bluuebunny/crossref_metadata_2025 huggingface dataset:
Person-fit feedback on inconsistent symptom reports in clinical depression care
Authors: Wanders Rob B. K. , Meijer Rob R. , Ruhé Henricus G. , Sytema Sjoerd , Wardenaar Klaas J. , de Jonge Peter
Published: November 2017

Background

Depressive patients can present with complex and different symptom patterns in clinical care. Of these, some may report patterns that are inconsistent with typical patterns of depressive symptoms. This study aimed to evaluate the validity of person-fit statistics to identify inconsistent symptom reports and to assess the clinical usefulness of providing clinicians with person-fit score feedback during depression assessment.

Methods

Inconsistent symptom reports on the Inventory of Depressive Symptomatology Self-Report (IDS-SR) were investigated quantitatively with person-fit statistics for both intake and follow-up measurements in the Groningen University Center of Psychiatry (n = 2036). Subsequently, to investigate the causes and clinical usefulness of on-the-fly person-fit alerts, qualitative follow-up assessments were conducted with three psychiatrists about 20 of their patients that were randomly selected.

Results

Inconsistent symptom reports at intake (12.3%) were predominantly characterized by reporting of severe symptoms (e.g. psychomotor slowing) without mild symptoms (e.g. irritability). Person-fit scores at intake and follow-up were positively correlated (r = 0.45). Qualitative interviews with psychiatrists resulted in an explanation for the inconsistent response behavior (e.g. complex comorbidity, somatic complaints, and neurological abnormalities) for 19 of 20 patients. Psychiatrists indicated that if provided directly after the assessment, a person-fit alert would have led to new insights in 60%, and be reason for discussion with the patient in 75% of the cases.

Conclusions

Providing clinicians with automated feedback when inconsistent symptom reports occur is informative and can be used to support clinical decision-making.
NEWS ABOUT TAXES AND EXPECTATIONS-DRIVEN BUSINESS CYCLES
Authors: Sirbu Anca-Ioana
Published: November 2017

This paper analyzes the possibility of expectations-driven business cycles to emerge in a one-sector real business cycle model if the unique driving force is news about future income tax rates. We find that good news about labor income tax rates cannot generate expectations-driven business cycles, whereas good news about capital income tax rates can. We show that a one-sector real business cycle model enriched with (i) variable capital utilization and (ii) investment adjustment costs and driven solely by news shocks about capital income tax rates is able to generate qualitatively and quantitatively realistic business cycle fluctuations. In contrast to numerous studies in the news-driven business cycle literature, our model maintains separable preferences.
Evaluation of different Ethiopian common bean, Phaseolus vulgaris (Fabaceae) genotypes for host resistance to the Mexican bean weevil, Zabrotes subfasciatus (Coleoptera: Bruchidae)
Authors: Tigist Shiferaw G. , Melis Rob , Sibiya Julia , Keneni Gemechu
Published: November 2017

Common bean (Phaseolus vulgarisL.) is amongst the most important grain legume crops in Africa in general, and Ethiopia in particular. The Mexican been weevil (Zabrotes subfasciatusBoheman) heavily attacks the grain of common bean. A total of 300 common bean entries were subjected to a ‘no-choice’ test at Melkassa Agricultural Research Centre, Ethiopia, using a randomized complete block design with three replications, to evaluate for resistance to the Mexican bean weevil. Data on insect and seed traits were collected and a significant level (P<0.01) of variation in all parameters measured was observed amongst genotypes. Relative resistance was recorded in landraces, improved genotypes and breeding lines, but the resistant genotypes, RAZ-11, RAZ-36, RAZ-2, RAZ-44, RAZ-120, RAZ-40 and MAZ-203, showed consistently complete resistance, with zero index of susceptibility value. Two other promising entries were also identified from the breeding lines (SCR-11) and landrace collections (NC-16) of Ethiopia. Stratified ranking diagrams showed that accessions from different eco-geographical origins in Ethiopia and those with different colours showed different patterns of response to infestation. The Ethiopian bean breeding programme should take up the resistant genotypes for a comprehensive yield trial at the national level and direct release them as commercial varieties. The incorporation of bean weevil resistance genes into adapted varieties through backcross breeding techniques, supported with marker assisted selection, seems to be the best strategy not only in terms of time saving but also in terms of effectiveness and efficiency.
InAlGaN/GaN with AlGaN back-barrier HEMT technology on SiC for Ka-band applications
Authors: Piotrowicz Stéphane , Jacquet Jean-Claude , Gamarra Piero , Patard Olivier , Dua Christian , Chartier Eric , Michel Nicolas , Oualli Mourad , Lacam Cedric , Potier Clément , Altuntas Philippe , Delage Sylvain
Published: November 2017

