bluuebunny/crossref_metadata_2025 huggingface dataset:
Economic burden of schizophrenia in Italy: a probabilistic cost of illness analysis
Authors: Marcellusi Andrea , Fabiano Gianluca , Viti Raffaella , Francesa Morel Pier Cesare , Nicolò Giuseppe , Siracusano Alberto , Mennini Francesco Saverio
Published: February 2018

Objectives

Schizophrenia is a chronic, debilitating psychiatric disease with highly variable treatment pathways and consequent economic impacts on resource utilisation. The aim of the study was to estimate the economic burden of schizophrenia in Italy for both the societal and Italian National Healthcare perspective.

Methods

A probabilistic cost of illness model was applied. A systematic literature review was carried out to identify epidemiological and economic data. Direct costs were calculated in terms of drugs, hospitalisations, specialist services, residential and semiresidential facilities. Indirect costs were calculated on the basis of patients’ and caregivers’ loss of productivity. In addition, the impact of disability compensation was taken into account using a database from the Italian National Social Security Institute —Italy (INPS).

Results

Overall, 303 913 prevalent patients with schizophrenia were estimated. Of these, 212 739 (70%) were diagnosed and 175 382 (82%) were treated with antipsychotics. The total economic burden was estimated at €2.7 billion (95% CI €1771.93 to €3988.65), 50.5% due to indirect costs and 49.5% to direct costs. Drugs corresponded to 10% of direct costs and hospitalisations (including residential and semiresidential facilities) accounted for 81%.

Conclusions

This study highlighted that indirect costs and hospitalisations (including residential and semiresidential facilities) play a major role within the expenses associated with schizophrenia in Italy, and this may be considered as a tool for public decision-makers.
Cross-sectional analysis of the prevalence and predictors of statin utilisation in Ireland with a focus on primary prevention of cardiovascular disease
Authors: Byrne Paula , Cullinan John , Murphy Catríona , Smith Susan M
Published: February 2018

Objective

To describe the prevalence of statin utilisation by people aged over 50 years in Ireland and the factors associated with the likelihood of using a statin, focusing particularly on those using statins for primary prevention of cardiovascular disease (CVD).

Methods

This is a cross-sectional analysis of cardiovascular risk and sociodemographic factors associated with statin utilisation from wave 1 of The Irish Longitudinal Study on Ageing. A hierarchy of indications for statin utilisation, consisting of eight mutually exclusive levels of CVD-related diagnoses, was created. Participants were assigned one level of indication. The prevalence of statin utilisation was calculated. The likelihood that an individual was using a statin was estimated using a multivariable logistic regression model, controlling for cardiovascular risk and sociodemographic factors.

Results

In this nationally representative sample (n=5618) of community-dwelling participants aged 50 years and over, 1715 (30.5%) were taking statins. Of these, 65.0% (57.3% of men and 72.7% of women) were doing so for the primary prevention of CVD. Thus, almost two-thirds of those taking statins did so for primary prevention and there was a notable difference between women and men in this regard. We also found that statin utilisation was highest among those with a prior history of CVD and was significantly associated with age (compared with the base category 50–64 years; 65–74 years OR 1.38 (95% CI 1.16 to 1.65); 75+ OR 1.33 (95% CI 1.04 to 1.69)), living with a spouse or partner (compared with the base category living alone; OR 1.35 (95% CI 1.10 to 1.65)), polypharmacy (OR 1.74 (95% CI 1.39 to 2.19)) and frequency of general practitioner visits (compared with the base category 0 visits per year; 1–2 visits OR 2.46 (95% CI 1.80 to 3.35); 3–4 visits OR 3.24 (95% CI 2.34 to 4.47); 5–6 visits OR 2.98 (95% CI 2.08 to 4.26); 7+ visits OR 2.51 (95% CI 1.73 to 3.63)), even after controlling for clinical need. There was no association between using statins and gender, education, income, social class, health insurance status, location or Systematic Coronary Risk Evaluation (SCORE) risk in the multivariable analysis.

Conclusion

Statin utilisation among those with no history of CVD accounted for almost two-thirds of all statin use, in part reflecting the high proportion of the population with no history of CVD, although utilisation rates were highest among those with a history of CVD.
‘Because my brain isn’t as active as it should be, my eyes don’t always see’: a qualitative exploration of the stress process for those living with posterior cortical atrophy
Authors: Harding Emma , Sullivan Mary Pat , Woodbridge Rachel , Yong Keir X X , McIntyre Anne , Gilhooly Mary L , Gilhooly Kenneth J , Crutch Sebastian J
Published: February 2018

Objectives

To explore the stress process for individuals living with posterior cortical atrophy (PCA) and their families.

Design

A qualitative study using in-depth semi-structured dyadic and individual interviews with people living with a diagnosis of PCA and a family carer. Interview transcripts were thematically analysed.

Setting

Participants’ homes.

Participants

20 individuals in the mild to moderate stages of PCA and 20 family carers.

