bluuebunny/crossref_metadata_2025 huggingface dataset:
Meta-analysis of antibiotics for simple hand injuries requiring surgery
Authors: Murphy G R F , Gardiner M D , Glass G E , Kreis I A , Jain A , Hettiaratchy S
Published: February 2016

Background

Simple hand trauma is very common, accounting for 1·8 million emergency department visits annually in the USA alone. Antibiotics are used widely as postinjury prophylaxis, but their efficacy is unclear. This meta-analysis assessed the effect of antibiotic prophylaxis versus placebo or no treatment on wound infection rates in hand injuries managed surgically.

Methods

Embase, MEDLINE, PubMed, Cochrane Central, ClinicalTrials.gov and the World Health Organization International Clinical Trials Portal were searched for published and unpublished studies in any language from inception to September 2015. The primary outcome was the effect of antibiotic prophylaxis on wound infection rates. Open fractures, crush injuries and bite wounds were excluded. Study quality was assessed using the Cochrane risk-of-bias tool. Data were pooled using random-effects meta-analysis, and risk ratios (RRs) and 95 per cent c.i. obtained.

Results

Thirteen studies (2578 patients) were included, comprising five double-blind randomized clinical trials, five prospective trials and three cohort studies. There was no significant difference in infection rate between the antibiotic and placebo/no antibiotic groups (RR 0·89, 95 per cent c.i. 0·65 to 1·23; P = 0·49). Subgroup analysis of the five double-blind randomized clinical trials (864 patients) again found no difference in infection rates (RR 0·66, 0·36 to 1·21; P = 0·18).

Conclusion

There was moderate-quality evidence that routine use of antibiotics does not reduce the infection rate in simple hand wounds that require surgery.
Ethernet and PC‐based experiments on barometric altimetry using MEMS in a wireless sensor network
Authors: Bolanakis Dimosthenis E. , Kotsis Konstantinos T. , Laopoulos Theodore
Published: February 2016

This paper presents a training framework that applies to Micro‐Electro‐Mechanical‐Systems (MEMS) technology. Recommendations are in line with a prototype educational platform along with an innovative set of experiments for a creative training on barometric altimetry. The proposed platform relies on a wireless sensor network system of Ethernet as well as PC‐based (i.e., LabVIEW) user interface for ambient air pressure acquisition. The web user interface renders feasible the implementation of a single setup per class, while also minimizes students' occupation on software and hardware configuration activities; hence, students are concentrated on the problem solving process. The LabVIEW controlled interface advocates tutor‐demonstration by means of real‐time graphical monitoring of the measurement procedure. The wireless system feature provides flexibility in experimentation, allowing the examination of particular sensor characteristics (related to the design of a MEMS system) that regularly require an exceptionally expensive apparatus. © 2016 Wiley Periodicals, Inc. Comput Appl Eng Educ 24:443–455, 2016; View this article online at wileyonlinelibrary.com/journal/cae; DOI 10.1002/cae.21722
MiR‐24 enhances radiosensitivity in nasopharyngeal carcinoma by targeting SP1
Authors: Kang Min , Xiao Jingjian , Wang Jun , Zhou Pingting , Wei Tingting , Zhao Tingting , Wang Rensheng
Published: February 2016

Radioresistance remains a major problem in the treatment of patients suffering from nasopharyngeal carcinoma (NPC). A better understanding of the mechanisms of radioresistance may generate new strategies to improve NPC patients' responses to therapy. This study was designed to investigate the effect of microRNA on the radiosensitivity of NPC cells. A microRNA microarray indicated that miR‐24 was downregulated in NPC cell lines and tissues. Furthermore, cell proliferation was suppressed and radiosensitivity increased when miR‐24 was ectopically expressed in NPC cells. Specificity protein 1 (SP1) was additionally verified as a direct functional target of miR‐24, which was found to be involved in cell viability as well as the radiosensitivity of NPC cells. In conclusion, the results of this study suggest that the miR‐24/SP1 pathway contributed to the reduction in radioresistance in human NPC and that it may thus represent a therapeutic target.
Recreational physical activity and ovarian cancer risk in African American women
Authors: Abbott Sarah E. , Bandera Elisa V. , Qin Bo , Peres Lauren C. , Moorman Patricia G. , Barnholtz‐Sloan Jill , Schwartz Ann G. , Funkhouser Ellen , Peters Edward S. , Cote Michele L. , Alberg Anthony J. , Terry Paul , Bondy Melissa , Paddock Lisa E. , Crankshaw Sydnee , Wang Frances , Camacho Fabian , Schildkraut Joellen M.
Published: February 2016

