bluuebunny/crossref_metadata_2025 huggingface dataset:
Fair regression for health care spending
Authors: Zink Anna , Rose Sherri
Published: December 2019

The distribution of health care payments to insurance plans has substantial consequences for social policy. Risk adjustment formulas predict spending in health insurance markets in order to provide fair benefits and health care coverage for all enrollees, regardless of their health status. Unfortunately, current risk adjustment formulas are known to underpredict spending for specific groups of enrollees leading to undercompensated payments to health insurers. This incentivizes insurers to design their plans such that individuals in undercompensated groups will be less likely to enroll, impacting access to health care for these groups. To improve risk adjustment formulas for undercompensated groups, we expand on concepts from the statistics, computer science, and health economics literature to develop new fair regression methods for continuous outcomes by building fairness considerations directly into the objective function. We additionally propose a novel measure of fairness while asserting that a suite of metrics is necessary in order to evaluate risk adjustment formulas more fully. Our data application using the IBM MarketScan Research Databases and simulation studies demonstrates that these new fair regression methods may lead to massive improvements in group fairness (eg, 98%) with only small reductions in overall fit (eg, 4%).
A test of homogeneity of distributions when observations are subject to measurement errors
Authors: Lee DongHyuk , Lahiri Soumendra N. , Sinha Samiran
Published: December 2019

When the observed data are contaminated with errors, the standard two‐sample testing approaches that ignore measurement errors may produce misleading results, including a higher type‐I error rate than the nominal level. To tackle this inconsistency, a nonparametric test is proposed for testing equality of two distributions when the observed contaminated data follow the classical additive measurement error model. The proposed test takes into account the presence of errors in the observed data, and the test statistic is defined in terms of the (deconvoluted) characteristic functions of the latent variables. Proposed method is applicable to a wide range of scenarios as no parametric restrictions are imposed either on the distribution of the underlying latent variables or on the distribution of the measurement errors. Asymptotic null distribution of the test statistic is derived, which is given by an integral of a squared Gaussian process with a complicated covariance structure. For data‐based calibration of the test, a new nonparametric Bootstrap method is developed under the two‐sample measurement error framework and its validity is established. Finite sample performance of the proposed test is investigated through simulation studies, and the results show superior performance of the proposed method than the standard tests that exhibit inconsistent behavior. Finally, the proposed method was applied to real data sets from the National Health and Nutrition Examination Survey. An R package MEtest is available through CRAN.
People with learning disabilities and access to mainstream arts and culture: A participatory action research approach
Authors: Gratton Nicola
Published: December 2019

Accessible summary

Ten people with learning disabilities were trained to work with a university to carry out research about people with learning disabilities, arts and culture.

They spoke to 82 people with learning disabilities to find out what gets in the way of attending arts and culture activities.

The research found that transport, cost and needing support often got in the way of people being able to go to activities and people needed to feel safe and welcomed when they attend an arts and culture activity.

It was found that including more people with learning disabilities in making decisions about art and culture could help more people attend activities. It was also found that involving more people with learning disabilities in training people who work in arts and culture could help people feel safe when they go to activities.

Background

Arts and culture have proven benefits. However, access to arts and culture is not consistent. For people with learning disabilities, arts and culture are often considered therapeutic activities, and therefore, the needs of people with learning disabilities in accessing mainstream arts and culture are often overlooked. This research explores how people with learning disabilities experience culture, the barriers they experience in accessing it and how cultural sector organisations can improve access to their activities and events.

Methods

A participatory action research approach was adopted for the study. Interviews and focus groups were conducted. The findings were analysed and resulting themes discussed with the peer research team. The group codelivered a workshop aimed at representatives from the cultural sector to share their findings.

Results

The results from the focus groups and interviews indicated that for people with learning disabilities, community is central to their experience of arts and culture. The study found that transport, cost and needing support to attend cultural activities were barriers to access, whereas consideration of physical access and “emotional access” needs improved access for people with learning disabilities. Recommendations include improved consultation with people with learning disabilities about cultural opportunities and the formation of cocreated training delivered with people with learning disabilities to support cultural sector staff to offer a warm and safe environment.

Conclusions

The findings from the study provided useful learning for cultural sector organisations. However, both the findings of the research and the process of participatory action research were noted as being significant for how the cultural sector can build an ethos of inclusivity to ensure their offer is relevant and accessible to people with learning disabilities.
Cardiovascular shunting in vertebrates: a practical integration of competing hypotheses
Authors: Burggren Warren , Filogonio Renato , Wang Tobias
Published: December 2019