Findings

Three major themes were identified: (1) the diagnostic journey: mostly an unsettling and convoluted process, owing to the early age of onset, rarity and atypical symptom profile of PCA. (2) Interactions with the physical environment: profound difficulties with functional and leisure activities were usually compensated for with adaptations maximising familiarity or simplicity. (3) Implications within the psychosocial environment: symptoms impacted individuals’ sense of independence and identity and required reallocations of roles and responsibilities. Ongoing uncertainties and the progressive nature of PCA caused most dyads to take a ‘one day at a time’ approach to coping. Relatively well-preserved insight and memory were a benefit and burden, as individuals shared the illness experience with family members and also compared their current situation to pre-diagnosis. The experience was framed by background and contextual factors and understood within an ever-changing temporal context.

Conclusion

The stress process in PCA is characterised by uncertainty and unpredictability from diagnosis through to ongoing management. The provision of tailored information about cortical visual problems and associated functional difficulties, time-sensitive environmental adaptations to help those with PCA to identify what and where things are and psychosocial interventions for the marital/family unit as a whole would be useful to improve both functional status and psychological well-being. Future research exploring (1) stress and coping in the later stages of PCA and (2) the nature and impact of visual impairment(s) in typical Alzheimer’s disease would be worthwhile.
Impact of the New Cooperative Medical Scheme on the trend of catastrophic health expenditure in Chinese rural households: results from nationally representative surveys from 2003 to 2013
Authors: Xie Biao , Huo Minghe , Wang Zhiqiang , Chen Yongjie , Fu Rong , Liu Meina , Meng Qun
Published: February 2018

Objective

To evaluate the trend of catastrophic health expenses (CHE) for inpatient care in relation to the commencement of the New Cooperative Medical Scheme (NCMS) in rural China from 2003 to 2013, and the roles of NCMS in protecting affected households from CHE.

Methods

We assessed the 10-year trend of the incidence and severity of CHE in rural households with hospitalised members using data from the Chinese National Health Services Survey. Generalised estimating equations were used to estimate the OR and 95% CI of the association between incidence rates of CHE (RCHE) and NCMS reimbursement.

Results

The incidence and severity of CHE after NCMS reimbursement both decreased and their changes increased rapidly from 2003 to 2013. After adjustment of the covariates,RCHEbefore reimbursement was significantly higher than that after reimbursement, and the OR (95% CI) was 1.50 (1.24 to 1.81), 1.79 (1.69 to 1.90) and 2.94 (2.77 to 3.11) in 2003, 2008 and 2013, respectively.

Conclusion

The incidence and severity of CHE both reduced after NCMS reimbursements in each year. Excluding some confounding factors,RCHEwas significantly associated with NCMS reimbursement. NCMS partly protected the rural households with hospitalised members from CHE. However, the inequalities between different income groups still existed.RCHEin rural households with hospitalised members was still rather high in 2003, 2008 and 2013 even though they were covered by NCMS. This study will provide suggestions for further reforms in China and guidance for other low-income/middle-income countries.
Association of common comorbidities with osteonecrosis: a nationwide population-based case–control study in Denmark
Authors: Dima Alina , Pedersen Alma Becic , Pedersen Lars , Baicus Cristian , Thomsen Reimar Wernich
Published: February 2018

Objective

To examine recent time trends in the incidence of osteonecrosis (ON) in Denmark and to investigate different common comorbidities association with ON in a population-based setting.

Methods

Using Danish medical databases, we included all patients with a first-time hospital diagnosis of ON during 1995–2012. Each ON case was matched with 10 randomly selected population control subjects from general population. For all participants, we obtained a complete hospital history of comorbidities included in the CharlsonComorbidity Index 5 years preceding the inclusion date.

Results

4107 ON cases and 41 063 controls were included. The incidence of ON increased from 3.9 in 1995 to 5.5 in 2012 per 100 000 inhabitants. Solid cancer was the most common comorbidity, associated with an adjusted OR (aOR) for ON of 2.0 (95% CI 1.7 to 2.2). For advanced metastatic cancer, leukaemia and lymphoma, aORs of ON were 3.4 (95% CI 2.5 to 4.5), 4.3 (95% CI 2.7 to 7.0) and 5.8 (95% CI 4.3 to 7.8), respectively. Among other chronic conditions, aORs were 3.5 (95% CI 3.0 to 4.1) for connective tissue diseases and 2.3 (95% CI 2.0 to 2.7) for chronic pulmonary diseases. aORs were also increased at 2.8 (95% CI 1.9 to 4.1) and 4.5 (95% CI 2.5 to 8.2) for mild and moderate-to-severe liver disease, respectively, and 4.2 (95% CI 3.4 to 5.2) for renal disease.

Conclusion

This large population-based study provides evidence for an increasing ON incidence in the general population and documents an association between several common comorbid conditions and risk of ON.
Dehydration is how you define it: comparison of 318 blood and urine athlete spot checks
Authors: Hew-Butler Tamara D , Eskin Christopher , Bickham Jordan , Rusnak Mario , VanderMeulen Melissa
Published: February 2018

Clinical medicine defines dehydration using blood markers that confirm hypertonicity (serum sodium concentration ([Na+])>145 mmol/L) and intracellular dehydration. Sports medicine equates dehydration with a concentrated urine as defined by any urine osmolality (UOsm) ≥700 mOsmol/kgH2O or urine specific gravity (USG) ≥1.020.

Objective

To compare blood versus urine indices of dehydration in a cohort of athletes undergoing routine screenings.