The literature on recreational physical activity (RPA) and ovarian cancer risk is inconclusive and most studies of RPA and ovarian cancer have been conducted in white populations. This study is the first to investigate the association between RPA and ovarian cancer in an exclusively African American (AA) population. We analyzed data from an ongoing U.S. population‐based, case–control study of AA women, which included 393 women recently diagnosed with invasive epithelial ovarian cancer (IEOC) and 611 controls. A baseline interview assessed RPA frequency, intensity, and duration. Each RPA intensity was assigned a metabolic equivalent of task (MET) value and MET‐min/week were calculated. Unconditional multivariable logistic regression was performed to investigate associations between RPA and IEOC risk. Compared with sedentary women, predominantly mild intensity RPA was significantly inversely associated with IEOC risk for women reporting above median (>297) MET‐min/week (odds ratio [OR] = 0.52; 95% confidence interval [CI]: 0.34, 0.78) and nonsignificantly for <297 MET‐min/week (OR = 0.71; 95% CI: 0.44, 1.12). Predominantly moderate intensity RPA was associated with significantly increased risk for women reporting above median (>540) MET‐min/week (OR = 1.51; 95% CI: 1.03, 2.23). Predominantly strenuous intensity RPA was nonsignificantly associated with lower IEOC risk for women reporting above median (>1800) MET‐min/week (OR = 0.72; 95% CI: 0.33, 1.57). The inverse associations for mild and strenuous intensity RPA were most pronounced in obese women (body mass index >30 kg/m2). The findings that mild and strenuous RPA may reduce the risk of IEOC particularly among obese women are difficult to reconcile with the increased risk observed for moderate RPA. Further research is warranted to determine whether these findings are genuine and, if so, their mechanistic basis.
Body mass index and survival after diagnosis of invasive breast cancer: a study based on the Japanese National Clinical Database—Breast Cancer Registry
Authors: Kawai Masaaki , Tomotaki Ai , Miyata Hiroaki , Iwamoto Takayuki , Niikura Naoki , Anan Keisei , Hayashi Naoki , Aogi Kenjiro , Ishida Takanori , Masuoka Hideji , Iijima Kotaro , Masuda Shinobu , Tsugawa Koichiro , Kinoshita Takayuki , Nakamura Seigo , Tokuda Yutaka
Published: February 2016

Few studies have reported the association between body mass index (BMI) and outcome among Asian breast cancer patients. We analyzed data for 20,090 female invasive breast cancer patients who had been followed‐up for a median period of 6.7 years entered in the National Clinical Database–Breast Cancer Registry between 2004 and 2006. We used mainly theWHOcriteria forBMI (kg/m2) categories; <18.5 (underweight), ≥18.5–<21.8 (reference), ≥21.8–<25, ≥25–<30 (overweight), and ≥30 (obese). We divided normal weight patients into two subgroups because this category includes many patients compared to others. The timing ofBMImeasurement was not specified. The Cox proportional hazards model and cubic spline regression were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Smoking, alcohol, and physical activity were not controlled. A total of 1418 all‐cause, 937 breast cancer–specific deaths, and 2433 recurrences were observed. Obesity was associated with an increased risk of all‐cause (HR: 1.46; 95%CI: 1.16–1.83) and breast cancer–specific death (HR: 1.47; 95%CI: 1.11–1.93) for all patients, and with all‐cause (HR: 1.47; 95%CI: 1.13–1.92) and breast cancer–specific death (HR: 1.58; 95%CI: 1.13–2.20) for postmenopausal patients. Being underweight was associated with an increased risk of all‐cause death for all (HR: 1.41; 95%CI: 1.16–1.71) and for postmenopausal patients (HR: 1.45; 95%CI: 1.15–1.84). With regard to subtype and menopausal status, obesity was associated with an increased risk of breast cancer–specific death for all cases of luminal B tumor (HR: 2.59; 95%CI: 1.51–4.43; Pheterogeneityof Luminal B vs. Triple negative = 0.016) and for postmenopausal patients with luminal B tumor (HR: 3.24; 95%CI: 1.71–6.17). Being obese or underweight is associated with a higher risk of death among female breast cancer patients in Japan.
Unilateral lower abdominal wall protrusion and umbilical deviation
Authors: Shikino Kiyoshi , Miyahara Masahito , Noda Kazutaka , Ohira Yoshiyuki , Ikusaka Masatomi
Published: February 2016

Key Clinical Message

Postherpetic pseudohernia must be suspected when a patient develops motor dysfunction coincident with or following a herpes zoster eruption.
Should the BK polyomavirus cytopathic effect be best classified as atypical or benign in urine cytology specimens?
Authors: Allison Derek B. , Olson Matthew T. , Lilo Mohammed , Zhang Mingjuan L. , Rosenthal Dorothy L. , VandenBussche Christopher J.
Published: February 2016

BACKGROUND

According to The Paris System for Reporting Urinary Cytology (TPS), the category of atypical urothelial cells (AUC) should not be applied to specimens in which cellular changes can be entirely attributed to the polyoma (BK) virus cytopathic effect (CPE). Until recently, cases with BK CPE at The Johns Hopkins Hospital were categorized as atypical urothelial cells of uncertain significance (AUC‐US), which is equivalent to the TPS AUC category. This study was performed to determine how significantly the rate of AUC‐US specimens would decrease if specimens with only BK CPE were classified as benign.

METHODS

Two reviewers and 1 adjudicator re‐evaluated urinary tract specimens to determine whether sufficient cytological atypia justified an AUC‐US diagnosis independent of the presence of BK CPE. For patients with surgical follow‐up, the rate of high‐grade urothelial carcinoma (HGUC) on tissue biopsy was tracked over a 5‐year period.

RESULTS

The reclassification rate of AUC‐US cases with BK CPE as benign was 62.6%. The rate of subsequent HGUC was 6.0% for cases reclassified as benign and 10.0% for cases still classified as AUC‐US. These rates were not significantly elevated in comparison with control cohorts among all‐comers. However, for patients without a history of HGUC, the rate of HGUC on follow‐up was significantly elevated in comparison with the rate for a benign control cohort and was similar to the rate for the AUC‐US control cohort.