This review explores the long‐standing question: ‘Why do cardiovascular shunts occur?’ An historical perspective is provided on previous research into cardiac shunts in vertebrates that continues to shape current views. Cardiac shunts and when they occur is then described for vertebrates. Nearly 20 different functional reasons have been proposed as specific causes of shunts, ranging from energy conservation to improved gas exchange, and including a plethora of functions related to thermoregulation, digestion and haemodynamics. It has even been suggested that shunts are merely an evolutionary or developmental relic. Having considered the various hypotheses involving cardiovascular shunting in vertebrates, this review then takes a non‐traditional approach. Rather than attempting to identify the single ‘correct’ reason for the occurrence of shunts, we advance a more holistic, integrative approach that embraces multiple, non‐exclusive suites of proposed causes for shunts, and indicates how these varied functions might at least co‐exist, if not actually support each other as shunts serve multiple, concurrent physiological functions. It is argued that deposing the ‘monolithic’ view of shunting leads to a more nuanced view of vertebrate cardiovascular systems. This review concludes by suggesting new paradigms for testing the function(s) of shunts, including experimentally placing organ systems into conflict in terms of their perfusion needs, reducing sources of variation in physiological experiments, measuring possible compensatory responses to shunt ablation, moving experiments from the laboratory to the field, and using cladistics‐related approaches in the choice of experimental animals.
Chemical chaperones reverse early suppression of regulatory circuits during unfolded protein response in B cells from common variable immunodeficiency patients
Authors: Bhatt D , Stan R C , Pinhata R , Machado M , Maity S , Cunningham-Rundles C , Vogel C , de Camargo M M
Published: December 2019

B cells orchestrate pro-survival and pro-apoptotic inputs during unfolded protein response (UPR) to translate, fold, sort, secrete and recycle immunoglobulins. In common variable immunodeficiency (CVID) patients, activated B cells are predisposed to an overload of abnormally processed, misfolded immunoglobulins. Using highly accurate transcript measurements, we show that expression of UPR genes and immunoglobulin chains differs qualitatively and quantitatively during the first 4 h of chemically induced UPR in B cells from CVID patients and a healthy subject. We tested thapsigargin or tunicamycin as stressors and 4-phenylbutyrate, dimethyl sulfoxide and tauroursodeoxycholic acid as chemical chaperones. We found an early and robust decrease of the UPR upon endoplasmic reticulum (ER) stress in CVID patient cells compared to the healthy control consistent with the disease phenotype. The chemical chaperones increased the UPR in the CVID patient cells in response to the stressors, suggesting that misfolded immunoglobulins were stabilized. We suggest that the AMP-dependent transcription factor alpha branch of the UPR is disturbed in CVID patients, underlying the observed expression behavior.
Heart rate and early progression of cardiac allograft vasculopathy: A prospective study using highly automated 3‐D optical coherence tomography analysis
Authors: Pazdernik Michal , Wichterle Dan , Chen Zhi , Bedanova Helena , Kautzner Josef , Melenovsky Vojtech , Karmazin Vladimir , Malek Ivan , Stiavnicky Peter , Tomasek Ales , Ozabalova Eva , Krejci Jan , Wahle Andreas , Zhang Honghai , Kovarnik Tomas , Sonka Milan
Published: December 2019

Introduction

Heart rate slowing agents are frequently prescribed to manage heart transplant (HTx) patients with the assumption that higher heart rate is a risk factor in cardiovascular disease.

Patients and Methods

This prospective two‐center study investigated early progression of cardiac allograft vasculopathy (CAV) in 116 HTx patients. Examinations by coronary optical coherence tomography and 24‐hour ambulatory ECG monitoring were performed both at baseline (1 month after HTx) and during follow‐up (12 months after HTx).

Results

During the first post‐HTx year, we observed a significant reduction in the mean coronary luminal area from 9.0 ± 2.5 to 8.0 ± 2.4 mm2 (P < .001), and progression in mean intimal thickness (IT) from 106.5 ± 40.4 to 130.1 ± 53.0 µm (P < .001). No significant relationship was observed between baseline and follow‐up mean heart rates and IT progression (R = .02, P = .83; R = −.13, P = .18). We found a mild inverse association between beta‐blocker dosage at 12 months and IT progression (R = −.20, P = .035).

Conclusion

Our study did not confirm a direct association between mean heart rate and progression of CAV. The role of beta blockers warrants further investigation, with our results indicating that they may play a protective role in early CAV development.
Clinical outcomes of sedation during emergency endoscopic band ligation for variceal bleeding: Multicenter cohort study
Authors: Park Chan Hyuk , Park Se Woo , Jung Jang Han , Kim Gyeong Guk , Choi Se Young , Kim Eun Sun , In Dong Hyun , Kim Hong Deok
Published: December 2019

Background and Aims

Few studies have directly compared the efficacy of sedated‐ and un‐sedated endoscopic variceal ligation (EVL) for acute variceal bleeding. We aimed to determine whether sedation during EVL in patients with variceal bleeding is safe and effective.

Methods

We analyzed data from patients who underwent EVL for acute variceal bleeding according to sedation in six hospitals of Hallym University Medical Center. The primary endpoint was treatment failure, defined as a failure to control bleeding, death during EVL, or rebleeding within 5 days. Secondary endpoints included the procedure time, adverse events, and 30‐day mortality.

Results

Of 1,300 patients who were included, only 430 (33.1%) received sedation during EVL. Propofol alone was used for sedation in 85% of sedated‐EVLs. The mean procedure time in the sedation group was shorter than that of the non‐sedation group (12.4 ± 9.5 min versus 13.8 ± 9.4 min, P = 0.010). The proportion of treatment failure did not differ between the groups (7.4% versus 9.1%, P = 0.374). In the multivariable analysis, an AIMS65 score ≥2 and blood transfusion within 72 hours were associated with treatment failure of EVL; however, the use of sedation was not (odds ratio [95% confidence interval (CI)] = 0.96 [0.60–1.51]). Adverse events during EVL and hepatic encephalopathy did not differ between the two groups. Sedation also did not affect the 30‐day mortality (hazard ratio [95% CI] = 0.99 [0.66–1.47]).

