bluuebunny/crossref_metadata_2025 huggingface dataset:
Mortalidad intrahospitalaria en adultos mayores chilenos con fractura de cadera: incidencia, causas y otros elementos de interés
Authors: Dinamarca Montecinos José , Améstica Lazcano Gedeón , Carrasco Buvinic Alejandro
Published: August 2018

Introducción Las fracturas de cadera (FC) presentan alta mortalidad. Existen escasos estudios que profundizan en la mortalidad intrahospitalaria (MIH) asociada.

Objetivo Describir MIH en pacientes ≥ 60 años con FC.

Materiales y Métodos Corte transversal, descriptivo y analítico, monocéntrico, de colección completa. Fueron evaluados 647 sujetos, de ambos géneros, ingresados con FC entre 01.01.2010 y 31.12.2012, agrupándolos en fallecidos y egresados vivos. Se registró fallecimientos, género, edad, ubicación anatómica, tipo de traumatismo, lugar de ocurrencia de FC, tiempo fractura-fallecimiento, tiempo de estancia hospitalaria, porcentaje de operados, diagnósticos asociados a FC, diagnóstico de fallecimiento, comorbilidad asociada al diagnóstico de fallecimiento y lugar de fallecimiento. Datos en planilla ortogeriátrica, análisis descriptivo.

Resultados MIH = 3,09%. Edad promedio 84 años. Los diagnósticos de fallecimiento más importantes fueron infecciones (40%) y enfermedad tromboembólica (15%). El 80% presentó comorbilidad crónica relacionada con la causa de fallecimiento. Sin diferencias significativas según edad, género, ubicación anatómica de la FC, lugar de ocurrencia de la FC, tiempo de estancia hospitalaria. Hubo diferencias significativas en cantidad de no operados, mayor en el grupo con MIH (p < 0.000), esperable por sesgo de selección. Es deseable identificar precozmente los sujetos con FC que presentan alto riesgo de MIH. Esto, para definir manejo conservador, optimizar calidad de vida y recursos hospitalarios.
Principios quirúrgicos y biomecánicos de los métodos de fijación actual en el tratamiento de fracturas de Hoffa
Authors: Colmenares Sandoval Oscar , Carredano González Xabier , Díaz Allende Pedro , López Morales Mario , Donoso Martínez Rodrigo , O'Connell Godoy Luis , Figueroa Poblete David
Published: August 2018

Las fracturas de los cóndilos femorales en el plano coronal (Hoffa), son lesiones que afectan directamente la biomecánica de la rodilla. Están expuestas a un factor intrínseco de inestabilidad causado por el compromiso de los ligamentos y tendones insertados al fragmento condilar fracturado y a un factor extrínseco de inestabilidad dependiente del estrés mecánico en varo/valgo durante la fase de apoyo de la marcha y movimientos de flexo-extensión. El tratamiento quirúrgico con tornillos canulados sólo permite la compresión interfragmentaria y cierto grado de estabilidad rotacional, sin embargo, ese tipo de fijación podría no ser suficiente para soportar o neutralizar las cargas. Distintos autores han publicado otros métodos de osteosíntesis con el uso de placas en el plano lateral o posterior más la colocación de tornillos en sentido postero-anterior, pero siguen siendo opciones controversiales debido al tipo de morbilidad inherente a cada constructo. El objetivo de este artículo es realizar una revisión de la literatura para analizar la validez de los principios quirúrgicos y biomecánicos en el tratamiento de fracturas tipo hoffa.
Note: Parametric tuning of the Helmholtz coil and its optimal designs with thick winding pairs
Authors: Yang Jianhang , Wang Yanzhao , Pan Jie , Wang Yuxing
Published: August 2018

Thick winding pairs are generally utilized in high-power Helmholtz coil systems, where the coil-heating and insulation are usually of concern for their field uniformity. Beyond the ideal thin model, we discuss the field uniformity of thick Helmholtz coils and their optimal designs based on the numerical and experimental analysis. Furthermore, the design tuning parameters, i.e., ampere-turn configurations, are introduced to the numerical models to investigate their influence on the magnets’ field uniformity. The results show that different ampere-turn realizations of one ideal Helmholtz coil could induce up to ∼30% uniformity variation within the central region. Regardless of whether it is the conventional Helmholtz coil or its optimal designs, the increase in layer number and axial insulation gaps tends to improve the field uniformity. However, the increase in turns per layer results in a great reduction in their field uniformity. By optimizing the ampere-turn arrangement, it is possible to further improve the performance of a Helmholtz-coil-based magnet.
Electron density measurement of a lightning stepped leader by oxygen spectral lines
Authors: Cen Jianyong , Hou Qiang , Yuan Ping , Zhang Jinjun , Sun Minna , Pan Junxing , Cao Zengli
Published: August 2018

The time-resolved spectrum of a lightning stepped leader in downward process has been obtained by using a slitless spectrograph. Neutral oxygen and nitrogen spectral lines in the near infrared region are observed in the spectra. The electron density of the lightning stepped leader was calculated by using the Stark broadening of the oxygen spectral lines at 777.4 and 844.6 nm. The evolution characteristic of the electron density with time and channel height of the lightning stepped leader was analysed. The results shown that the electron density of the lightning stepped leader was in the order of 1018 cm-3. The electron density decreased when the lightning stepped leader propagates downward to ground.
Participation in Hospital in the Home for patients in inner metropolitan Sydney: implications for access and equity
Authors: Page Jude , Comino Elizabeth , Burgess Mandy , Cullen John , Harris Elizabeth
Published: August 2018

Objective
The aim of this study was to identify whether the Hospital in the Home (HITH) program was taken up equitably by eligible patients in relation to their age, sex, country of birth, place of residence and primary diagnosis.