CONCLUSIONS

Reclassification as benign would have decreased the rate of AUC‐US from 24.8% to 20.7% during the study year. However, the high rate of subsequent HGUC among nonsurveillance patients suggests that the reclassification of specimens with BK CPE in these patients may be inappropriate. Cancer Cytopathol 2016;124:436–42. © 2016 American Cancer Society.
Napsin A/p40 antibody cocktail for subtyping non‐small cell lung carcinoma on cytology and small biopsy specimens
Authors: Nishino Michiya , Hoang Mai P. , Della Pelle Patricia , Morales‐Oyarvide Vicente , Huynh Tiffany G. , Mark Eugene J. , Mino‐Kenudson Mari
Published: February 2016

BACKGROUND

Subtyping non‐small cell lung carcinomas (NSCLC) into adenocarcinoma (ACA) or squamous cell carcinoma (SQCC) is important for treatment and specimen triage for molecular studies. To preserve tissue for molecular studies in cytology/small biopsy specimens, a 2‐antibody cocktail for NSCLC subtyping was developed.

METHODS

Markers for lung ACA (thyroid transcription factor 1 and napsin A) and SQCC (cytokeratin 5/6 and p40) were evaluated on tissue microarrays (TMAs) with 143 ACA and 98 SQCC specimens. The napsin A/p40 combination was selected for NSCLC subtyping and validated on the TMA as well as on a cohort of cell block/small biopsy specimens from 80 poorly differentiated NSCLCs.

RESULTS

Using TMA analysis, the napsin A‐positive (+)/p40± immunophenotype identified ACA with 94% sensitivity and 100% specificity, whereas the napsin A (negative)‐/p40+ immunophenotype identified SQCC with 100% sensitivity and specificity. On the validation cohort of 80 cell block and small biopsy specimens, the napsin A/p40 cocktail accurately subtyped 63 of 70 NSCLC (90%) as ACA or SQCC using the subsequent surgical resection as reference histology. Of the remaining 17 cases, 15 were classified as NSCLC‐not otherwise specified based on a napsin A‐/p40‐ immunophenotype; their corresponding resections were diagnosed as ACA (7 cases), large cell carcinoma (7 cases), or pleomorphic carcinoma (1 case). Two additional large cell carcinoma cases showed a napsin A‐/p40+ or napsin A+/p40+ profile in the preoperative cell block/small biopsy sample.

CONCLUSIONS

A napsin A/p40 cocktail can accurately subtype NSCLC into ACA and SQCC in most cell block/small biopsy specimens of poorly differentiated NSCLC. In the minority of cases in which the napsin A/p40 immunophenotype is indeterminate, additional stains may be necessary for precise classification. Cancer Cytopathol 2016;124:472–84. © 2016 American Cancer Society.
Decorative surface finishes: Bronzing, patina‐antiqua, verd‐antique in NY furniture 1810–1830: New York workshops practices 1810–1830
Authors: Patris Pascale
Published: February 2016

In Europe during the late 18th century, neo‐classical style had a great influence in architecture and furniture design. The furniture that reflected an archeological reference led furniture makers to replicate in their design the tonalities, colors, and patinas of the deteriorated surfaces of the bronze oxidation by means of artificial processes. A comparative study of verd‐antique samples taken from the decorative surfaces of furniture in the collection of the Metropolitan Museum of Art, as well as in diverse private or American museums collections, led to a better understanding in workshops practices of the most influential cabinetmakers working in New York from 1810 to 1830. The layering techniques were predominantly examined in cross‐sections using reflected light microscopy. After extensive research it is now possible to draw conclusions about the methods in use. These methods always based on similar concept, used superposition of pigmented paint layers, and transparent resin coatings, embedded brass particles, or gold powder and glazing. The well preserved faux‐bronze finishes examples are representative of specific verd‐antique variations. It provides case studies from which benchmark examples can be compared to other furniture of the period, and can contribute to attribution to workshops. It also confirms great disparities and variations in the workshop practices. © 2016 Wiley Periodicals, Inc. Col Res Appl, 41, 232–240, 2016
A methodology for predicting the color trend to get a three‐colored combination
Authors: Hsiao Shih‐Wen , Yang Meng‐Hua
Published: February 2016

A color design/selection system for predicting the color trend based on aesthetic measures is proposed in this article. In this method, the analytic hierarchy process theory was used to evaluate the weights for four major consumption style factors in human environment, including Economy, Education, Culture, and Technology. Then 10 product imageries were selected by using the questionnaire, and mapped the images and the factors with the weighted results and clustered both variables with the corresponding ranks. During the implementation procedure, 111 colors samples covering the entire domain of the PCCS (Practical Color Co‐ordinate System) color system were taken, and the aesthetic measure for three‐colored harmony based on aesthetic measure theory was calculated. Then 200 tri‐colored combinations were divided into 10 clusters by using fuzzy clustering. The three‐colored products were then mapped into each cluster with the calculated grand average and Standard Deviation of the imagery values obtained for the three‐colored products. According to the above implementation logic, the relationship among the consumption style factors, the images, as well as the tri‐colored cars can be obtained, and then used to construct a color trend based on market requirement. With the aid of this system, one can get a three‐colored car to match his/her requirement. Although the selection of three‐colored car is taken as an example to specify the methodology, it can also be used to develop a system for other products. © 2016 Wiley Periodicals, Inc. Col Res Appl, 42, 102–114, 2017
Paternal heat exposure causes DNA methylation and gene expression changes of Stat3 in Wild guinea pig sons
Authors: Weyrich Alexandra , Benz Stephanie , Karl Stephan , Jeschek Marie , Jewgenow Katarina , Fickel Joerns
Published: February 2016