Conclusion

Sedation reduced the procedure time of EVL. Sedation is safe to use during EVL for variceal bleeding in patients with cirrhosis.
Retracted: Increasing connectivity of Great Lakes tributaries: Interspecific and intraspecific effects on resident brook trout and brown trout populations
Authors: Zorn Troy G. , Hessenauer Jan‐Michael , Wills Todd C.
Published: December 2019

The above article from the Ecology of Freshwater Fish, published online on 20 December 2019 in Wiley Online Library (https://onlinelibrary.wiley.com/doi/abs/10.1111/eff.12527), has been retracted by agreement between the journal Editor‐in‐Chief; the symposium editor, Phaedra Budy; and the author, Troy Zorn. The retraction has been made due to a mistake in the classification (accessible vs. landlocked) of one of the survey locations in Table 1, which affected the accuracy of other analyses in the article.
First report of 16Sr II‐C subgroup phytoplasma association with Acacia mangium in Tripura, India
Authors: Rao Govind Pratap , Bahadur Amar , Das Sukhen Chandra , Ranebennur Hemavati , Mitra Surabhi , Kumar Manish , Kumar Shailender
Published: December 2019

Leaf yellowing symptoms were observed on Acacia mangium in the Sipahijala district of Tripura, India, during June 2017. Symptomatic and asymptomatic leaf samples (three of each) were collected from roadside trees of A. mangium for DNA extraction using the CTAB method. Amplicons of ~1.25 kb and ~480 bp were detected in all the symptomatic samples using the phytoplasma‐specific universal 16S rRNA and secA gene primers. Pair wise sequence analysis of 16S rRNA gene sequences, virtual RFLP and phylogenetic analysis revealed that the phytoplasma strain associated with A. mangium belonged to phytoplasma subgroup 16SrII‐C. This is the first report of an association between the 16SrII‐C subgroup and A. mangium leaf yellowing.
Epileptogenicity in tuberous sclerosis complex: A stereoelectroencephalographic study
Authors: Neal Andrew , Ostrowsky‐Coste Karine , Jung Julien , Lagarde Stanislas , Maillard Louis , Kahane Philippe , Touraine Renaud , Catenoix Helene , Montavont Alexandra , Isnard Jean , Arzimanoglou Alexis , Bartolomei Fabrice , Guenot Marc , Rheims Sylvain
Published: December 2019

Objective

In tuberous sclerosis complex (TSC)‐associated drug‐resistant epilepsy, the optimal invasive electroencephalographic (EEG) and operative approach remains unclear. We examined the role of stereo‐EEG in TSC and used stereo‐EEG data to investigate tuber and surrounding cortex epileptogenicity.

Methods

We analyzed 18 patients with TSC who underwent stereo‐EEG (seven adults). One hundred ten seizures were analyzed with the epileptogenicity index (EI). In 13 patients with adequate tuber sampling, five anatomical regions of interest (ROIs) were defined: dominant tuber (tuber with highest median EI), perituber cortex, secondary tuber (tuber with second highest median EI), nearby cortex (normal‐appearing cortex in the same lobe as dominant tuber), and distant cortex (in other lobes). At the seizure level, epileptogenicity of ROIs was examined by comparing the highest EI recorded within each anatomical region. At the patient level, epileptogenic zone (EZ) organization was separated into focal tuber (EZ confined to dominant tuber) and complex (all other patterns).

Results

The most epileptogenic ROI was the dominant tuber, with higher EI than perituber cortex, secondary tuber, nearby cortex, and distant cortex (P < .001). A focal tuber EZ organization was identified in seven patients. This group had 80% Engel IA postsurgical outcome and distinct dominant tuber characteristics: continuous interictal discharges (IEDs; 100%), fluid‐attenuated inversion recovery (FLAIR) hypointense center (86%), center‐to‐rim EI gradient, and stimulation‐induced seizures (71%). In contrast, six patients had a complex EZ organization, characterized by nearby cortex as the most epileptogenic region and 40% Engel IA outcome. At the intratuber level, the combination of FLAIR hypointense center, continuous IEDs, and stimulation‐induced seizures offered 98% specificity for a focal tuber EZ organization.

Significance

Tubers with focal EZ organization have a striking similarity to type II focal cortical dysplasia. The presence of distinct EZ organizations has significant implications for EZ hypothesis generation, invasive EEG approach, and resection strategy.
In conversation with Gerard Evan
Authors: Dhillon Paraminder , Evan Gerard
Published: December 2019

Gerard Evan is Head of Department and Sir William Dunn Professor at the Department of Biochemistry, University of Cambridge, UK. Driven by his innate passion to understand how things work, Gerard has devoted much of his career to understanding the molecular basis of cancer, particularly the roles played by oncogenes such as Myc. His work has helped elucidate the complex role that this gene plays in cell proliferation and apoptosis, and paved new avenues for the treatment of aggressive cancers. In this interview, Gerard provides an overview of what is known about the role of Myc in normal and cancer cells and provides a persuasive argument for the application of ‘impersonalised therapy’ involving Myc inhibition as part of future chemotherapeutic drug regimes.
The novel peroxin Pex37: the Pxmp2 family joins the peroxisomal fission machinery
Authors: Platta Harald W. , Erdmann Ralf
Published: December 2019

