bluuebunny/crossref_metadata_2025 huggingface dataset:
CFL learners’ recognition and production of pragmatic routine formulae
Authors: Yang Jia
Published: June 2016

A pragmatic routine formula is any expression with a stable form that is commonly repeated in the routinized social interactions of a given culture. Previous research has reported that such pragmatic routine formulae are often underused by foreign language learners, even when they have been studying the language for a long time. To explore the reasons for this underuse, this study investigated the development of 59 Chinese as a foreign language (CFL) learners’ recognition and production of pragmatic routine formulae in situations they might encounter in China. Results showed that length of stay in the target language country had a significant effect on recognition but not on production. CFL learners with longer periods of residence abroad were able to recognize more pragmatic routine formulae, but which specific formulae were recognized depended on the interactional settings in which learners had engaged. Further analysis revealed that learning challenges may arise in three kinds of situations: (1) those requiring a pragmatic formula in the target language but a different formula in the learner’s native language, (2) those requiring a routine formula in the target language but no remarks in the native language, and (3) those in which the learner overgeneralizes a more familiar form.
The rise of catchword “被bei-XX”
Authors: Xiao Yun
Published: June 2016

Recent studies on Chinese language use show that the rapid development of Internet communication in China has created a new linguistic variety, Chinese Internet language (CIL). Marked with innovations and catch words, CIL is officially branded as 平民化pingminhua(‘grassroots,’ ‘ordinary’), 低门槛dimenkan(‘low-standard,’ ‘vulgar’) (Language Situation in China2012: 205). Nevertheless, the new usages in CIL have attracted tremendous attention; prominent among them is the usage of 被bei- XX. In Modern Chinese grammar,beiis a preposition followed by an agent (bei+ agent + verb) in passive sentences. However, since the news broke out that Prisoner Li Guofu died in a prison hospital and was announced as “a suicide” by the administration in 2008, the usage of 被自杀bei zisha(to be presumably murdered) started to appear in the Internet and was soon analogized; consequently, numerous new usages ofbei-XX swept through the media like wildfire. Taking the grammaticalization approach (Hopper and Traugott 2003), this study intends to explore the semantic changes, linguistic features, and grammatical role ofbeiin thebei-XX construction. It examines the historical development ofbeiin the grammaticalization process and evaluates previous and recent analyses associated with it. Drawing on data from China’s national annual reports entitled 《中国语言生活状况报告》Language Situation in China(2005 to 2013) and online CIL publications, the study proposes an alternative analysis ofbeiin thebei-XX construction and predicts that this newbeiwill become an established prefix in the Chinese language and, further, create large word families withbei-XX as the blueprint.
Given/New: What do the terms refer to?
Authors: O’Grady Gerard
Published: June 2016

Previous studies indicate that speakers signal the informational status of referents through a combination of intonation, word order and lexical realisation. In this paper, I argue for a non-binary view of information structure with referents being (1) hearer and discourse new, (2) discourse new but hearer given and (3) hearer and discourse given. Thus there can be no simple one-to-one relationship between information structure, lexical realisation and accenting. In the spoken data examined, evidence was found to substantiate a relationship between referential distance and lexical realisation but not between referential distance and tonic accenting. Tonic accents signal speakers’ subjective projection of the importance of a referent but the exact informational meaning signalled by the referent depends on a combination of tonic accent, tone choice, key, linear position and lexical realisation.
Dynamism in exchange structure
Authors: Berry Margaret
Published: June 2016

This paper considers the meaning of the term ‘dynamism’ in relation to systemic functional linguistic accounts of exchange structure, in which a distinction is often drawn between ‘dynamic’ accounts and ‘synoptic’ accounts. The paper then discusses and develops a model of exchange structure which is intended to be dynamic, focusing in turn on ‘supporting moves’, ‘queries’ and ‘challenges’. The eventual aim is that the model should be applicable to various forms of discourse, bringing out the differences between them and relating these to the contexts of situation. Applications to be particularly considered in the present paper are to classroom discourse and to a sociologically interesting form of discourse such as interviews with young offenders.
Dynamicity and dialogue
Authors: Mackenzie J. Lachlan
Published: June 2016

The article surveys how Functional Discourse Grammar (FDG; Hengeveld & Mackenzie 2008) has responded to Simon Dik’s call for a functional grammar to have ‘psychological adequacy’ and draws parallels to similar initiatives from other approaches. After a brief history of what has later come to be known as cognitive adequacy, the impact of psycholinguistic notions on the architecture of FDG is discussed and exemplified with emphasis on how FDG confronts the tension between the static nature of a pattern model of grammar and the dynamicity of the communicative process. The article then turns to four ways in which FDG has responded in recent years to ongoing work in psycholinguistics. The first concerns how the incrementality of language production, i.e. the gradual earlier-to-later build-up of utterances, has inspired FDG’s coverage of fragmentary discourse acts and its Depth-First Principle. The second, pertaining to the role of prediction in language comprehension, is reflected in the countdown to a clause-final position PF. The third is priming, involving the reuse of elements of structure at all levels of analysis: this interferes with the mapping of function onto form in ways that have been explored in FDG. The fourth is dialogical alignment, the manner in which participants in dialogue mutually accommodate their language use; this has led to new understandings of the respective roles of FDG’s Conceptual and Contextual Components. Taken together, these developments have moved FDG towards modelling dialoguing interactants rather than an isolated speaker.
‘Performing identity’
Authors: Marais Adele
Published: June 2016