Epigenetic mechanisms convey environmental information through generations and can regulate gene expression. Epigenetic studies in wild mammals are rare, but enable understanding adaptation processes as they may occur in nature. In most wild mammal species, males are the dispersing sex and thus often have to cope with differing habitats and thermal changes more rapidly than the often philopatric females. As temperature is a major environmental selection factor, we investigated whether genetically heterogeneous Wild guinea pig (Cavia aperea) males adapt epigenetically to an increase in temperature, whether that response will be transmitted to the next generation(s), and whether it regulates mRNA expression. Five (F0) adult male guinea pigs were exposed to an increased ambient temperature for 2 months, corresponding to the duration of the species' spermatogenesis. To study the effect of heat, we focused on the main thermoregulatory organ, the liver. We analyzed CpG‐methylation changes of male offspring (F1) sired before and after the fathers' heat treatment (as has recently been described in Weyrich et al. [Mol. Ecol., 2015]). Transcription analysis was performed for the three genes with the highest number of differentially methylated changes detected: the thermoregulation gene Signal Transducer and Activator of Transcription 3 (Stat3), the proteolytic peptidase gene Cathepsin Z (Ctsz), and Sirtuin 6 (Sirt6) with function in epigenetic regulation. Stat3 gene expression was significantly reduced (P < 0.05), which indicated a close link between CpG‐methylation and expression levels for this gene. The two other genes did not show gene expression changes. Our results indicate the presence of a paternal transgenerational epigenetic effect. Quick adaptation to climatic changes may become increasingly relevant for the survival of wildlife species as global temperatures are rising.
Episodic bedrock erosion by gully‐head migration, Colorado High Plains, USA
Authors: Rengers F. K. , Tucker G. E. , Mahan S. A.
Published: February 2016

This study explores the frequency of bedrock exposure in a soil‐mantled low‐relief (i.e. non‐mountainous) landscape. In the High Plains of eastern Colorado, gully headcuts are among the few erosional features that will incise through the soil mantle to expose bedrock. We measured the last time of bedrock exposure using optically stimulated luminescence dating of alluvial sediment overlying bedrock in gully headcuts. Our dating suggests that headcuts in adjacent gullies expose bedrock asynchronously, and therefore, the headcuts are unlikely to have been triggered by a base‐level drop in the trunk stream. This finding supports the hypothesis that headcuts can develop locally in gullies as a result of focused scour in locations where hydraulic stress during a flash flood is sufficiently high, and/or ground cover is sufficiently weak, to generate a scour hole that undermines vegetation. Alluvium dating also reveals that gullies have been a persistent part of this landscape since the early Holocene. Copyright © 2016 John Wiley & Sons, Ltd.
Critical perspectives on mercury toxicity reference values for protection of fish
Authors: Fuchsman Phyllis C. , Henning Miranda H. , Sorensen Mary T. , Brown Lauren E. , Bock Michael J. , Beals Carla D. , Lyndall Jennifer L. , Magar Victor S.
Published: February 2016

Environmental management decisions at mercury-contaminated sediment sites are predicated on the understanding of risks to various receptors, including fish. Toxicity reference values (TRVs) for interpreting risks to fish have been developed to assess mercury concentrations in fish or fish prey. These TRVs were systematically evaluated based on several lines of evidence. First, their conceptual basis and specific derivation were evaluated, including a close review of underlying toxicity studies. Second, case studies were reviewed to investigate whether TRVs are predictive of effects on fish populations in the field. Third, TRVs were compared with available information regarding preindustrial and present-day background concentrations of mercury in fish. The findings show that existing TRVs are highly uncertain, because they were developed using limited data from studies not designed for TRV derivation. Although field studies also entail uncertainty, several case studies indicate no evidence of adverse effects despite mercury exposures that exceed the available TRVs. Some TRVs also fall within the range of background mercury concentrations in predatory or prey fish. Lack of information on the selenium status of mercury-exposed fish is a critical confounding factor, and the form of methylmercury used in toxicity testing may also contribute to differences between TRV-based predictions and field observations of mercury effects on fish. On balance, the available information indicates that several of the TRVs reviewed are lower than necessary to protect fish populations. The 20% effect concentration from a previously published dose–response analysis appears closer to an effect threshold, based on available laboratory data. Additional research is needed to provide a stronger basis to establish dose–response relationships for mercury effects on fish. Environ Toxicol Chem 2016;35:529–549. © 2016 SETAC
Environmental surveillance and monitoring—The next frontiers for high-throughput toxicology
Authors: Schroeder Anthony L. , Ankley Gerald T. , Houck Keith A. , Villeneuve Daniel L.
Published: February 2016