Peroxisomes can undergo fission during cell division, followed by their segregation between mother and daughter cells. Despite species‐specific variations in the molecular composition of the fission machinery, the central mechanistic factors can be assigned to two groups: the Pex11 family and the dynamin‐related protein family. In a recent study, Singh et al. describe the involvement of a member of the Pxmp2‐related protein family in peroxisome fission: the novel peroxin Pex37.
Tree growth influenced by warming winter climate and summer moisture availability in northern temperate forests
Authors: Harvey Jill E. , Smiljanić Marko , Scharnweber Tobias , Buras Allan , Cedro Anna , Cruz‐García Roberto , Drobyshev Igor , Janecka Karolina , Jansons Āris , Kaczka Ryszard , Klisz Marcin , Läänelaid Alar , Matisons Roberts , Muffler Lena , Sohar Kristina , Spyt Barbara , Stolz Juliane , van der Maaten Ernst , van der Maaten‐Theunissen Marieke , Vitas Adomas , Weigel Robert , Kreyling Jürgen , Wilmking Martin
Published: December 2019

The role of future forests in global biogeochemical cycles will depend on how different tree species respond to climate. Interpreting the response of forest growth to climate change requires an understanding of the temporal and spatial patterns of seasonal climatic influences on the growth of common tree species. We constructed a new network of 310 tree‐ring width chronologies from three common tree species (Quercus robur, Pinus sylvestris and Fagus sylvatica) collected for different ecological, management and climate purposes in the south Baltic Sea region at the border of three bioclimatic zones (temperate continental, oceanic, southern boreal). The major climate factors (temperature, precipitation, drought) affecting tree growth at monthly and seasonal scales were identified. Our analysis documents that 20th century Scots pine and deciduous species growth is generally controlled by different climate parameters, and that summer moisture availability is increasingly important for the growth of deciduous species examined. We report changes in the influence of winter climate variables over the last decades, where a decreasing influence of late winter temperature on deciduous tree growth and an increasing influence of winter temperature on Scots pine growth was found. By comparing climate–growth responses for the 1943–1972 and 1973–2002 periods and characterizing site‐level growth response stability, a descriptive application of spatial segregation analysis distinguished sites with stable responses to dominant climate parameters (northeast of the study region), and sites that collectively showed unstable responses to winter climate (southeast of the study region). The findings presented here highlight the temporally unstable and nonuniform responses of tree growth to climate variability, and that there are geographical coherent regions where these changes are similar. Considering continued climate change in the future, our results provide important regional perspectives on recent broad‐scale climate–growth relationships for trees across the temperate to boreal forest transition around the south Baltic Sea.
Global‐scale species distributions predict temperature‐related changes in species composition of rocky shore communities in Britain
Authors: Burrows Michael T. , Hawkins Stephen J. , Moore J. Jon , Adams Leoni , Sugden Heather , Firth Louise , Mieszkowska Nova
Published: December 2019

Changes in rocky shore community composition as responses to climatic fluctuations and anthropogenic warming can be shown by changes in average species thermal affinities. In this study, we derived thermal affinities for European Atlantic rocky intertidal species by matching their known distributions to patterns in average annual sea surface temperature. Average thermal affinities (the Community Temperature Index, CTI) tracked patterns in sea surface temperature from Portugal to Norway, but CTI for communities of macroalgae and plant species changed less than those composed of animal species. This reduced response was in line with the expectation that communities with a smaller range of thermal affinities among species would change less in composition along thermal gradients and over time. Local‐scale patterns in CTI over wave exposure gradients suggested that canopy macroalgae allow species with ranges centred in cooler than local temperatures (‘cold‐affinity’) to persist in otherwise too‐warm conditions. In annual surveys of rocky shores, communities of animal species in Shetland showed a shift in dominance towards warm‐affinity species (‘thermophilization’) with local warming from 1980 to 2018 but the community of plant and macroalgal species did not. From 2002 to 2018, communities in southwest Britain showed the reverse trend in CTI: declining average thermal affinities over a period of modest temperature decline. Despite the cooling, trends in species abundance were in line with the general mechanism of direction and magnitude of long‐term trends depending on the difference between species thermal affinities and local temperatures. Cold‐affinity species increased during cooling and warm‐affinity ones decreased. The consistency of responses across different communities and with general expectations based on species thermal characteristics suggests strong predictive accuracy of responses of community composition to anthropogenic warming.
Critiquing Construct Validity in World City Network Research: Moving from Office Location Networks to Inter‐Organizational Projects in the Modeling of Intercity Business Flows
Authors: Pažitka Vladimír , Wójcik Dariusz , Knight Eric
Published: December 2019

