bluuebunny/crossref_metadata_2025 huggingface dataset:
Cyclodialysis cleft repair: A multi‐centred, retrospective case series
Authors: Popovic Marko , Shareef Shakeel , Mura Juan J. , Valenzuela Felipe , González Martín‐Moro Julio , Schlenker Matthew B. , Barton Keith , Muñoz‐Negrete Francisco , Razeghinejad Mohammad Reza , Ahmed Iqbal Ike K.
Published: August 2018

Importance

There is a paucity of evidence analysing the treatment of cyclodialysis clefts.

Background

We describe outcomes following the treatment of this rare condition at six centres internationally.

Design

Retrospective case series.

Participants

Thirty‐six patients with a cyclodialysis cleft from 2003 to 2017 were recruited.

Methods

Clefts were treated with cycloplegic agents, laser therapy and/or surgery.

Main Outcome Measures

Postoperative best recorded visual acuity (BRVA), intraocular pressure (IOP) and the rate of cleft closure.

Results

The mean age was 45 ± 17 years and 29 (80.6%) patients were male. One eye (2.8%) received only medical therapy, 5 (13.9%) received laser, 14 (38.9%) underwent surgery after laser failure and 16 (44.4%) eyes received exclusively surgery. Over 80% of eyes had a BRVA improvement of more than two lines. Closure was attained in 30 eyes (93.8%; n = 32), with postoperative stabilized IOP ≥ 12 mmHg in 29 eyes (80.6%; n = 36) and postoperative BRVA ≤20/50 in 20 eyes (58.8%; n = 34). Improved postoperative BRVA was related to better preoperative BRVA (P = 0.006) and preoperative IOP ≥ 4 mmHg (P = 0.03). There was no significant difference between treatment approach for IOP ≥ 12 mmHg (P = 0.85) or postoperative BRVA ≤20/50 (P = 0.80). Only two eyes at last follow‐up required IOP lowering medication.

Conclusions and Relevance

There was a high closure rate with most eyes eventually requiring surgery. Clinically significant improvements in BRVA were found in most eyes. Improved postoperative BRVA was significantly related to better preoperative BRVA and IOP.
Do Infants Learn Words From Statistics? Evidence From English‐Learning Infants Hearing Italian
Authors: Shoaib Amber , Wang Tianlin , Hay Jessica F. , Lany Jill
Published: August 2018

Infants are sensitive to statistical regularities (i.e., transitional probabilities, or TPs) relevant to segmenting words in fluent speech. However, there is debate about whether tracking TPs results in representations of possible words. Infants show preferential learning of sequences with high TPs (HTPs) as object labels relative to those with low TPs (LTPs). Such findings could mean that only the HTP sequences have a word‐like status, and they are more readily mapped to a referent for that reason. But these findings could also suggest that HTP sequences are easier to encode, just like any other predictable sequence. Here we aimed to distinguish between these explanations. To do so, we built on findings that infants become resistant to learning labels that are not typical of their native language as they approach 2 years of age and add words to their lexicons. If tracking TPs in speech results in identifying candidate words, at this age TPs may have reduced power to confer lexical status when they yield a unit that is very dissimilar to word forms that are typical of infants’ native language. Indeed, we found that at 20 months, English‐learning infants with relatively small vocabularies learned HTP Italian words (but not LTP words) as object labels, while infants with larger vocabularies resisted learning HTP Italian words. These findings suggest that the HTP sequences may be represented as candidate words, and more broadly, that TP statistics are relevant to word learning.
The impact of human leukocyte antigen donor and recipient serotyping and matching on liver transplant graft failure in primary sclerosing cholangitis, autoimmune hepatitis, and primary biliary cholangitis
Authors: Patel Yuval A. , Henson Jacqueline B. , Wilder Julius M. , Zheng Jiayin , Chow Schein‐Chung , Berg Carl L. , Knechtle Stuart J. , Muir Andrew J.
Published: August 2018

Human leukocyte antigen (HLA) serotyping is not considered to have significant impact on liver graft survival and does not factor into U.S. organ allocation. Immune‐related liver diseases such as primary sclerosing cholangitis (PSC), autoimmune hepatitis (AIH), and primary biliary cholangitis (PBC) have been speculated to represent a disease subgroup that may have significantly different graft outcomes depending on HLA donor/recipient characterization. The aim of this study was to investigate whether HLA serotyping/matching influenced post‐transplant graft failure for immune‐related liver diseases using the United Network for Organ Sharing database. From 1994 to 2015, 5665 patients underwent first‐time liver‐only transplants for PSC, AIH, and PBC with complete graft survival and donor/recipient HLA data. Graft failure was noted in 38.6% (2188/5665), and all groups had comparable 5‐year graft survival (75.1%‐78.8%, P = 0.069). The overall degree of, and loci‐specific mismatch level, did not influence outcomes. Multivariable Cox proportional hazards regression noted increased graft failure risk for recipient HLA‐B7, HLA‐B57, HLA‐B75, HLA‐DR13 and donor HLA‐B55, HLA‐B58, and HLA‐DR8 for PSC patients, protective effects for recipient HLA‐DR1 and HLA‐DR3 for AIH patients, and increased risk for HLA‐DR7 for AIH patients. These findings warrant further investigation to evaluate the impact of HLA serotyping on post‐transplant outcomes.
Design of Contracts and Workflows for Knowledge Intensive IT Service Environments
Authors: Dong Su , Johar Monica S. , Kumar Ram L.
Published: August 2018