This study examined the issue of Intimate Partner Violence (IPV) from the perspective of young adults. The focus was on how participants actively imparted meaning to themselves and others, and how they constructed and performed their identities through the situated interaction of the research interview. Students at the University of Cape Town (ages 18–25), were invited to participate in unstructured individual interviews and/or focus groups about IPV and intimate relationships. A total of 24 young adults volunteered to participate. The results revealed that young people are knowledgeable and concerned about IPV. Participants underscored the importance, intensity and timing of intimate relationships in their lives- and signaled its significance and consequence for their current identity projects. Female participants had specific investments in how their talk achieved selfpresentation goals: they used their narratives as a resource to account for their experiences, negotiate and present their preferred identities, and manage their reputations.
Using literary metaphor and characters as structural and symbolic tools
Authors: Netolicky Deborah
Published: June 2016

Narrative researchers are faced with the challenges of ethically co-constructing human data and writing meaningful, readable research texts, which protect participants’ anonymity. This article adds to the conversation of qualitative, and especially narrative, inquiry by presenting one creative approach to these challenges. It proposes that using extended literary metaphor and known literary characters, as analytical and structural tools, develops allegoric layers of meaning while preserving participant anonymity. Situating narrative research in the realm of imaginative story may help readers and researchers, like Alice in her Wonderland adventures, return from their journey through the research storyworld portal with new insights, and heightened understandings, of those phenomena being revealed and illuminated through narrative.
Incoherence matters
Authors: Gallinat Anselma
Published: June 2016

Life-stories are usually seen as showing considerable coherence even where they include turning points. More recent work has in contrast noted that “living” or “small narratives” do not follow this rule but contrastingly enable the pondering of unresolved life-events helping to develop understanding. This potential is particularly valuable in contexts of fundamental regime-change where changes of the value-system, such as after transition from state socialism to democracy, pose considerable challenges to narrative coherence. The article suggests reconsidering the question of coherence in life-stories and draws on two examples of individuals who experienced life in East Germany and German unification to argue that struggles for coherence in the life-story can be indicative of the lack of wider shared frameworks for the understandings of national events and historical problems.
Forms of identities and levels of positioning
Authors: Bernhard Stefan
Published: June 2016

What happens in narrative-biographical interviews? The present article answers this question by drawing on biographical (big story) and practice-based (small story) approaches. It starts from a practice theoretical reading of Harrison C. White’s identity theory and conceptualizes narrative-biographical interviews as arenas of storytelling practices that engage in identities of different forms and levels of positioning. Interviewees devise small identities, embed them in contexts and nest those identities-in-context with one another in the course of interactions with the interviewer. Meanwhile, the approach reflects autobiographic big storytelling as highly scripted and contextualized endeavors. It moves beyond the big story script by suggesting “style” as target concept for autobiographical analysis. This conceptual shift goes hand in hand with a move away from single-sited interviewing to multi-sited narrative research. The argument is exemplified using rich data on a nascent self-employed artist.
Issues of representation in narrative methodology in health research
Authors: Medeiros Priscilla
Published: June 2016

Engaging in collaborative inquiry creates a shared authorship in storytelling, but does not ensure that the final report will reflect the plurality of voices that contributed to the narrative. This paper describes how involving respondents in the research design, data analysis, and dissemination of research findings enables researchers to ensure equal representation of perspectives of individuals involved in health research.
Test–retest reliability of Kannada time-compressed speech test and time-compressed monosyllables test
Authors: Prabhu Prashanth , Seshadri Danush , Ganeshan Aishwarya , Babu Liny
Published: June 2016

Objective:

The study attempts to determine the test–retest reliability for time-compressed phonemically balanced (PB) words in Kannada and monosyllables across different compression ratios.

Study design:

The study was carried out on 30 normal hearing individuals, 15 males and 15 females. The PB words were time-compressed at 50%, 60% and 70% compression ratios and monosyllables were time-compressed at 50%, 60%, 70% and 80% compression ratios. The compressed material was administered three times (baseline, after 15 min break and after 1 week) at all the compression ratios for PB words and monosyllables.

Results:

The results of the study show that scores were higher for monosyllables at high compression ratios. The scores were more reliable at 60% compression ratio for both monosyllables and PB words. The study also shows that the reliability of the test does not vary across gender.