Methods

318 collegiate athletes (193 female) provided blood and urine samples and asked to rate how thirsty they were on a 10-point visual analogue scale. Serum was analysed for [Na+], while serum and UOsm were measured using an osmometer. USG was measured using a Chemstrip. Data were categorised into dehydrated versus hydrated groupings based on these UOsm and USG thresholds.

Results

Using UOsm ≥700 mOsmol/kgH2O to define dehydration, 55% of athletes were classified as dehydrated. Using any USG ≥1.020 to define dehydration, 27% of these same athletes were classified as dehydrated. No athlete met the clinical definition for dehydration (hypertonicity; serum [Na+]>145 mmol/L). Normonatremia (serum [Na+] between 135 mmol/L and 145 mmol/L) was maintained in 99.7% of athletes despite wide variation in UOsm (110–1298 mOsmol/kgH2O). A significant correlation was confirmed between serum [Na+] versus UOsm (r=0.18; P<0.01), although urine concentration extremes did not reflect derangement in serum markers or thirst rating.

Conclusion

Urine concentration thresholds classified 27%–55% of collegiate athletes as dehydrated, while no athlete was dehydrated according to blood [Na+] measurement. Practitioners should caution against using urine indices to diagnose or monitor dehydration, because urinary output is a response rather than a reflection of (tightly regulated) blood tonicity.
Enhanced patient research participation: a Photovoice study in Blantyre Malawi
Authors: Bates Maya Jane , Ardrey Jane , Mphwatiwa Treza , Squire Stephen Bertel , Niessen Louis Willem
Published: February 2018

Objectives

Patient involvement in palliative care research is a desirable if challenging goal. Photovoice is an action research method in which affected communities gather photographs to document and discuss their communities’ strengths and concerns. Engagement with policymakers is a separately stated goal. Photovoice is increasingly used in health-related research but has not been widely described in the palliative care literature. We report on experiences and lessons learnt using Photovoice in Blantyre, Malawi to encourage its wider use in research and practice.

Methods

Thirteen co-researchers (six patients and seven household carers, mean age 47 years) receiving community-based palliative care, attended nine half-day group sessions over a 4-month period. Co-researchers produced, selected and analysed photographs. On completion of data collection, they conducted an advocacy event, including a photographic exhibition, to which media representatives and community leaders were invited.

Results

Procedures to ensure safety of co-researchers and to obtain consent of individuals identified in the photographs were developed during the planning phase. Co-researchers engaged with the Photovoice process with enthusiasm, although frailty and physical disability (poor sight) limited participation for some older adults. Inclusion of palliative care staff within the research team helped to facilitate open dialogue and clinical review where appropriate.

Conclusions

In this Photovoice study, patients and family members receiving palliative care engaged in an exploration of household well-being using photography, participatory analysis and an advocacy event. With appropriate planning, Photovoice can be adapted to a range of settings to enhance patient participation.
Socioeconomic inequality in recovery from poor physical and mental health in mid-life and early old age: prospective Whitehall II cohort study
Authors: Tanaka Akihiro , Shipley Martin J , Welch Catherine A , Groce Nora E , Marmot Michael G , Kivimaki Mika , Singh-Manoux Archana , Brunner Eric J
Published: February 2018

Background

Few studies have examined the influence of socioeconomic status on recovery from poor physical and mental health.

Methods

Prospective study with four consecutive periods of follow-up (1991–2011) of 7564 civil servants (2228 women) recruited while working in London. Health was measured by the Short-Form 36 questionnaire physical and mental component scores assessed at beginning and end of each of four rounds. Poor health was defined by a score in the lowest 20% of the age–sex-specific distribution. Recovery was defined as changing from a low score at the beginning to a normal score at the end of the round. The analysis took account of retirement status, health behaviours, body mass index and prevalent chronic disease.

Results

Of 24 001 person-observations in the age range 39–83, a total of 8105 identified poor physical or mental health. Lower grade of employment was strongly associated with slower recovery from poor physical health (OR 0.73 (95% CI 0.59 to 0.91); trend P=0.002) in age, sex and ethnicity-adjusted analyses. The association was halved after further adjustment for health behaviours, adiposity, systolic blood pressure (SBP) and serum cholesterol (OR 0.85 (0.68 to 1.07)). In contrast, slower recovery from poor mental health was associated robustly with low employment grade even after multiple adjustment (OR 0.74 (0.59 to 0.93); trend P=0.02).

Conclusions

Socioeconomic inequalities in recovery from poor physical health were explained to a considerable extent by health behaviours, adiposity, SBP and serum cholesterol. These risk factors explained only part of the gradient in recovery for poor mental health.
Cardiovascular health among the Czech population at the beginning of the 21st century: a 12-year follow-up study
Authors: Lustigova Michala , Dzurova Dagmar , Pikhart Hynek , Kubinova Ruzena , Bobak Martin
Published: February 2018

Background

In the late 1980s, Czechia was among the countries which had the highest cardiovascular mortality in the world. In spite of enormous improvements since that time, there are still large opportunities in further improving cardiovascular health.

Methods

Based on the Czech Health, Alcohol and Psychosocial Factors in Eastern Europe sample (n=8449 at baseline, 12 years of follow-up, 494 cardiovascular disease (CVD) deaths up to 2015—events), the impact of selected covariates such as education, smoking habits, high blood pressure, blood cholesterol level, diabetes, obesity, physical activity and binge drinking and their multifactorial effects on cardiovascular mortality was evaluated by Cox regression. In addition, population attributable fractions (PAFs) were used to quantify the impact of these factors on CVD mortality in the population.