Organizations are increasingly adopting environments in which IT is delivered as a service. The relationship between service provider and the customer is managed through contracts or Service Level Agreements (SLAs). This article examines underresearched relationships between contract structure and performance from the point of view of the IT service provider. It develops two mathematical programming models to better understand relationships between workforce characteristics, workflow, contract structure, and the business environment under Managed Service and Hybrid demand conditions. We illustrate how workforce selection, workflow, and contract design decisions can be effectively used to optimize performance. Managerial implications for contracting and operating strategies are discussed.
Effectiveness of dapagliflozin versus comparators on renal endpoints in the real world: A multicentre retrospective study
Authors: Fadini Gian Paolo , Solini Anna , Manca Maria Laura , Penno Giuseppe , Gatti Adriano , Anichini Roberto , Del Prato Stefano , Avogaro Angelo ,   For The DARWIN‐T2D Network
Published: August 2018

Aim

To evaluate the changes in renal endpoints in type 2 diabetes patients treated with dapagliflozin versus other glucose‐lowering medications in routine clinical practice.

Materials and Methods

DARWIN‐T2D was a retrospective study conducted at 46 outpatient diabetes clinics in Italy. An automated software collected data on 17 285 patients who received dapagliflozin, glucagon‐like peptide‐1 receptor agonists, dipeptidyl peptidase‐4 inhibitors, or gliclazide, 6751 of whom had a follow‐up visit. We analysed changes in albumin excretion rate (AER) and estimated glomerular filtration rate (eGFR).

Results

Patients who received dapagliflozin (n = 473) were younger, more obese, and had a poorer glucose control than those who received a comparator (n = 2973). After ~6 months, median (interquartile range) AER declined by 37%, from 19.5 (7.5–78.2) to 13.2 (6.5–45.0) mg/g (P < 0.0001) in the dapagliflozin group and did not change in the comparator group. After adjusting for confounders, therapy with dapagliflozin versus comparators was associated with an AER reduction of 26.4 ± 13.1 mg/g (P = 0.045), and eGFR (mL/min/1.73 m2) diminished by 1.1 ± 0.5 (P = 0.049) in the dapagliflozin group and by 0.6 ± 9.1 (P = 0.002) in the comparator group (P = 0.35 between groups). No patient treated with dapagliflozin versus four patients treated with comparators experienced a doubling of serum creatinine.

Conclusions

The antiproteinuric effect of dapagliflozin is confirmed here for the first time by real‐world data. Despite a mild decline in eGFR, there was no evidence of clinically relevant worsening in renal function.
Pulmonary vascular resistance versus pulmonary artery pressure for predicting right ventricular remodeling and functional tricuspid regurgitation
Authors: Gual‐Capllonch Francisco , Teis Albert , Ferrer Elena , Núñez Julio , Vallejo Nuria , Juncà Gladys , López‐Ayerbe Jorge , Lupón Josep , Bayes‐Genis Antoni
Published: August 2018

Background

Pulmonary hypertension (PH) is a common cause of right ventricular (RV) remodeling and functional tricuspid regurgitation (FTR), but incremental pulmonary artery systolic pressure (PASP) does not always correlate with anatomic and functional RV changes. This study aimed to evaluate a noninvasive measure of pulmonary vascular resistance (PVR) for predicting RV dilatation, RV dysfunction, and severity of FTR.

Methods

We prospectively analyzed consecutive stable patients with PASP ≥ 35 mm Hg or any degree of RV dilatation or dysfunction secondary to PH. Noninvasive PVR was calculated based on FTR peak velocity and flow in RV outflow tract.

Results

We included 251 patients, aged 72.1 ± 11.4 years, 53% women, 74.9% with type 2 pulmonary hypertension. The mean PASP was 48.3 ± 12.2 mm Hg. Both PASP and PVR significantly correlated with FTR, RV dilatation, and RV systolic dysfunction. After dichotomizing FTR and RV dilatation and systolic dysfunction as nonsignificant vs significant, FTR and RV dilatation were similarly predicted by PASP and PVR, but RV dysfunction was better predicted by PVR (AUC = 0.78 [0.72–0.84] vs 0.66 [0.60–0.73] for PASP, P < 0.001). Patients with low PASP but high PVR showed worse RV and left ventricular function but lower rates of right heart failure and smaller inferior vena cava, compared to patients with high PASP but low PVR.

Conclusions

Noninvasive PVR was superior to PASP for predicting RV systolic dysfunction, but both were similarly associated with RV dilatation or FTR grade. PASP and PVR complement each other to define the echocardiographic findings and clinical status of the patient.
Coronary “balanced ischemia” with false negative regadenoson Technetium Tc99 m Sestamibi stress test subsequently diagnosed by FFRCT
Authors: Turner Michael C. , Kerut Edmund K.
Published: August 2018

A 63‐year‐old female with multiple cardiovascular risk factors presented with a nontypical chest pain syndrome. Myocardial perfusion imaging (MPI) with a regadenoson (Lexiscan) Technetium Tc99 m (Sestamibi) stress test was interpreted as normal. The patient's chest pain syndrome continued, and subsequently, she presented to the emergency room. Cardiac computed tomographic angiography (CCTA) revealed a partially calcified left main coronary artery (LMCA) plaque with mild positive remodeling, having low attenuation (68 Hounsfield units—HU) in the noncalcified portion. In addition, a significant proximal left anterior descending coronary artery (LAD) noncalcified plaque was also noted. These lesions were hemodynamically significant by CCTA fractional flow reserve (FFRCT) as evidenced by a significant drop across the LMCA, followed by the LAD and circumflex (CX) vessels. Stenting of the stenosis was performed with resolution of symptoms. The phenomenon of “balanced ischemia” was not readily detected with a regadenoson Technetium Tc99 m perfusion stress test but was readily documented by FFRCT.
Combining mitochondrial and nuclear genome analyses to dissect the effects of colonization, environment, and geography on population structure in Pinus tabuliformis
Authors: Xia Hanhan , Wang Baosheng , Zhao Wei , Pan Jin , Mao Jian‐Feng , Wang Xiao‐Ru
Published: August 2018