This paper presents performances achieved with InAlGaN/GaN HEMTs with 0.15 µm gate length on SiC substrate. Technology Computer Aided Design simulations were used to optimize the heterostructure. Special attention was paid to the design of the buffer structure. I-V measurements with DC and pulsed bias voltages were performed. CW measurements at millimeter waves were also carried out and are detailed in the following sections. The technology, optimized for power applications up to 45 GHz, demonstrates a current gain cut-off frequency FTof 70 GHz and a maximum available gain cut-off frequency FMAGof 140 GHz. CW Load-pull power measurements at 30 GHz enable to achieve a maximum PAE of 41% associated with an output power density of 3.5 W/mm when biased at VDS= 20 V. These devices, with an improved buffer structure show, reduced recovery time in pulsed operating conditions. These improved characteristics should have a positive impact for pulsed or modulated signal applications.
Genetic Influences on Evening Preference Overlap with Those for Bipolar Disorder in a Sample of Mexican Americans and American Indians
Authors: Melroy-Greif Whitney E. , Gizer Ian R. , Wilhelmsen Kirk C. , Ehlers Cindy L.
Published: December 2017

Diurnal preference (e.g., being an owl or lark) has been associated with several psychiatric disorders including bipolar disorder (BP), major depressive disorder, and substance use disorders. Previous large-scale genome-wide association studies (GWAS) aimed at identifying genetic influences on diurnal preference have exclusively included subjects of European ancestry. This study examined the genetic architecture of diurnal preference in two minority samples: a young adult sample of Mexican Americans (MAs), and a family-based sample of American Indians (AIs). Typed or imputed variants from exome chip data from the MA sample and low pass whole-genome sequencing from the AI cohort were analyzed using a mixed linear model approach for association with being an owl, as defined by a usual bedtime after 23:00 hrs. Genetic risk score (GRS) profiling detected shared genetic risk between evening preference and related disorders. Four variants in KIAA1549 like (KIAA1549L), a gene previously associated with attempted suicide in bipolar patients, were suggestively associated with being an owl atp< 1.82E-05; post hoc analyses showed the top variant trending in both the MA and AI cohorts atp= 2.50E-05 andp= .030, respectively. Variants associated with BP atp< .03 from the Psychiatric Genomics Consortium nominally predicted being an owl in the MA/AI cohort atp= .012. This study provides some additional evidence that genetic risk factors for BP also confer risk for being an owl in MAs/AIs and that evening preference may be a useful endophenotype for future studies of BP.
An improved ENSO simulation by representing chlorophyll-induced climate feedback in the NCAR Community Earth System Model
Authors: Kang Xianbiao , Zhang Rong-Hua , Gao Chuan , Zhu Jieshun
Published: December 2017

The El Niño-Southern oscillation (ENSO) simulated in the Community Earth System Model of the National Center for Atmospheric Research (NCAR CESM) is much stronger than in reality. Here, satellite data are used to derive a statistical relationship between interannual variations in oceanic chlorophyll (CHL) and sea surface temperature (SST), which is then incorporated into the CESM to represent oceanic chlorophyll -induced climate feedback in the tropical Pacific. Numerical runs with and without the feedback (referred to as feedback and non-feedback runs) are performed and compared with each other. The ENSO amplitude simulated in the feedback run is more accurate than that in the non-feedback run; quantitatively, the Niño3 SST index is reduced by 35% when the feedback is included. The underlying processes are analyzed and the results show that interannual CHL anomalies exert a systematic modulating effect on the solar radiation penetrating into the subsurface layers, which induces differential heating in the upper ocean that affects vertical mixing and thus SST. The statistical modeling approach proposed in this work offers an effective and economical way for improving climate simulations.
Polarimetry and spectroscopy of the “oxygen flaring” DQ Herculis-like nova: V5668 Sagittarii (2015)
Authors: Harvey E. J. , Redman M. P. , Darnley M. J. , Williams S. C. , Berdyugin A. , Piirola V. E. , Fitzgerald K. P. , O’Connor E. G. P.
Published: November 2017

Context. Classical novae are eruptions on the surface of a white dwarf in a binary system. The material ejected from the white dwarf surface generally forms an axisymmetric shell of gas and dust around the system. The three-dimensional structure of these shells is difficult to untangle when viewed on the plane of the sky. In this work a geometrical model is developed to explain new observations of the 2015 nova V5668 Sagittarii.