Conclusion:

The study recommends using 60% compression ratio for PB words and monosyllables while testing a clinical population.
The written language of children with cochlear implant
Authors: Arfé Barbara , Ghiselli Sara , Montino Silvia
Published: June 2016

In the era of cochlear implants (CIs) and newborn hearing screening programmes, the oral language skills of deaf children have improved significantly. The literature documents sizable gains in their speech perception and receptive and expressive spoken language. However, the improvements in the area of reading and writing are less remarkable, and reading and writing continue today to be a major challenge for children with CIs. The article discusses the role of two cognitive factors that may contribute to make writing difficult to achieve for children with CIs: poor executive functions and verbal working memory. Recommendations for assessment and intervention are derived from this analysis.
The cell biology of inflammasomes: Mechanisms of inflammasome activation and regulation
Authors: Sharma Deepika , Kanneganti Thirumala-Devi
Published: June 2016

Over the past decade, numerous advances have been made in the role and regulation of inflammasomes during pathogenic and sterile insults. An inflammasome complex comprises a sensor, an adaptor, and a zymogen procaspase-1. The functional output of inflammasome activation includes secretion of cytokines, IL-1β and IL-18, and induction of an inflammatory form of cell death called pyroptosis. Recent studies have highlighted the intersection of this inflammatory response with fundamental cellular processes. Novel modulators and functions of inflammasome activation conventionally associated with the maintenance of homeostatic biological functions have been uncovered. In this review, we discuss the biological processes involved in the activation and regulation of the inflammasome.
Untangling Topo II’s function at mitotic centromeres
Authors: Short Ben
Published: June 2016

Two studies reveal a conserved, noncatalytic role for Topo II’s C-terminal domain in recruiting the checkpoint kinase Aurora B.
Pragmatic Considerations on Comparative Probability
Authors: Icard Thomas F.
Published: June 2016

While pragmatic arguments for numerical probability axioms have received much attention, justifications for axioms of qualitative probability have been less discussed. We offer an argument for the requirement that an agent’s qualitative (comparative) judgments be probabilistically representable, inspired by, but importantly different from, the Money Pump argument for transitivity of preference and Dutch book arguments for quantitative coherence. The argument is supported by a theorem, to the effect that a subject is systematically susceptible to dominance given her preferred acts, if and only if the subject’s comparative judgments preclude representation by a standard probability measure (or set of such measures).
Doctor, when should I feed solid foods to my infant?
Authors: Fiocchi Alessandro , Dahdah Lamia , Bahna Sami L. , Mazzina Oscar , Assa’ad Amal
Published: June 2016

Purpose of review

Modalities and timing of the introduction of solid foods to infants may influence growth, obesity, atherosclerosis, hyperlipidemia, hypertension, diabetes, and metabolic disease. The most debated effects of solid foods introduction are those on the development of food allergy.

Recent findings

For the first time, in recent years prospective studies have been published about the effects of early vs. delayed introduction of allergenic foods into the infants’ diet on food allergy. According to these studies, the early introduction of peanut may be a powerful protecting factor against peanut allergy in some risk categories. This seems not be true for wheat, cow's milk, sesame, and whitefish. The effect of early introduction of egg on egg allergy are controversial.

The recent studies have changed the practice recommendations given by healthcare providers to families. We review the modifications of the recommendations of international societies on the introduction of solid foods, both to the general population and to infants at risk for allergy.
Intestinal dysbiosis in systemic lupus erythematosus: cause or consequence?
Authors: López Patricia , Sánchez Borja , Margolles Abelardo , Suárez Ana
Published: June 2016

Purpose of review

Recent discoveries relay commensal gut microbiota as a relevant factor in the maintenance of intestinal homeostasis.

Recent findings

Alterations in the composition of the intestinal microbiota have been reported in patients with systemic lupus erythematosus and many other inflammatory and autoimmune conditions. However, the mechanisms by which the intestinal microbiota can influence systemic immunity in these situations remain to be elucidated. The inappropriate immune responses of patients with systemic lupus erythematosus could originate a breakdown of tolerance towards the microbiota, leading to the expansion and/or contraction of specific bacterial groups that may culminate in a dysbiotic state. Conversely, an altered composition of the intestinal microbiome in genetically predisposed individuals could influence systemic immunity by several mechanisms, leading to a breakdown of tolerance to self-antigens. Moreover, humoral immune responses can be affected by specific bacterial groups in these individuals.

Recent findings support an important role for the crosstalk between bacteria and immune cells to maintain an intestinal homeostasis crucial to sustain tolerance toward self-antigens and intestinal microbiota.
Update on enthesitis-related arthritis
Authors: Weiss Pamela F.
Published: June 2016

Purpose of review

This review provides a detailed update regarding the genetics, pathogenesis, disease phenotype evaluation, therapies and expected outcomes for children with enthesitis-related arthritis (ERA).

Recent findings

Recent studies evaluated human leukocyte antigen (HLA)-B27 subtypes and non-major histocompatibility complex genes including toll like receptor 4, NLRP3, CXCR4 and PTPN12 in children with ERA. The microbiome and γδ-T cells have also been an area of active investigation. Several studies focus on the imaging phenotype of children with ERA, including the use of ultrasonography and MRI. MRI techniques studied in this population include dedicated MRI, whole-body MRI and diffusion-weighted imaging. Conventional and biologic disease-modifying agents continue to be the mainstay of therapy, though the past 2 years have witnessed several greatly needed randomized controlled trials to study the efficacy of these medications in ERA. Finally, long-term effectiveness studies of biologics in children with ERA have helped inform provider and patient expectations of disease response and prognosis.