The phylogeographic histories of plants in East Asia are complex and shaped by both past large‐scale climatic oscillations and dramatic tectonic events. The impact of these historic events, as well as ecological adaptation, on the distribution of biodiversity remains to be elucidated. Pinus tabuliformis is the dominant coniferous tree in northern China, with a large distribution across wide environmental gradients. We examined genetic variation in this species using genotyping‐by‐sequencing and mitochondrial (mt) DNA markers. We found population structure on both nuclear and mt genomes with a geographic pattern that corresponds well with the landscape of northern China. To understand the contributions of environment, geography, and colonization history to the observed population structure, we performed ecological niche modeling and partitioned the among‐population genomic variance into isolation by environment (IBE), isolation by distance (IBD), and isolation by colonization (IBC). We used mtDNA, which is transmitted by seeds in pine, to reflect colonization. We found little impact of IBE, IBD, and IBC on variation in neutral SNPs, but significant impact of IBE on a group of outlier loci. The lack of IBC illustrates that the maternal history can be quickly eroded from the nuclear genome by high rates of gene flow. Our results suggest that genomic variation in P. tabuliformis is largely affected by neutral and stochastic processes, and the signature of local adaptation is visible only at robust outlier loci. This study enriches our understanding on the complex evolutionary forces that shape the distribution of genetic variation in plant taxa in northern China, and guides breeding, conservation, and reforestation programs for P. tabuliformis.
Cor pulmonale secondary to pulmonary fibrosis in a 16‐year‐old mare
Authors: Le Corre S. , Thomas‐Cancian A. , Peyrecave X. , Leblond A. , Cadoré J. L.
Published: August 2018

A 16‐year‐old mare was presented as an emergency to the Equine Hospital of the Veterinary School of Lyon, with a 1‐month history of respiratory distress. On admission the mare was in poor body condition, with severe inspiratory and expiratory dyspnoea associated with severe hypoxaemia and marked tachycardia. Wheezes were auscultated. A pulmonary biopsy revealed fibrosis of about 40% of the parenchyma. Following an episode of atrial fibrillation, an echocardiogram was carried out which revealed signs of pulmonary hypertension, consistent withcor pulmonale. Despite the lack of aetiologic explanation for the primary pulmonary disease, the general condition of the mare improved with the administration of high‐dosed corticoids and antimicrobial therapy.
A modified slacks‐based ranking method handling negative data in data envelopment analysis
Authors: Wei Fangqing , Song Jiayun , Jiao Chuanya , Yang Feng
Published: August 2018

Performance ranking for a set of comparable decision‐making units (DMUs) with multiple inputs and outputs is an important and often‐discussed topic in data envelopment analysis (DEA). Conventional DEA models distinguish efficient units from inefficient ones but cannot further discriminate the efficient units, which all have a 100% efficiency score. Another weakness of these models is that they cannot handle negative inputs and/or outputs. In this paper, a new modified slacks‐based measure is proposed that works in the presence of negative data and provides quantitative data that helps decision makers obtain a full ranking of DMUs in situations where other methods fail. In addition, the new method has the properties of unit invariance and translation invariance, and it can give targets for inefficient DMUs to guide them to achieve full efficiency. Two numerical examples are analysed to demonstrate the usefulness of the new method.
Identification of a co‐target for enhancing efficacy of sorafenib in HCC through a quantitative modeling approach
Authors: Mishra Madhulika , Jayal Priyanka , Karande Anjali A. , Chandra Nagasuma
Published: August 2018

Sorafenib (SFB), a multi‐kinase inhibitor, is the only approved drug for treating hepatocellular carcinoma (HCC). However, SFB shows low efficacy in many cases. HCC related mortality therefore remains to be high worldwide. SFB, a multi‐kinase inhibitor is also known to modulate the redox homeostasis in cancer cells. To understand the effect of SFB on the redox status, a quantitative understanding of the system is necessary. Kinetic modeling of the relevant pathways is a useful approach for obtaining a quantitative understanding of the pathway dynamics and to rank the individual factors based on the extent of influence they wield on the pathway. Here, we report a comprehensive model of the glutathione reaction network (GSHnet), consisting of four modules and includes SFB‐induced redox stress. We compared GSHnet simulations for HCC of six different etiologies with healthy liver, and correctly identified the expected variations in cancer. Next, we studied alterations induced in the system upon SFB treatment and observed differential H2O2 dynamics in all the conditions. Using metabolic control analysis, we identified glutathione S‐transferase (GST) as the enzyme with the highest selective control coefficient, making it an attractive co‐target for potentiating the action of SFB across all six etiologies. As a proof‐of‐concept, we selected ethacrynic acid (EA), a known inhibitor of GST, and verified ex vivo that EA synergistically potentiates the cytotoxic effect of SFB. Being an FDA approved drug, EA is a promising candidate for repurposing as a combination therapy with SFB for HCC treatment.
Carbon quality regulates the temperature dependence of aquatic ecosystem respiration
Authors: Jane Stephen F. , Rose Kevin C.
Published: August 2018

Ecosystems are responding to broad‐scale changes in climate and other factors in complex ways. Two key changes occurring in many inland waterbodies are increasing temperatures and increasing terrestrial dissolved organic matter (tDOM) inputs. Due in part to tDOM inputs, inland waters play an important role in the global carbon cycle, with release of CO2 from these ecosystems a substantial portion of the combined carbon sinks of terrestrial ecosystems and the oceans.

