bluuebunny/crossref_metadata_2025 huggingface dataset:
Factorial Validity and Measurement Invariance of the Appreciation,	Fun, and Suspense Scales Across US-American and German Samples
Authors: Schneider Frank M. , Bartsch Anne , Oliver Mary Beth
Published: December 2017

Abstract. Recent approaches in entertainment research have extended the scope from hedonic gratifications (fun, suspense) to meaningful and thought-provoking entertainment experiences (appreciation). The present research examines the cross-national measurement validity of these theoretical constructs by testing the factorial structure of the German version of the Appreciation, Fun, and Suspense scales developed by Oliver and Bartsch (2010) . Measurement invariance of the scales across US-American ( N = 262) and German ( N = 274) samples is examined by reanalyzing data sets from two published studies. Findings support the theoretically assumed three-factorial model of the German scale and partial scalar invariance across samples. In addition, exploratory analyses of a third data set ( N = 200) revealed that an alternative wording for an item of the Suspense scale may be superior.
Clustered repetitive transcranial magnetic stimulation for the prevention of depressive relapse/recurrence: a randomized controlled trial
Authors: Wang Hua-Ning , Wang Xiao-Xia , Zhang Rui-Guo , Wang Ying , Cai Min , Zhang Ya-Hong , Sun Run-Zhu , Guo Li , Qiao Yu-Ting , Liu Jun-Chang , He Hong , Wang Zhong-Heng , Wan Yu-Chen , Tan Qing-Rong , Zhang Zhang-Jin
Published: December 2017

Repetitive transcranial magnetic stimulation (rTMS) may have the potential to prevent depressive relapse. This assessor-blinded, randomized controlled study was designed to evaluate the efficacy and safety of rTMS as a mono- and combination therapy in the prevention of depressive relapse/recurrence. A total of 281 depressed patients who had achieved stable full or partial remission on a 6-month antidepressant (ADP) run-in treatment were randomly assigned to an rTMS (n = 91), ADP (n = 108), or combined (rTMS + ADP, n = 82) treatment group for 12 months. Monthly clustered rTMS was conducted in 5–10 sessions over a 3–5-day period. Maintenance outcomes were assessed using time to relapse/recurrence and relapse/recurrence rate. Overall, 71.2% (200/281) of the participants completed the treatment per the protocol. rTMS + ADP and rTMS significantly reduced the risk of relapse/recurrence compared with ADP (P = 0.000), with hazard ratios of 0.297 and 0.466, respectively. Both rTMS-containing regimens produced significantly lower relapse/recurrence rates than ADP (15.9% and 24.2% vs. 44.4%, P < 0.001). In the relapsed/recurrent subgroup, first-episode depressed, rTMS-treated patients had a markedly lower relapse/recurrence rate than ADP-treated patients. Five patients on the ADP-containing regimens, but none on rTMS alone, developed acute mania. The rTMS-containing regimens had considerably more certain side effects than did the ADP group. We concluded that TMS, whether as a mono- or additional therapy, is superior to antidepressants in preventing depressive relapse/recurrence, particularly in first-episode depressed patients. The treatment does not increase the risk of manic switch, but may increase the risk of certain side effects.
Diffusion MRI measurements in challenging head and brain regions via cross-term spatiotemporally encoding
Authors: Solomon Eddy , Liberman Gilad , Zhang Zhiyong , Frydman Lucio
Published: December 2017

Cross-term spatiotemporal encoding (xSPEN) is a recently introduced imaging approach delivering single-scan 2D NMR images with unprecedented resilience to field inhomogeneities. The method relies on performing a pre-acquisition encoding and a subsequent image read out while using the disturbing frequency inhomogeneities as part of the image formation processes, rather than as artifacts to be overwhelmed by the application of external gradients. This study introduces the use of this new single-shot MRI technique as a diffusion-monitoring tool, for accessing regions that have hitherto been unapproachable by diffusion-weighted imaging (DWI) methods. In order to achieve this, xSPEN MRI’s intrinsic diffusion weighting effects are formulated using a customized, spatially-localized b-matrix analysis; with this, we devise a novel diffusion-weighting scheme that both exploits and overcomes xSPEN’s strong intrinsic weighting effects. The ability to provide reliable and robust diffusion maps in challenging head and brain regions, including the eyes and the optic nerves, is thus demonstrated in humans at 3T. New avenues for imaging other body regions are also briefly discussed.
Prognostic and predictive role of spatially positioned tumour infiltrating lymphocytes in metastatic HER2 positive breast cancer treated with trastuzumab
Authors: Honkanen Tiia J. , Moilanen Tiina , Karihtala Peeter , Tiainen Satu , Auvinen Päivi , Väyrynen Juha P. , Mäkinen Markus , Koivunen Jussi P.
Published: December 2017