The interlocking world city network model and other office location approaches (OLAs) have become the most widely used empirical models of the world city network (WCN). Despite numerous methodological improvements, they continue to rely on a legacy of using data on office locations of firms to indirectly estimate intercity business flows. To advance the dialogue about how to improve on existing empirical models of the WCN, we examine the content, construct and structural validity of OLAs. We analyze the link between the theoretical construct of intercity business flows and network projections obtained from office location data and uncover evidence that calls into question the validity of OLAs as empirical models of the WCN. In the spirit of no deconstruction without reconstruction, we then develop an alternative empirical model of the WCN, based on directly observable relational ties among APS firms, which are formed through co‐production of complex services. We call this the inter‐organizational project approach (IOPA). We argue for IOPA's construct validity as an empirical model of the WCN and offer empirical evidence for its structural validity. We demonstrate it using a global sample of 161,114 investment bank syndicates in the 2000–2015 period.
Reflection in practice: How can patient experience feedback trigger staff reflection in hospital acute care settings?
Authors: Jones Jennifer , Bion Julian , Brown Celia , Willars Janet , Brookes Olivia , Tarrant Carolyn ,   the PEARL collaboration
Published: December 2019

Background

Patient and staff experiences provide important insights into care quality, but health systems have difficulty using these data to improve care. Little attention has been paid to understanding how patient experience feedback can act as a prompt to reflection in practice in the clinical setting.

Objective

We aimed to identify the ways in which different types of patient experience feedback act as a trigger or prompt for engagement in reflection in clinical practice in acute hospital settings and identify important considerations for enhancing the value of patient experience data for reflective learning.

Methods

We conducted an ethnographic study in eight acute care units in three NHS hospital trusts in England, including 140 hours of observations and 45 semi‐structured interviews with nursing, medical and managerial staff working in acute medical units and intensive care units. The data were analysed thematically.

Findings

We distinguished between formal patient experience data sources: data purposively collected and collated to capture the patient experience of care, generally at organizational level, including surveys, complaints and comments; and informal sources of feedback on the patient experience recognized by staff alongside the formal data. We also identified patient narratives as an ‘in between’ source of data. The impact of different types of patient feedback in triggering reflection primarily depended on the extent to which the feedback was experienced as personally relevant, meaningful and emotionally salient.

Discussion

Patient experience feedback is multi‐faceted, but our study suggests that all types of feedback could be harnessed more effectively to prompt reflection.
Patterns of presentation and survival of HIV‐infected patients admitted to a tertiary‐level intensive care unit
Authors: Maphula RW , Laher AE , Richards GA
Published: December 2019

Objectives

Compared to other countires internationally, South Africa has the largest number of people living with HIV. There are limited data in developing countries on the outcomes of HIV‐infected patients in the intensive care unit (ICU). The objectives of this study were to describe the pattern of presentation of these patients and to determine factors that may influence survival to ICU discharge.

Methods

The medical charts of 204 consecutive HIV‐infected individuals who were admitted to the Charlotte Maxeke Johannesburg Academic Hospital adult general ICU during the calendar year 2017 were retrospectively reviewed. Relevant data were subjected to univariate and multivariate analysis.

Results

Two‐hundred and four (22.6%) out of a total of 903 patients who were admitted to the ICU were HIV positive. Sepsis‐related illnesses were the most common reason for ICU admission (n = 95; 46.6%), followed by post‐operative care (n = 69; 33.8%) and non‐sepsis‐related illnesses (n = 40; 19.6%). The median length of stay in the ICU was 5 (interquartile range 2–9) days. ICU mortality was 33.3% (n = 68). On univariate analysis, age (P = 0.039), length of stay in the ICU (P = 0.040), primary diagnostic category (P < 0.05), sepsis acquired during the ICU stay (P = 0.012), inotrope/vasopressor administration (P < 0.001), mechanical ventilation (P < 0.001), haemodialysis (P = 0.001), CD4 cell count (P = 0.011), Acute Physiology and Chronic Health Assessment (APACHE) II score (P < 0.001) and Sequential Organ Failure Assessment (SOFA) score (P < 0.001) were significantly associated with mortality.

Conclusions

Age, diagnostic category, sepsis acquired during the ICU stay, inotrope/vasopressor administration, mechanical ventilation, haemodialysis, CD4 cell count, APACHE II score, SOFA score and length of ICU stay were associated with ICU mortality in HIV‐infected patients.
STICKY PRICES AND COSTLY CREDIT
Authors: Wang Liang , Wright Randall , Liu Lucy Qian
Published: December 2019

We develop a theory of money and credit as competing payment instruments, then put it to work in applications. Agents use cash and credit because the former (latter) is subject to the inflation tax (transaction costs). Frictions that make the choice of payment method interesting also imply equilibrium price dispersion. We derive closed‐form solutions for money demand, and show how to simultaneously account for the price‐change facts, cash–credit shares in micro data, and money‐interest correlations in macro data. The effects of inflation on welfare, price dispersion and markups are discussed, as are nonstationary equilibria with dynamics in the price distribution.
How to work out and avoid procrastination: The role of goal focus
Authors: Kaftan Oliver J. , Freund Alexandra M.
Published: December 2019

This 8‐week longitudinal experience sampling study with N = 346 participants (n = 242 completers) of a high‐intensity interval training program explored how goal focus (i.e., a focus on the process vs. outcome of goal pursuit) is related to procrastination and successful goal pursuit. Specifically, the study investigated the association between goal focus and participants' adherence to their workout plans (i.e., procrastination), their immediate experience during the workout (e.g., pleasantness), and their intentions to work out when they were procrastinating. Moreover, the study examined how process and outcome focus are linked to overall goal achievement, workout satisfaction, and objective fitness gains. Converging with previous research, results suggest that adopting a process focus is adaptive. In addition, the analyses revealed some positive relationships between outcome focus and immediate indicators of successful goal pursuit. However, in contrast to process focus, outcome focus was not related to the overall measures and even seemed maladaptive once people were procrastinating.
Regenerative surgery versus access flap for the treatment of intra‐bony periodontal defects: A systematic review and meta‐analysis
Authors: Nibali Luigi , Koidou Vasiliki P. , Nieri Michele , Barbato Luigi , Pagliaro Umberto , Cairo Francesco
Published: December 2019

Background

The aim of this systematic review was to compare clinical, radiographic and patient‐reported outcomes (PROMs) in intra‐bony defects treated with regenerative surgery or access flap.