Further evaluation of the role of the microbiome and the interleukin 17/interleukin 23 axis, techniques to optimize evaluation of disease features, and efficacy and effectiveness of newer medications are greatly needed in this understudied population of children.
Radiographic Analysis of the Pediatric Hip Patients With Hereditary Multiple Exostoses (HME)
Authors: Duque Orozco Maria del Pilar , Abousamra Oussama , Rogers Kenneth J. , Thacker Mihir M.
Published: June 2016

Background:

This study aimed to report the radiographic presentation of involved hips in children with hereditary multiple exostoses (HME). This included radiographic hip measurements, osteochondromas location, and relationship with hip subluxation.

Methods:

Anteroposterior pelvis radiographs of children with HME, seen between 2003 and 2014, were retrospectively reviewed. Only patients who were skeletally immature at the first visit were included. One radiograph per patient per year was reviewed. Radiographs were examined for the presence of osteochondromas and their locations. Different parameters were evaluated: femoral neck-shaft angle, Reimer migration percentage (MP), Sharp acetabular angle, Wiberg angle, femoral head-neck ratio (coronal plane), and Shenton line. All measured radiographs were divided into 3 age groups:≤8,>8 and <13, and ≥13 years. Differences of the measured parameters with age were evaluated. Children with hip subluxation were identified and any relationship with osteochondromas locations, as well as MP changes over time, was recorded. Radiographs of children with a minimum 2-year follow-up were identified and changes of their hip measurements and osteochondromas’ presence over time were recorded.

Results:

A total of 51 children (102 hips) with HME were identified. In most locations, there was an overall increase of the occurrence of osteochondromas in the older age groups. However, in the medial femoral neck, a significantly less numbers of osteochondromas were found after 13 years of age (P=0.018). There was a decrease in MP with age (P<0.05). There was also an increase in Sharp and Wiberg angles in the older patients (P<0.05). Hips with broken Shenton line decreased in number with age (P 0.028). Hip subluxation was encountered in 23 hips. No specific location of osteochondromas was found to have a relationship with subluxation. Thirty-six children had a minimum follow-up of 2 years (mean age at first visit 8.5 y and at last visit 13.1 y). In these children, an increased occurrence of lesions was found in medial femoral neck and ischium (P<0.05) between the first and the last visit.

Conclusions:

In children with HME, radiographic evaluation of the hip is necessary based on the high percentage of hip involvement. When hip osteochondromas are found, radiographic surveillance is recommended to detect hip subluxation. Surgery may certainly be necessary for symptomatic osteochondromas. However, given the possibility of improvement in hip parameters with age, early surgical treatment to improve hip longevity does not seem to be warranted.

Level of Evidence:

Level IV—prognostic study.
Vertebral Fractures in Duchenne Muscular Dystrophy Patients Managed With Deflazacort
Authors: Singh Amardeep , Schaeffer Emily K. , Reilly Christopher W.
Published: June 2016

Background:

Corticosteroids are widely used in the management of patients with Duchenne muscular dystrophy (DMD). They improve quality of life in these patients by prolonging ambulation and preserving cardiorespiratory status. However, corticosteroid treatment is associated with a decrease in bone mineral density (BMD) and an increased risk of vertebral fractures (VF). The purpose of this study was to investigate the prevalence of VF in patients with DMD undergoing long-term treatment with the corticosteroid deflazacort.

Methods:

We retrospectively reviewed 49 male patients with DMD on long-term deflazacort therapy at a single institution. All patients had received deflazacort for at least 2 years. VF prevalence, age at start of deflazacort treatment, duration of treatment, BMD Z-score and patient ambulatory status at the time of fracture were evaluated.

Results:

Of the 49 patients on long-term deflazacort treatment, 26 had VF. Out of these patients who had VF, 19% showed evidence of VF in their third year of therapy, 50% within 5 years of starting therapy, 69% within 7 years of starting therapy, and 100% within 9 years. The first evidence of VF was observed at mean BMD Z-score, lumbar (L)=−2.2 and whole body (B)=−3.1. Eighty-five percent of these patients had at least 3 collapsed vertebrae. Mean BMD Z-score at the time of or before when multiple fractures were noted was −2.4 (L) and −3.4 (B). Patients who started deflazacort at age 3 to 5, 5 to 7 or 7 to 9 years developed a VF after a mean of 4.7, 5.4, or 5.7 years, respectively. Sixty-two percent of patients had VF by the age of 12 years and 91% of patients by age of 15 years. Twenty-one of 26 patients were ambulatory at the time of VF.

Conclusions:

Our findings suggest that there is a high risk of VF associated with length of deflazacort use in DMD patients, regardless of age at start of therapy.