Aim. We aim to better understand the early evolution of classical nova shells in the context of the relationship between polarisation, photometry, and spectroscopy in the optical regime. To understand the ionisation structure in terms of the nova shell morphology and estimate the emission distribution directly following the light curve’s dust-dip.

Methods. High-cadence optical polarimetry and spectroscopy observations of a nova are presented. The ejecta is modelled in terms of morpho-kinematics and photoionisation structure.

Results. Initially observational results are presented, including broadband polarimetry and spectroscopy of V5668 Sgr nova during eruption. Variability over these observations provides clues towards the evolving structure of the nova shell. The position angle of the shell is derived from polarimetry, which is attributed to scattering from small dust grains. Shocks in the nova outflow are suggested in the photometry and the effect of these on the nova shell are illustrated with various physical diagnostics. Changes in density and temperature as the super soft source phase of the nova began are discussed. Gas densities are found to be of the order of 109 cm−3 for the nova in its auroral phase. The blackbody temperature of the central stellar system is estimated to be around 2.2 × 105 K at times coincident with the super soft source turn-on. It was found that the blend around 4640 Å commonly called “nitrogen flaring” is more naturally explained as flaring of the O II multiplet (V1) from 4638–4696 Å, i.e. “oxygen flaring”.

Conclusions. V5668 Sgr (2015) was a remarkable nova of the DQ Her class. Changes in absolute polarimetric and spectroscopic multi-epoch observations lead to interpretations of physical characteristics of the nova’s evolving outflow. The high densities that were found early-on combined with knowledge of the system’s behaviour at other wavelengths and polarimetric measurements strongly suggest that the visual “cusps” are due to radiative shocks between fast and slow ejecta that destroy and create dust seed nuclei cyclically.
Comparable Periprocedural Outcomes of Percutaneous Coronary Intervention in Male and Female Patients with Type C Lesions
Authors: Reddy Narapureddy , Lalita Nemani
Published: December 2017

Background Percutaneous coronary intervention (PCI) in type C lesions has low success and has high procedural risk. We aimed at studying the outcomes of PCI in patients with type C lesions.

Material and Methods Total 180 patients with type C lesions who underwent PCI from January 2007 to December 2014 were taken into study and analyzed.

Results Of 180 patients, 141(78.3%) were males and 39 (21.7%) were females. Mean hemoglobin concentration, mean serum triglycerides, and mean estimated glomerular filtration rate were significantly lower in females compared with males. Seventy-seven (42.8%) patients had lesions in right coronary artery, 67 (37.2%) had lesions in left anterior descending coronary artery, 31 (17.2%) had lesions in left circumflex artery, and 5 (2.8%) had left main coronary artery disease. Complex lesions were common in males. Chronic total occlusion (CTO) was found in 140 cases and other than CTO of type C lesions in 40 patients. Predilatation was done in 169 (93.9%) patients. Successful PCI was done in 157 (87.2%) patients. Lesion could not be crossed in 11 (6.1%) patients. Only plain old balloon angioplasty could be done in 9 (5%) patients. Other complications occurred in 3 (1.67%) patients. There was no difference between female and male patients in requiring predilatation or crossing the lesion or in not being able to deliver the stent.

Conclusion PCI success rate among patients with type C lesions was 87.2% with low-complication rate in the present era. There was no difference in between female and male patients in success rate or complications.
Secondary Treatment of Naso-orbital Ethmoid Injuries
Authors: Herford Alan
Published: December 2017

Central midface fractures should be treated early due to their propensity for secondary devastating and disfiguring consequences. For example, the expected sequelae to inadequately repaired naso-orbital ethmoid (NOE) injuries include shortened retruded nose, altered palpebral fissures, telecanthus, enophthalmos, and ocular dystopia, to name a few. Secondary repair of NOE fractures is indicated when primary surgical repair is not possible and for any of the aforementioned sequelae. When secondary repair of NOE fractures is necessary, these should be planned carefully while focusing on restoring facial function and aesthetics. Specific attention should focus on midface projection and intercanthal relationship. Virtual surgical planning as intraoperative navigation can be helpful for complex secondary reconstructions.
DaraEx verhindert Daratumumab-Interferenz im indirekten Antihumanglobulintest
Authors: Schneeweiß Clemens , Grüger Daniela , Heuft Hans-Gert
Published: December 2017