High-throughput toxicity testing technologies along with the World Wide Web are revolutionizing both generation of and access to data regarding the biological activities that chemicals can elicit when they interact with specific proteins, genes, or other targets in the body of an organism. To date, however, most of the focus has been on the application of such data to assessment of individual chemicals. The authors suggest that environmental surveillance and monitoring represent the next frontiers for high-throughput toxicity testing. Resources already exist in curated databases of chemical–biological interactions, including highly standardized quantitative dose–response data generated from nascent high-throughput toxicity testing programs such as ToxCast and Tox21, to link chemicals detected through environmental analytical chemistry to known biological activities. The emergence of the adverse outcome pathway framework and the associated knowledge base for linking molecular-level or pathway-level perturbations of biological systems to adverse outcomes traditionally considered in risk assessment and regulatory decision-making through a series of measurable biological changes provides a critical link between activity and hazard. Furthermore, environmental samples can be directly analyzed via high-throughput toxicity testing platforms to provide an unprecedented breadth of biological activity characterization that integrates the effects of all compounds present in a mixture, whether known or not. Novel application of these chemical–biological interaction data provides an opportunity to transform scientific characterization of potential hazards associated with exposure to complex mixtures of environmental contaminants. Environ Toxicol Chem 2016;35:513–525. © 2016 SETAC
Policy‐Oriented Macroeconomic Forecasting with Hybrid DGSE and Time‐Varying Parameter VAR Models
Authors: Bekiros Stelios D. , Paccagnini Alessia
Published: February 2016

Micro‐founded dynamic stochastic general equilibrium (DSGE) models appear to be particularly suited to evaluating the consequences of alternative macroeconomic policies. Recently, increasing efforts have been undertaken by policymakers to use these models for forecasting, although this proved to be problematic due to estimation and identification issues. Hybrid DSGE models have become popular for dealing with some of the model misspecifications and the trade‐off between theoretical coherence and empirical fit, thus allowing them to compete in terms of predictability with VAR models. However, DSGE and VAR models are still linear and they do not consider time variation in parameters that could account for inherent nonlinearities and capture the adaptive underlying structure of the economy in a robust manner. This study conducts a comparative evaluation of the out‐of‐sample predictive performance of many different specifications of DSGE models and various classes of VAR models, using datasets for the real GDP, the harmonized CPI and the nominal short‐term interest rate series in the euro area. Simple and hybrid DSGE models were implemented, including DSGE‐VAR and factor‐augmented DGSE, and tested against standard, Bayesian and factor‐augmented VARs. Moreover, a new state‐space time‐varying VAR model is presented. The total period spanned from 1970:Q1 to 2010:Q4 with an out‐of‐sample testing period of 2006:Q1–2010:Q4, which covers the global financial crisis and the EU debt crisis. The results of this study can be useful in conducting monetary policy analysis and macro‐forecasting in the euro area. Copyright © 2016 John Wiley & Sons, Ltd.
Geriatric characteristics in randomised controlled trials on antidepressant drugs for older adults: a systematic review
Authors: Benraad Carolien E. M. , Kamerman‐Celie Floor , van Munster Barbara C. , Oude Voshaar Richard C. , Spijker Jan , Olde Rikkert Marcel G.M.
Published: February 2016

Objective

Meta‐analyses of antidepressant drug treatment trials have found that increasing age is associated with a less favourable outcome. Because the prevalence of geriatric characteristics, like disability, medical co‐morbidity, malnutrition, cognitive (dys)function and frailty increase with age and are associated with depression, these characteristics are likely to modify the treatment outcome of antidepressant drugs in late‐life depression. This review examines how these five characteristics are taken into account in randomised controlled trials (RCTs) with antidepressant drugs for major depressive disorder in patients aged 60 years or above.

Design

A systematic search in PubMED, PsychInfo and EMBASE, from the year 2000 onwards, yielded 27 RCTs, with a total of 6356 subjects with a median age of 71 years. Two reviewers independently assessed whether each characteristic was considered as inclusion or exclusion criterion, descriptive variable, stratification variable, co‐variable, outcome measure, or in adverse effect monitoring.

Results

Malnutrition and frailty were not taken into account in any study. Disability was used as an outcome measure in five studies. Two studies explicitly included a population with possibly serious medical co‐morbidity. Cognitive status was the only condition taken into account as co‐variable (n = 3) or stratifying variable (n = 1) and was used as outcome measure in seven studies.

Conclusions

We conclude that geriatric characteristics are rarely taken into account in RCTs on antidepressant drugs in late‐life depression, and studies including the oldest adults are underrepresented. This warrants recruitment of the oldest adults and adjustment of treatment strategies in future studies. Copyright © 2016 John Wiley & Sons, Ltd.
Effective but costly: How to tackle difficult trade‐offs in evaluating health improving technologies in liver diseases
Authors: Mantovani Lorenzo Giovanni , Cortesi Paolo Angelo , Strazzabosco Mario
Published: February 2016

In the current context of rising health care costs and decreasing sustainability, it is becoming increasingly common to resort to decision analytical modeling and health economics evaluations. Decision analytic models are analytical tools that help decision makers to select the best choice between alternative health care interventions, taking into consideration the complexity of the disease, the socioeconomic context, and the relevant differences in outcomes. We present a brief overview of the use of decision analytical models in health economic evaluations and their applications in the area of liver diseases. The aim is to provide the reader with the basic elements to evaluate health economic analysis reports and to discuss some limitations of the current approaches, as highlighted by the case of the therapy of chronic hepatitis C. To serve its purpose, health economics evaluations must be able to do justice to medical innovation and the market while protecting patients and society and promoting fair access to treatment and its economic sustainability. Conclusion: New approaches and methods able to include variables such as prevalence of the disease, budget impact, and sustainability into the cost‐effectiveness analysis are needed to reach this goal. (Hepatology 2016;64:1331‐1342)
Correlations for Natural Convective Heat Transfer from Isothermal Surface of Octagonal and Hexagonal Shapes of Different Aspect Ratios
Authors: Kalendar Abdulrahim , Karar Sayed , Kalendar Ahmad , Oosthuizen Patrick
Published: February 2016