Disease outcomes of HER2+ breast cancers have dramatically changed after targeted therapies, such as trastuzumab, came to clinical practice but predictive factors for trastuzumab sensitivity and resistance are frequently unknown. Current work included metastatic breast cancer patients (n = 48), who were treated with trastuzumab and had pre-treatment tumour samples available. The tumours were immunostained for T-cell (CD3, CD8), natural killer (NK)-cell (CD56) and macrophage (CD68) markers and quantitative analysis of the immune cells was carried out using a computer-assisted image analysis in different tumour locations. High number of CD3 and CD8 positive T-cells was associated with significant survival benefit in the center of the tumour (CT) (p = 0.007, p = 0.001) but not in the invasive margin. The number of NK-cells and macrophages in the CT showed non-significant tendency towards improved survival. In subgroup analyses, high density of CD8 CT cells was associated with significant survival benefit in non-bone only disease, in TX or T1-3, and in ER+ tumours (p = 0.006, p = 0.003, p = 0.001). Moreover, high CD8 CT cell density associated significantly with long trastuzumab interruption periods in response. The results suggest important prognostic and predictive role of tumour infiltrating lymphocytes in center of the tumours in metastatic HER2+ breast cancer.
Age-Related Eye Disease and Participation in Cognitive Activities
Authors: Varin Melanie , Kergoat Marie-Jeanne , Belleville Sylvie , Li Gisele , Rousseau Jacqueline , Roy-Gagnon Marie-Hélène , Moghadaszadeh Solmaz , Freeman Ellen E.
Published: December 2017

Studies have found a benefit to living a cognitively active life in older age. Our goal was to quantify participation in cognitively stimulating activities in adults with and without age-related eye disease. We conducted a cross-sectional hospital-based study in Montreal, Canada of older adults (n = 303) having either age-related macular degeneration (AMD) (n = 96), glaucoma (n = 93), or normal vision (n = 114). To be eligible, the AMD group had to have bilateral late stage AMD with a better eye visual acuity of 20/30 or worse. The glaucoma group had to have a diagnosis of bilateral primary open-angle glaucoma with visual field mean deviation <  = −4 dB in their better eye. Further inclusion criteria included age ≥ 65 and a Mini-Mental State Exam Blind score ≥ 10. Cognitive activities were measured using the Victoria Longitudinal Study Activity Questionnaire. Linear regression was used. Patients with AMD (β = −4.2, 95% confidence interval (CI) −6.0, −2.4) and glaucoma (β = −1.8, 95% CI −3.3, −0.3) participated in fewer cognitive activities per month compared to those with normal vision after adjusting for age, sex, education, diabetes, number of comorbidities, cognition, and cataract. People with AMD and glaucoma participated in fewer cognitive activities, which could put them at risk for future cognitive impairment.
Coordination of rare earth element cations on the surface of silica-derived nanoadsorbents
Authors: Polido Legaria E. , Saldan I. , Svedlindh P. , Wetterskog E. , Gunnarsson K. , Kessler V. G. , Seisenbaeva G. A.
Published: December 2017

The coordination of REE cations adsorbed on the surface of non-functionalized and complexone-functionalized silica particles was revealed by EXAFS spectroscopy and magnetic studies using X-ray single crystal models as a reference.
The cinchona alkaloid squaramide catalyzed asymmetric Pictet–Spengler reaction and related theoretical studies
Authors: Qi Liang , Hou Huacui , Ling Fei , Zhong Weihui
Published: December 2017

An asymmetric Pictet–Spengler reaction between tryptamine derivatives and aldehydes has been developed using a cinchona alkaloid squaramide as the catalyst. The reaction produced tetrahedron-β-carbolines in good to excellent yields and ee values. A rational mechanistic pathway was proposed based on DFT calculations.
4D printing of a self-morphing polymer driven by a swellable guest medium
Authors: Su Jheng-Wun , Tao Xiang , Deng Heng , Zhang Cheng , Jiang Shan , Lin Yuyi , Lin Jian
Published: December 2017

There is a significant need of advanced materials that can be fabricated into functional devices with defined three-dimensional (3D) structures for application in tissue engineering, flexible electronics, and soft robotics.
Modeling individual and pairs of adsorbed polymer-grafted nanoparticles: structure and entanglements
Authors: Ethier Jeffrey G. , Hall Lisa M.
Published: December 2017

Canopies of polymer-grafted nanoparticles adsorbed on a surface interpenetrate more at lower graft density, increasing interparticle entanglements per chain.
Unique faster‐than‐Nyquist transceiver of the ACM system
Authors: Wang Ke , Liu Aijun , Liang Xiaohu , Pen Siming
Published: December 2017

The link adaptive transmission system chooses the optimum combinations of modulation order and code rate according to the characteristics of wireless channels to make use of the channel resources. To improve the spectral efficiency further, the authors apply the faster‐than‐Nyquist (FTN) signalling to the adaptive coding and modulation (ACM) system. The ACM system based on FTN signalling can take advantage of the channel resources by adjusting the packing ratios, modulation orders and code rates. However, the variable packing ratios correspond to variable sampling rate, which challenges the receiver of the ACM system. They propose a new transceiver of the FTN‐based ACM system which can detect the FTN signal at a constant sampling rate. Moreover, they search for the optimum modulation and coding schemes of ACM based on FTN by analysing the extrinsic information transfer diagram. The simulation results show that the FTN‐based ACM system has additional gains compared with the traditional way and the proposed transceiver may be a better choice in the ACM system.
Build‐up steady‐state analysis of wind‐driven self‐excited induction generators
Authors: Li Haitao , Chen Lili , Zheng Xiaodan , Luo Yunxia , Peng Xuehu
Published: December 2017