Methods
This study presents results of a descriptive analysis of the administrative records of 3552 people with specific conditions who met the study criteria of potential eligibility to HITH and resided within the health district boundary.

Results
Systematic differences were found for participation in HITH and in-patient care according to sex, language spoken at home and socioeconomic status based on place of residence. This suggests that people from higher socioeconomic backgrounds who speak English at home were more likely to participate in and benefit from HITH. Tailored interventions were identified as a potential way to reduce the gap in access to quality health care for women and people who speak a language other than English at home. If HITH is the optimum treatment available, then these differences could be considered potentially avoidable and unfair.

Conclusion
Data analysis through an equity lens can effectively identify who is accessing health services and who is missing out. Further analysis is required to understand patient and system barriers to accessing HITH.

What is known about the topic?
Advances in medical and surgical treatments and pharmaceuticals reduce the need for in-patient hospitalisation. For some conditions, home-based treatment is safer, cheaper and preferable to the patient and carers, particularly some older people who may experience deteriorating cognitive and physical functioning related to hospitalisation. It is well known that health and access to health care is not equally distributed in society.

What does this paper add?
This study represents the first effort to quantitatively evaluate differences in patterns of participation in HITH related to socioeconomic and language characteristics. There are underutilised opportunities for improved participation in HITH by identifying who is not accessing programs at a comparable rate and therefore not benefitting from optimal health services. By exploring why this may be occurring at an individual and system level, we can be more informed to address these reasons and achieve better health and social outcomes.

What are the implications for practitioners?
It is important to consider both consumer and service provider views in shaping current and future service models. Comprehensive assessment of support needs to participate in HITH for patients and carers, as well as communicating potential benefits in ways patients understand, can improve participation and satisfaction, reduce health costs and improve health outcomes.
Integrative systematics of clathrinid sponges: morphological, reproductive and phylogenetic characterisation of a new species of Leucetta from Antarctica (Porifera, Calcarea, Calcinea) with notes on the occurrence of flagellated sperm
Authors: Riesgo Ana , Cavalcanti Fernanda F. , Kenny Nathan J. , Ríos Pilar , Cristobo Javier , Lanna Emilio
Published: August 2018

Our study reports on the occurrence of a new species of Leucetta (Calcinea, Calcarea) from the Southern Ocean, Leucetta giribeti, sp. nov., collected in the shallow waters (15m depth) of Deception Island, South Shetland Islands. This new taxon is described based on a combination of morphological and molecular data, including the description of oocytes, embryos, larvae and sperm found in the choanosome. While female reproductive elements showed great similarities with those of other calcineans, sperm is reported here for the first time in the whole Calcinea subclass. Sperm cells are flagellated and possess a typical spermatic mid-piece, which is usually observed in cnidarians. In our phylogenetic analyses, we recovered Leucetta giribeti, sp. nov. as sister species of a clade formed by species of the genera Leucetta, Pericharax and Leucettusa. Although the clade in which Leucetta giribeti, sp. nov. is placed is supported by molecular and morphological features, we cannot propose a new genus due to uncertainties regarding the type species of the genus, Leucetta primigenia Haeckel, 1872. Our study reinforces the relevance of integrative approaches in the description of new taxa and contributes to resolving the poorly known reproductive patterns of Antarctic sponge species.
Spatial and temporal dynamics of the overwater structure fouling community in southern California
Authors: Obaza Adam K. , Williams Jonathan P.
Published: August 2018

Overwater structures within coastal estuaries are novel habitats that may facilitate the introduction and spread of non-native fouling organisms, although permitting agencies lack quantitative data to develop mitigation measures. To explore this habitat impact, abundance (percentage cover) and community composition of fouling communities were examined over space and time, using photoquadrats on floating docks. Floating dock pontoons within 12 bays and harbours were sampled throughout southern California to document spatial patterns in non-native species. To evaluate community development on newly available substrate, dock floats within Alamitos Bay were sampled quarterly for 1 year following removal of fouling organisms. Percentage coverage of non-native species was greater than coverage of native or cryptogenic species both underneath and along the sides of structures in outer and inner bay areas of embayments and community composition varied significantly among sampling locations. The percentage cover of non-native species and community composition in cleared floats rapidly converged on those of uncleared control floats, suggesting that seasonal dynamics are a strong driver of non-native species colonisation. Quantification of these dynamics could serve as a starting point in the development of mitigation measures and highlights the importance of evaluating all possible impacts from coastal development projects during the permitting process.
Clarifying the meaning of mantras in wildland fire behaviour modelling: reply to Cruz et al. (2017)
Authors: Mell William , Simeoni Albert , Morvan Dominique , Hiers J. Kevin , Skowronski Nicholas , Hadden Rory M.
Published: August 2018

