognitive performance after mild traumatic brain injury; however, a thorough evaluation of this body of research has not been addressed in the literature. Objectives: The aim of this study was to provide a synthesis and critical review of current research studies that have tested the efficacy of computer-based interventions on cognitive performance after mild traumatic brain injury. Methods: A critical review was conducted by identifying relevant studies in the electronic databases PubMed/MEDLINE, PsycInfo, and CINAHL from 2011 to the present. Because of the limited number of publications focused exclusively on mild traumatic brain injury, research studies that assessed the impact of computer-based interventions on cognitive outcomes in populations with acquired brain injury were included. Results: Of the 58 studies identified, only 10 publications included participants with mild traumatic brain injury. Overall, the identified studies did not use a standard method for assessing the severity of traumatic brain injury, and many studies included participants with a wide variety of etiologies for acquired brain injury and used multiple measures of cognitive performance, which made comparisons difficult across studies. In addition to small sample sizes, the study samples were heterogeneous in regard to the number of previous traumatic brain injuries, time elapsed since injury, and age and gender distributions. Preinjury comorbidities that may affect cognitive performance, such as depression, anxiety, or learning disabilities, were often not assessed. Discussion: There is weak evidence that computer-based interventions can improve working memory and cognitive function in individuals after mild traumatic brain injury. Because of the low-quality evidence, seminal questions remain regarding the optimal format, dosage, timing, and duration of computer-based intervention for improving cognitive performance. Future studies should focus on using a strong research design, such as a prospective, longitudinal, repeated-measures study, with an adequate number of participants who meet mild traumatic brain injury criteria. Preinjury comorbidities, cognitive reserve, time since injury, age, and gender should be addressed in the design because there may be differences in recovery time and mechanisms of cognitive plasticity among populations. Conclusions: Overall, computer-based interventions seem promising as an approach to improve working memory in individuals with acquired brain injury. There is no evidence that currently available interventions are specific to mild traumatic brain injury. Well-designed research studies with adequate sample sizes are needed to assess the effect of computer-based interventions on cognitive performance after mild traumatic brain injury.
Continuous In-Home Symptom and Mobility Measures for Individuals With Multiple Sclerosis: A Case Presentation
Authors: Newland Pamela , Kimutis Alyssa , Salter Amber , Flick Louise , Thomas Florian P. , Rantz Marilyn , Skubic Marjorie
Published: June 2017

Gait impairment represents one of the most common and disabling symptoms of multiple sclerosis (MS). To identify which temporal or spatial parameters of gait could be used as outcome measures in interventional studies of individuals with MS with different levels of disability, we evaluated characteristics of these parameters in a case study of 3 participants with MS, using 1 case as an exemplar and the other participants as validation. A case study of an exemplar participant was conducted with a 67-year-old woman with secondary progressive MS served as exemplar, with 2 other participants (52 and 55 years old) as validation. The primary outcome measures we used were stride time, stride length, gait velocity, and daily symptoms. Stride length and velocity of gait decreased with increasing pain and fatigue. The step time was significantly longer later in the day, whereas the step length remained the same. Stride length and velocity are associated with the level of fatigue and pain, as well as the time of day. These characteristics and parameters of gait need to be considered in future studies of gait in MS, with particular attention to temporality of occurrence in persons with MS.
Increased Risk of Bleeding in Left Ventricular Assist Device Patients Treated with Enoxaparin as Bridge to Therapeutic International Normalized Ratio
Authors: Bhatia Ankit , Juricek Colleen , Sarswat Nitasha , Adatya Sirtaz , Kim Gene , Sayer Gabriel , Ota Takeyoshi , Jeevanandam Valluvan , Uriel Nir
Published: June 2017

Anticoagulation therapy is used to prevent thromboembolic events in patients with left ventricular assist devices (LVADs). This study aims to determine the safety of low molecular weight heparin (enoxaparin) for bridging subtherapeutic international normalized ratio (INR) in LVAD patients. In this retrospective single-center study, all patients who underwent LVAD implantation were examined between January 1, 2013, and December 31, 2014. Patients were divided into two groups: enoxaparin bridge and no bridge, with identification of major bleeding episodes (MBEs) and thrombotic events (TEs). Major bleeding episode and TE incidence was compared between the two groups, with subanalysis of incidence in the enoxaparin group between the periods on and off treatment. One hundred eighteen patients were included in this analysis. Fifty-five patients received enoxaparin, whereas 63 patients did not receive enoxaparin, with no significant difference between groups in all baseline characteristics. For the study period, enoxaparin patients had no increased incidence of MBEs (0.53 vs. 0.35 MBE per year; p = 0.12). However, there was a fourfold increase in MBEs during the bridged period in the enoxaparin group (2.02 vs. 0.45 MBE per year; p = 0.03). Major bleeding episodes on versus off enoxaparin had no major difference in transfusion requirements (2.7 ± 2.9 vs. 2.5 ± 3.4 units; p = 0.57) or mortality (p = 0.11). The enoxaparin group trended to a higher incidence of TEs (0.20 vs. 0.11 events per year; p = 0.08). Enoxaparin bridging in patients with subtherapeutic INR is associated with a significantly increased risk of MBEs. Prospective studies are needed to confirm these findings; however, until then, caution should be used with enoxaparin for bridging in LVAD patients.
Unrecognized Left Heart Failure in LVAD Recipients: The Role of Routine Invasive Hemodynamic Testing
Authors: Shah Palak , Badoe Nina , Phillips Sheila , Abdullah Kamil , May Christopher W. , Nabut Jose L. , Singh Ramesh , deFilippi Christopher , Desai Shashank S.
Published: June 2017