Materials and Methods

A systematic review protocol was written following the PRISMA checklist. Electronic and hand searches were performed to identify randomized clinical trials (RCTs) on regenerative treatment of deep intra‐bony defects (≥3 mm) with a follow‐up of at least 12 months. Primary outcome variables were probing pocket depth (PPD) reduction, clinical attachment level (CAL) gain and tooth loss. Secondary outcome variables were Rec, radiographic bone gain, pocket “closure,” PROMs and adverse events. Meta‐analysis was carried out when possible. To evaluate treatment effect, odds ratios were combined for dichotomous data and mean differences for continuous data using a random‐effect model.

Results

A total of 79 RCTs (88 articles) published from 1990 to 2019 and accounting for 3,042 patients and 3,612 intra‐bony defects were included in this systematic review. Only 10 of included studies were rated at low risk of bias. A total of 13 meta‐analyses were performed. All regenerative procedures provided adjunctive benefit in terms of CAL gain (1.34 mm; 0.95–1.73) compared with open flap debridement alone. Both enamel matrix derivative (EMD) and guided tissue regeneration (GTR) were superior to OFD alone in improving CAL (1.27 mm; 0.79–1.74 mm and 1.43 mm; 0.76–2.22, respectively), although with moderate–high heterogeneity. Among biomaterials, the addition of deproteinized bovine bone mineral (DBBM) improved the clinical outcomes of both GTR with resorbable barriers and EMD. Papillary preservation flaps enhanced the clinical outcomes. The strength of evidence was low to moderate.

Conclusion

EMD or GTR in combination with papillary preservation flaps should be considered the treatment of choice for residual pockets with deep (≥3 mm) intra‐bony defects.
Relationship between herpesviruses and periodontal disease progression
Authors: Emecen‐Huja Pinar , Danaher Robert J. , Dawson Dolphus R. , Wang Chunmei , Kryscio Richard J. , Ebersole Jeffrey L. , Miller Craig S.
Published: December 2019

Aim

To investigate the role of Epstein–Barr virus (EBV), cytomegalovirus (CMV), and anaerobic bacteria in the progression of periodontitis.

Methods

Eighty‐one adults with generalized moderate to severe periodontitis were randomly assigned to: oral hygiene or scaling and root planning ± placebo or polyunsaturated fatty acids fish oil. Subgingival plaque samples collected from three healthy and three disease sites at weeks 0, 16, and 28 and from sites demonstrating disease progression were analysed for EBV, CMV, P. gingivalis (Pg), T. forsythia (Tf), and T. denticola (Td) DNA using quantitative polymerase chain reaction.

Results

Cytomegalovirus was detected in 0.3% (4/1454) sites. EBV was present in 12.2% of healthy sites (89/728) and 27.6% disease sites (201/726; p < .0001), but was in low copy number. Disease progression occurred in 28.4% of participants (23/81) and developed predominantly at sites identified as diseased (75/78; 96.2%). CMV and EBV were not associated with disease progression (p = .13) regardless of treatment. In contrast, disease sites were associated with higher levels of Pg, Td, Tf, and total bacteria, and sites that exhibited disease progression were associated with an abundance of Td and Tf (p < .04).

Conclusion

Disease progression was associated with Gram‐negative anaerobic bacteria; not EBV or CMV.
Assessing the potential for post‐ejaculatory female choice in a polyandrous beach‐spawning fish
Authors: Orbach Dara N. , Rooke Anna C. , Evans Jonathan P. , Pitcher Trevor E. , Purchase Craig F.
Published: December 2019

In species with limited opportunities for pre‐ejaculatory sexual selection (behavioural components), post‐ejaculatory mechanisms may provide opportunities for mate choice after gametes have been released. Recent evidence from a range of taxa has revealed that cryptic female choice (i.e., female‐mediated differential fertilization bias), through chemical cues released with or from eggs, can differentially regulate the swimming characteristics of sperm from various males and ultimately determine male fertilization success under sperm competition. We assessed the potential role that such female‐modulated chemical cues play in influencing sperm swimming characteristics in beach‐spawning capelin (Mallotus villosus), an externally fertilizing fish that mates as couples (one male and one female) or threesomes (two males and one female) with presumably limited opportunities for pre‐ejaculatory sexual selection. We assayed sperm swimming characteristics under varying doses and donor origins of egg cues and also examined the possibility of assortative mating based on body size. We found mating groups were not associated by size, larger males did not produce better quality ejaculates, and egg cues (regardless of dosage or donor identity) did not influence sperm swimming characteristics. Our findings suggest that intersexual pre‐ejaculatory sexual selection and cryptic female choice mediated by female chemical cues are poorly developed in capelin, possibly due to unique natural selection constraints on reproduction.
Exercise‐induced lordosis in zebrafish Danio rerio (Hamilton, 1822)
Authors: Printzi Alice , Fragkoulis Stefanos , Dimitriadi Anastasia , Keklikoglou Kleoniki , Arvanitidis Christos , Witten P. Eckhard , Koumoundouros George
Published: December 2019