Ecosystem respiration (ER) is an important mechanism regulating CO2 in aquatic systems, and ER rates are temperature‐dependent. However, it is unknown how ER rates will change in the future because ER is sensitive to factors other than temperature, such as the concentration and source of organic matter. Theory posits that ER rates supported by refractory carbon compounds should exhibit a greater temperature dependence than ER rates supported by labile carbon compounds, but empirical tests of this theory are inconclusive.

We experimentally manipulated temperature and carbon quality in mesocosms while monitoring dissolved oxygen (DO) with in situ high frequency DO sensors. We used two highly divergent, natural DOM sources and diluted the more refractory source so that dissolved organic carbon concentrations were similar in all mesocosms. We calculated daily ER rates over 27 days in each mesocosm.

We found that ER increased more with temperature when tDOM dominated the organic carbon pool. Given widespread increases in temperature and tDOM inputs to aquatic ecosystems, these results highlight important interactions governing how ecosystems may respond to concurrent environmental changes and alter their contributions to the global carbon cycle.
Longitudinal Analysis of Patient‐Reported Outcomes From an Interdisciplinary Pediatric Pain Rehabilitation Program for Children With Chronic Migraine and Headache
Authors: Benore Ethan , Webster Erin E. , Wang Lu , Banez Gerard
Published: August 2018

Background

Many children suffering from chronic headache and migraine present with comorbid functional disability, including physical, social, emotional, and academic activities. For children severely impaired by headache, intensive interdisciplinary pain rehabilitation treatment (IIPT) can improve functioning. However, there are limited data evaluating children's response to rehabilitation across several time points.

Objective

This study aims to evaluate the trajectory of recovery for children undergoing IIPT for chronic headache, as well as to examine the proposed assumption that physical and psychosocial functioning improves prior to a reported reduction in pain.

Methods

A retrospective analysis of patient‐reported outcomes in a clinical database of 135 children admitted to an IIPT program between the years 2008 and 2014 was analyzed. Available data across 5 separate time points (up to 1‐year post‐discharge) were reviewed.

Results

One hundred and thirty‐five children of mean age 15.2 (SD = 2.2) and 74% female provided data for review. Linear mixed model demonstrated a statistically significant improvement in pain‐specific measures of functioning, including daily functioning (change estimate = −14.53) emotional functioning (change estimate = −14.63), family functioning (change estimate = −5.78), and school absences (change estimate = −11.47) over a 12‐month period (all P’s ≤ .01). A more general measure of quality of life improved during the program, based upon child (change estimate = +10.07) and parent report (change estimate = +15.31); although these gains did not continue to improve post‐discharge. As expected, although children did not report a reduction in pain during rehabilitation (change estimate = +0.07), they did report a significant drop in perceived pain in the 12 months following discharge from the program (change estimate = −2.12, P ≤ .01).

Conclusions

Children with chronic headache and migraine who are severely functionally impaired demonstrated linear improvement in pain‐specific patient‐reported outcomes over time; however, there remains a need for improved methodology in analyzing response to IIPT programs.
Food consumption, lifestyle patterns, and body mass index of a group of white South African students
Authors: Viljoen Annemarie T. , van der Spuy Esther , du Rand Gerrie E.
Published: August 2018

There is worldwide concern that higher education students are increasingly engaging in unhealthy eating and lifestyle practices. A total of 488 white students participated in a study aimed at investigating the current food consumption and related lifestyle patterns of students at a South African residential university. The respondents’ self‐reported weight and height was used to calculate their body mass index (BMI). Closed and open‐ended questions measured aspects of the respondents’ usual eating patterns and lifestyles. The meal patterns and composition confirmed Western‐orientated food practices, as the majority consumed three meals a day, with in‐between meal snacking, and a different meal pattern over weekends. Respondents’ food intake was further characterized by a low intake of fruit, vegetables, and dairy products and frequent consumption of foods high in fat, sugar, and sodium. Although the majority (66.8%) of the study group were classified as normal weight according to their BMI, when comparing males and females, more males than females were overweight and obese. Only 54% of the males had a normal weight compared to 82% of the females. There was, however, no statistically significant difference (p = 0.149) between how males and females in the different BMI groups felt about their weight. The study also explored the relationships between the respondents’ BMI, gender, food consumption patterns, and type of residence. The features of the food consumption patterns were depicted according to whether breakfast was eaten or not; snacking activity between meals; the consumption of ready‐prepared convenience meals, fast foods; home‐cooked meals; and eating out. There were no statistical significant differences between the BMI categories of males and females regarding their habit to eat breakfast or not; and to snack between meals either during the morning, in the afternoon or after supper. Similarly, no statistical significant differences were noted when relating the BMI categories of the gender groups to the frequency of consumption of ready‐prepared, convenience type meals, fast foods, and home‐cooked meals. However, a statistical significant difference (p‐value 0.006) was found between BMI categories per gender and general frequency of eating out. No statistical differences was noted between BMI categories, gender and place of residence irrespective of the type, whether the student lived with parents, independently in a flat or apartment, or a house with friends or a room, or in a university residence.
Guidance for quality control practices and precision goals for CBCs based on IQMH patterns‐of‐practice survey
Authors: Johnston Anna , Bourner Gini , Martin Tracy , McFarlane Andrew , Good David , Padmore Ruth , Raby Anne , Aslan Berna
Published: August 2018

Introduction

Effective medical laboratory quality management systems ensure confidence in analyzing and reporting accurate and reliable patient results. To guarantee quality assurance, each laboratory needs appropriate internal quality control (IQC) procedures to monitor their test systems. The Institute for Quality Management in Healthcare (IQMH) Centre for Proficiency Testing conducted a survey on quality control (QC) practices in routine hematology.