The role of routine right heart catheterizations (RHCs) in left ventricular assist device (LVAD) patients is undefined. We analyzed 105 continuous-flow LVAD recipients who underwent an RHC approximately 3 months after implant. In 38 patients, LVAD speed was ramped with the goal of optimizing hemodynamics. Our cohort consisted of 71 (68%) HeartMate II (HMII) and 34 (32%) HeartWare (HVAD) patients. Thirty patients (29%) had either a reduced cardiac index (CI ≤ 2.2 L/min/m2), elevated pulmonary capillary wedge pressure (PCWP > 18 mm Hg), or both. A subgroup of 38 patients (19 with abnormal hemodynamics) underwent LVAD ramping. With LVAD ramping, normalization of hemodynamics was achieved in 13 (68%) patients with abnormal hemodynamics. In ramped patients, the CI increased from 2.1 L/min/m2 (2.0–2.3) to 2.5 L/min/m2 (2.3–2.6; p = 0.004), and the PCWP dropped from 21 mm Hg (20–26) to 18 mm Hg (14–21, p < 0.001). The 6-minute walk distance improved from 338 m (253–394) to 353 m (320–442, p = 0.041). A 400 rpm change in HMII speed was like a 130 rpm change in HVAD speed and led to a change in cardiac output (CO) of 0.3 L/min. The correlation between device-reported flow and measured CO for both the HMII (R
s = 0.50, p < 0.001) and HVAD (R
s = 0.47, p < 0.001) was moderate. At 3 months after LVAD implant, most patients have normal hemodynamics. Of those patients with abnormal hemodynamics, LVAD ramping results in normalization of hemodynamics and improvement in 6-minute walk distance.
Rightsizing Projects for Non–Research-Intensive Schools of Nursing via Academic-Clinical Partnerships
Authors: Kooken Wendy Carter , Eckhardt Ann L. , McNutt-Dungan Marianne , Woods Jonathan
Published: June 2017

Most academic-clinical partnerships are described as formal agreements between schools of nursing at research-intensive universities and large teaching hospitals. This article demonstrates less formal versions of academic-clinical partnerships established between a small, private liberal arts university school of nursing and 2 regional clinical agencies. In both exemplars, students, faculty, and staff contributed to evidence-based practice projects. Schools of nursing in non–research-intensive environments can develop right-size academic-clinical partnerships that are beneficial for all parties involved.
Sexually Transmitted Disease Testing of Human Immunodeficiency Virus–Infected Men Who Have Sex With Men: Room for Improvement
Authors: Dean Bonnie B. , Scott Mia , Hart Rachel , Battalora Linda , Novak Richard M. , Durham Marcus D. , Brooks John T. , Buchacz Kate
Published: June 2017

Background

In the United States, sexually transmitted infection (STI) testing is recommended at least annually for sexually active men who have sex with men (MSM). We evaluated human immunodeficiency virus (HIV) providers’ STI testing practices and frequency of positive test results.

Methods

We analyzed data from HIV Outpatient Study (HOPS) participants who, from 2007 to 2014, completed a confidential survey about risk behaviors. Using medical records data, we assessed the frequency of gonorrhea, chlamydia, and syphilis testing and positive results during the year after the survey for MSM who reported sex without a condom in the prior 6 months. We compared testing frequency and positivity for men having 1, 2 to 3, and 4 or more sexual partners. Correlates of STI testing were assessed using general linear model to derive relative risks (RR) with associated 95% confidence intervals (CI).

Results

Among 719 MSM, testing frequency was 74.5%, 74.3%, and 82.9% for gonorrhea, chlamydia, and syphilis, respectively, and was higher in those men who reported more sexual partners (P < 0.001 for all). In multivariable analysis, testing for gonorrhea was significantly more likely among non-Hispanic black versus white men (RR, 1.17; 95% CI, 1.03–1.33), among men seen in private versus public clinics (RR, 1.16; 95% CI, 1.05–1.28), and among men with 2 to 3 and 4 or more sexual partners versus 1 partner (RR, 1.12; 95% CI, 1.02–1.23, and RR, 1.18; 95% CI, 1.08–1.30, respectively). Correlates of chlamydia and syphilis testing were similar. Test positivity was higher among men with more sexual partners: for gonorrhea 0.0%, 3.0%, and 6.7% for men with 1, 2 to 3, and 4 or more partners, respectively (P < 0.001, syphilis 3.7%, 3.8% and 12.5%, P < 0.001).