In a recent communication, Cruz et al. (2017) called attention to several recurring statements (mantras) in the wildland fire literature regarding empirical and physical fire behaviour models. Motivated by concern that these mantras have not been fully vetted and are repeated blindly, Cruz et al. (2017) sought to verify five mantras they identify. This is a worthy goal and here we seek to extend the discussion and provide clarification to several confusing aspects of the Cruz et al. (2017) communication. In particular, their treatment of what they call physical models is inconsistent, neglects to reference current research activity focussed on combined experimentation and model development, and misses an opportunity to discuss the potential use of physical models to fire behaviour outside the scope of empirical approaches.
Designing policy robustness: outputs and processes
Authors: Capano Giliberto , Woo Jun Jie
Published: August 2018

Faced with growing policy complexity and environmental uncertainty, policymakers are increasingly concerned with ensuring that policy processes retain functionality amidst shock and uncertainty. In this paper, we seek to address the ways in which robustness – or the capability of policies to maintain functionality and effectiveness in policy goal attainment – can be designed into policies, institutions or systems. We suggest that robust policy designs can be characterized by diversity, modularity and redundancy, whereas robust policy design processes require the presence of polycentric decisional process, political capacity and technical capacity. In identifying these design elements of policy robustness, we argue that robustness is a property that can be designed to ensure that policies continue to deliver, over time, its intended functions, purposes and objectives, even under negative circumstances.
Local labor market size and qualification mismatch
Authors: Berlingieri Francesco
Published: August 2018

This paper investigates the effect of the size of the local labor market on skill mismatch. Using survey data for Germany, I find that workers in large cities are both less likely to be overqualified for their job and to work in a different field than the one for which they trained. Different empirical strategies are employed to account for the potential sorting of talented workers into more urbanized areas. Results on individuals who have never moved away from the place in which they grew up and fixed effects estimates obtaining identification through regional migrants suggest that sorting does not fully explain the existing differences in qualification mismatch across areas. This provides evidence of the existence of agglomeration economies through better matches. However, lower qualification mismatch in larger cities is found to explain at best a small part of the urban wage premium.
Novel Mineral–Vitamin Treatment for Reduction in Cigarette Smoking: A Fully Blinded Randomized Placebo-Controlled Trial
Authors: Reihana Phillipa K , Blampied Neville M , Rucklidge Julia J
Published: August 2018

Introduction

Many smokers do not achieve abstinence using current smoking cessation options. This randomized controlled trial (RCT) investigated a novel nutritional supplement to assist with quitting smoking.

Methods

Following a baseline phase where cigarettes per day and nicotine dependence were measured, participants (n = 107) were randomized to placebo (n = 50) or micronutrient conditions (n = 57). A 4-week pre-quit phase permitted titration up to 12 capsules/day. During the quit phase (12 weeks), participants were registered with a public Quitline while consuming micronutrients or placebo. Carbon monoxide levels were measured to confirm smoking cessation.

Results

Forty-five (42%) participants completed the trial. Treatment and placebo groups did not differ on the primary outcome of continuous abstinence at 12 weeks using intention-to-treat analysis; however, 28% of the micronutrient-treated group had quit versus 18% for placebo (odds ratio [OR] = 1.78, 95% confidence interval [CI] = 0.71 to 4.48), with number needed to treat = 10. Comparison of cigarette consumption (cigarettes per day) between micronutrient and placebo groups showed that those taking micronutrients reported reduced consumption throughout the trial, notably at pre-quit weeks 1 and 4, and at quit phase week 4. There were no serious adverse events, blinding was successful, and there were no substantive group differences in side effects or dropout rate.

Conclusion

This is the first RCT investigating the impact of micronutrients on smoking reduction, finding that micronutrients reduced harm through reduction in number of cigarettes smoked relative to placebo. The small sample and high dropout rate limit confidence in the conclusions and generalizability of the study; however, assessed by number needed to treat, micronutrients are comparable to other smoking cessation treatments but with fewer side effects. Future research using larger and longer trials including cost-effectiveness and biomarker measures is encouraged.

Implications

Micronutrients are being increasingly studied for the treatment of psychiatric conditions, but direct application of micronutrients as a treatment for addictions is novel. There is extensive evidence that micronutrients alleviate stress. Given that tobacco smoking is often used to cope with stress, taking micronutrients may moderate the stress of withdrawal and increase the chance of a successful quit attempt. This study is the first known RCT to investigate the use of micronutrients to support smoking cessation. Treatments that are safe, effective, relatively inexpensive, and readily available are needed and micronutrient supplements offer one such possible alternative.
Translational genomic research: the role of genetic polymorphisms in MBSR program among breast cancer survivors (MBSR[BC])
Authors: Park Jong Y , Lengacher Cecile A , Reich Richard R , Alinat Carissa B , Ramesar Sophia , Le Alice , Paterson Carly L , Pleasant Michelle L , Park Hyun Y , Kiluk John , Han Hyo , Ismail-Khan Roohi , Kip Kevin E
Published: August 2018