Level of Evidence:

Level III—retrospective therapeutic study.
The Declining Incidence of Legg-Calve-Perthes’ Disease in Northern Ireland: An Epidemiological Study
Authors: Mullan Conor J. , Thompson Lara J. , Cosgrove Aidan P.
Published: June 2016

Background:

Legg-Calve-Perthes’ disease (LCPD) is an idiopathic disease of the femoral head affecting the pediatric population. The causative factors remains poorly understood and it is associated with significant hip pathology in adult life. Research has demonstrated wide geographical variation in the incidence rates of LCPD with a relatively high incidence occurring in Northern Ireland (NI) shown in a previous study of incidence from the same unit. The number of new diagnoses of LCPD seems to be declining over time. This study aimed to track changes in the incidence of LCPD within the 0- to 14-year-old population over a 15-year period in NI.

Methods:

An established database was utilized to collate information of any individual between the ages of 0 to 14 years with a diagnosis of LCPD. The data were compared with electronic radiologic records to confirm the diagnosis. Postal code data were used to the determine location of residence and used as a proxy measure of deprivation.

Results:

The results of this epidemiological study have demonstrated a 61% decrease in the incidence of LCPD over a 15-year period within the pediatric population of NI. Comparison between 2 cohorts reveals no distinguishable change in distribution of age or sex. The relationship between geographical proxy measures of deprivation in NI and LCPD remains evident.

Conclusions:

The number of new cases of LCPD is decreasing over time. The epidemiological data are unchanged between 2 cohorts over a 15-year period, and this therefore supports a change within the patients’ environment relating to this decline. This change could relate to a number of factors including smoking rates, breastfeeding, lead use, and vaccination implementation.

Level of Evidence:

Level IV—retrospective cohort study.
Role of the microbiome, probiotics, and ‘dysbiosis therapy’ in critical illness
Authors: Wischmeyer Paul E. , McDonald Daniel , Knight Rob
Published: June 2016

Purpose of review

Loss of ‘health-promoting’ microbes and overgrowth of pathogenic bacteria (dysbiosis) in ICU is believed to contribute to nosocomial infections, sepsis, and organ failure (multiple organ dysfunction syndrome). This review discusses new understanding of ICU dysbiosis, new data for probiotics and fecal transplantation in ICU, and new data characterizing the ICU microbiome.

Recent findings

ICU dysbiosis results from many factors, including ubiquitous antibiotic use and overuse. Despite advances in antibiotic therapy, infections and mortality from often multidrug-resistant organisms (i.e., Clostridium difficile) are increasing. This raises the question of whether restoration of a healthy microbiome via probiotics or other ‘dysbiosis therapies’ would be an optimal alternative, or parallel treatment option, to antibiotics. Recent clinical data demonstrate probiotics can reduce ICU infections and probiotics or fecal microbial transplant (FMT) can treat Clostridium difficile. This contributes to recommendations that probiotics should be considered to prevent infection in ICU. Unfortunately, significant clinical variability limits the strength of current recommendations and further large clinical trials of probiotics and FMT are needed. Before larger trials of ‘dysbiosis therapy’ can be thoughtfully undertaken, further characterization of ICU dysbiosis is needed. To addressing this, we conducted an initial analysis demonstrating a rapid and marked change from a ‘healthy’ microbiome to an often pathogen-dominant microbiota (dysbiosis) in a broad ICU population.

A growing body of evidence suggests critical illness and ubiquitous antibiotic use leads to ICU dysbiosis that is associated with increased ICU infection, sepsis, and multiple organ dysfunction syndrome. Probiotics and FMT show promise as ICU therapies for infection. We hope future-targeted therapies using microbiome signatures can be developed to correct ‘illness-promoting’ dysbiosis to restore a healthy microbiome post-ICU to improve patient outcomes.
Racial/Ethnic and Socioeconomic Differences in Colorectal and Breast Cancer Treatment Quality
Authors: Popescu Ioana , Schrag Deborah , Ang Alfonso , Wong Mitchell
Published: June 2016

Background:

Despite a large body of research showing racial/ethnic and socioeconomic disparities in cancer treatment quality, the relative role of physician-level variations in care is unclear.

Objective:

To examine the effect of physicians on disparities in breast and colorectal cancer care.

Subjects:

Linked SEER Medicare data were used to identify Medicare beneficiaries diagnosed with colorectal and breast cancer during 1995–2007 and their treating physicians.

Research Design:

We identified treating physicians from Medicare claims data. We measured the use of NIH guideline–recommended therapies from SEER and Medicare claims data, and used logistic models to examine the relationship between race/ethnicity, socioeconomic status, and cancer quality of care. We used physician fixed effects to account for between-physician variations in treatment.

Results:

Minority and low socioeconomic status beneficiaries with breast and colorectal cancer were less likely to receive any recommended treatments as compared with whites. Overall, between-physician variation explained <20% of the total variation in quality of care. After accounting for between-physician differences, median household income explained 14.3%, 18.4%, and 13.2% of the variation in use of breast-conserving surgery, chemotherapy, and radiation for breast cancer, and 13.7%, 12.9%, and 12.6% of the within-physician variation in use of colorectal surgery, chemotherapy, and radiation for colorectal cancer, whereas race and ethnicity explained <2% of the within-physician variation in cancer care.