Results

Education was found as the strongest determinant of CVD mortality (primary vs university, HR 2.77, P<0.001; PAF=50.5%). CVD risk was two times higher for persons with diabetes compared with those without (HR 2.02, P<0.001, PAF=23.2%). Furthermore, significant factors found were smoking (smoker vs non-smoker, HR 1.91, P<0.001; PAF=26.5%), high blood pressure (HR 1.73, P<0.001; PAF=35.3%) and physical inactivity (none vs sufficient, HR 1.60, P<0.001; PAF=22.9%). Conversely, the effect of obesity was low (HR 1.29, P value =0.020), and binge drinking and high blood cholesterol level were not significant at all.

Conclusions

Education had the largest impact on cardiovascular mortality among the Czech population. More than 50% of CVD death would be prevented if the whole population had the same risk values as the highest educated population. Reducing disparities in health related to education should benefit from attention to cardiovascular health literacy.
Psychological resilience and post-traumatic growth in disaster-exposed organisations: overview of the literature
Authors: Brooks Samantha , Amlôt R , Rubin G J , Greenberg N
Published: February 2018

As disasters become increasingly prevalent, and reported on, a wealth of literature on post-disaster mental health has been published. Most published evidence focuses on symptoms of mental health problems (such as post-traumatic stress disorder, depression and anxiety) and psychosocial factors increasing the risk of such symptoms. However, a recent shift in the literature has moved to exploring resilience and the absence of adverse lasting mental health effects following a disaster. This paper undertakes a qualitative review of the literature to explore factors affecting psychological resilience, as well as the potential positive impact of experiencing a disaster (post-traumatic growth) by examining the literature on employees in disaster-exposed organisations. We identify several protective factors: training, experience, and perceived (personal) competence; social support; and effective coping strategies. Post-traumatic growth frequently appeared to occur at both personal and professional levels for those rescue staff after a disaster, giving employees a greater appreciation of life and their relationships, enhancing their self-esteem and providing a sense of accomplishment and better understanding of their work. Implications, in terms of how to build a resilient workforce, are discussed.
At the intersection of self and not-self: finding the locus of ‘self’ in autoimmunity
Authors: Katz James David
Published: February 2018

Individuals with chronic autoimmune disease experience a sense of vulnerability. In part, this relates to the struggle for finding the meaning of the illness. The consequent existential distress may manifest in an unseated sense of personhood. Insight into the mechanism of this state of powerlessness and of perceived loss of agency is central to establishing a supportive clinician–patient relationship. This present exposition underscores the concept of autoimmunity as one that represents a demarcation in the psyche: one that is not just a threat to our sense of self-hood but also to our humanity. Autoimmunity exposes the challenge imposed on the relating of the self to one’s own self and hence is an ontological challenge. The breach of the boundary between self andnot-selfthat is caused by the autoimmune process culminates in feelings of alienation.
Paradigm shift? Purity, progress and the origins of first-episode psychosis
Authors: Berkhout Suze G
Published: February 2018

First-episode psychosis has garnered significant attention and resources within mental health services in North America, Europe and Australia/New Zealand since the 1990s. Despite this widespread embrace, little scholarship exists that examines underlying concepts, ideologies and imagery embedded within the early intervention paradigm. In this paper, I offer a sociohistorical analysis of the emergence of first-episode psychosis and early intervention as entities in psychiatry, drawing on contemporary philosophical thought to explore various concepts embedded in them. Although scattered references to ‘prodrome’ and ‘incipient cases’ exist in the historic psychiatric literature, the notion of first-episode psychosis as a distinct chronological stage emerged in the late 1980s. This occurred in response to a desire for a homogeneous, medication-naive population within schizophrenia research. Thematically, concerns regarding ‘purity’ as well as notions of ‘progress’ can be read off of the body of work surrounding the creation of the term and its development into a clinical organising concept. Furthermore, examining the sociohistorical context of the term demonstrates its entanglement with the course of atypical antipsychotic drug development, the expansion of clinical rating scales and wider neoliberal biopolitics within healthcare. Within psychiatry, the early intervention model has been termed a ‘paradigm shift,’ with the promise that earlier interventions will translate into shorter durations of untreated illness, improved utilisation of services and better prognoses for recovery. While these are laudable goals, they are tied to assumptions about biomedical progress and idealisations of clinical populations that feminist and disability critiques problematise.
Early experience with a temporary bridging device (Comaneci) in the endovascular treatment of ruptured wide neck aneurysms
Authors: Sirakov Stanimir , Sirakov Alexander , Hristov Hristo , Minkin Krasimir , Penkov Marin , Karakostov Vasil
Published: February 2018

Background

The difficulties in obtaining complete and stable endovascular occlusion are most evident for ruptured aneurysms exhibiting a wide neck and unfavorable geometric features. The aim of our study was to presentourexperience with the Comaneci temporary bridging device in ruptured wide neck aneurysms.

Methods

From May to July 2017, 29 ruptured aneurysms underwent endovascular embolization with the Comaneci device. Angiographic and clinical results were retrospectively analyzed.