Genetic variations of breast cancer survivors (BCS) may contribute to level of residual symptoms, such as depression, stress, fatigue, and cognitive impairment. The objective of this study was to investigate whether particular single-nucleotide polymorphisms (SNPs) moderated symptom improvement resulting from the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR[BC]) program. An overarching goal of personalized medicine is to identify individuals as risk for disease and tailor interventions based on genetic profiles of patients with diseases including cancer. BCS were recruited from Moffitt Cancer Center and University of South Florida’s Breast Health Program and were randomized to either the 6-week MBSR(BC) program (n = 92) or Usual Care (n = 93). Measures of symptoms, demographic, and clinical history data were attained at baseline, 6 weeks, and 12 weeks. A total of 10 SNPs from eight genes known to be related to these symptoms were studied using genomic DNA extracted from blood. Our results were examined for effect sizes, consistency, and statistical significance (p < .05). Three SNPs (rs4680 in COMT, rs6314 in HTR2A, and rs429358 in APOE) emerged as having the strongest (though relatively weak) and most consistent effects in moderating the impact of the MBSR program on symptom outcomes. Although effects were generally weak, with only one effect withstanding multiple comparisons correction for statistical significance, this translational behavioral research may help start the identification of genetic profiles that moderate the impact of MBSR(BC). The ultimate goal of this study is the development of personalized treatment programs tailored to the genetic profile of each patient.
Reflections on the evolution of the vertebrate tissue inhibitors of metalloproteinases
Authors: Brew Keith
Published: August 2018

Jawed vertebrates (Gnathostomes) have 4 tissue inhibitors of metalloproteinases (TIMPs), multifunctional proteins that all inhibit members of the large matrix metalloproteinase (MMP) family but differ in their other roles, including the regulation of pro‐MMP activation, cell growth, apoptosis and angiogenesis, and the structure of extracellular matrices (ECMs). Molecular phylogeny analyses indicate that vertebrate TIMP genes arose from an invertebrate ancestor through 3 successive duplications, possibly including 2 whole genome duplications, during early vertebrate phylogeny. TIMPs from invertebrates also inhibit metalloproteinases, bind to pro‐MMPs, and contribute to ECM structures but are not orthologs of any particular vertebrate TIMP. The most ancient vertebrate superclass, the Agnatha (jawless fish), seems to provide a snapshot of a stage in TIMP evolution preceding the third gene duplication. This review examines the structures of TIMPs from different vertebrate orders using information relating to the structural basis of their various functions. Provisional conclusions are that during their evolutionary divergence, various TIMPs lost inhibitory activity toward some metalloproteinases, specialized in effects on different pro‐MMPs, and developed new interactions with discrete targets (including integrins and receptors), while recapitulating a role in ECM structure. The analysis is limited by the sparse information available regarding the functional properties of nonmammalian TIMPs.—Brew, K. Reflections on the evolution of the vertebrate tissue inhibitors of metalloproteinases. FASEB J. 33, 71–87 (2019). www.fasebj.org
Inflammatory Diabetic Neuropathy: Helpful Diagnostic Parameters
Authors: Thaisetthawatkul Pariwat , Fernandes J. Americo , Piccione Ezequiel , Truong Laetitia , Dyck P. James B.
Published: August 2018

Objectives:

Mild inflammatory diabetic neuropathies (IDNs) overlap with diabetic sensorimotor neuropathy (DPN) in clinical presentation and electrophysiological and laboratory tests. This study is to determine whether IDN can be differentiated from DPN by clinical features, electrophysiological, pathological, or laboratory tests.

Methods:

Suspected IDN cases were identified by a subacute onset and progressive sensory or motor neuropathy in patients with diabetes.

Results:

IDN occurred earlier in the course of diabetes mellitus and had higher prevalence of limb weakness, walking difficulty, and more severe electrophysiological abnormalities suggesting both demyelination and axonal loss. Sensory nerve biopsies in IDN showed perivascular inflammatory infiltrates, decreased fiber density, increased demyelination, and axonal degeneration. Most patients with IDN improved with immunotherapy.

Conclusions:

Features that favor IDN over DPN are limb weakness, more severe nerve conduction abnormalities, inflammatory infiltrates on nerve biopsy, and a favorable response to immunotherapy. A nerve biopsy can help establish an inflammatory cause.
Autoimmune Neuromuscular Diseases Induced by Immunomodulating Drugs
Authors: Supakornnumporn Songkit , Katirji Bashar
Published: August 2018

Immunomodulating drugs are widely used in autoimmune, transplant, and cancer patients. However, these drugs are associated with various autoimmune neuromuscular diseases such as demyelinating polyneuropathy, myasthenia gravis, and myositis. Early recognition of these complications and immediately terminating these drugs are very essential since some are life-threatening conditions. This review provides a general overview of drug-induced autoimmunity and autoimmune neuromuscular diseases associated with tumor necrosis factor alpha (TNF-α) antagonists, immune checkpoint inhibitors, and interferon (IFN) type 1 (IFN-β and IFN-α).
Low Sensitivity of Skin Biopsy in Diagnosing Small Fiber Neuropathy in Chinese Americans
Authors: Jin Peter , Cheng Ling , Chen Ming , Zhou Lan
Published: August 2018

Objectives:

To compare skin biopsy sensitivity for diagnosing small fiber sensory neuropathy in Chinese American and non-Chinese American patients.

Methods:

We screened our skin biopsy database and performed chart review to identify Chinese and non-Chinese American patients with a high clinical suspicion for a distal small fiber sensory neuropathy, and compared the skin biopsy sensitivity.

Results:

Twenty-three Chinese American and 32 non-Chinese American patients with the presence of distal small fiber sensory symptoms and signs were studied. Intraepidermal nerve fiber density (IENFD) (fibers/mm) at the distal leg was higher (7.1 ± 3.9), and the diagnostic sensitivity using the worldwide normative reference values of IENFD at the distal leg was lower (26.1%) in the Chinese American group than in the non-Chinese American group (5.1 ± 3.0, P < 0.05; 62.5%, P < 0.05).