The effect of surface shape on laminar natural convective heat transfer from vertical isothermal hexagonal and octagonal flat plates embedded in a plane adiabatic surface, the adiabatic surface being in the same plane as the surface of the heated plate, has been numerically investigated. Results for the hexagonal and octagonal surface shapes with different aspect ratios have been obtained. It has been assumed that the fluid properties are constant except for the density change with temperature which gives rise to the buoyancy forces, this having been treated using the Boussinesq approach. The solution has been obtained by numerically solving the full three‐dimensional form of governing equations, these equations being written in dimensionless form. The solution was obtained using the commercial finite volume method based cfd code, FLUENT©14.5. The solution has the surface shape, the Rayleigh number, the dimensionless plate width and the Prandtl number as parameters. Results have only been obtained for a Prandtl number of 0.7 for Rayleigh numbers between 103 and 108 for various surface shapes with width‐to‐height ratios between 0 and 0.6. The effect of these parameters on the mean Nusselt number has been studied and empirical correlation equations for the mean heat transfer rate have been derived.
Flood hydrograph reconstruction from the peak flow value in ephemeral streams using a simplified robust single‐parameter model
Authors: Ronen‐Eliraz G. , Ginat H. , Dody A. , Blumberg D. , Dahan O.
Published: February 2016

Flood hydrographs from ephemeral streams in arid areas provide valuable information for assessing run‐off and groundwater recharge. However, such data are often scarce or incomplete, especially in hyper‐arid regions. The hypothesis of this study was that it is possible to reconstruct a hydrograph of a specific point along an ephemeral stream with the knowledge of only the peak flow rate of a flood event at that point and that this can be done at almost every point along the stream. The feasibility of this approach lies in the shape of the recession stage of the flood hydrograph, which is known to be a repeating phenomenon. The recession stage comes immediately after the peak flow rate, when it begins its decline, and lasts until the flood is extinguished. A general shape of the flood recession stage can be provided. Because the recession stage represents ~80% of the duration of a flood event, it can provide a general idea of the flood hydrograph's shape. A simple model based on geometric progression is suggested to describe the repeating recession stage of a flood. The advantage of the proposed model is that it requires only one parameter: the recession characteristic at a fixed point along the ephemeral stream, termed recession coefficient q. By knowing the recession coefficient of a fixed point and the peak flow rate of a flood event at that point, one can plot the flood hydrograph. A good agreement is shown between the observed and computed values of the recession stage. Copyright © 2016 John Wiley & Sons, Ltd.
The Catalytic, Formal Homo‐Nazarov Cyclization as a Template for Diversity‐Oriented Synthesis
Authors: Martin≠ M. Cynthia , Shenje≠ Raynold , France Stefan
Published: February 2016

Since the formal characterization of diversity‐oriented synthesis (DOS), identification of effective examples of DOS remains an important endeavor for synthetic and pharmaceutical chemists requiring new strategies to generate broader skeletal diversity. Over the last decade, the formal homo‐Nazarov cyclization has been an increasingly popular strategy for the concise assembly of functionalized six‐membered rings due to the advent of catalytic methods to promote the transformation under milder reaction conditions. Moreover, using the formal homo‐Nazarov cyclization as a mechanistic template, reactions can be strategically devised as an effort towards diversity‐oriented synthesis. The resulting “homo‐Nazarov‐inspired” reactions are then demonstrated as a means to access broad structural diversity. This review discusses the development of these catalytic approaches and the successful implementation of the formal homo‐Nazarov reaction as a viable template for diversity‐oriented synthesis.
PATHS in Croatia: A school‐based randomised‐controlled trial of a social and emotional learning curriculum
Authors: Novak Miranda , Mihić Josipa , Bašić Josipa , Nix Robert L.
Published: February 2016

This study represents the first rigorous evaluation of a social‐emotional learning curriculum, PATHS (Promoting Alternative Thinking Strategies; Kusché & Greenberg, 1994), in elementary schools in Croatia. This study randomly assigned 29 schools to receive the universal preventive intervention or continue with usual practices. Within those schools, this study included 57 classrooms and 568 children. Teachers rated nine child behaviours in the middle of first grade (pre‐intervention) and near the end of second grade (post‐intervention). Hierarchical linear models, nesting children within classrooms, revealed few changes in behaviour across the sample as a whole or among higher risk children. However, there were changes on eight of the nine behaviours for lower risk children. The findings are considered in the context of the classroom culture and teachers' preparation and readiness to implement a social‐emotional learning curriculum in Croatia. This study highlights the need to supplement universal preventive interventions with selective preventive interventions that can provide more intensive and targeted skill practice for higher risk children. This study also highlights the nuanced effects of a universal preventive intervention in helping different children in different ways.
On Skew E–W Matrices
Authors: Armario José Andrés , Frau María Dolores
Published: February 2016