Daratumumab ist ein humaner, monoklonaler Anti-CD38-Antikörper, der zur Therapie des multiplen Myeloms eingesetzt wird. CD38 ist ein Oberflächenmolekül, das auf einer Reihe von Zellen und Geweben exprimiert wird, auch auf Erythrozyten. Nach Verabreichung von Daratumumab kommt es regelmäßig zur Interferenz im indirekten Antihumanglobulintest (IAT). In der Folge werden alle auf dem IAT basierenden immunhämatologischen Testverfahren (serologische Verträglichkeitsproben, Antikörpersuchtests, Antikörperdifferenzierungen) unspezifisch positiv. Die Daratumumab-Interferenz kann bis zu 6 Monate nach Ende der Behandlung auftreten. Das aktuelle Standardverfahren mit Dithiothreitol (DTT) zur Behebung der Interferenz ist mit Nachteilen verbunden (unter anderem hoher Zeitbedarf, Beeinträchtigung der Erythrozytenmembran mit Zerstörung bestimmter Blutgruppen und Hämolyse). Wir stellen hier einen neuen, einfachen und zeitsparenden Ansatz zur Vermeidung der Daratumumab-Interferenz vor, der auch den mit DTT verbundenen Erythrozytenschaden vermeidet.
Completing the story of aerobreakup with the analysis of shear-thickening liquids
Authors: Cockbill Louisa
Published: December 2017

Advanced techniques taking detailed images of shear-thickening liquids’ droplet aerobreakup complete an in-depth series of investigations into aerobreakup.
Dark matter and dark energy are rethought for an averaged theory of gravity
Authors: Larter Raima
Published: December 2017

Possible averaged theory of gravity raises questions about the nature of the universe.
Multiple warren use by subadult wild rabbits, Oryctolagus cuniculus, and its implications for disease transmission
Authors: Jennings Scott , Mutze Gregory
Published: November 2017

Context
Contact rates are a key determinant of disease transmission. Territorial behaviour has generally been considered to limit contact between European rabbits occupying different warrens, particularly during the breeding season.

Aims
We investigated warren use by subadult rabbits during a period of low population density to determine their potential role in transmission of rabbit haemorrhagic disease and myxomatosis.

Methods
Subadult rabbits were radio-collared in late summer and relocated twice-weekly for 25 weeks, during which time they grew to adult size and breeding commenced.

Key results
Rabbits of both sexes used an average of four warrens each on a regular basis, even after older rabbits had commenced breeding. Warrens used by individual rabbits formed a continuously overlapping, irregular array. Subadult rabbits did not belong to separate social groups that utilised separate groups of warrens.

Conclusions
Subadult or young adult rabbits did not display the same territorial warren fidelity that had been previously described for rabbits. They have potential to carry pathogens between warrens at a landscape scale.

Implications
Movement of subadult rabbits between warrens is therefore likely to play a critical role in disease transmission, particularly when population density is low. This may help to explain the prevalent seasonality of RHD epizootics in spring when first-born litters of each breeding season typically reach that size.
“Siamo vicini, no?”
Authors: Tudini Vincenza , Strambi Antonella
Published: December 2017

Focusing specifically on the negotiation of commonality, this study explores rapport building (Spencer-Oatey, 2000) in online intercultural text chat, where Australian students of Italian interact with L1 Italian speakers. Although the initial purpose of the examined chat exchanges is to facilitate L2 acquisition, analysis of transcripts indicates that participants also seek to establish affiliation and friendship, through discussion of shared experiences, preferred leisure activities, and personal likings. Such orientation to like-mindedness and commonality can be an implicit concern in their interactions, as well as an explicit mentionable in their talk. Participants also successfully engage in complex face-saving and rapport maintenance strategies where there is potential for disagreement. Overall, the data suggest that identified rapport-building language and behaviors promote the establishment of positive relationships, as a key component of online intercultural text chat. Thus, from a pedagogical viewpoint, these interactions appear beneficial both for L2 learning and student wellbeing. The study concludes with suggestions for the integration of similar tasks into language programs.
Sketching for large-scale learning of mixture models
Authors: Keriven Nicolas , Bourrier Anthony , Gribonval Rémi , Pérez Patrick
Published: November 2017