Methods

An online survey was sent to 184 Ontario laboratories performing complete blood counts (CBC) and leukocyte differentials.

Results

All participants used three levels of commercial QC for test system monitoring. Eighty percent of laboratories supplement with in‐house patient QC.

The frequency of QC analysis was variable based on:

Manufacturer recommendations (80%)

Parameter stability (25%)

Clinical impact of incorrect results (21%)

Number of samples potentially requiring retesting if there is a QC failure (11%).

All laboratories used established QC rules and limits to monitor results. They utilized various methods in establishing limits including:

Standard deviation of QC results (60%)

Manufacturer precision goals (55%)

Published precision goals (24%)

IQMH allowable performance limits (APLs) (37%).

Conclusion

Considerable variation in QC practices of Ontario laboratories was identified, and consensus practice recommendations and precision goals were developed to guide and standardize QC practice.
The burden of influenza‐associated respiratory hospitalizations in Bhutan, 2015‐2016
Authors: Thapa Binay , Roguski Katherine , Azziz‐Baumgartner Eduardo , Siener Karen , Gould Philip , Jamtsho Thinley , Wangchuk Sonam
Published: August 2018

Background

Influenza burden estimates help provide evidence to support influenza prevention and control programs. In this study, we estimated influenza‐associated respiratory hospitalization rates in Bhutan, a country considering influenza vaccine introduction.

Methods

Using real‐time reverse transcription‐polymerase chain reaction laboratory results from severe acute respiratory infection (SARI) surveillance, we estimated the proportion of respiratory hospitalizations attributable to influenza each month among patients aged <5, 5‐49, and ≥50 years in six Bhutanese districts for 2015 and 2016. We divided the sum of the monthly influenza‐attributed hospitalizations by the total of the six district populations to generate age‐specific rates for each year.

Results

In 2015, 10% of SARI patients tested positive for influenza (64/659) and 18% tested positive (129/736) in 2016. The incidence of influenza‐associated hospitalizations among all age groups was 50/100 000 persons (95% confidence interval [CI]: 45‐55) in 2015 and 118/100 000 persons (95% CI: 110‐127) in 2016. The highest rates were among children <5 years: 182/100 000 (95% CI: 153‐210) in 2015 and 532/100 000 (95% CI: 473‐591) in 2016. The second highest influenza‐associated hospitalization rates were among adults ≥50 years: 110/100 000 (95% CI: 91‐130) in 2015 and 193/100 000 (95% CI: 165‐221) in 2016.

Conclusions

Influenza viruses were associated with a substantial burden of severe illness requiring hospitalization especially among children and older adults. These findings can be used to understand the potential impact of seasonal influenza vaccination in these age groups.
Informed collaboration in health care: An embedded‐cases study in geriatric telepsychiatry
Authors: Hansen Sean W. , Gogan Janis L. , Baxter Ryan J. , Garfield Monica J.
Published: August 2018

Telemedicine, the delivery of medical consultation and services, is enabled by information and communications technologies. Participants in telemedicine consultation services (ie, clinicians, patients, and other parties) use video conferencing, special‐purpose software and/or hardware, and data and notes from electronic medical records and other systems to formulate effective treatment plans. Telemedicine is a particular mode of informed collaboration—information and communications technology–supported collaborative activity in which collaborators rely (wholly or in part) on digitally stored information retrieved from various sources to pursue their collective objectives. We report on an embedded‐cases study of a long‐running geriatric telepsychiatry clinic in the north‐eastern United States. Our analysis draws on the theory of distributed cognition (DCog) to explicate the ways in which information and cognitive effort are distributed across individuals and artefacts to support psychiatric consultation from a distance and how these processes play out over time in routines. On the basis of this case study, we offer a refinement of DCog theory, focusing on four interrelated dynamic processes that, we propose, act as critical enablers of informed collaboration: cognitive offloading, visibility of action, intersubjective understanding, and knowledge redundancy. We discuss practical implications for designing telemedicine services and tools, and we offer suggestions for further research on informed collaboration.
Sensitivity analyses and measurements for group decisions using weighted scoring rules
Authors: Zhao Yong , Wu Fan , Chen Yang
Published: August 2018

Weighted scoring rules (WSRs) are usually used for solving problems of group decisions based on individual ordinal preferences. Generally, individuals are influenced by some subjective and objective factors, which lead to the mutability of individual preferences in group decisions. Therefore, while getting optimal solutions, decision makers often need to make qualitative or quantitative sensitivity analyses of their decisions or choices, and to evaluate reliabilities of the solutions. First, by using inclined angles of score vectors, this paper proposes a sensitivity measuring method and some related concepts of group decision using WSRs. Then, a calculation method is presented, and a size of a minimum disturbance group is discussed in depth because this size is also a useful index to evaluate sensitivities or reliabilities of the decisions. Next, we investigate and discuss the sensitivities of WSRs via their weights, and obtain some suggestions about designing WSRs. Finally, we use the sensitivity degree to analyze a controversy of the National Basketball Association Most Valuable Player evaluation. Our measuring methods are: well visualized, scale invariant, commensurable, and calculability.
Understanding the Hawthorne effect in wound research—A scoping review
Authors: Nguyen Van NB , Miller Charne , Sunderland Janine , McGuiness William
Published: August 2018