Conclusions

Among HIV-infected MSM patients in HIV care who reported sex without a condom, subsequent testing was not documented in clinic records during the following year for up to a quarter of patients. Exploring why STI testing did not occur may improve patient care.
Screening for Sexually Transmitted Infections in Adolescent Girls and Young Women in Mombasa, Kenya: Feasibility, Prevalence, and Correlates
Authors: Masese Linnet N. , Wanje George , Kabare Emmanuel , Budambula Valentine , Mutuku Francis , Omoni Grace , Baghazal Anisa , Richardson Barbra A. , McClelland R. Scott
Published: June 2017

Introduction

As adolescents and young women become sexually active, they are at risk of adverse reproductive health outcomes including sexually transmitted infections (STIs). We assessed feasibility and acceptability of STI screening among 15- to 24-year-old women in Mombasa, Kenya.

Methods

After sensitization activities, participants were recruited from 3 high schools and 1 university. Study staff conducted informational sessions. Students interested in participating were given consent forms to take home, and invited to visit our clinic for STI screening. During clinic visits, participants completed a self-administered questionnaire and provided a urine specimen for STI testing using a nucleic acid amplification test.

Results

Between August 2014 and March 2015, 463 high school and 165 university students collected consent forms. Of these, 293 (63%) from high schools versus 158 (95%) from university attended clinic for STI screening (P < 0.001). Of the 150 (33%) who reported any history of insertive vaginal sex, 78 (52.0%) reported condom use at the last sex act, 31 (20.7%) reported using modern nonbarrier contraceptive methods, and 37 (24.7%) reported not using any contraception at the last sex act. Twenty-six (5.8%) participants were diagnosed with STIs (7 [1.6%] Neisseria gonorrhoeae, 16 [3.6%] Chlamydia trachomatis, 3 [0.7%] Trichomonas vaginalis). In multivariable analyses, reporting receptive vaginal sex without a condom was associated with having a laboratory confirmed STI (odds ratio, 6.21; 95% confidence interval, 1.72–22.28).

Conclusions

These findings support the need for reproductive health interventions to reduce the risk of STIs in a population of adolescent girls and young women in East Africa.
Why an Open Disclosure Procedure Is and Is not Followed After an Avoidable Adverse Event
Authors: Carrillo Irene , Mira José Joaquín , Guilabert Mercedes , Lorenzo Susana ,   On behalf of the Second and Third Victim Research Group
Published: June 2017

Objective

The aim of the study was to analyze the relationships between factors that contribute to healthcare professionals informing and apologizing to a patient after an avoidable adverse event (AAE).

Methods

A secondary study based on the analysis of data collected in a cross-sectional study conducted in 2014 in Spain was performed. Health professionals from hospitals and primary care completed an online survey.

Results

The responses from 1087 front-line healthcare professionals were analyzed. The willingness of the professionals to fully disclose an AAE was greater among those who were backed by their institution (odds ratio [OR] = 72.6, 95% confidence interval [CI] = 37.5–140.3) and who had experience with that type of communication (OR = 2.4, 95% CI = 1.3–4.5). An apology for the patient was more likely when there was institutional support (OR = 31.3, 95% CI = 14.4–68.2), the professional was not aware of lawsuits (OR = 2.7, 95% CI = 1.2–6.1), and attributed most AAE to human error (OR = 2.2, 95% CI = 1.1–4.2). The fear of lawsuits was determined by the lack of support from the center in disclosing AAE (OR = 5.5, 95% CI = 2.8–10.6) and the belief that being open would result in negative consequences (OR = 2.0, 95% CI = 1.1–3.6).

Conclusions

The culture of safety, the experience of blame, and the expectations about the outcome from communicating an AAE to patients affect the frequency of open disclosure. Nurses are more willing than physicians to participate in open disclosure. Health care organizations must act to establish a framework of legal certainty for professionals.
Small fibre neuropathy
Authors: Cazzato Daniele , Lauria Giuseppe
Published: June 2017

Purpose of review

To provide a review on the state-of-art of clinical features, diagnostics, genetics and treatments of small fibre neuropathy (SFN).

Recent findings

The spectrum of clinical features has been widened from the classical presentation of burning feet as length-dependent SFN to that of small fibre dysfunction and/or degeneration associated with focal, diffuse and episodic neuropathic pain syndromes. The involvement of small nerve fibres in neurodegenerative diseases has been further defined, challenging the relationship between neuropathic pain symptoms and small fibre loss. The clinical reliability of skin biopsy has been strengthened by the availability of normative values for both the immunohistochemistry techniques used and their comparison, and by side and short-term follow-up analyses. Corneal confocal microscopy has implemented its diagnostic potentiality because of the availability of age-adjusted and sex-adjusted normative values. Genetic studies expanded the panel on genes involved in SFN because of the discovery of new mutations in SCN10A and SCN11A, besides the first found in SCN9A, and identification of mutations in COL6A5 in patients with itching.

In the last 5 years, the chapter of SFN has been widened by new clinical and genetics descriptions leading to a more comprehensive approach to patients in clinical practice and research.