Results

29 ruptured intracranial aneurysms from different locations were included. Successful embolization was achieved in all lesions; complete post-procedure occlusion was seen in 25 (86%) cases. Insufficient embolization or neck remnant was observed in four cases (13.7%). Complications probably related, directly related, or indirectly related to the device occurred in 3.44% of patients (1/29 patients). At least one angiographic follow-up was performed in each of the 29 cases. The 12 month follow-up examination has yet to be done.

Conclusion

The Comaneci device offers a new promising and reliable technique that can safely support aneurysm coiling occlusion even in a rupture environment. However, long term monitoring of patients treated by this device is mandatory.
Influence of alternative husbandry systems on postmortem findings and prevalence of important bacteria and parasites in layers monitored from end of rearing until slaughter
Authors: Zloch Angelika , Kuchling Sabrina , Hess Michael , Hess Claudia
Published: February 2018

In the present study 66 layer flocks housed in different alternative husbandry systems were monitored from placement of birds on the farm until slaughter to evaluate a possible influence on the occurrence of selected non‐infectious as well as infectious diseases. Postmortems were performed and the occurrence of extraintestinal Escherichia coli and Gallibacterium anatis was investigated. No specific postmortem findings were seen in pullets. Non‐infectious diseases were mainly found in layers. Most prominent postmortem findings in layers were reproductive tract lesions and the presence of intestinal helminths. From each flock E coli and from approximately 65 per centof the flocks G anatis were isolated. No significant differences were seen in regard to the housing system, but the prevalence of G anatis increased with the age of birds. The majority of reproductive tract lesions could be associated with E coli alone or G anatis co‐infections. The prevalence of Ascaridia galli and Heterakis gallinarum was not influenced by the housing system, but significantly increased with age. Cestodes were present in six flocks. Histomonosis was detected twice. Dermanyssus gallinae was found in 5 pullet and 20 layer flocks. Additional investigations were performed on demand. Again, reproductive tract lesions were the most prominent postmortem findings. In one flock each histomonosis or erysipelas was diagnosed, respectively. Severe affection by D gallinae was found once. Necrotic enteritis was seen in two layer flocks.
Pre-exercise β-hydroxy-β-methylbutyrate free-acid supplementation improves work capacity recovery: a randomized, double-blinded, placebo-controlled study
Authors: Correia Ana Luiza Matias , de Lima Filipe Dinato , Bottaro Martim , Vieira Amilton , da Fonseca Andrew Correa , Lima Ricardo Moreno
Published: February 2018

The purpose of this study was to investigate the effects of a single-dose of β-hydroxy-β-methylbutyrate free acid (HMB-FA) supplementation on muscle recovery after a high-intensity exercise bout. Twenty-three trained young males were randomly assigned to receive either a single-dose supplementation of 3 g of HMB-FA (n = 12; age, 22.8 ± 3.0 years) or placebo (PLA; n = 11; age, 22.9 ± 3.1 years). A muscle damage protocol was applied 60 min after supplementation, and consisted of 7 sets of 20 drop jumps from a 60-cm box with 2-min rest intervals between sets. Muscle swelling, countermovement jump (CMJ), maximal voluntary isometric torque (MVIT), and work capacity (WC) were measured before, immediately after, and 24, 48, and 72 h after the exercise protocol. Muscle swelling, CMJ, and MVIT changed similarly in both groups after the exercise protocol (p < 0.001), but returned to pre-exercise levels after 24 h in both groups. WC decreased similarly in both groups after the exercise protocol (p < 0.01). For HMB-FA, WC returned to pre-exercise level 24 h after exercise protocol. However, for PLA, WC did not return to pre-exercise level even 72 h after the exercise protocol. In summary, a single-dose of HMB-FA supplementation improved WC recovery after a high-intensity exercise bout. However, HMB-FA did not affect the time-course of muscle swelling, MVIT, and CMJ recovery.
pH-related fluorescence quenching mechanism of pterin derivatives and the effects of 6-site substituents
Authors: Liu Lei , Sun Bingqing
Published: February 2018

2-Amino-4-hydroxypteridine (pterin) and its derivatives serve as photooxidants and exhibit strong fluorescence. When they interact with hydrogen acceptors such as acetate and phosphate, their fluorescences are significantly quenched in acidic conditions (pH 4.9–5.5) but are retained in basic conditions (pH 10.0–10.5). This pH-related fluorescence quenching mechanism of pterin and its derivatives are fully investigated by using density functional theory (DFT) and time-dependent density functional theory (TD-DFT). Pterin and its derivatives are demonstrated to show favorable excited-state proton transfer (ESPT) abilities in acidic conditions that induce the experimentally observed fluorescence quenching. In contrast, the ESPT processes are found to be retarded due to the lack of strong hydrogen-bonding interactions in basic environments, which sustain their fluorescence. Interestingly, these ESPT processes are found to show different site specificities depending on the 6-site substituents. The introduction of electron-donating substituent activates the N1 site, making it the preferred ESPT site. By contrast, the introduction of an electron-withdrawing substituent activates the N5 site, making it the favorable ESPT site. The substitutions of different functional groups are found to affect the locations of acidic centers during the excitation and relaxation processes. This further affects the hydrogen-bonding patterns and ultimately brings site specificity to the ESPT process.
Location-specific consequences of beach seine and gillnet capture on upriver-migrating sockeye salmon migration behavior and fate
Authors: Bass Arthur L. , Hinch Scott G. , Patterson David A. , Cooke Steven J. , Farrell Anthony P.
Published: February 2018