An E–W matrix M is a ( − 1, 1)‐matrix of order , where t is a positive integer, satisfying that the absolute value of its determinant attains Ehlich–Wojtas' bound. M is said to be of skew type (or simply skew) if is skew‐symmetric where I is the identity matrix. In this paper, we draw a parallel between skew E–W matrices and skew Hadamard matrices concerning a question about the maximal determinant. As a consequence, a problem posted on Cameron's website [7] has been partially solved. Finally, codes constructed from skew E–W matrices are presented. A necessary and sufficient condition for these codes to be self‐dual is given, and examples are provided for lengths up to 52.
Minimum Degree and Dominating Paths
Authors: Faudree Ralph J. , Gould Ronald J. , Jacobson Michael S. , West Douglas B.
Published: February 2016

A dominating path in a graph is a path P such that every vertex outside P has a neighbor on P. A result of Broersma from 1988 implies that if G is an n‐vertex k‐connected graph and , then G contains a dominating path. We prove the following results. The lengths of dominating paths include all values from the shortest up to at least . For , where a is a constant greater than 1/3, the minimum length of a dominating path is at most logarithmic in n when n is sufficiently large (the base of the logarithm depends on a). The preceding results are sharp. For constant s and , an s‐vertex dominating path is guaranteed by when n is sufficiently large, but (where ) does not even guarantee a dominating set of size s. We also obtain minimum‐degree conditions for the existence of a spanning tree obtained from a dominating path by giving the same number of leaf neighbors to each vertex.
BLOTS AND ALL: A HISTORY OF THE RORSCHACH INK BLOT TEST IN BRITAIN
Authors: HUBBARD KATHERINE , HEGARTY PETER
Published: February 2016

Despite the easily recognizable nature of the Rorschach ink blot test very little is known about the history of the test in Britain. We attend to the oft‐ignored history of the Rorschach test in Britain and compare it to its history in the US. Prior to the Second World War, Rorschach testing in Britain had attracted advocates and critiques. Afterward, the British Rorschach Forum, a network with a high proportion of women, developed around the Tavistock Institute in London and The Rorschach Newsletter. In 1968, the International Rorschach Congress was held in London but soon after the group became less exclusive, and fell into decline. A comparative account of the Rorschach in Britain demonstrates how different national institutions invested in the ‘projective hypothesis’ according to the influence of psychoanalysis, the adoption of a nationalized health system, and the social positioning of ‘others’ throughout the twentieth century. In comparing and contrasting the history of the Rorschach in Britain and the US, we decentralize and particularize the history of North American Psychology.
Predicting all‐cause readmissions using electronic health record data from the entire hospitalization: Model development and comparison
Authors: Nguyen Oanh Kieu , Makam Anil N. , Clark Christopher , Zhang Song , Xie Bin , Velasco Ferdinand , Amarasingham Ruben , Halm Ethan A.
Published: February 2016

BACKGROUND

Incorporating clinical information from the full hospital course may improve prediction of 30‐day readmissions.

OBJECTIVE

To develop an all‐cause readmissions risk‐prediction model incorporating electronic health record (EHR) data from the full hospital stay, and to compare “full‐stay” model performance to a “first day” and 2 other validated models, LACE (includes Length of stay, Acute [nonelective] admission status, Charlson Comorbidity Index, and Emergency department visits in the past year), and HOSPITAL (includes Hemoglobin at discharge, discharge from Oncology service, Sodium level at discharge, Procedure during index hospitalization, Index hospitalization Type [nonelective], number of Admissions in the past year, and Length of stay).

DESIGN

Observational cohort study.

SUBJECTS

All medicine discharges between November 2009 and October 2010 from 6 hospitals in North Texas, including safety net, teaching, and nonteaching sites.

MEASURES

Thirty‐day nonelective readmissions were ascertained from 75 regional hospitals.

RESULTS

Among 32,922 admissions (validation = 16,430), 12.7% were readmitted. In addition to many first‐day factors, we identified hospital‐acquired Clostridium difficile infection (adjusted odds ratio [AOR]: 2.03, 95% confidence interval [CI]: 1.18‐3.48), vital sign instability on discharge (AOR: 1.25, 95% CI: 1.15‐1.36), hyponatremia on discharge (AOR: 1.34, 95% CI: 1.18‐1.51), and length of stay (AOR: 1.06, 95% CI: 1.04‐1.07) as significant predictors. The full‐stay model had better discrimination than other models though the improvement was modest (C statistic 0.69 vs 0.64‐0.67). It was also modestly better in identifying patients at highest risk for readmission (likelihood ratio +2.4 vs. 1.8–2.1) and in reclassifying individuals (net reclassification index 0.02–0.06).

CONCLUSIONS

Incorporating clinically granular EHR data from the full hospital stay modestly improves prediction of 30‐day readmissions. Given limited improvement in prediction despite incorporation of data on hospital complications, clinical instabilities, and trajectory, our findings suggest that many factors influencing readmissions remain unaccounted for. Further improvements in readmission models will likely require accounting for psychosocial and behavioral factors not currently captured by EHRs. Journal of Hospital Medicine 2016;11:473–480. © 2016 Society of Hospital Medicine
Preparedness for hospital discharge and prediction of readmission
Authors: Mixon Amanda S. , Goggins Kathryn , Bell Susan P. , Vasilevskis Eduard E. , Nwosu Samuel , Schildcrout Jonathan S. , Kripalani Sunil
Published: February 2016

BACKGROUND, OBJECTIVE

Patients' self‐reported preparedness for discharge has been shown to predict readmission. It is unclear what differences exist in the predictive abilities of 2 available discharge preparedness measures. To address this gap, we conducted a comparison of these measures.