The Hawthorne Effect (HE) is considered a methodological artefact in research, although its definition and influence on research outcomes lack consensus. This review explored how this term has been mentioned and discussed in the area of wound research. A scoping review was conducted on ProQuest Central, Scopus, EbscoHost, and online databases of indexed wound journals using the methodological framework by Arksey and Malley. A review protocol was applied to detail key terms, truncation and Boolean operators, and inclusion and exclusion criteria. Search findings were reported using PRISMA guidelines. A total of 38 articles reporting primary evidence were identified. Three themes emerged from the review: wound researchers' awareness of HE, the acknowledgement of the existence or otherwise of HE, and the mentioning of HE in passing. These results reflect a lack of attention to and understanding and awareness of the HE in the area of wound research. It is suggested that the HE receives more attention as a methodological concern, and its potential influence is considered and mitigated when planning future studies. Recommendations are provided to minimise the impact of the HE on the rigour of the research and confidence afforded to research findings.
A confirmatory study on the efficacy of dehydrated human amnion/chorion membrane dHACM allograft in the management of diabetic foot ulcers: A prospective, multicentre, randomised, controlled study of 110 patients from 14 wound clinics
Authors: Tettelbach William , Cazzell Shawn , Reyzelman Alexander M , Sigal Felix , Caporusso Joseph M , Agnew Patrick S
Published: August 2018

A randomised, controlled multicentre clinical trial was conducted at 14 wound care centres in the United States to confirm the efficacy of dehydrated human amnion/chorion membrane allograft (dHACM) for the treatment of chronic lower extremity ulcers in persons with diabetes. Patients with a lower extremity ulcer of at least 4 weeks duration were entered into a 2‐week study run‐in phase and treated with alginate wound dressings and appropriate offloading. Those with less than or equal to 25% wound closure after run‐in were randomly assigned to receive weekly dHACM application in addition to offloading or standard of care with alginate wound dressings, for 12 weeks. A total of 110 patients were included in the intent‐to‐treat (ITT) analysis, with n = 54 in the dHACM group and n = 56 in the no‐dHACM group. Of the participants, 98 completed the study per protocol, with 47 receiving dHACM and 51 not receiving dHACM. The primary study outcome was percentage of study ulcers completely healed in 12 weeks, with both ITT and per‐protocol participants receiving weekly dHACM significantly more likely to completely heal than those not receiving dHACM (ITT—70% versus 50%, P = 0.0338, per‐protocol—81% versus 55%, P = 0.0093). A Kaplan–Meier analysis was performed to compare the time‐to‐healing performance with/without dHACM, showing a significantly improved time to healing with the use of allograft, log‐rank P < 0.0187. Cox regression analysis showed that dHACM‐treated subjects were more than twice as likely to heal completely within 12 weeks than no‐dHACM subjects (HR: 2.15, 95% confidence interval 1.30–3.57, P = 0.003). At the final follow up at 16 weeks, 95% of dHACM‐healed ulcers and 86% of healed ulcers in the no‐dHACM group remained closed. These results confirm that dHACM is an efficacious treatment for lower extremity ulcers in a heterogeneous patient population.
Insights into the influencing factors on the micro‐mechanical properties of calcium‐silicate‐hydrate gel
Authors: Hu Chuanlin , Yao Shun , Zou Fubing , Nie Shuai , Liu Zhichao , Wang Fazhou
Published: August 2018

So far, many researchers have attempted to unveil the micro‐mechanical features of calcium‐silicate‐hydrate (C‐S‐H) gel that contributes the most to the engineering performances of cement‐based materials. Due to the highly heterogeneous nature of C‐S‐H gel present in cement‐based materials, the influencing factors of the micro‐mechanical properties of C‐S‐H gel are still not clear. This study aims to provide an insight into the factors that govern the micro‐mechanical properties of C‐S‐H gel by investigating the morphology, composition, and micro‐mechanical properties of C‐S‐H gels present in a relatively simple system, ie, a C3S paste. Through this study, it is revealed that the reinforcement by the crystal phase and the size of C3S clinker influence the micro‐mechanical properties of inner product C‐S‐H gel.
Tax avoidance, financial experts on the audit committee, and business strategy
Authors: Hsu Pei‐Hui , Moore Jared A. , Neubaum Donald O.
Published: August 2018

We examine whether financial expert audit committee members tailor their approach to overseeing the corporate tax planning process according to the firm's business strategy. We predict and find that such directors encourage defender‐type firms (characterized partially by high risk aversion) to engage in more tax avoidance activities and prospector‐type firms (characterized partially by innovation and risk seeking) to scale back on tax avoidance, relative to the opposing strategy type. We also find that both accounting experts and non‐accounting financial experts on the audit committee contribute to our results to some extent, although the effects of non‐accounting financial experts present more consistently. Overall, our results suggest that financial experts on the audit committee tend to play more of an advising role for defenders and more of a monitoring role for prospectors, relative to one another.
Development of a self‐efficacy questionnaire, ‘Insulin Therapy Self‐efficacy Scale (ITSS)’, for insulin users in Japanese: The Self‐Efficacy‐Q study
Authors: Nakaue Junko , Koizumi Miyuki , Nakajima Hiroki , Okada Sadanori , Mohri Takako , Akai Yasuhiro , Furuya Miyuki , Hayashino Yasuaki , Sato Yasunori , Ishii Hitoshi
Published: August 2018

Aims/Introduction

Although patient self‐efficacy is known to affect adherence to therapy, no available tool measures self‐efficacy of insulin therapy administration while addressing the entire therapeutic process and management. In light of this, we developed the ‘Insulin Therapy Self‐efficacy Scale (ITSS).’