Fish released after capture, or fish interacting with gear but escaping, sometimes experience fishing-related incidental mortality (FRIM). For adult Pacific salmon migrations, knowing the magnitude of FRIM is important to estimate escapement accurately and to understand the total impact of a specific fishery. To determine how multiple gear types are associated with FRIM at different levels of maturity, we captured sockeye salmon (Oncorhynchus nerka) by both gill net and beach seine at three locations along their migration route (10%, 26%, and 72% of a 500 km freshwater migration) and determined their migratory success using biotelemetry. FRIM was higher for fish captured by gill net except at the location closest to spawning grounds. In addition, salmon captured by gill net at the lower river locations temporarily delayed migration, potentially indicating a requirement for lengthier recovery time compared with beach-seined fish. These results provide the first empirical and parallel comparison of these two common in-river fishing methods for salmon, revealing clear differences in FRIM between the two fishing methods in lower river fisheries and the importance of maturity.
Practical Secure Naïve Bayesian Classification Over Encrypted Big Data in Cloud
Authors: Zhu Youwen , Li Xingxin , Wang Jian , Liu Yining , Qu Zhiguo
Published: February 2018

Cloud can provide much convenience for big data storage and analysis. To enjoy the advantage of cloud service with privacy preservation, huge data is increasingly outsourced to cloud in encrypted form. Unfortunately, encryption may impede the analysis and computation over the outsourced dataset. Naïve Bayesian classification is an effective algorithm to predict the class label of unlabeled samples. In this paper, we investigate naïve Bayesian classification on encrypted large-scale dataset in cloud, and propose a practical and secure scheme for the challenging problem. In our scheme, all the computation task of naïve Bayesian classification are completed by the cloud, which can dramatically reduce the burden of data owner and users. We give a formal security proof for our scheme. Based on the theoretical proof, we can strictly guarantee the privacy of both input dataset and output classification results, i.e., the cloud can learn nothing useful about the training data of data owner and the test samples of users throughout the computation. Additionally, we not only theoretically analyze our computation complexity and communication overheads, but also evaluate our implementation cost by leveraging extensive experiments over real dataset, which shows our scheme can achieve practical efficiency.
Thermal stability of black holes with arbitrary hairs
Authors: Sinha Aloke Kumar
Published: February 2018

We have derived the criteria for thermal stability of charged rotating black holes, for horizon areas that are large relative to the Planck area (in these dimensions). In this paper, we generalized it for black holes with arbitrary hairs. The derivation uses results of loop quantum gravity and equilibrium statistical mechanics of the grand canonical ensemble and there is no explicit use of classical spacetime geometry at all in this analysis. The assumption is that the mass of the black hole is a function of its horizon area and all the hairs. Our stability criteria are then tested in detail against some specific black holes, whose metrics provide us with explicit relations for the dependence of the mass on the area and other hairs of the black holes. This enables us to predict which of these black holes are expected to be thermally unstable under Hawking radiation.
ELASTICITY MEASUREMENTS BY SHEAR WAVE ELASTOGRAPHY: COMPARISON AND SELECTION OF SHEAR WAVE, RAYLEIGH WAVE AND LAMB WAVE THEORY
Authors: XU HAO , MO JIAN-QIANG , CHEN SHIGAO , AN KAI-NAN , LUO ZONG-PING
Published: February 2018

Shear wave elastography (SWE) is a powerful method for the diagnosis of tissue disorders or degeneration based on tissue elasticity. In SWE application, it was recognized that the wave speed depends not only on the tissue elasticity but also on the structural shape, leading to different theoretical models. For liver, skin and myocardium, the appropriate theoretical model is known to be shear wave, Rayleigh wave and Lamb wave theory, respectively. Therefore, appropriate theoretical model should be adopted for the proper application of SWE. In this study, we verify these theoretical models in gelatin samples of different thicknesses, using experimental and numerical SWE tests. The results indicate that the wave speed was influenced by the ratio of the wavelength and sample thickness and the measurement region. Based on these results, the selection of theoretical model could be divided into three cases, and the appropriate theoretical model can be selected accordingly.
SIZE-CONTROLLED DROPLET GENERATION IN A MICROFLUIDIC DEVICE FOR RARE DNA AMPLIFICATION BY OPTIMIZING ITS EFFECTIVE PARAMETERS
Authors: LASHKARIPOUR ALI , MEHRIZI ALI ABOUEI , GOHARIMANESH MASOUD , RASOULI MOHAMMADREZA , BAZAZ SAJAD RAZAVI
Published: February 2018