Conclusions:

There may be ethnic differences in IENFD at the distal leg, and a different set of IENFD normative values may be developed for ethnic Chinese to improve the skin biopsy sensitivity.
Cybersecurity: Positive Changes Through Processes and Team Culture
Authors: Pullin Dennis W.
Published: August 2018

Protecting your organization’s technology systems, devices, and electronic information is more important than ever before as healthcare increasingly becomes a target for cyberattacks, phishing, and ransomware. Hackers have turned this cyber warfare into a multibillion-dollar business, and the attacks are only getting worse. No company or individual is immune to the risks of cyberattacks, which can not only damage an organization’s operations and reputation but also affect patient care quality and safety.

At Virtua, one of New Jersey’s largest health systems, cybersecurity is a team effort. From board trustees to frontline employees, everyone is held accountable for protecting the organization against cyberattacks. Virtua’s action plans include technology solutions, process improvements, governance under a chief information security officer, vendor management, and employee education and awareness.

Completely eliminating the threat of cyberattacks, phishing, and ransomware is impossible, but keeping cybersecurity a part of an organization’s strategic plan is vital because the best possible offense is a strong, dependable defense.
Orbital Apex Syndrome in Pseudomonas Sinusitis After Functional Endoscopic Sinus Surgery
Authors: Leung Vannessa , Dunn Hamish , Newey Allison , O’Donnell Brett
Published: August 2018

Sinusitis complicated by orbital apex syndrome is rare. The majority of cases are due to mucormycosis in immunocompromised patients. The authors report a case of orbital apex syndrome secondary to Pseudomonas sinusitis. The patient was a 79-year-old Type 2 diabetic woman who underwent left-sided functional endoscopic sinus surgery. Three months postprocedure, she presented with a 3-week history of gradual vision loss and constant temporal headache on the ipsilateral side. Examination revealed light perception vision, a relative afferent pupillary defect, absent corneal reflex, and disc pallor. Imaging revealed opacification of the posterior ethmoidal air cells extending to involve the orbital apex. Urgent orbital and sinonasal decompression was performed. Intraoperative specimens grew Pseudomonas aeruginosa. The patient was treated with liposomal amphotericin B, posaconazole, and piperacillin/tazobactam. The patient recovered with no visual sequelae. Pseudomonas is an important mimicker to consider in sinusitis causing orbital apex syndrome, and it may occur following functional endoscopic sinus surgery.
Soft Tissue Chondroma of the Eyelid
Authors: Aseem Fazila , Pace S. Tyler , Onajin Oluwakemi , Sangueza Omar P. , Yeatts R. Patrick
Published: August 2018

A 54-year-old woman presented with a 2-year history of a slow-growing subcutaneous nodule of the medial right lower eyelid adjacent to the inferior canaliculus. The patient reported right-sided epiphora suggesting lacrimal outflow obstruction. The surgically excised nodule was consistent with a chondroma. A rare tumor, soft tissue chondroma, is most often seen in the extremities, but has also been observed in the head and neck region. To their knowledge, this is the first reported case of a soft tissue chondroma of the eyelid.
Health Insurance Portability and Accountability Act Violations by Physician Assistant Students: Applying Laws to Clinical Vignettes
Authors: Calhoun Bridget C. , Kiel Joan M. , Morgan Allison A.
Published: August 2018

Students enrolled in medical schools, nursing schools, and physician assistant (PA) programs are required to have instruction on patient privacy and protection of health-related information. The medical literature has several examples of breaches of patient privacy by clinicians, which likely represents only a fraction of the violations that occur. Patient privacy and the protection of health-related information constitute both an ethical issue and a legal issue and are associated with significant consequences. Medical, PA, and allied health students are required to comply with the same federal laws related to patient privacy and confidentiality as licensed professionals. Universities must work diligently to create a culture in which students are taught about the legal requirements of the federal Health Insurance Portability and Accountability Act (HIPAA) and are held accountable for compliance with such requirements. The Health Insurance Portability and Accountability Act must be considered part of standard classroom instruction and be embedded and upheld at all clinical training sites. We present a series of 7 HIPAA violations by PA students, along with a brief description of the HIPAA provisions associated with each case. These real-life examples provide a comprehensive overview of important HIPAA components and illustrate how easily violations can occur in clinical settings.
Suicide Acceptability and Suicide Attempt
Authors: Sun Long , Zhang Jie
Published: August 2018

In the past decades, many studies have discussed the topic of suicide acceptability. However, there is no empirical study which identified that suicide acceptability is associated with suicide attempt worldwide. In the present study participants were 791 medically serious suicide attempters and controls aged 15 to 54 years in rural China. Suicide acceptability was evaluated by four questions in the General Social Survey and some social psychological variables were collected in a face-to-face interview. Logistic regression analysis was performed to examine the association between suicide acceptability and suicide attempt. After controlling some social psychological variables, suicide acceptability was still associated with suicide attempt (odds ratio, 2.85;p< 0.001). Tired of living was the most acceptable reason for the medically serious suicide attempters (32.7%). Suicide acceptability should be assessed when we evaluate an individual’s suicide risk. The results contribute to our understanding about suicide acceptability, and they may also be translated into practice in suicide prevention.
Manic Episodes Due to Medical Illnesses
Authors: Torales Julio , González Israel , Barrios Iván , Ventriglio Antonio , Bhugra Dinesh
Published: August 2018