Learning parameters from voluminous data can be prohibitive in terms of memory and computational requirements. We propose a ‘compressive learning’ framework, where we estimate model parameters from a sketch of the training data. This sketch is a collection of generalized moments of the underlying probability distribution of the data. It can be computed in a single pass on the training set and is easily computable on streams or distributed datasets. The proposed framework shares similarities with compressive sensing, which aims at drastically reducing the dimension of high-dimensional signals while preserving the ability to reconstruct them. To perform the estimation task, we derive an iterative algorithm analogous to sparse reconstruction algorithms in the context of linear inverse problems. We exemplify our framework with the compressive estimation of a Gaussian mixture model (GMM), providing heuristics on the choice of the sketching procedure and theoretical guarantees of reconstruction. We experimentally show on synthetic data that the proposed algorithm yields results comparable to the classical expectation-maximization technique while requiring significantly less memory and fewer computations when the number of database elements is large. We further demonstrate the potential of the approach on real large-scale data (over $10^{8}$ training samples) for the task of model-based speaker verification. Finally, we draw some connections between the proposed framework and approximate Hilbert space embedding of probability distributions using random features. We show that the proposed sketching operator can be seen as an innovative method to design translation-invariant kernels adapted to the analysis of GMMs. We also use this theoretical framework to derive preliminary information preservation guarantees, in the spirit of infinite-dimensional compressive sensing.
NALT M cells are important for immune induction for the common mucosal immune system
Authors: Date Yasuhiro , Ebisawa Masashi , Fukuda Shinji , Shima Hideaki , Obata Yuuki , Takahashi Daisuke , Kato Tamotsu , Hanazato Misaho , Nakato Gaku , Williams Ifor R , Hase Koji , Ohno Hiroshi
Published: November 2017

Nasopharynx-associated lymphoid tissue (NALT) is one of the major constituents of the mucosa-associated lymphoid tissue (MALT), and has the ability to induce antigen-specific immune responses. However, the molecular mechanisms responsible for antigen uptake from the nasal cavity into the NALT remain largely unknown. Immunohistochemical analysis showed that CCL9 and CCL20 were co-localized with glycoprotein 2 (GP2) in the epithelium covering NALT, suggesting the existence of M cells in NALT. In analogy with the reduced number of Peyer’s patch M cells in CCR6-deficient mice, the number of NALT M cells was drastically decreased in CCR6-deficient mice compared with the wild-type mice. Translocation of nasally administered Salmonella enterica serovar Typhimurium into NALT via NALT M cells was impaired in CCR6-deficient mice, whereas S. Typhimurium demonstrated consistent co-localization with NALT M cells in wild-type mice. When wild-type mice were nasally administered with an attenuated vaccine strain of S. Typhimurium, the mice were protected from a subsequent challenge with wild-type S. Typhimurium. Antigen-specific fecal and nasal IgA was detected after nasal immunization with the attenuated vaccine strain of S. Typhimurium only in wild-type mice but not in CCR6-deficient mice. Taken together, these observations demonstrate that NALT M cells are important as a first line of defense against infection by enabling activation of the common mucosal immune system (CMIS).
The Curious Case of Chastine Cox: Murder, Race, Medicine and the Media in the Gilded Age
Authors: Thompson Courtney E
Published: November 2017

This paper explores the intersection of race, law and medical authority in Gilded Age New York through an examination of the trial and execution of Chastine Cox. This case was a media sensation due to two controversies which played out in the courtroom and the court of public opinion. For the public, Cox’s race inflected the debate over the crime and execution. Within the courtroom, however, controversy centred on the interpretation of medical evidence, which raised the possibility that Cox was not guilty. In particular, the defence strategy centred on medical theories of suspended animation, making use of new medical evidence about the line between life and death to prompt uncertainties both about the possibility of murder and the reliability of medical professionals. This paper demonstrates the ways in which anxieties about life, death, law, race and medicine were negotiated in courts of law and public opinion.
Comparison of the Effectiveness of a Virtual Simulator With a Plastic Arm Model in Teaching Intravenous Catheter Insertion Skills
Authors: Günay İsmailoğlu Elif , Zaybak Ayten
Published: November 2017