Versatility and portability of microfluidic devices play a dominant role in their widespread use by researchers. Droplet-based microfluidic devices have been extensively used due to their precise control over sample volume, and ease of manipulating and addressing each droplet on demand. Droplet-based polymerase chain reaction (PCR) devices are particularly desirable in single DNA amplification. If the droplets are small enough to contain only one DNA molecule, single molecule amplification becomes possible, which can be advantageous in several cases such as early cancer detection. In this work, flow-focusing microfluidic droplet generation’s parameters are numerically investigated and optimized for generating the smallest droplet possible, while considering fabrication limits. Taguchi design of experiment method is used to study the effects of key parameters in droplet generation. By exploiting this approach, a droplet with a radius of 111[Formula: see text]nm is generated using a 3[Formula: see text][Formula: see text]m orifice. Since the governing physics of the droplet generation process is not totally understood yet, by means of analysis of variance (ANOVA) analysis, a generalized linear model (GLM) is proposed to predict the droplet radius, given the values of eight major parameters affecting the droplet size. The proposed model shows a correlation of 95.3% and 64.95% for droplets of radius greater than and lower than 5[Formula: see text][Formula: see text]m, respectively. Finally, the source of this variation of behavior in different size scales is identified.
IMPLEMENTATION OF A SMARTPHONE AS A WIRELESS ACCELEROMETER PLATFORM FOR QUANTIFYING HEMIPLEGIC GAIT DISPARITY IN A FUNCTIONALLY AUTONOMOUS CONTEXT
Authors: LEMOYNE ROBERT , MASTROIANNI TIMOTHY
Published: February 2018

The utility of the smartphone, such as the iPhone, constitutes considerable potential for the advancement of the biomedical and healthcare industry. A notable feature of the iPhone is the capacity to combine the internal accelerometer sensor with a software application to enable the functionality of a wireless accelerometer platform. Preliminary research has demonstrated the iPhone’s ability to quantify features of healthy gait. The research applies a single iPhone mounted proximal to the lateral malleolus of the affected leg and subsequently the unaffected leg to ascertain quantified disparity of hemiplegic gait from an engineering proof of concept perspective. In order to maintain a consistent gait velocity, a constant velocity treadmill is incorporated into the research endeavor. Post-processing of the gait acceleration waveform is greatly facilitated through the use of a software automation program using Matlab that emphasizes on the rhythmicity of gait. Two gait parameters were obtained: stance-to-stance temporal disparity and stance-to-stance time-averaged acceleration, and demonstrated considerable accuracy, consistency, and reliability. As noted per the constant treadmill velocity, stance-to-stance temporal disparity for the affected and unaffected legs was established as not statistically significant. A statistical significance was determined for the stance-to-stance time-averaged acceleration regarding the affected and unaffected legs. The iPhone application represents a wireless accelerometer platform capable of identifying statistically significant and quantified disparity of hemiplegic gait features through automated post-processing in a functionally autonomous environment.
MATHEMATICAL MODELING OF THE INTERPLAY BETWEEN STRESS AND ANISOTROPIC GROWTH OF AVASCULAR TUMORS
Authors: VALDÉS-RAVELO FERNANDO , RAMÍREZ-TORRES ARIEL , RODRÍGUEZ-RAMOS REINALDO , BRAVO-CASTILLERO JULIÁN , GUINOVART-DÍAZ RAÚL , MERODIO JOSÉ , PENTA RAIMONDO , CONCI AURA , SABINA FEDERICO J. , GARCÍA-REIMBERT CATHERINE
Published: February 2018

In this work, we propose a new mathematical framework for the study of the mutual interplay between anisotropic growth and stresses of an avascular tumor surrounded by an external medium. The mechanical response of the tumor is dictated by anisotropic growth, and reduces to that of an elastic, isotropic, and incompressible material when the latter is not taking place. Both proliferation and death of tumor cells are in turn assumed to depend on the stresses. We perform a parametric analysis in terms of key parameters representing growth anisotropy and the influence of stresses on tumor growth in order to determine how these effects affect tumor progression. We observe that tumor progression is enhanced when anisotropic growth is considered, and that mechanical stresses play a major role in limiting tumor growth.
Numerical Simulation of Instantaneous Wave-Free Ratio of Stenosed Coronary Artery
Authors: Wang Wenxin , Mao Boyan , Li Bao , Zhao Xi , Xu Chensi , Liu Youjun , Liu Jian
Published: February 2018

Instantaneous wave-free ratio (iFR), an invasive index of coronary artery tree, can evaluate the functional performance of vascular stenosis without pharmacological vasodilators. The noninvasive assessment of diameter stenosis (DS) obtained from coronary computed tomography angiography (CTA) has high false positive rate in contrast to iFR. The aim of this study was to develop a numerical simulation method that predicts the iFR and noninvasively assess the myocardial ischemia. Based on the CTA images, a patient-specific three-dimensional model of the aorta and coronary arteries were reconstructed. A stenosis was created in the left anterior descending artery (LAD) by reducing the DS of geometric model (40%, 50%, 60%, 75% and 90%). The patient-specific LPM boundary condition were set up to compute iFRct value during the wave-free period at the resting condition. The computed pressure and flow of coronary artery were realistic as compared to literature data. In contrast to invasive iFR, the iFRct can make a cost-benefit balance in terms of clinical cost and patient’s health.
Impact of the SPRINT Trial on Hypertension Management
Authors: Ghazi Lama , Oparil Suzanne
Published: February 2018