Conclusions:

Between-physician variations partially explain racial disparities in cancer care. Residual within-physician disparities may be due to differences in patient-provider communication, patient preferences and treatment adherence, or unmeasured clinical severity.
Measuring Workplace Climate in Community Clinics and Health Centers
Authors: Friedberg Mark W. , Rodriguez Hector P. , Martsolf Grant R. , Edelen Maria O. , Vargas Bustamante Arturo
Published: June 2016

Background:

The effectiveness of community clinics and health centers’ efforts to improve the quality of care might be modified by clinics’ workplace climates. Several surveys to measure workplace climate exist, but their relationships to each other and to distinguishable dimensions of workplace climate are unknown.

Objective:

To assess the psychometric properties of a survey instrument combining items from several existing surveys of workplace climate and to generate a shorter instrument for future use.

Materials and Methods:

We fielded a 106-item survey, which included items from 9 existing instruments, to all clinicians and staff members (n=781) working in 30 California community clinics and health centers, receiving 628 responses (80% response rate). We performed exploratory factor analysis of survey responses, followed by confirmatory factor analysis of 200 reserved survey responses. We generated a new, shorter survey instrument of items with strong factor loadings.

Results:

Six factors, including 44 survey items, emerged from the exploratory analysis. Two factors (Clinic Workload and Teamwork) were independent from the others. The remaining 4 factors (staff relationships, quality improvement orientation, managerial readiness for change, and staff readiness for change) were highly correlated, indicating that these represented dimensions of a higher-order factor we called “Clinic Functionality.” This 2-level, 6-factor model fit the data well in the exploratory and confirmatory samples. For all but 1 factor, fewer than 20 survey responses were needed to achieve clinic-level reliability >0.7.

Conclusions:

Survey instruments designed to measure workplace climate have substantial overlap. The relatively parsimonious item set we identified might help target and tailor clinics’ quality improvement efforts.
Outcome-specific Charlson Comorbidity Indices for Predicting Poor Inpatient Outcomes Following Noncardiac Surgery Using Hospital Administrative Data
Authors: Moodley Yoshan
Published: June 2016

Background:

A need exists for adapting existing perioperative risk stratification methods such as the Charlson Comorbidity Index (CCI) for application with hospital administrative data in noncardiac surgery populations.

Objective:

Develop and validate outcome-specific CCIs for predicting inpatient mortality, and cardiac and renal morbidity in noncardiac surgery patients using hospital administrative data.

Methods:

We used hospital administrative data from the 2010 and 2011 California State Inpatient Database (SID) to develop (derivation cohort: 2010 SID, n=177,280) and validate (validation cohort: 2011 SID, n=179,145) 3 outcome-specific CCIs. Along with the 17 CCI comorbidities, the clinical importance and weighted point scores for age, male sex, race, emergent admission, and high-risk surgery were also determined from the coefficients of a logistic regression model. Cumulative outcome-specific CCI, CCI, and age-adjusted CCI (AACCI) scores were calculated for each patient. Receiver-operator characteristic curve analyses were used to determine the prognostic accuracy (area under the curve) of each outcome-specific CCIs, the CCI, and the AACCI. Risk was stratified according to cumulative point scores for each outcome-specific CCI, and posttest probabilities for each risk category were calculated.

Results:

All outcome-specific CCIs showed good performance as a prognostic tools (area under the curve>0.800 for all) and performed better than the CCI and AACCI. We attached clinical relevance to a given cumulative point score by determining posttest probabilities for each outcome-specific index.

Conclusions:

We successfully adapted and validated 3 outcome-specific CCIs for use in noncardiac surgery patients based on ICD-9 and hospital admission data. Further validation of these outcome-specific CCIs is warranted.
Baseline CD4 Count and Adherence to Antiretroviral Therapy: A Systematic Review and Meta-Analysis
Authors: Bock Peter , James Anelet , Nikuze Alliance , Peton Neshaan , Sabapathy Kalpana , Mills Edward , Fidler Sarah , Ford Nathan
Published: June 2016

Background:

In light of recent changes to antiretroviral treatment (ART) guidelines of the World Health Organization and ongoing concerns about adherence with earlier initiation of ART, we conducted a systematic review of published literature to review the association between baseline (pre-ART initiation) CD4 count and ART adherence among adults enrolled in ART programs worldwide.

Methods:

We performed a systematic search of English language original studies published between January 1, 2004 and September 30, 2015 using Medline, Web of Science, LILACS, AIM, IMEMR, and WPIMR databases. We calculated the odds of being adherent at higher CD4 count compared with lower CD4 count according to study definitions and pooled data using random effects models.

Results:

Twenty-eight articles were included in the review and 18 in the meta-analysis. The odds of being adherent was marginally lower for patients in the higher CD4 count group (pooled odds ratio, 0.90; 95% confidence interval, 0.84 to 0.96); however, the majority of studies found no difference in the odds of adherence when comparing CD4 count strata. In analyses restricted to comparisons above and below a CD4 count of 500 cells per microliter, there was no difference in adherence (pooled odds ratio, 1.01; 95% confidence interval: 0.97 to 1.05).