The anabolic effect of exercise on muscles and bones is well documented. In teleost fish, exercise has been shown to accelerate skeletogenesis, to increase bone volume, and to change the shape of vertebral bodies. Still, increased swimming has also been reported to induce malformations of the teleost vertebral column, particularly lordosis. This study examines whether zebrafish (Danio rerio) develops lordosis as a result of continuous physical exercise. Zebrafish were subjected, for 1 week, to an increased swimming exercise of 5.0, 6.5 or 8.0 total body lengths (TL) per second. Control and exercise group zebrafish were examined for the presence of vertebral abnormalities, by in vivo examination, whole mount staining for bone and cartilage and histology and micro‐computed tomography (CT) scanning. Exercise zebrafish developed a significantly higher rate of lordosis in the haemal part of the vertebral column. At the end of the experiment, the frequency of lordosis in the control groups was 0.5 ± 1.3% and that in the exercise groups was 7.5 ± 10.6%, 47.5 ± 10.6% and 92.5 ± 6.0% of 5.0, 6.5 and 8.0 TL∙s−1, respectively. Histological analysis and CT scanning revealed abnormal vertebrae with dorsal folding of the vertebral body end plates. Possible mechanisms that trigger lordotic spine malformations are discussed. This is the first study to report a quick, reliable and welfare‐compatible method of inducing skeletal abnormalities in a vertebrate model during the post‐embryonic period.
Clinical relevance of innovative immunoassays for serum ustekinumab and anti‐ustekinumab antibody levels in Crohn's disease
Authors: Morita Yasuhiro , Imai Takayuki , Bamba Shigeki , Takahashi Kenichiro , Inatomi Osamu , Miyazaki Takako , Watanabe Kenji , Nakamura Shiro , Yoshida Atsushi , Endo Yutaka , Ohmiya Naoki , Tsujikawa Tomoyuki , Andoh Akira
Published: December 2019

Background and Aim

Ustekinumab is a human monoclonal antibody to the p40 subunit of human IL‐12/IL‐23. The purpose of this report is to verify the newly developed immunoassays for serum ustekinumab and anti‐ustekinumab antibody (AUA) concentrations and assess their clinical utility.

Methods

Serum ustekinumab trough levels and AUA levels were measured using new immunoassays in 38 patients with Crohn's disease under ustekinumab maintenance injection.

Results

Mean ustekinumab trough levels were 2.54 ± 2.1 μg/mL, and 3 of 38 patients (7.9%) were positive for AUAs. There was no association between ustekinumab trough levels and AUA levels. The optimal trough level of ustekinumab to maintain negative C‐reactive protein levels (≤ 0.3 mg/dL) was 1.67 μg/mL determined by receiver operating characteristic curve analysis. Ustekinumab trough level negatively but significantly correlated with C‐reactive protein, erythrocyte sedimentation rate, and Crohn's disease activity index and positively and significantly correlated with serum albumin levels. Ustekinumab trough levels were significantly higher in biologics‐naïve patients than in biologics‐experienced patients, although there was no difference in AUA levels.

Conclusions

We developed new assays for serum ustekinumab trough and AUA levels. These assays might provide new insights into therapeutic drug monitoring‐based management of Crohn's disease patients under ustekinumab therapy.
Does taking selfies lead to increased desire to undergo cosmetic surgery
Authors: Shome Debraj , Vadera Sapna , Male Shiva Ram , Kapoor Rinky
Published: December 2019

Background

India is the country with the highest number of selfie‐related deaths. However, little is known whether this selfie craze contributes toward the behavioral changes and desire to undergo cosmetic procedures & surgery.

Aim

To analyse how taking, altering and posting selfies on social media, affects individuals’ self‐esteem, confidence, body image perception and mood in the Indian population. And to see whether the practice of taking selfies leads to the promotion of self‐image dysmorphia and an increased desire to undergo cosmetic surgical procedures.

Methods

A total of 300 participants from four Indian cities (75 each from Delhi, Hyderabad, Kolkata, and Mumbai) were included in the study. The study experimentally tested whether taking and posting selfie, with and without photograph retouching, elicits changes in mood, body image, and desire to undergo cosmetic surgery among young men and women.

Results

A significant increase in the level of social anxiety (P < .004), feeling of decrease in confidence (P < .002), feeling of decrease in physical attractiveness (P < .001) and the desire to undergo cosmetic surgery (P < .001) was noted in the experimental group. Also, all the findings were higher in women compared with men.

Conclusion

This first of its kind experimental study in the Indian population highlights the deleterious effects of uploading selfies on human mankind and well‐being. The prevalent obsessively looks‐oriented culture is engulfing our youth's innocence and warrants immediate attention. Few steps taken in the right direction and at the right time can save us from the disastrous effects of this selfie craze in future.
Clinical Study of the Influence of Ambient Light Scanning Conditions on the Accuracy (Trueness and Precision) of an Intraoral Scanner
Authors: Revilla‐León Marta , Subramanian Sai Ganesh , Özcan Mutlu , Krishnamurthy Vinayak Raman
Published: December 2019

Purpose

To quantify the impact of ambient lighting conditions on the accuracy (trueness and precision) of an intraoral scanner (IOS) when maxillary complete‐arch and maxillary right quadrant digital scans were performed in a patient.