DESIGN, SETTING, PATIENTS

Adults hospitalized for cardiovascular diagnoses were enrolled in a prospective cohort.

MEASUREMENTS

Two patient‐reported preparedness measures assessed during postdischarge calls: the 11‐item Brief Prescriptions, Ready to re‐enter community, Education, Placement, Assurance of safety, Realistic expectations, Empowerment, Directed to appropriate services (B‐PREPARED) and the 3‐item Care Transitions Measure (CTM‐3). Cox proportional hazard models analyzed the relationship between preparedness and time to first readmission or death at 30 and 90 days, adjusted for readmission risk using the administrative database‐derived Length of stay, Acuity, Comorbidity, and Emergency department use (LACE) index and other covariates.

RESULTS

Median preparedness scores were: B‐PREPARED 21 (interquartile range [IQR] 18–22) and CTM‐3 77.8 (IQR 66.7–100). In individual Cox models, a 4‐point increase in B‐PREPARED score was associated with a 16% decrease in time to readmission or death at 30 and 90 days. A 10‐point increase in CTM‐3 score was not associated with readmission or death at 30 days, but was associated with a 6% decrease in readmission or death at 90 days. In models with both preparedness scores, B‐PREPARED retained an association with readmission or death at both 30 and 90 days. However, neither preparedness score was as strong a predictor as the LACE index when all were included in the model predicting 30‐ and 90‐day readmission or death.

CONCLUSION

The B‐PREPARED score was more strongly associated with readmission or death than the more widely adopted CTM‐3, but neither predicted readmission as well as the LACE index. Journal of Hospital Medicine 2016;11:603–609. © 2016 Society of Hospital Medicine
Can the identification of an idle line facilitate its removal? A comparison between a proposed guideline and clinical practice
Authors: Kara Areeba , Johnson Cynthia S. , Murray Michelle , Dillon Jill , Hui Siu L.
Published: February 2016

BACKGROUND

There are 250,000 cases of central line–associated blood stream infections in the United States annually, some of which may be prevented by the removal of lines that are no longer needed.

OBJECTIVE

To test the performance of criteria to identify an idle line as a guideline to facilitate its removal.

METHODS

Patients with central lines on the wards were identified. Criteria for justified use were defined. If none were met, the line was considered “idle.” We proposed the guideline that a line may be removed the day following the first idle day and compared actual practice with our proposed guideline.

RESULTS

One hundred twenty‐six lines in 126 patients were observed. Eighty‐three (65.9%) were peripherally inserted central catheters. Twenty‐seven percent (n= 34) were placed for antibiotics. Seventy‐six patients had lines removed prior to discharge. In these patients, the line was in place for 522 days, of which 32.7% were idle. The most common reasons to justify the line included parenteral antibiotics and meeting systemic inflammatory response (SIRS) criteria. In 11 (14.5%) patients, the line was removed prior to the proposed guideline. Most (n = 36, 47.4%) line removals were observed to be in accordance with our guideline. In another 29 (38.2%), line removal was delayed compared to our guideline.

CONCLUSIONS

Idle days are common. Central line days may be reduced by the consistent daily reevaluation of a line's justification using defined criteria. The practice of routine central line placement for prolonged antibiotics and the inclusion of SIRS criteria to justify the line may need to be reevaluated. Journal of Hospital Medicine 2016;11:489–493. © 2016 Society of Hospital Medicine
Lipid profile of human synovial fluid following intra‐articular ankle fracture
Authors: Leimer Elizabeth M. , Pappan Kirk L. , Nettles Dana L. , Bell Richard D. , Easley Mark E. , Olson Steven A. , Setton Lori A. , Adams Samuel B.
Published: February 2016

This study characterizes the metabolic profile of synovial fluid after intra‐articular ankle fracture with an emphasis on changes in the lipid profile. Bilateral ankle synovial fluid from 19 patients with unilateral intra‐articular ankle fracture was submitted for metabolic profiling. Contralateral ankle synovial fluid from each patient served as a matched control. Seven patients participated in a second bilateral synovial fluid collection after 6 months. Random forest classification, matched pairs t‐tests (α < 0.01), repeated measures ANOVA with post‐test contrasts (α < 0.01), correlation to cytokines and matrix metalloproteinases, and fracture and injury classification analyses yielded key lipid biomarkers in synovial fluid following intra‐articular fracture. Free fatty acids, sphingomyelins, and lysolipids demonstrated significant elevation in fractured ankles at baseline. Fatty acids and sphingomyelins showed a significant decrease 6 months post‐surgery. Random forest analysis showed predominantly fatty acids differentiating between groups. Significant correlations included fatty acids, sphingomyelins, and lysolipids with inflammatory cytokines and matrix metalloproteinases. Fracture classification showed increased fatty acids, lysolipids, and inositol metabolites as fracture severity increased. Fatty acid and sn‐1 lysolipid elevation could be detrimental to the joint, as these strongly correlated with matrix metalloproteinases and TNF‐α. This elevation also suggests involvement of phospholipase A2, a potential target for therapeutic intervention. Together with elevated 2‐hydroxyl fatty acids, these findings suggest elevated sn‐1 lysolipids, sphingomyelins, and subsequent lipid metabolites in synovial fluid as biomarkers of ankle injury. Reversal of this signature after 6 months suggests temporary involvement of these metabolites in disease progression, although they may activate signaling pathways which drive progression to osteoarthritis. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:657–666, 2017.