For the contradiction between the increasing importance of the application of induction generator in the new energy power generation such as wind energy and the relative laggard of research on its comprehensive performance, the build‐up steady‐state analysis is performed for the wind‐driven self‐excited induction generator (SEIG) system based on the unloaded transient equivalent circuits and its mathematic model of SEIG in the two‐phase stationary reference frame. Thus, it obtains the build‐up steady‐state conditions represented by the unloaded transient mathematic model. On the basis of the result obtained for the build‐up steady‐state limit cycle condition, the analytic solution for the build‐up steady‐state operating point condition and the analytic formulas for the limit magnetising induction are further obtained. Example analysis is to test out the only set of analytic solution for the build‐up steady‐state condition. Thus, the analytic solution for the build‐up steady‐state condition produces the formulas of the torture and the power factor, which can be applicable to further analysis for the system dynamics and build‐up steady‐state operating performance, showing practicability and referenced value in engineering.
Analysis on the peak load adjustment adaptability of the existing 300 MW cogeneration unit manufactured by STC
Authors: Yang Haisheng , Lu Shengyang , Wang Wenying
Published: December 2017

With the increasing pressure of the strengthening the peak load adjustment capability for the cogeneration units, it is absolutely necessary that the adaptability of peak load adjustment for the existing cogeneration units be precisely studied. Model‐based software is utilised for the simulation of the 300 MW subcritical cogeneration unit manufactured by Shanghai Turbine Corporation, and detailed explanation is provided for the specific details during the modelling process. The peak load adjustment capability under various heating loads is calculated and analysed for the given unit. It is shown that with the increasing of the heating load, the span of the peak load adjustment range is gradually contracted, and the minimum power operation load is increased. The peak load adjustment capability of the existing cogeneration unit can meet the minimum load requirement of the state regulation plan for the fossil fired generation unit under 75% or lower heating load conditions. Therefore, the flexibility upgrading of the cogeneration unit should be focused on the peak load adjustment capability under large heating load conditions.
Partial discharge of white noise suppression method based on EEMD and higher order statistics
Authors: Wang Wei , Peng Weiwen , Tian Muqin , Tao Wenbiao
Published: December 2017

The insulation deterioration of mining dry‐type transformer is always accompanied with partial discharge (PD). The assessment accuracy of transformer insulation performance is directly affected by the authenticity of the PD signal. Based on the ensemble empirical mode decomposition (EEMD) and combining the principle of higher order statistics, a hybrid method for suppressing white noise in PD signals was proposed. First, the PD signals were decomposed into a number of intrinsic mode function (IMF) components. Then the signal's Gaussian components were detected and removed by kurtosis as gaussianity estimators supplemented by bootstrap techniques. The white noise in the components were suppressed through thresholding and reconstructing each IMF with adaptive thresholds. Finally, the results were reconstructed and return to the original signal. The validity of this method is proved by simulated signals and practical PD signals.
Research on low‐voltage ride through control based on model predictive control
Authors: Yuan Jianhua , Chen Yu , Chen Nan , Zhang Yunlong , Lin Yuliang
Published: December 2017

Based on the model predictive control (MPC) of photovoltaic (PV) grid‐connected inverter, combined with improved maximum power point tracking control, the low‐voltage ride through (LVRT) control of PV system is realised. Aiming at the contradiction between the voltage drop of the inverter and the reactive power output of the inverter to support the grid voltage, the LVRT control strategy based on the MPC is proposed. When the voltage drop occurs on the grid side, the PV array operating point can be adjusted according to the improved maximum power point tracking, so as to reduce the active power injected into the inverter and prevent it from overcurrent. At the same time, the grid‐connected inverter uses the MPC to change the reactive current reference value to improve the reactive power of the inverter output. Through the modelling and simulation verification, the control strategy in the voltage drop failure to ensure that the inverter is not over the flow on the basis of the inverter can adjust the reactive power output, optimise reactive power support problems caused by the voltage drop.
Effect of Blood Group on Ultrahigh Frequency Auditory Sensitivity
Authors: Prabhu Prashanth , Chandrashekhar Akhila , Cariappa Janani , Ghosh Nayanika
Published: December 2017

Introduction Individuals with blood group O are reported to have reduced otoacoustic emissions (OAEs) compared with individuals with different blood groups.

Objective The present study attempted to determine if the blood group has any effect on high-frequency auditory sensitivity using ultrahigh-frequency audiometry and ultrahigh-frequency distortion product otoacoustic emissions (DPOAEs).

Methods High-frequency thresholds and high-frequency DPOAEs were measured in 60 individuals with normal hearing and different blood groups.

Results The results of the study showed that there was a significant reduction in DPOAE amplitude for individuals with blood group O compared with individuals with other blood groups. However, there was no significant difference in ultrahigh-frequency thresholds across the blood groups.

Conclusion This reduction in OAE amplitude may be attributed to a lower number of healthy outer hair cells in individuals with blood group O. Further studies on larger groups of individuals are essential for a better generalization of the results.
The effect of the wiggler magnetic field strength on the self-focusing of an intense laser pulse propagating through a magnetized non-Maxwellian plasma
Authors: Abedi-Varaki Mehdi
Published: December 2017