The body of evidence for mania as a secondary syndrome due to organic diseases is small. The clinical diagnosis and management of these patients are mainly based on clinical experience and on some case reports. Treatment should be focused on both the underlying medical illness and the control of acute symptoms. Mania due to a medical condition is relevant in the clinical setting, and thus more research is needed to add evidence-based recommendations to the currently available clinical knowledge. In this review, we summarize the latest information on the etiology, epidemiology, diagnostic aspects, and management of secondary mania.
Oscillatory brain states govern spontaneous fMRI network dynamics
Authors: Gutierrez-Barragan Daniel , Basson M. Albert , Panzeri Stefano , Gozzi Alessandro
Published: August 2018

Spontaneous brain activity as assessed with resting-state fMRI exhibits rich spatiotemporal structure. However, the principles by which brain-wide patterns of spontaneous fMRI activity reconfigure and interact with each other, remain unclear. We devised a frame-wise clustering approach to map spatiotemporal dynamics of spontaneous fMRI activity with voxel resolution in the resting mouse brain. We show that brain-wide patterns of fMRI co-activation can be reliably mapped at the group and subject level, defining a restricted set of recurring brain states characterized by rich network structure. We document that these functional states are characterized by contrasting patterns of spontaneous fMRI activity and exhibit coupled oscillatory dynamics, with each state occurring at specific phases of global fMRI signal fluctuations. Finally, we show that autism-associated genetic alterations result in the engagement of non-canonical brain states and altered coupled oscillatory dynamics. Our approach reveals a new set of fundamental principles guiding the spatiotemporal organization of resting state fMRI activity, and its disruption in brain disorders.
Metabolic engineering of Escherichia coli for de novo biosynthesis of vitamin B12
Authors: Fang Huan , Li Dong , Kang Jie , Jiang Pingtao , Sun Jibin , Zhang Dawei
Published: August 2018

The only known source of vitamin B12 (adenosylcobalamin) is from bacteria and archaea, and the only unknown step in its biosynthesis is the production of the intermediate adenosylcobinamide phosphate. Here, using genetic and metabolic engineering, we generated an Escherichia coli strain that produces vitamin B12 via an engineered de novo aerobic biosynthetic pathway. Excitingly, the BluE and CobC enzymes from Rhodobacter capsulatus transform L-threonine into (R)-1-Amino-2-propanol O-2-Phosphate, which is then condensed with adenosylcobyric acid to yield adenosylcobinamide phosphate by either CobD from the aeroic R. capsulatus or CbiB from the anerobic Salmonella typhimurium. These findings suggest that the biosynthetic steps from co(II)byrinic acid a,c-diamide to adocobalamin are the same in both the aerobic and anaerobic pathways. Finally, we increased the vitamin B12 yield of a recombinant E. coli strain by more than ∼250-fold to 307.00 µg/g DCW via metabolic engineering and optimization of fermentation conditions. Beyond our scientific insights about the aerobic and anaerobic pathways and our demonstration of E. coli as a microbial biosynthetic platform for vitamin B12 production, our study offers an encouraging example of how the several dozen proteins of a complex biosynthetic pathway can be transferred between organisms to facilitate industrial production.
Electrical synapses and transient signals in feedforward canonical circuits
Authors: Pham Tuan , Haas Julie S.
Published: August 2018

As information about the world traverses the brain, the signals exchanged between neurons are passed and modulated by synapses, or specialized contacts between neurons. While neurotransmitter-based synapses tend to be either relay excitatory or inhibitory pulses of influence on the postsynaptic neuron, electrical synapses, composed of plaques of gap junction channels, are always-on transmitters that can either excite or inhibit a coupled neighbor. A growing body of evidence indicates that electrical synapses, similar to their chemical counterparts, are modified in strength during physiological neuronal activity. The synchronizing role of electrical synapses in neuronal oscillations has been well established, but their impact on transient signal processing in the brain is much less understood. Here we constructed computational models based on the canonical feedforward neuronal circuit, and included electrical synapses between inhibitory interneurons. We provided discrete closely-timed inputs to the circuits, and characterize the influence of electrical synapses on both the subthreshold summation and spike trains in the output neuron. Our simulations highlight the diverse and powerful roles that electrical synapses play even in simple circuits. Because these canonical circuits are represented widely throughout the brain, we expect that these are general principles for the influence of electrical synapses on transient signal processing across the brain.

Author Summary

The role that electrical synapses play in neural oscillations, network synchronization and rhythmicity is well established, but their role neuronal processing of transient inputs is much less understood. Here we used computational models of canonical feedforward circuits and networks to investigate how the strength of electrical synapses regulates the flow of transient signals passing through those circuits. We show that because the influence of electrical synapses on coupled neighbors can be either inhibitory or excitatory, their role in network information processing is heterogeneous.. Because of the widespread existence of electrical synapses between interneurons as well as a growing body of evidence for their plasticity, we expect such effects play a significant role in how the brain processes transient inputs.
Length-independent telomere damage drives cardiomyocyte senescence
Authors: Anderson Rhys , Lagnado Anthony , Maggiorani Damien , Walaszczyk Anna , Dookun Emily , Chapman James , Birch Jodie , Salmonowicz Hanna , Ogrodnik Mikolaj , Jurk Diana , Proctor Carole , Correia-Melo Clara , Victorelli Stella , Fielder Edward , Berlinguer-Palmini Rolando , Owens Andrew , Greaves Laura , Kolsky Kathy L. , Parini Angelo , Douin-Echinard Victorine , LeBrasseur Nathan K. , Arthur Helen M. , Tual-Chalot Simon , Schafer Marissa J. , Roos Carolyn M , Miller Jordan , Robertson Neil , Mann Jelena , Adams Peter D. , Tchkonia Tamara , Kirkland James L , Mialet-Perez Jeanne , Richardson Gavin D , Passos João F.
Published: August 2018