Conclusions:

This review was unable to find consistent evidence of differences in adherence according to baseline CD4 count. Although this is encouraging for the new recommendations to treat all HIV-positive individuals irrespective of CD4 count, there is a need for additional high-quality studies, particularly among adults initiating ART at higher CD4 cell counts.
Closing the Gap in Antiretroviral Initiation and Viral Suppression: Time Trends and Racial Disparities
Authors: Haines Charles F. , Fleishman John A. , Yehia Baligh R. , Lau Bryan , Berry Stephen A. , Agwu Allison L. , Moore Richard D. , Gebo Kelly A.
Published: June 2016

Background:

In the current antiretroviral (ART) era, the evolution of HIV guidelines and emergence of new ART agents might be expected to impact the times to ART initiation and HIV virologic suppression. We sought to determine if times to AI and virologic suppression decreased and if disparities exist by age, race/ethnicity, and HIV risk.

Methods:

We performed a retrospective cohort study of data from 12 sites of the HIV Research Network, a consortium of US clinics caring for HIV-infected patients. HIV-infected adults (≥18 year old) newly presenting for care between 2003 and 2013 were included in this study. Times to AI and virologic suppression were defined as time from enrollment to AI and HIV RNA <400 copies per milliliter, respectively. We conducted time-to-event analyses using competing risk regression in the HIV Research Network cohort from 2003 to 2012 in 2-year intervals, with follow-up through 2013.

Results:

Among 15,272 participants, 76.9% were male, 48.4% black, and 10.9% were injection drug use with median age of 38 years (interquartile range: 29–46 years). The adjusted subdistribution hazards ratios (SHRs) for AI and virologic suppression each increased for years 2007–2008 [SHR 1.23 (1.16–1.30), and SHR 1.25 (1.17–1.34), respectively], 2009–2010 [1.55 (1.46–1.64), and 1.54 (1.43–1.65), respectively], and 2011–2012 [1.94 (1.83–2.07), and 1.73 (1.61–1.86), respectively] compared with 2003–2004. Blacks had a lower probability of AI than whites and Hispanics.

Conclusions:

Since 2007, times from enrollment to AI and virologic suppression have decreased significantly compared with 2003–2004, but persisting disparities should be addressed.
Rationale for local treatment in the management of metastatic prostate cancer
Authors: Gandaglia Giorgio , Fossati Nicola , Dell’Oglio Paolo , Moschini Marco , Cucchiara Vito , Suardi Nazareno , Mottrie Alexandre , Mirone Vincenzo , Montorsi Francesco , Briganti Alberto
Published: June 2016

Purpose of review

To evaluate the rationale supporting the role of local treatment in the management of patients with metastatic prostate cancer (PCa).

Recent findings

Not all patients with metastatic PCa share the same prognosis, in which selected individuals with oligometastatic PCa might benefit from local therapies. These men would harbor a biologically different disease as compared with their counterparts with widespread metastases. Local treatment would eliminate the source of tumor-promoting factors, destroy the origin of metastatic cells, and stop the self-seeding process. Moreover, decreasing tumor burden would eventually allow for an improved response to systemic therapies. Recent clinical studies support an oncologic role of surgery or radiotherapy in metastatic PCa. However, their retrospective nature limits the relevance of these findings. Results of ongoing trials assessing the impact of local treatment in metastatic patients are needed to comprehensively address its role.

Preclinical observations provide a rationale for treatment of the primary tumor in selected patients with metastatic PCa. However, available clinical evidence comes from retrospective investigations, and only results of ongoing randomized trials would clarify the role of local treatment in the metastatic setting.
A phenome-wide examination of neural and cognitive function
Authors: Poldrack RA , Congdon E , Triplett W , Gorgolewski KJ , Karlsgodt KH , Mumford JA , Sabb FW , Freimer NB , London ED , Cannon TD , Bilder RM
Published: June 2016

This data descriptor outlines a shared neuroimaging dataset from the UCLA Consortium for Neuropsychiatric Phenomics, which focused on understanding the dimensional structure of memory and cognitive control (response inhibition) functions in both healthy individuals (138 subjects) and individuals with neuropsychiatric disorders including schizophrenia (58 subjects), bipolar disorder (49 subjects), and attention deficit/hyperactivity disorder (45 subjects). The dataset includes an extensive set of task-based fMRI assessments, resting fMRI, structural MRI, and high angular resolution diffusion MRI. The dataset is shared through the OpenfMRI project, and is formatted according to the Brain Imaging Data Structure (BIDS) standard.
Unsupervised Learning of Temporal Features for Word Categorization in a Spiking Neural Network Model of the Auditory Brain
Authors: Higgins Irina , Stringer Simon , Schnupp Jan
Published: June 2016

The nature of the code used in the auditory cortex to represent complex auditory stimuli, such as naturally spoken words, remains a matter of debate. Here we argue that such representations are encoded by stable spatio-temporal patterns of firing within cell assemblies known as polychronous groups, or PGs. We develop a physiologically grounded, unsupervised spiking neural network model of the auditory brain with local, biologically realistic, spike-time dependent plasticity (STDP) learning, and show that the plastic cortical layers of the network develop PGs which convey substantially more information about the speaker independent identity of two naturally spoken word stimuli than does rate encoding that ignores the precise spike timings. We furthermore demonstrate that such informative PGs can only develop if the input spatio-temporal spike patterns to the plastic cortical areas of the model are relatively stable.