In this paper, the effect of the wiggler magnetic field strength on the self-focusing of an intense laser pulse propagating through a magnetized non-Maxwellian plasma is studied. By using a relativistic fluid model, a non-linear equation describing the spot-size of the laser pulse for right- and left-hand polarizations has been derived. The evaluation of the spot-size in the self-focusing of laser pulse with the respect to the kind of polarization is investigated. Besides, the effects of wiggler magnetic field and a non-Maxwellian distribution of charge density on the evolution of the laser spot-size have been discussed. The results show that in the right-hand polarization, the existence of superthermal particles and wiggler magnetized field simultaneously cause improvement in the self-focusing quality. In addition, for the left-hand polarization, the self-focusing in the presence of wiggler field increases with an increase in the ki. Furthermore, the self-focusing decreases with an increase in the wiggler amplitudes for the left-hand polarization. Moreover, it is observed that an increase in the normalized laser frequency leads to an increase in the variation in the laser spot-size, and then the laser pulse becomes more focused.
High-performance joining technology for aluminium matrix composites using ultrasonic-assisted brazing
Authors: Leng Xuesong , Yang Wei , Zhang Jiaheng , Ma Xing , Zhao Weiwei , Yan Jiuchun
Published: December 2017

High-performance aluminium matrix composite joints were fabricated using a new joining technology assisted by ultrasonic vibration. The performance of the joints was close to that of the parent materials. The microstructure and the mechanical performance were found to be systematically dependent on the volume fraction and the distribution of reinforcement particles in the bond region. The authors believe that this study can be generalised to the bonding of other ceramic-reinforced metal matrix composites.
Obscenity and Censorship in the Reign of Henri III
Authors: Patterson Jonathan
Published: December 2017

The Parisian Pierre de L’Estoile was an obsessive compiler of politically motivated, obscene ephemera during the reign of King Henri III (r. 1574–89). This article explores how and why L’Estoile kept on adding to a vast archive of “vilain” (“vile”) materials that he purportedly despised. Examining L’Estoile’s manuscripts at close quarters, the article traces a complex practice of censure and self-censorship alongside similar practices by contemporary writers (Henri Estienne and Pierre de Brantôme). L’Estoile’s contribution to the history of sexuality is that of a self-aware critic, legitimating his compulsion to disavow the obscenities he chose to preserve.
The Patronage Politics of Equestrian Ballet: Allegory, Allusion, and Satire in the Courts of Seventeenth-Century Italy and France
Authors: Goethals Jessica
Published: December 2017

Equestrian ballet was a spectacular genre of musical theater popular in the Baroque court. A phenomenon with military roots, the ballet communicated both the might and grace of its organizers, who often played starring roles. This essay explores the ballet’s centrality by tracing the itinerant opera singer and writer Margherita Costa’s use of the genre as a means of securing elite patronage: from an elegant manuscript libretto presented to Grand Duke Ferdinando II de’ Medici and later revised in print for Cardinal Jules Mazarin in Paris, to occasional poetry written for the Barberini in Rome, and even burlesque caricatures.
Positivity of twisted relative pluricanonical bundles and their direct images
Authors: Păun Mihai , Takayama Shigeharu
Published: December 2017

Our main goal in this article is to establish a metric version of the positivity properties of twisted relative pluricanonical bundles and their direct images. Some of the important technical points of our proof are an

L

2

/

m

L^{2/m}

-extension theorem of Ohsawa-Takegoshi type which is derived from the original result by a simple fixed point method and the notion of “singular Hermitian metric” on vector bundles, together with an appropriate definition of positivity of the associated curvature. Part of this article is based on the joint work of the first-named author with Bo Berndtsson, and it can be seen as an expanded and updated version of it.
Link synthetic lethality to drug sensitivity of cancer cells
Authors: Wang Ruiping , Han Yue , Zhao Zhangxiang , Yang Fan , Chen Tingting , Zhou Wenbin , Wang Xianlong , Qi Lishuang , Zhao Wenyuan , Guo Zheng , Gu Yunyan
Published: December 2017

Synthetic lethal (SL) interactions occur when alterations in two genes lead to cell death but alteration in only one of them is not lethal. SL interactions provide a new strategy for molecular-targeted cancer therapy. Currently, there are few drugs targeting SL interactions that entered into clinical trials. Therefore, it is necessary to investigate the link between SL interactions and drug sensitivity of cancer cells systematically for drug development purpose. We identified SL interactions by integrating the high-throughput data from The Cancer Genome Atlas, small hairpin RNA data and genetic interactions of yeast. By integrating SL interactions from other studies, we tested whether the SL pairs that consist of drug target genes and the genes with genomic alterations are related with drug sensitivity of cancer cells. We found that only 6.26%∼34.61% of SL interactions showed the expected significant drug sensitivity using the pooled cancer cell line data from different tissues, but the proportion increased significantly to approximately 90% using the cancer cell line data for each specific tissue. From an independent pharmacogenomics data of 41 breast cancer cell lines, we found three SL interactions (ABL1–IFI16, ABL1–SLC50A1 and ABL1–SYT11) showed significantly better prognosis for the patients with both genes being altered than the patients with only one gene being altered, which partially supports the SL effect between the gene pairs. Our study not only provides a new way for unraveling the complex mechanisms of drug sensitivity but also suggests numerous potentially important drug targets for cancer therapy.
Endotype Transitions During the Acute Phase of Pediatric Septic Shock Reflect Changing Risk and Treatment Response
Authors: Wong Hector R. , Cvijanovich Natalie Z. , Anas Nick , Allen Geoffrey L. , Thomas Neal J. , Bigham Michael T. , Weiss Scott L. , Fitzgerald Julie C. , Checchia Paul A. , Meyer Keith , Quasney Michael , Hall Mark , Gedeit Rainer , Freishtat Robert J. , Nowak Jeffrey , Lutfi Riad , Gertz Shira , Grunwell Jocelyn R. , Lindsell Christopher J.
Published: December 2017

Objective:

We previously identified septic shock endotypes A and B based on 100 genes reflecting adaptive immunity and glucocorticoid receptor signaling. The endotypes differ with respect to outcome and corticosteroid responsiveness. We determined whether endotypes change during the initial 3 days of illness, and whether changes are associated with outcomes.