Materials and Methods

Development of the ITSS involved three phases: (i) item generation and creation of a questionnaire draft; (ii) testing and correcting the items through interviews with patients; and (iii) a multicenter, single‐arm study to validate the questionnaire.

Results

A factor analysis and Cronbach's α both confirmed good internal consistency in the patients’ confidence regarding the following four factors: the insulin injection procedure, insulin titration, glycemic control and ability to cope with hypoglycemia. Reproducibility was confirmed using weighted κ statistics and intraclass correlations. Good concurrent validity was confirmed with two other questionnaires. The ITSS score was also found to correlate with several patient characteristics and clinical parameters, as well as with a better adherence to injected insulin therapy 6 months later, suggesting the predictive validity of this scale.

Conclusions

The ITSS is a reliable and valid tool for assessing and quantifying patients’ self‐efficacy. The ITSS estimation of self‐efficacy can predict a patient's glycemic control and future adherence to insulin therapy. These characteristics will ensure the usefulness of the ITSS in ensuring a successful therapeutic process for patients and physicians.
Effect of switching to teneligliptin from other dipeptidyl peptidase‐4 inhibitors on glucose control and renoprotection in type 2 diabetes patients with diabetic kidney disease
Authors: Kitada Munehiro , Ogura Yoshio , Nitta Kyoko , Fujii Mizue , Kanasaki Keizo , Konishi Kazunori , Iida Yasuo , Nakagawa Atsushi , Koya Daisuke
Published: August 2018

Aims/Introduction

The objective of the present study was to elucidate the effect of switching to teneligliptin from other dipeptidyl peptidase‐4 (DPP‐4) inhibitors on glucose control and renoprotection in type 2 diabetes mellitus patients with diabetic kidney disease.

Materials and Methods

The present study was a single‐arm, open‐label, observational study. A total of 23 patients, who had urinary albumin/creatinine ratios (UACR) ≥30 mg/gCr in their first urine in the early morning, and received other DPP‐4 inhibitors and renin‐angiotensin system inhibitors, switched to teneligliptin 20 mg/day. After switching to teneligliptin for 24 weeks, we evaluated changes in glycated hemoglobin (HbA1c), fasting plasma glucose levels, plasma DPP‐4 activity and UACR.

Results

HbA1c, fasting plasma glucose and UACR values showed no significant change after 24 weeks compared with baseline. However, plasma DPP‐4 activity was significantly reduced after 24 weeks (0.57 ± 0.26 nmol/min/mL, P = 0.012, vs baseline), compared with baseline (1.49 ± 1.73 nmol/min/mL), and there was a positive relationship between the change rate of plasma DPP‐4 activity (Δ%DPP‐4) for 24 weeks and the levels of plasma DPP‐4 activity (r = −0.5997, P = 0.0025) and fasting plasma glucose (r = −0.4235, P = 0.0440) at baseline. Additionally, the Δ%DPP‐4 for 24 weeks was significantly correlated to the change rate of UACR (r = 0.556, P = 0.0059). However, there was no relationship between Δ%DPP‐4 and ΔHbA1c (amount of HbA1c change).

Conclusions

Switching to teneligliptin from other DPP‐4 inhibitors for 24 weeks reduces plasma DPP‐4 activity, which is associated with a reduction in albuminuria, independent of the change in glucose levels, in type 2 diabetes mellitus patients with diabetic kidney disease.
In the future, ‘new’ categories in the evaluation of pressure ulcers should be considered
Authors: Dissemond J.
Published: August 2018

Linked article: This is a commentary on J.‐H. Chen et al., pp. 1589–1596 in this issue. To view this article visit https://doi.org/10.1111/jdv.14911
Cutaneous infection – would you think of algae?
Authors: Schöfer H.
Published: August 2018

Linked article: This is a commentary on H.‐C. Tseng et al., pp. 1575–1583 in this issue. To view this article visit https://doi.org/10.1111/jdv.14804
Interaction Between Visual Acuity and Peripheral Vascular Disease with Balance
Authors: Vafaei Afshin , Aubin Marie‐Josée , Buhrmann Ralf , Kergoat Marie‐Jeanne , Aljied Rumaisa , Freeman Ellen E.
Published: August 2018

Objectives

To determine whether visual acuity is related to balance in older adults with peripheral vascular disease (PVD) or diabetes mellitus.

Design

Cross‐sectional analysis.

Setting

Canada.

Participants

Community‐dwelling adults aged 45 to 85 from the Canadian Longitudinal Study on Aging (N=30,097).

Measurements

Visual acuity was measured wearing habitual distance correction using the Early Treatment of Diabetic Retinopathy Study chart at a 2‐m distance. Poor balance was defined as being unable to stand on 1 leg for at least 60 seconds. PVD and diabetes mellitus were assessed according to self‐report of a physician diagnosis. Multiple logistic regression was used.