The objective of this study was to compare the effectiveness of a virtual intravenous simulator with a plastic arm model in teaching intravenous catheter insertion skills to nursing students. We used a randomized controlled quasi-experimental trial design and recruited 65 students who were assigned to the experimental (n = 33) and control (n = 32) groups using the simple random sampling method. The experimental group received intravenous catheterization skills training on the virtual intravenous simulator, and the control group received the same training on a plastic model of a human arm. Data were collected using the personal information form, intravenous catheterization knowledge assessment form, Intravenous Catheterization Skill Test, Self-Confidence and Satisfaction Scale, and Fear Symptoms Scale. In the study, the mean scores in the control group were 20.44 for psychomotor skills, 15.62 for clinical psychomotor skills, 31.78 for self-confidence, and 21.77 for satisfaction. The mean scores in the experimental group were 45.18 for psychomotor skills, 16.28 for clinical psychomotor skills, 34.18 for self-confidence, and 43.89 for satisfaction. The results indicated that psychomotor skills and satisfaction scores were higher in the experimental group, while the clinical psychomotor skills and self-confidence scores were similar in both groups. More students in the control group reported experiencing symptoms such as cold and sweaty hands, significant restlessness, and tense muscles than those in the experimental group.
Preclinical Optimization of a CD20-specific Chimeric Antigen Receptor Vector and Culture Conditions
Authors: Lee Sang Yun , Olsen Philip , Lee Dong Hoon , Kenoyer Aimee L. , Budde Lihua E. , O’Steen Shyril , Green Damian J. , Heimfeld Shelly , Jensen Michael C. , Riddell Stanley R. , Press Oliver W. , Till Brian G.
Published: November 2017

Chimeric antigen receptor (CAR)-based adoptive T-cell therapy is a highly promising treatment for lymphoid malignancies, and CD20 is an ideal target antigen. We previously developed a lentiviral construct encoding a third generation CD20-targeted CAR but identified several features that required additional optimization before clinical translation. We describe here several improvements, including replacement of the immunogenic murine antigen-binding moiety with a fully human domain, streamlining the transgene insert to enhance lentiviral titers, modifications to the extracellular IgG spacer that abrogate nonspecific activation resulting from binding to Fc receptors, and evaluation of CD28, 4-1BB, or CD28 and 4-1BB costimulatory domains. We also found that restimulation of CAR T cells with an irradiated CD20+ cell line boosted cell growth, increased the fraction of CAR-expressing cells, and preserved in vivo function despite leading to a reduced capacity for cytokine secretion in vitro. We also found that cryopreservation of CAR T cells did not affect immunophenotype or in vivo antitumor activity compared with fresh cells. These optimization steps resulted in significant improvement in antitumor activity in mouse models, resulting in eradication of established systemic lymphoma tumors in 75% of mice with a single infusion of CAR T cells, and prolonged in vivo persistence of modified cells. These results provide the basis for clinical testing of a lentiviral construct encoding a fully human CD20-targeted CAR with CD28 and 4-1BB costimulatory domains and truncated CD19 (tCD19) transduction marker.
The role of N-methyl-d-aspartate receptors and metabotropic glutamate receptor 5 in the prepulse inhibition paradigms for studying schizophrenia: pharmacology, neurodevelopment, and genetics
Authors: Wu Zhemeng , Yang Zhigang , Zhang Mengjiao , Bao Xiaohan , Han Fang , Li Liang
Published: November 2017

Treatments for the positive and negative symptoms of schizophrenia have been explored for decades, but no completely successful therapy has been found as yet. Metabotropic glutamate receptor 5 (mGluR5), which potentiates N-methyl-d-aspartate receptors in brain regions implicated in schizophrenia, has become a novel drug target in the treatment of schizophrenia, especially for the mGluR5-positive allosteric modulators. Individuals with schizophrenia show deficits in prepulse inhibition (PPI), which is an operational measurement of sensorimotor gating. In this review, we focus on pharmacological, neurodevelopmental, and genetic animal models of disrupted PPI, with the aim of showing the potential role of mGluR5 in modulating the activity of N-methyl-d-aspartate receptors and their contributions toward the treatment of schizophrenia. As, the impairment of attentional modulation of PPI, but not that of baseline PPI, in individuals with schizophrenia is correlated with their symptom severity, this review also highlights that investigation of attentional modulation of PPI is critical for studying both cognitive impairments and glutamatergic dysfunctions of schizophrenia.
Comparison of Pterygium Recurrence Rates Among Different Races and Ethnicities After Primary Pterygium Excision by Surgeons in Training
Authors: Campagna Giovanni , Adams Matthew , Wang Li , Khandelwal Sumitra , Al-Mohtaseb Zaina
Published: November 2017

Purpose:

To evaluate the impact of race and ethnicity, surgical technique, and level of surgeon training on recurrence rates after primary pterygium excision.

Methods:

A retrospective review of patients who underwent primary pterygium excision at our academic institution was performed. The surgical technique—conjunctival autografting (CAG) or amniotic membrane grafting (AMG)—was chosen at the attending surgeon's discretion, and all surgeries were performed by surgeons in training. The primary outcome measure was pterygium recurrence, defined as regrowth of fibrovascular tissue onto a clear cornea in the region of previous pterygium removal.