Material and Methods

One complete dentate patient was selected. A complete maxillary arch vinyl polysiloxane impression was obtained and poured using Type IV dental stone. The working cast was digitized using a laboratory scanner (E4 Dental Scanner; 3Shape) and the reference standard tessellation language (STL file) was obtained. Two groups were created based on the extension of the maxillary digital scans performed namely complete‐arch (CA group) and right quadrant (RQ) groups. The CA and RQ digital scans of the patient were performed using an IOS (TRIOS 3; 3Shape) with 4 lighting conditions chair light (CL), 10 000 lux, room light (RL), 1003 lux, natural light (NL), 500 lux, and no light (ZL), 0 lux. Ten digital scans per group at each ambient light settings (CL, RL, NL, and ZL) were consecutively obtained (n = 10). The STLR file was used to analyze the discrepancy between the digitized working cast and digital scans using MeshLab software. Kruskal‐Wallis, one‐way ANOVA, and pair‐wise comparison were used to analyze the data.

Results

Significant difference in the trueness and precision values were found across different lighting conditions where RL condition obtained the lowest absolute error compared with the other lighting conditions tested followed by CL, NL, and ZL. On the CA group, RL condition also obtained the best accuracy values, CL and NL conditions performed closely and under ZL condition the mean error presented the highest values. On the RQ group, CL condition presented the lowest absolute error when compared with the other lighting conditions evaluated. A pair‐wise multicomparison showed no significant difference between NL and ZL conditions. In all groups, the standard deviation was higher than the mean errors from the control mesh, indicating that the relative precision was low.

Conclusions

Light conditions significantly influenced on the scanning accuracy of the IOS evaluated. RL condition obtained the lowest absolute error value of the digital scans performed. The extension of the digital scan was a scanning accuracy influencing factor. The higher the extension of the digital scan performed, the lower the accuracy values obtained. Furthermore, ambient light scanning conditions influenced differently depending on the extension of the digital scans made.
Population pharmacokinetics of cefuroxime and uptake into hip and spine bone of patients undergoing orthopaedic surgery
Authors: Gergs Ulrich , Becker Lina , Okoniewski Richard , Weiss Michael , Delank Karl-Stefan , Neumann Joachim
Published: December 2019

Objectives

To reduce the incidence of peri- or postoperative infections in orthopaedic surgery, patients are prophylactically treated with antibiotics. Here, we wanted to know whether effective bone and intervertebral disc concentrations of cefuroxime are reached.

Methods

Patients undergoing surgery of hip (N = 40; 62.5% male) or spine (N = 40; 55% male) were pretreated with 1.5 g of the second-generation cephalosporin cefuroxime before surgery. We studied plasma population kinetics and bone and intervertebral disc (C5/6 till L5/S1) concentrations of cefuroxime using high-performance liquid chromatography.

Key findings

The plasma kinetics of cefuroxime in 80 patients was analysed using a population approach. The clearance amounted to 7.86 l/h. The peripheral and central volumes of distribution were estimated as 8.45 and 10.4 l, respectively. The concentrations in hip samples amounted to 9.8 ± 0.6 µg/g in cancellous bone and 8.9 ± 0.8 µg/g in cortical bone. Cefuroxime concentrations in vertebral bone and intervertebral discs were calculated as 9.6 ± 1.3 and 8.9 ± 1.1 µg/g, respectively.

Conclusion

Even if a majority of patients undergoing hip or spine surgery probably achieved adequate concentrations of cefuroxime, not all patients reached bone concentrations of cefuroxime above a recommended breakpoint for susceptible germs at the time of surgery.
Patient‐reported outcome measure for obstructive sleep apnea: Symptoms, Tiredness, Alertness, Mood and Psychosocial questionnaire: Preliminary results
Authors: Mehta Nishchay , Mandavia Rishi , Patel Ankit , Zhang Henry , Liu Zi‐Wei , Kotecha Bhik , Veer Vik
Published: December 2019

Obstructive sleep apnea (OSA) is a common chronic condition that has a significant impact on the biopsychosocial aspects of the patient's life. There is currently no psychometrically validated patient‐reported outcome measure to assess the impact of this condition on the health‐related quality of life. We designed a novel instrument based on common patient statements, prioritized by patient preference. Sixty‐three patients with OSA and 33 participants with no symptoms of sleep‐disordered breathing were asked to complete a 20‐item initial questionnaire. The acceptability, reliability and validity of the instrument were assessed using known psychometric techniques. The instrument had strong acceptability and was completed within 180 s with no missing data. Five items were removed as they had a high ceiling factor. A further three items were removed as they did not represent the central construct uniquely. The final 12‐item instrument had high internal consistency (Cronbach's alpha 0.91), strong test–retest reliability (p = .83) and high discriminant validity when comparing mean total scores of controls (6.88; 95% confidence interval [CI], 4.67–9.08) and those with OSA (31.39; 95% CI, 27.94–34.84) (p < .001). Further studies are planned to help validate this instrument for clinical use.