Design:

Observational cohort study including existing and newly enrolled participants.

Setting:

Multiple PICUs.

Patients:

Children with septic shock.

Interventions:

None.

Measurements and Main Results:

We measured the 100 endotyping genes at day 1 and day 3 of illness in 375 patients. We determined if endotype assignment changes over time, and whether changing endotype is associated with corticosteroid response and outcomes. We used multivariable logistic regression to adjust for illness severity, age, and comorbidity burden. Among the 132 subjects assigned to endotype A on day 1, 56 (42%) transitioned to endotype B by day 3. Among 243 subjects assigned to endotype B on day 1, 77 (32%) transitioned to endotype A by day 3. Assignment to endotype A on day 1 was associated with increased odds of mortality. This risk was modified by the subsequent day 3 endotype assignment. Corticosteroids were associated with increased risk of mortality among subjects who persisted as endotype A.

Conclusions:

A substantial proportion of children with septic shock transition endotypes during the acute phase of illness. The risk of poor outcome and the response to corticosteroids change with changes in endotype assignment. Patients persisting as endotype A are at highest risk of poor outcomes.
Efficacy and Safety of a Novel Method of Insulated Intralesional Radiofrequency Ablation for Deep Dermal and Subcutaneous Lesions: A 3-Year Institutional Experience
Authors: Subhadarshani Sweta , Gupta Vishal , Taneja Neha , Yadav Savita , Gupta Somesh
Published: December 2017

BACKGROUND

Although insulated intralesional radiofrequency ablation (IL-RFA) is being increasingly used in other specialties, not much information on its safety and efficacy in dermatology is available.

OBJECTIVE

To describe our experience with insulated IL-RFA for various dermatological conditions.

METHODS

This is a retrospective review of the patients who underwent IL-RFA in the past 3 years. Our technique involved creating a small window in the proximal end of plastic sheath of an intravenous cannula using a surgical blade, and then touching the RF probe to the cannula through the window to deliver the electric current. Information regarding diagnosis, number of sessions, adverse effects, and follow-up was recorded. Clinical improvement was assessed on a visual analog scale by the patient and 2 independent observers.

RESULTS

Data on 19 patients with lymphangioma circumscriptum (n = 9), venous or capillary-venous malformation (n = 4), angiolymphoid hyperplasia with eosinophilia (n = 3), arteriovenous malformation, hidradenitis suppurativa, and hypertrophic scar (n = 1 each) was available. The mean number of IL-RFA sessions was 2.26 ± 1.61. The mean patient and physician global assessment scores were 7.6 ± 2.22 and 7.3 ± 2.42, respectively. Adverse effects were seen in 9 (47.4%) patients. All patients, except 1, had sustained improvement in the mean follow-up period of 11.4 ± 11.6 months.

CONCLUSION

Insulated IL-RFA seems to be safe and effective in selectively targeting deep-seated cutaneous lesions.
Trends in Hospitalization, Acute Kidney Injury, and Mortality in Patients With Spontaneous Bacterial Peritonitis
Authors: Devani Kalpit , Charilaou Paris , Jaiswal Palashkumar , Patil Nirav , Radadiya Dhruvil , Patel Pranav , Young Mark , Rockey Don C. , Reddy Chakradhar M.
Published: December 2017

Goals:

The purpose of our study was to evaluate trends of hospitalization, acute kidney injury (AKI) and mortality in cirrhotic patients with spontaneous bacterial peritonitis (SBP).

Background:

SBP is a frequent bacterial infection in cirrhotic patients leading to increased morbidity and mortality.

Materials and Methods:

A total of 4,840,643 patients hospitalized with cirrhosis from 2005 to 2014 were identified using the Nationwide Inpatient Sample database, of which 115,359 (2.4%) had SBP. We examined annual trends and used multivariable mixed-effects logistic regression analyses to obtain adjusted odds ratios by accounting for hospital level and patient level variables.

Results:

We identified a striking increase in hospitalizations for SBP in cirrhotic patients (0.45% to 3.12%) and AKI in SBP patients (25.6% to 46.7%) from 2005 to 2014. Inpatient mortality decreased over the study period in patients with SBP (19.1% to 16.1%) and in patients with SBP plus AKI (40.9% to 27.6%). Patients with SBP had a higher inpatient mortality rate than those without SBP [15.5% vs. 6%, adjusted odd ratio (aOR): 2.02, P<0.001]. AKI was 2-fold more prevalent in cirrhotics with SBP than those without SBP (42.8% vs. 17.2%, aOR: 1.91, P<0.001) and concomitant AKI was associated with a 6-fold mortality increase (aOR: 5.84, P<0.001). Cirrhotic patients with SBP had higher hospitalization costs and longer length of stays than patients without SBP.