Author Summary

Currently we still do not know how the auditory cortex encodes the identity of complex auditory objects, such as words, given the great variability in the raw auditory waves that correspond to the different pronunciations of the same word by different speakers. Here we argue for temporal information encoding within neural cell assemblies for representing auditory objects. Unlike the more traditionally accepted rate encoding, temporal encoding takes into account the precise relative timing of spikes across a population of neurons. We provide support for our hypothesis by building a neurophysiologically grounded spiking neural network model of the auditory brain with a biologically plausible learning mechanism. We show that the model learns to differentiate between naturally spoken digits “one” and “two” pronounced by numerous speakers in a speaker-independent manner through simple unsupervised exposure to the words. Our simulations demonstrate that temporal encoding contains significantly more information about the two words than rate encoding. We also show that such learning depends on the presence of stable patterns of firing in the input to the cortical areas of the model that are performing the learning.
Small-angle neutron scattering spectrometer Suanni equipped with ultra-thin biconcave focusing lenses
Authors: Chen Liang , Sun Liangwei , Wang Yun , Wang Yunlong , Zou Lin , Yan Guanyun , Chen Jie , Tian Qiang , Peng Mei , Gong Jian , Chen Bo , Sun Guangai , Liu Dong
Published: June 2016

The small-angle neutron scattering (SANS) spectrometer Suanni at the liquid hydrogen cold neutron source of the 20 MW China Mianyang Research Reactor has recently been upgraded. Ultra-thin biconcave MgF2lenses with a central thickness down to 0.2 mm have been installed between the collimator chamber and the sample stage. The lenses are able to improve the flux without too excessive an increase in the neutron beam size on the detector. A smaller minimumQ(Qmin) can be obtained by decreasing the beam size without changing the total length of the spectrometer. By testing the central beam profiles under different neutron wavelengths (∼0.56–1 nm) with both traditional pinhole SANS (PSANS) and focusing SANS (FSANS) geometries, the gain factor thanks to the neutron lenses is about one order of magnitude. Given the loss of intensity due to the absorption of neutrons by the lenses, the benefits of the focusing can only be realized if it is possible to increase the aperture size. With an identical source aperture, FSANS can minimize the nominalQminfrom 7.20 × 10−3 nm−1(for PSANS) to 5.55 × 10−3 nm−1at a neutron wavelength of 1 nm. The practical benefit provided by the lenses is verified with a solution of poly(methyl methacrylate) nanospheres, which yields a scattering intensity one order of magnitude higher and a better resolution with the FSANS geometry than with that of PSANS.
Accurate optimization of amino acid form factors for computing small-angle X-ray scattering intensity of atomistic protein structures
Authors: Tong Dudu , Yang Sichun , Lu Lanyuan
Published: June 2016

Structure modellingviasmall-angle X-ray scattering (SAXS) data generally requires intensive computations of scattering intensity from any given biomolecular structure, where the accurate evaluation of SAXS profiles using coarse-grained (CG) methods is vital to improve computational efficiency. To date, most CG SAXS computing methods have been based on a single-bead-per-residue approximation but have neglected structural correlations between amino acids. To improve the accuracy of scattering calculations, accurate CG form factors of amino acids are now derived using a rigorous optimization strategy, termed electron-density matching (EDM), to best fit electron-density distributions of protein structures. This EDM method is compared with and tested against other CG SAXS computing methods, and the resulting CG SAXS profiles from EDM agree better with all-atom theoretical SAXS data. By including the protein hydration shell represented by explicit CG water molecules and the correction of protein excluded volume, the developed CG form factors also reproduce the selected experimental SAXS profiles with very small deviations. Taken together, these EDM-derived CG form factors present an accurate and efficient computational approach for SAXS computing, especially when higher molecular details (represented by theqrange of the SAXS data) become necessary for effective structure modelling.
EosFit7-GUI: a new graphical user interface for equation of state calculations, analyses and teaching
Authors: Gonzalez-Platas Javier , Alvaro Matteo , Nestola Fabrizio , Angel Ross
Published: June 2016

EosFit7-GUIis a full graphical user interface designed to simplify the analysis of thermal expansion and equations of state (EoSs). The software allows users to easily perform least-squares fitting of EoS parameters to diffraction data collected as a function of varying pressure, temperature or both. It has been especially designed to allow rapid graphical evaluation of both parametric data and the EoS fitted to the data, making it useful both for data analysis and for teaching.