Results:

There was a significant difference in age at presentation between white (64.3 ± 11.4), Hispanic (50.0 ± 13.5), black (64.8 ± 14.5), and Asian (59.3 ± 9.2) patients (P < 0.001). Average time to recurrence was 4.4 ± 3.0 months and was similar between races (P = 0.98). There was a significant difference in recurrence rates between the white (13%), Hispanic (28%), black (33%), and Asian (0%) patients (P = 0.049). Over 12 months, a significant difference in cumulative proportion with recurrence after AMG versus CAG was observed in Hispanic (75% vs. 30%; P = 0.002) and black (100% vs. 42%; P = 0.001) patients. Sex, method of graft fixation (glue, suture, or both), and level of surgeon training showed no difference in pterygium recurrence (P > 0.05).

Conclusions:

Hispanic and black patients are more likely to experience pterygium recurrence after AMG than CAG. White patients are less likely than Hispanic or black patients to experience recurrence regardless of the surgical technique. To reduce the likelihood of recurrence, surgeons may consider race and ethnicity when selecting their operative technique.
Collagen-Based Fillers as Alternatives to Cyanoacrylate Glue for the Sealing of Large Corneal Perforations
Authors: Samarawickrama Chameen , Samanta Ayan , Liszka Aneta , Fagerholm Per , Buznyk Oleksiy , Griffith May , Allan Bruce
Published: November 2017

Purpose:

To describe the use of collagen-based alternatives to cyanoacrylate glue for the sealing of acute corneal perforations.

Methods:

A collagen analog comprising a collagen-like peptide conjugated to polyethylene glycol (CLP-PEG) and its chemical crosslinker were tested for biocompatibility. These CLP-PEG hydrogels, which are designed to act as a framework for corneal tissue regeneration, were then tested as potential fillers in ex vivo human corneas with surgically created full-thickness perforations. Bursting pressures were measured in each of 3 methods (n = 10 for each condition) of applying a seal: 1) cyanoacrylate glue with a polyethylene patch applied ab externo (gold standard); 2) a 100-μm thick collagen hydrogel patch applied ab interno, and 3) the same collagen hydrogel patch applied ab interno supplemented with CLP-PEG hydrogel molded in situ to fill the remaining corneal stromal defect.

Results:

Cyanoacrylate gluing achieved a mean bursting pressure of 325.9 mm Hg, significantly higher than the ab interno patch alone (46.3 mm Hg) and the ab interno patch with the CLP-PEG filler (86.6 mm Hg). All experimental perforations were sealed effectively using 100 μm hydrogel sheets as an ab interno patch, whereas conventional ab externo patching with cyanoacrylate glue failed to provide a seal in 30% (3/10) cases.

Conclusions:

An ab interno patch system using CLP-PEG hydrogels designed to promote corneal tissue regeneration may be a viable alternative to conventional cyanoacrylate glue patching for the treatment of corneal perforation. Further experimentation and material refinement is required in advance of clinical trials.
Role of Confocal Microscopy in the Diagnosis of Pythium insidiosum Keratitis
Authors: Anutarapongpan Orapin , Thanathanee Onsiri , Worrawitchawong Jittraporn , Suwan-apichon Olan
Published: November 2017

Purpose:

To investigate the role of in vivo confocal microscopy for detection of Pythium insidiosum keratitis.

Methods:

Medical records and confocal microscopy findings of 20 patients (21 eyes) with culture- or polymerase chain reaction–proven P. insidiosum keratitis diagnosed at the Khon Kaen University Eye Center from January 2009 to December 2015 were retrospectively reviewed. Confocal microscopy was performed using Nidek ConfoScan 4. The images from 21 eyes with P. insidiosum keratitis and 4 other fungal keratitides were analyzed visually for morphology of the hyphae and special characteristics that would enable physicians to distinguish P. insidiosum keratitis from other fungal keratitides.

Results:

A total of 21 eyes of 20 patients were included in the study. Fourteen (70%) were men, and 6 (30%) were women. In vivo confocal microscopy was able to identify hyphae in 20 of 21 eyes (95%). Beaded string-like hyperreflective branching structures with mean branching angles at 78.6 degrees or thin hyperreflective long lines were found in confocal microscopy findings of P. insidiosum keratitis. The diameter of the hyphae varied from 1.5 to 7.5 μm.