Conclusions:

Despite a higher hospitalization rate and prevalence of concomitant AKI, mortality in patients with SBP decreased during the study period. SBP is associated with high likelihood of development of AKI, which in turn, increases mortality.
Improved outcomes in elderly trauma patients with the implementation of two innovative geriatric-specific protocols—Final report
Authors: Bradburn Eric H. , Gross Brian W. , Jammula Shreya , Adams William H. , Miller Jo Ann
Published: December 2017

BACKGROUND

Elderly trauma care is challenging owing to the unique physiology and comorbidities prevalent in this population. To improve the care of these patients, two practice management guidelines (PMGs) were implemented: high-risk geriatric protocol (HRGP), which triages patients based on injury patterns and comorbid conditions for occult hypotension, and the anticoagulation and trauma (ACT) alert, which is designed to streamline the care of geriatric trauma patients on anticoagulants. We hypothesized that both HRGP and ACT would decrease mortality and complications in geriatric trauma patients.

METHODS

Geriatric blunt trauma patients (aged ≥65) presenting to our Level II center from January 2000 to July 2016 were extracted from the trauma registry. Do-not-resuscitate patients were excluded. The study period was divided into three phases: Phase 1, no PMGs in place (2000 to January 2006); Phase 2, HRGP only (February 2006 to February 2012); and Phase 3, HRGP + ACT (March 2012 to July 2016). Multivariate logistic regression models assessed adjusted mortality and complications during these phases to quantify the impact of these protocols. Statistical significance was set at p < 0.05.

RESULTS

A total of 8,471 geriatric trauma patients met inclusion criteria. Overall mortality rate was 5.6% (Phase 1, 7.2%; Phase 2, 6.1%; Phase 3, 4.0%). No significant change in mortality was observed during Phase 2 with the HRGP only (adjusted odds ratio (OR), 0.98; 95% confidence interval, 0.73–1.34; p = 0.957); however, a significantly reduced OR of mortality was found during Phase 3 with the combination of both the HRGP and ACT (adjusted OR, 0.67; 95% confidence interval, 0.47–0.94; p = 0.021). No significant changes in incidence of complications was observed over the study duration.

CONCLUSIONS

Geriatric trauma patients are not simply older adults. Improved outcomes can be realized with specific PMGs tailored to the geriatric trauma patients’ needs.

LEVEL OF EVIDENCE

Epidemiologic study, level III.
Safety and efficacy of brain injury guidelines at a Level III trauma center
Authors: Martin Grace E. , Carroll Christopher P. , Plummer Zachary J. , Millar D A. , Pritts Timothy A. , Makley Amy T. , Joseph Bellal A. , Ngwenya Laura B. , Goodman Michael D.
Published: December 2017

BACKGROUND

Patients with mild to moderate traumatic brain injury (TBI) are often primarily managed by emergency medicine and trauma/acute care physicians. The Brain Injury Guidelines (BIG) were developed at an American College of Surgeons–accredited Level 1 trauma center to triage mild to moderate TBI patients and help identify patients who warrant neurosurgical consultation. The BIG have not been validated at a Level III trauma center. We hypothesized that BIG criteria can be safely adapted to an American College of Surgeons–accredited Level III trauma center to guide transfers to a higher echelon of care.

METHODS

We reviewed the trauma registry at a Level III trauma center to identify TBI patients who presented with an Abbreviated Injury Severity-Head score greater than zero. Demographic data, injury details, and clinical outcomes were abstracted with primary outcome measures of worsening on second computed tomography of the head, neurosurgical intervention, transfer to a Level I trauma center, and in-hospital mortality. Patients were classified using the BIG criteria. After validating the BIG in our cohort, we reclassified patients using updated BIG criteria. Updated criteria included mechanism of injury, reclassification of anticoagulation or antiplatelet use, and replacement of the neurologic examination component with stratification by admission Glasgow Coma Scale (GCS) score.

RESULTS

From July 2013 to June 2016, 332 TBI patients were identified: 115 BIG-1, 25 BIG-2, and 192 BIG-3. Patients requiring neurosurgical intervention (n = 30) or who died (n = 29) were BIG-3 with one exception. Patients with GCS score of less than 12 had worse outcomes than those with a GCS score of 12 or greater, regardless of BIG classification. Anticoagulant or antiplatelet use was not associated with worsened outcomes in patients not meeting other BIG-3 criteria. The updated BIG resulted in more patients in BIG-1 (n = 109) and BIG-2 (n = 100) without negatively affecting outcomes.

CONCLUSION

The BIG can be applied in the Level III trauma center setting. Updated BIG criteria can aid triage of mild to moderate TBI patients to a Level I trauma center and may reduce secondary overtriage.

LEVEL OF EVIDENCE

Care management, level IV.
Speed is not everything: Identifying patients who may benefit from helicopter transport despite faster ground transport
Authors: Chen Xilin , Gestring Mark L. , Rosengart Matthew R. , Billiar Timothy R. , Peitzman Andrew B. , Sperry Jason L. , Brown Joshua B.
Published: December 2017

BACKGROUND

Helicopter emergency medical services (HEMS) have demonstrated survival benefits over ground emergency medical services (GEMS) for trauma patient transport. While HEMS speed is often-cited, factors such as provider experience and level of care may also play a role. Our objective was to identify patient groups that may benefit from HEMS even when prehospital time for helicopter utilization is longer than GEMS transport.