The Systolic Blood Pressure Intervention Trial is the first large prospective randomized controlled trial to demonstrate the benefit of an intensive systolic blood pressure (SBP) treatment target (<120 mm Hg) compared to a standard target (<140 mm Hg) in reducing cardiovascular morbidity and mortality and all-cause mortality in high-risk hypertensive patients. The impact of SPRINT on hypertension treatment has been large, but major questions remain about the feasibility of achieving the SPRINT intensive SBP target in routine practice, the generalizability of the SPRINT findings to hypertensive populations that were excluded from the trial, and the cost effectiveness of adopting the SPRINT intensive treatment goal. In this review, we discuss the generalizability of SPRINT data to the general population of adults with hypertension and with various comorbidities, the cost effectiveness of intensive SBP-lowering therapy, and the implications of SPRINT for future hypertension guideline development and clinical practice.
What Metrics Accurately Reflect Surgical Quality?
Authors: Ibrahim Andrew M. , Dimick Justin B.
Published: February 2018

Surgeons are increasingly under pressure to measure and improve their quality. While there is broad consensus that we ought to track surgical quality, there is far less agreement about which metrics matter most. This article reviews the important statistical concepts of case mix and chance as they apply to understanding the observed wide variation in surgical quality. We then discuss the benefits and drawbacks of current measurement strategies through the framework of structure, process, and outcomes approaches. Finally, we describe emerging new metrics, such as video evaluation and network optimization, that are likely to take on an increasingly important role in the future of measuring surgical quality.
Intrinsic Neuronal Stress Response Pathways in Injury and Disease
Authors: Farley Madeline M. , Watkins Trent A.
Published: February 2018

From injury to disease to aging, neurons, like all cells, may face various insults that can impact their function and survival. Although the consequences are substantially dictated by the type, context, and severity of insult, distressed neurons are far from passive. Activation of cellular stress responses aids in the preservation or restoration of nervous system function. However, stress responses themselves can further advance neuropathology and contribute significantly to neuronal dysfunction and neurodegeneration. Here we explore the recent advances in defining the cellular stress responses within neurodegenerative diseases and neuronal injury, and we emphasize axonal injury as a well-characterized model of neuronal insult. We highlight key findings and unanswered questions about neuronal stress response pathways, from the initial detection of cellular insults through the underlying mechanisms of the responses to their ultimate impact on the fates of distressed neurons.
Desmosomes in Human Disease
Authors: Najor Nicole A.
Published: February 2018

Tissue integrity is crucial for maintaining the homeostasis of living organisms. Abnormalities that affect sites of cell-cell contact can cause a variety of debilitating disorders. The desmosome is an essential cell-cell junctional protein complex in tissues that undergo stress, and it orchestrates intracellular signal transduction. Desmosome assembly and junctional integrity are required to maintain the overall homeostasis of a tissue, organ, and organism. This review discusses the desmosome and the human diseases associated with its disruption.
VIP is involved in peripheral CRF-induced stimulation of propulsive colonic motor function and diarrhea in male rats
Authors: Yakabi Seiichi , Wang Lixin , Karasawa Hiroshi , Yuan Pu-Qing , Koike Kazuhiko , Yakabi Koji , Taché Yvette
Published: February 2018

We investigated whether vasoactive intestinal peptide (VIP) and/or prostaglandins contribute to peripheral corticotropin-releasing factor (CRF)-induced CRF1 receptor-mediated stimulation of colonic motor function and diarrhea in rats. The VIP antagonist, [4Cl-D-Phe6, Leu17]VIP injected intraperitoneally completely prevented CRF (10 µg/kg ip)-induced fecal output and diarrhea occurring within the first hour after injection, whereas pretreatment with the prostaglandins synthesis inhibitor, indomethacin, had no effect. In submucosal plexus neurons, CRF induced significant c-Fos expression most prominently in the terminal ileum compared with duodenum and jejunum, whereas no c-Fos was observed in the proximal colon. c-Fos expression in ileal submucosa was colocalized in 93.4% of VIP-positive neurons and 31.1% of non-VIP-labeled neurons. CRF1 receptor immunoreactivity was found on the VIP neurons. In myenteric neurons, CRF induced only a few c-Fos-positive neurons in the ileum and a robust expression in the proximal colon (17.5 ± 2.4 vs. 0.4 ± 0.3 cells/ganglion in vehicle). The VIP antagonist prevented intraperitoneal CRF-induced c-Fos induction in the ileal submucosal plexus and proximal colon myenteric plexus. At 60 min after injection, CRF decreased VIP levels in the terminal ileum compared with saline (0.8 ± 0.3 vs. 2.5 ± 0.7 ng/g), whereas VIP mRNA level detected by qPCR was not changed. These data indicate that intraperitoneal CRF activates intestinal submucosal VIP neurons most prominently in the ileum and myenteric neurons in the colon. It also implicates VIP signaling as part of underlying mechanisms driving the acute colonic secretomotor response to a peripheral injection of CRF, whereas prostaglandins do not play a role.

NEW & NOTEWORTHY Corticotropin-releasing factor (CRF) in the gut plays a physiological role in the stimulation of lower gut secretomotor function induced by stress. We showed that vasoactive intestinal peptide (VIP)-immunoreactive neurons in the ileal submucosal plexus expressed CRF1 receptor and were prominently activated by CRF, unlike colonic submucosal neurons. VIP antagonist abrogated CRF-induced ileal submucosal and colonic myenteric activation along with functional responses (defecation and diarrhea). These data point to VIP signaling in ileum and colon as downstream effectors of CRF.