Results

People who reported PVD (n=1,295) were more likely to have worse balance than those who did not (odds ratio (OR)=1.50, 95% confidence interval (CI)=1.29–1.77). In those who did not report PVD (n=26,211), a 1‐line worse score on the visual acuity test was associated with 23% higher odds of being unable to stand for at least 60 seconds after adjusting for age, sex, education, province, body mass index, and diabetes mellitus (OR=1.23, 95% CI=1.20–1.26). In those who reported PVD, the odds of being unable to stand was almost double (OR=1.41, 95% CI=1.22–1.62). The interaction between visual acuity and PVD was statistically significant (P=.02).

Conclusions

Visual acuity and PVD interact in their relationship with balance. People with poor vision and PVD may be at an especially high risk of mobility difficulties.
Determinants of Incident Malnutrition in Community‐Dwelling Older Adults: A MaNuEL Multicohort Meta‐Analysis
Authors: Streicher Melanie , van Zwienen‐Pot Judith , Bardon Laura , Nagel Gabriele , Teh Ruth , Meisinger Christine , Colombo Miriam , Torbahn Gabriel , Kiesswetter Eva , Flechtner‐Mors Marion , Denkinger Michael , Rothenbacher Dietrich , Thorand Barbara , Ladwig Karl‐Heinz , Corish Clare A. , Clarke Michelle , Kerse Ngaire , Muru‐Lanning Marama , Gibney Eileen R. , O'Connor Eibhlís M. , Visser Marjolein , Volkert Dorothee ,   on behalf of the MaNuEL consortium
Published: August 2018

Objectives

To identify determinants of incident malnutrition in community‐dwelling older adults.

Design

Meta‐analysis of 6 community‐based longitudinal datasets with follow‐up of 1 to 3 years.

Setting

Datasets from MaNuEL (MalNutrition in the Elderly) partners were included: 3 studies from Germany and 1 each from Ireland, the Netherlands, and New Zealand.

Participants

community‐dwelling adults aged 65 and older (N=4,844).

Measurement

The same definition of incident malnutrition was used for all cohorts (body mass index < 20.0 kg/m2 at follow‐up or weight loss ≥10 % between baseline and follow‐up). Twenty‐one potential baseline determinants from 7 domains (demographic, nutritional, lifestyle, social, psychological, physical functioning, medical) and 2 follow‐up variables (hospitalization, falls) were harmonized for all studies. Binary logistic regression analyses were performed to assess the association between each variable, adjusted for specific confounders, and incident malnutrition. Combined odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random‐effects meta‐analyses.

Results

Studies included between 209 and 1,841 participants without malnutrition at baseline; mean age ranged from 71.7 to 84.6. Incidence of malnutrition varied from 5.1% and 17.2%. Meta‐analyses identified 6 variables as independent determinants of incident malnutrition; with increasing age, the risk of developing malnutrition increased continuously. Unmarried, separated, or divorced participants were more likely to develop malnutrition than married participants, whereas no association was found for widowed participants. Participants with difficulty walking (OR=1.41, 95% CI=1.06–1.89) or difficulty climbing stairs (OR=1.45, 95% CI=1.14–1.85) and those who were hospitalized before baseline (OR=1.49, 95% CI=1.25–1.76) and during follow‐up (OR=2.02, 95% CI=1.41–2.88) had higher odds of incident malnutrition.

Conclusion

In this harmonized meta‐analysis based on prospective data of older, community‐dwelling adults, age, marital status, limitations with walking and climbing stairs, and hospitalization were identified as determinants of incident malnutrition. J Am Geriatr Soc 66:2335–2343, 2018.
Caregiver‐Based Interventions to Optimize Medication Safety in Vulnerable Elderly Adults: A Systematic Evidence‐Based Review
Authors: Wagle Kamal C. , Skopelja Elaine N. , Campbell Noll L.
Published: August 2018

Objectives

To study the effect of caregiver‐focused interventions to support medication safety in older adults with chronic disease.

Design

Systematic review.

Setting

Studies published before January 31, 2017, searched using Ovid Medline, PubMed, EMBASE, Scopus, CINAHL, PsycINFO, and Google Scholar.

Participants

Caregivers with or without a care recipient.

Measurements

Inclusion criteria: interventions focused on caregivers aiming to improve medication safety. Studies not focusing on older adults, not evaluating medication safety, failing to include caregivers, or without a comparison group were excluded.

Results

The initial search revealed 1,311 titles. Eight studies met inclusion criteria. The strategies used in randomized trials were a home‐based medication review and adherence assessment by a clinical pharmacist (2 home visits 6–8 weeks apart, with pharmacist and physician meeting independently) that found no difference in nonelective hospital admissions (p=.8) but fewer medications (p=.03); a 19‐minute educational DVD and an hour‐long medication education and training that improved caregiver satisfaction (p<.04); a medication education and adherence intervention (2–3 home visits per care recipient and caregiver dyad over 8 weeks) that found no difference in knowledge, administration, or accessibility of medications (p=.29); and a collaborative case management program (16‐month program of assessment, meeting, and monthly follow‐up telephone calls) that reduced perceived caregiver burden (p=.03). Quasi‐experimental trials included collaborative care transitional coaches, an outpatient collaborative care model, and education and training programs. Of these, educational interventions showed improvements in self‐efficacy, confidence, and preparedness. The collaborative care intervention reduced rehospitalizations (p=.04) and improved quality‐of‐care outcomes.

Conclusion

Although some interventions improved caregiver medication knowledge and self‐efficacy, effects on clinical outcomes and healthcare use were insufficiently studied. Two studies implementing collaborative care models with medication management components showed potential for improvement in quality of clinical care and reductions in healthcare visits and warrant further study with respect to medication safety.J Am Geriatr Soc 66:2128–2135, 2018.