Ageing is the biggest risk factor for cardiovascular health and is associated with increased incidence of cardiovascular disease. Cellular senescence, a process driven in part by telomere shortening, has been implicated in age-related tissue dysfunction. Here, we address the question of how senescence is induced in rarely dividing/post-mitotic cardiomyocytes and investigate if clearance of senescent cells attenuates age related cardiac dysfunction. During ageing, human and murine cardiomyocytes acquire a senescent-like phenotype characterised by persistent DNA damage at telomere regions that can be driven by mitochondrial dysfunction, and crucially can occur independently of cell-division and telomere length. Length-independent telomere damage in cardiomyocytes activates the classical senescence-inducing pathways, p21CIPand p16INK4aand results in a non-canonical senescence-associated secretory phenotype. Pharmacological or genetic clearance of senescent cells in mice alleviates myocardial hypertrophy and fibrosis, detrimental features of cardiac ageing, and promotes cardiomyocyte regeneration. Our data describes a mechanism by which senescence can occur and contribute to ageing in post-mitotic tissues.
Robust Automated Assessment of Human Blastocyst Quality using Deep Learning
Authors: Khosravi Pegah , Kazemi Ehsan , Zhan Qiansheng , Toschi Marco , Malmsten Jonas E. , Hickman Cristina , Meseguer Marcos , Rosenwaks Zev , Elemento Olivier , Zaninovic Nikica , Hajirasouliha Iman
Published: August 2018

Morphology assessment has become the standard method for evaluation of embryo quality and selecting human blastocysts for transfer inin vitro fertilization(IVF). This process is highly subjective for some embryos and thus prone to human bias. As a result, morphological assessment results may vary extensively between embryologists and in some cases may fail to accurately predict embryo implantation and live birth potential. Here we postulated that an artificial intelligence (AI) approach trained on thousands of embryos can reliably predict embryo quality without human intervention.

To test this hypothesis, we implemented an AI approach based on deep neural networks (DNNs). Our approach called STORK accurately predicts the morphological quality of blastocysts based on raw digital images of embryos with 98% accuracy. These results indicate that a DNN can automatically and accurately grade embryos based on raw images. Using clinical data for 2,182 embryos, we then created a decision tree that integrates clinical parameters such as embryo quality and patient age to identify scenarios associated with increased or decreased pregnancy chance. This IVF data-driven analysis shows that the chance of pregnancy varies from 13.8% to 66.3%.

In conclusion, our AI-driven approach provides a novel way to assess embryo quality and uncovers new, potentially personalized strategies to select embryos with an improved likelihood of pregnancy outcome.
ML-DSP: Machine Learning with Digital Signal Processing for ultrafast, accurate, and scalable genome classification at all taxonomic levels
Authors: Randhawa Gurjit S. , Hill Kathleen A. , Kari Lila
Published: August 2018

Background

Although methods and software tools abound for the comparison, analysis, identification, and taxonomic classification of the enormous amount of genomic sequences that are continuously being produced, taxonomic classification remains challenging. The difficulty lies within both the magnitude of the dataset and the intrinsic problems associated with classification. The need exists for an approach and software tool that addresses the limitations of existing alignment-based methods, as well as the challenges of recently proposed alignment-free methods.

Results

We combine supervisedMachineLearning withDigitalSignalProcessing to designML-DSP, an alignment-free software tool for ultrafast, accurate, and scalable genome classification at all taxonomic levels.

We test ML-DSP by classifying 7,396 full mitochondrial genomes from the kingdom to genus levels, with 98% classification accuracy. Compared with the alignment-based classification tool MEGA7 (with sequences aligned with either MUSCLE, or CLUSTALW), ML-DSP has similar accuracy scores while being significantly faster on two small benchmark datasets (2,250 to 67,600 times faster for 41 mammalian mitochondrial genomes). ML-DSP also successfully scales to accurately classify a large dataset of 4,322 complete vertebrate mtDNA genomes, a task which MEGA7 with MUSCLE or CLUSTALW did not complete after several hours, and had to be terminated. ML-DSP also outperforms the alignment-free tool FFP (Feature Frequency Profiles) in terms of both accuracy and time, being three times faster for the vertebrate mtDNA genomes dataset.