METHODS

Adult patients transported by HEMS or GEMS from the scene of injury in the Pennsylvania State Trauma Registry were included. Propensity score matching was used to match HEMS and GEMS patients for likelihood of HEMS, keeping only pairs in which the HEMS patient had longer total prehospital time than the matched GEMS patient. Mixed-effects logistic regression evaluated the effect of transport mode on survival while controlling for demographics, admission physiology, transfusions, and procedures. Interaction testing between transport mode and existing trauma triage criteria was conducted and models stratified across significant interactions to determine which criteria identify patients with a significant survival benefit when transported by HEMS even when slower than GEMS.

RESULTS

From 153,729 eligible patients, 8,307 pairs were matched. Helicopter emergency medical services total prehospital time was a median of 13 minutes (interquartile range, 6–22) longer than GEMS. Patients with abnormal respiratory rate (odds ratio [OR], 2.39; 95% confidence interval [CI], 1.26–4.55; p = 0.01), Glasgow Coma Scale score of 8 or less (OR, 1.61; 95% CI, 1.16–2.22; p < 0.01), and hemo/pneumothorax (OR, 2.25; 95% CI, 1.06–4.78; p = 0.03) had a significant survival advantage when transported by HEMS even with longer prehospital time than GEMS. Conversely, there was no association between transport mode and survival in patients without these factors (p > 0.05).

CONCLUSION

Patients with abnormal respiratory rate, Glasgow Coma Scale score of 8 or less, and hemo/pneumothorax benefit from HEMS transport even when GEMS transport was faster. This may indicate that these patients benefit primarily from HEMS care, such as advanced airway and chest trauma management, rather than simply faster transport to a trauma center.

LEVEL OF EVIDENCE

Therapeutic, level III.
Demographic causes of adult sex ratio variation and their consequences for parental cooperation
Authors: Eberhart-Phillips Luke J. , Küpper Clemens , Carmona-Isunza María Cristina , Vincze Orsolya , Zefania Sama , Cruz-López Medardo , Kosztolányi András , Miller Tom E. X. , Barta Zoltán , Cuthill Innes C. , Burke Terry , Székely Tamás , Hoffman Joseph I. , Krüger Oliver
Published: December 2017

The adult sex ratio (ASR) is a fundamental concept in population biology, sexual selection, and social evolution. However, it remains unclear which demographic processes generate ASR variation and how biases in ASR in turn affect social behaviour. Here, we evaluate the demographic mechanisms shaping ASR and their consequences for parental cooperation using detailed survival, fecundity, and behavioural data on 6,119 individuals from six wild shorebird populations exhibiting flexible parental strategies. We show that these closely related populations express strikingly different ASRs, despite having similar ecologies and life histories, and that ASR variation is largely driven by sex differences in the apparent survival of juveniles. Furthermore, families in populations with biased ASRs were predominantly tended by a single parent, suggesting that parental cooperation breaks down with unbalanced sex ratios. Taken together, our results indicate that sex biases emerging during early life have profound consequences for social behaviour.
Intrinsic neuronal dynamics predict distinct functional roles during working memory
Authors: Wasmuht DF , Spaak E , Buschman TJ , Miller EK , Stokes MG
Published: December 2017

Working memory (WM) is characterized by the ability to maintain stable representations over time; however, neural activity associated with WM maintenance can be highly dynamic. We explore whether complex population coding dynamics during WM relate to the intrinsic temporal properties of single neurons in lateral prefrontal cortex (lPFC), the frontal eye fields (FEF) and lateral intraparietal cortex (LIP) of two monkeys (Macaca mulatta). We found that cells with short timescales carried memory information relatively early during memory encoding in lPFC; whereas long timescale cells played a greater role later during processing, dominating coding in the delay period. We also observed a link between functional connectivity at rest and intrinsic timescale in FEF and LIP. Our results indicate that individual differences in the temporal processing capacity predicts complex neuronal dynamics during WM; ranging from rapid dynamic encoding of stimuli to slower, but stable, maintenance of mnemonic information.
Ultrasound Produces Extensive Brain Activation via a Cochlear Pathway
Authors: Guo Hongsun , Hamilton Mark , Offutt Sarah J. , Gloeckner Cory D. , Li Tianqi , Kim Yohan , Legon Wynn , Alford Jamu K. , Lim Hubert H.
Published: December 2017

Ultrasound (US) can noninvasively activate intact brain circuits, making it a promising neuromodulation technique. However, little is known about the underlying mechanism. Here, we apply transcranial US and perform brain mapping studies in guinea pigs using extracellular electrophysiology. We find that US elicits extensive activation across cortical and subcortical brain regions. However, transection of the auditory nerves or removal of cochlear fluids eliminates the US-induced activity, revealing an indirect auditory mechanism for US neural activation. US likely vibrates the cerebrospinal fluid in the brain, which is continuous with the fluid in the cochlea via cochlear aqueducts; thus, US can activate the ascending auditory pathways and other non-auditory regions through cross-modal projections. This finding of a cochlear fluid-induced vibration mechanism challenges the idea that US can directly activate neurons in the intact brain, suggesting that future US stimulation studies will need to control for this effect to reach reliable conclusions.
Probabilistic thresholding of functional connectomes: application to schizophrenia
Authors: Váša František , Bullmore Edward T. , Patel Ameera X.
Published: December 2017