Conclusions

We provide empirical evidence that ML-DSP distinguishes complete genome sequences at all taxonomic levels. Ultrafast and accurate taxonomic classification of genomic sequences is predicted to be highly relevant in the classification of newly discovered organisms, in distinguishing genomic signatures, in identifying mechanistic determinants of genomic signatures, and in evaluating genome integrity.
Occurrence of non-western magic in the European brain
Authors: Koten Jan Willem , Schüppen André , Kumar Vinod , Wood Guilherme
Published: August 2018

Timecourses that exhibit identical behaviour at distinct measurement occasions are reliable. Voodoo connectivity occurs when connectivity among brain regions exceeds within subject timecourse reliability. Thus, timecourse reliability limits the true detectable connectivity. We reproduced a working memory related connectome consisting of 561 paths obtained from 67 individuals. We tested >100000 fc-MRI pipelines and show that Savitzky Golay (SG) filters maximize true connectivity while conserving cognitively relevant changes of signals. This is noteworthy for approaches that focus on rapidly changing aspects of connectomes. Furthermore, SG filters detect zombie activity. These “resting state oscillations” are not under human control and contaminate working state signals. SPM pipelines exhibit more voodoo connectivity than SG pipelines. With the SPM pipeline, we observed a connectivity of r=0.44 and a poor true connectivity of r=0.23, but with the SG pipeline we observed a connectivity of r=0.59 and a fair true connectivity of r=0.43. The number of paths detected with fair true connectivity (r >0.4) was 4 for the SPM pipeline but 352 for the SG based pipeline. However, superior statistical properties of SG pipelines may not reflect neural reality. Hence, causal external validation of fc-MRI pipelines is crucial. Without such studies, different pipelines produce at best “alternative maps”.
Human antibody cocktail deploys multiple functions to confer pan-ebolavirus protection
Authors: Wec Anna Z. , Bornholdt Zachary A. , He Shihua , Herbert Andrew S. , Goodwin Eileen , Wirchnianski Ariel S. , Gunn Bronwyn M. , Zhang Zirui , Zhu Wenjun , Liu Guodong , Abelson Dafna M. , Moyer Crystal L. , Jangra Rohit K. , James Rebekah M. , Bakken Russell R. , Bohorova Natasha , Bohorov Ognian , Kim Do H. , Pauly Michael H. , Velasco Jesus , Bortz Robert H. , Whaley Kevin J. , Goldstein Tracey , Anthony Simon J. , Alter Galit , Walker Laura M. , Dye John M. , Zeitlin Larry , Qiu Xiangguo , Chandran Kartik
Published: August 2018

During the unprecedented 2013–2016 Ebola virus disease (EVD) epidemic in Western Africa and in its aftermath, the passive administration of monoclonal antibodies (mAbs) emerged as a promising treatment approach1–7. However, all antibody-based therapeutics currently in advanced development are specific for a single member of the Ebolavirus genus, Ebola virus (EBOV), and ineffective against divergent outbreak-causing ebolaviruses, including Bundibugyo virus (BDBV) and Sudan virus (SUDV)2,3,5,7. Here we advance MBP134, a cocktail of two broadly neutralizing human mAbs targeting the filovirus surface glycoprotein, GP, as a candidate pan-ebolavirus therapeutic. One component of this cocktail is a pan-ebolavirus neutralizing mAb, ADI-15878, isolated from a human EVD survivor8,9. The second, ADI-23774, was derived by affinity maturation of a human mAb8,9 via yeast display to enhance its potency against SUDV. MBP134 afforded exceptionally potent pan-ebolavirus neutralization in vitro and demonstrated greater protective efficacy than ADI-15878 alone in the guinea pig model of lethal EBOV challenge. A second-generation cocktail, MBP134AF, engineered to effectively harness natural killer (NK) cells afforded additional, unprecedented improvements in protective efficacy against EBOV and SUDV in guinea pigs relative to both its precursor and to any mAbs or mAb cocktails tested previously. MBP134AF is a best-in-class mAb cocktail suitable for evaluation as a pan-ebolavirus therapeutic in nonhuman primates.
High Postoperative Monocyte Indicated Inferior Clinicopathological Characteristics and Worse Prognosis in Lung Adenocarcinoma or Squamous Cell Carcinoma after Lobectomy
Authors: Hai Yang , Chen Nan , Wu Wenwen , Wang Zihuai , Lin Feng , Guo Chenglin , Liu Chengwu , Li Weiming , Liu Lunxu
Published: August 2018

Background

Peripheral monocyte count is an assessable parameter. Recently, evidence suggested an elevated preoperative monocyte counts predicting poor prognosis in malignancies. The aim of this study was to determine the prognostic effect of early postoperative blood monocyte count in patients with lung adenocarcinoma or squamous cell carcinoma following lobectomy.

Methods

We retrospectively reviewed patients with operated lung adenocarcinoma or squamous cell carcinoma from 2006 to 2011 in Western China Lung Cancer database. Univariate analysis on disease-free survival (DFS) and overall survival (OS) was performed using the Kaplan-Meier and log-rank tests, and multivariate analysis was conducted using the Cox proportional hazards regression model.

Results

There were 433 patients enrolled in our analysis. High postoperative elevated monocyte was associated with male gender (P<0.001), positive smoking history (P=0.005), and higher N stage (P=0.002) and higher tumor stage (P=0.026). Two-tailed log-rank test indicated patients with an early postoperative elevated monocyte count predicted a poor DFS and OS overall (P<0.001,P<0.001, respectively) as well as in subgroup analysis, and further presented as a promising independent prognostic factor for both DFS and OS (HR=2.991, 95%CI: 2.243-3.988,P<0.001; HR=2.705, 95%CI: 1.977-3.700,P<0.001, respectively) on multivariate analysis. However, no significance was detected for preoperative monocyte in multivariate analysis.

Conclusions

Elevated early postoperative peripheral monocyte count was an independent prognostic factor of poor prognosis and inferior clinicopathological features for patients with operable lung adenocarcinoma or squamous cell carcinoma by lobectomy.