Functional connectomes are commonly analysed as sparse graphs, constructed by thresholding cross-correlations between regional neurophysiological signals. Thresholding generally retains the strongest edges (correlations), either by retaining edges surpassing a given absolute weight, or by constraining the edge density. The latter (more widely used) method risks inclusion of false positive edges at high edge densities and exclusion of true positive edges at low edge densities. Here we apply new wavelet-based methods, which enable construction of probabilistically-thresholded graphs controlled for type I error, to a dataset of resting-state fMRI scans of 56 patients with schizophrenia and 71 healthy controls. By thresholding connectomes to fixed edge-specific P value, we found that functional connectomes of patients with schizophrenia were more dysconnected than those of healthy controls, exhibiting a lower edge density and a higher number of (dis)connected components. Furthermore, many participants’ connectomes could not be built up to the fixed edge densities commonly studied in the literature (~5-30%), while controlling for type I error. Additionally, we showed that the topological randomisation previously reported in the schizophrenia literature is likely attributable to “non-significant” edges added when thresholding connectomes to fixed density based on correlation. Finally, by explicitly comparing connectomes thresholded by increasing P value and decreasing correlation, we showed that probabilistically thresholded connectomes show decreased randomness and increased consistency across participants. Our results have implications for future analysis of functional connectivity using graph theory, especially within datasets exhibiting heterogenous distributions of edge weights (correlations), between groups or across participants.
Individual differences in fear acquisition: Multivariate analyses of different Emotional Negativity scales, physiological responding, subjective measures, and neural activation
Authors: Sjouwerman Rachel , Scharfenort Robert , Lonsdorf Tina B.
Published: December 2017

Negative emotionality is a well-established and stable risk factor for affective disorders. Individual differences in negative emotionality have been linked to associative learning processes which can be captured experimentally in fear conditioning paradigms. Literature suffers from underpowered samples, suboptimal methods, and an isolated focus on single questionnaires and single outcome measures. Here, we apply multivariate and dimensional approaches for three commonly investigated questionnaires in the field (STAI-T, NEO-FFI Neuroticism, Intolerance of Uncertainty Scale) across multiple analysis units (ratings, skin conductance, startle, BOLD-fMRI) during fear acquisition-training in two large samples (NStudy1=356; NStudy2=113). We investigate whether the specific or shared variance of these questionnaires is linked with CS-discrimination in specific outcome measures (Study 1). We identify a significant negative association between STAI-T and CS-discrimination in SCRs and between Intolerance of Uncertainty and CS-discrimination in startle responding. Yet, correlation coefficients for all questionnaire-outcome measure combinations did not differ significantly from each other. In Study 2 the STAI-T score was positively associated with CS-discrimination in a number of brain areas linked to conditioned fear (amygdala, putamen, thalamus), but not to SCRs or ratings. Importantly, we replicate potential sampling biases between fMRI and behavioral studies regarding anxiety levels. We discuss the implications of these results.
Verbalizing phylogenomic conflict: Representation of node congruence across competing reconstructions of the neoavian explosion
Authors: Franz Nico M. , Musher Lukas J. , Brown Joseph W. , Yu Shizhuo , Ludäscher Bertram
Published: December 2017

Phylogenomic research is accelerating the publication of landmark studies that aim to resolve deep divergences of major organismal groups. Meanwhile, systems for identifying and integrating the novel products of phylogenomic inference – such as newly supported clade concepts – have not kept pace. However, the ability toverbalizeboth node concept congruence and conflict across multiple, (in effect) simultaneously endorsed phylogenomic hypotheses, is a critical prerequisite for building synthetic data environments for biological systematics, thereby also benefitting other domains impacted by these (conflicting) inferences. Here we develop a novel solution to the conflict verbalization challenge, based on a logic representation and reasoning approach that utilizes the language of Region Connection Calculus (RCC–5) to produce consistentalignmentsof node concepts endorsed by incongruent phylogenomic studies. The approach employs clade concept labels to individuate concepts used by each source, even if these carry identical names. Indirect RCC–5 modeling ofintensional(property-based) node concept definitions, facilitated by the local relaxation of coverage constraints, allows parent concepts to attain congruence in spite of their differentially sampled children. To demonstrate the feasibility of this approach, we align two recently published phylogenomic reconstructions of higher-level avian groups that entail strong conflict in the “neoavian explosion” region. According to our representations, this conflict is constituted by 26 instances of input “whole concept” overlap. These instances are further resolvable in the output labeling schemes and visualizations as “split concepts”, thereby providing the provenance services needed to build truly synthetic phylogenomic data environments. Because the RCC–5 alignments fundamentally reflect the trained, logic-enabled judgments of systematic experts, future designs for such environments need to promote a culture where experts routinely assess the intensionalities of node concepts published by our peers – even and especially when we are not in agreement with each other.
Pediatric Bone Age Assessment Using Deep Convolutional Neural Networks
Authors: Iglovikov Vladimir , Rakhlin Alexander , Kalinin Alexandr A. , Shvets Alexey
Published: December 2017

Skeletal bone age assessment is a common clinical practice to diagnose endocrine and metabolic disorders in child development. In this paper, we describe a fully automated deep learning approach to the problem of bone age assessment using data from the 2017 Pediatric Bone Age Challenge organized by the Radiological Society of North America. The dataset for this competition consists of 12,600 radiological images. Each radiograph in this dataset is an image of a left hand labeled with bone age and sex of a patient. Our approach utilizes several deep neural network architectures trained end-to-end. We use images of whole hands as well as specific parts of a hand for both training and prediction. This approach allows us to measure the importance of specific hand bones for automated bone age analysis. We further evaluate the performance of the suggested method in the context of skeletal development stages. Our approach outperforms other common methods for bone age assessment.