Conclusions:

P.
insidiosum keratitis is a severe progressive infectious corneal disease that causes vision loss in most patients. Confocal microscopy may provide rapid in vivo visualization of P. insidiosum hyphae in corneal tissues, but it cannot distinguish P. insidiosum from other fungal keratitides. Culture identification with zoospore induction or polymerase chain reaction remains the most reliable means to confirm the diagnosis of P. insidiosum keratitis.
Can Appropriate Systemic Treatment Help Protect the Cornea in Patients With Rheumatoid Arthritis? A Multidisciplinary Approach to Autoimmune Ocular Involvement
Authors: Amador-Patarroyo Manuel J. , Jalil-Florencia Emilio , Otero-Marquez Oscar , Molano-Gonzalez Nicolás , Mantilla Ruben D. , Rojas-Villarraga Adriana , Anaya Juan-Manuel , Barraquer-Coll Carmen
Published: November 2017

Purpose:

To correlate rheumatologic with ophthalmic and laboratory findings in patients with rheumatoid arthritis (RA) to identify what effect these have on development of ocular disease.

Methods:

This is a cross-sectional study of 172 eyes of 86 patients with RA. Patients were examined by a group of rheumatologists. Sociodemographic, clinical, and laboratory data were collected. All patients underwent complete ophthalmologic examination including corneal topography and endothelial cell count.

Results:

There was no significant correlation between RA-negative prognostic indicators (NPIs) and pathologic corneal findings. Patients using disease-modifying antirheumatic drugs (DMARDs) and antimalarial drugs had greater corneal volumes (mean difference 8.51 mm3, 90% confidence interval [CI], 3.98–13.04, P = 0.004; and 2.24, 90% CI, 0.32–4.54, P = 0.048, respectively). Patients using azathioprine had lower endothelial cell counts compared with those using other drugs (mean difference 180 cells/mm2, 90% CI, 69–291, P = 0.008). Patients using biologic DMARDs had better tear osmolarity values (between 280 and 300 mOsm/L) than patients not using them (mean difference 14.3 mOsm/L, P = 0.022). There was no correlation between NPIs of RA and positive keratoconus screening indices (Spearman correlation OD −0.013, P = 0.91; OS −0.033, P = 0.76).

Conclusions:

There was no clear correlation between RA-NPIs and pathologic corneal findings in our study. DMARDs treatment may help maintain corneal integrity in our patients and prevented collagenolytic manifestations of RA. Other medications such as azathioprine should be used carefully, as endothelial damage may potentially occur.
Patient, Primary Care Provider, and Specialist Perspectives on Specialty Care Coordination in an Integrated Health Care System
Authors: Vimalananda Varsha G. , Dvorin Kelly , Fincke B. Graeme , Tardiff Nicole , Bokhour Barbara G.
Published: November 2017

Successful coordination of specialty care requires understanding the perspectives of patients, primary care providers, and specialists—that is, the specialty care “triad.” This study used qualitative methods to compare these perspectives in an integrated health care system, using diabetes specialty care as an exemplar. Primary care providers and endocrinologists relied on interclinician relationships to coordinate care. Clinicians rarely included patients or other staff in their conceptualization of specialty care coordination. Patients often assumed responsibility for specialty care coordination but struggled to succeed. We identified several opportunities to improve coordination across the triad. In an integrated medical system, the shared organizational structure can facilitate these efforts.
Primary Care and the Hypertension Care Continuum in Brazil
Authors: Macinko James , Leventhal Daniel G. P. , Lima-Costa Maria Fernanda
Published: November 2017

This study provides estimates of hypertension prevalence, awareness, treatment, and control in Brazil and assesses how well different modes of primary care delivery achieve each of these outcomes. Over one-third of the Brazilian adult population had measured hypertension or prior diagnosis. Nearly 90% of these had recent contact with the health system, but only 65% were aware of their condition. Only 62% of these regularly sought care for hypertension, but of these 92% received treatment. Hypertension control was 33% overall, but increased to 57% among those who received all levels of care.
A Pilot Study of a Topical Intervention for Treatment of Female Sexual Dysfunction
Authors: Gomaa Adel Abdel-Wadood , Abdel Aziz Nermeen M. , Thabet Romany H. , Fouly Howieda A. , Altellawy Sara H. , Gomaa Ghada A.
Published: November 2017

Purpose/Background

Many investigators reported that pharmacological treatment of female sexual dysfunction (FSD) has been a promising field yet to be explored. The purpose of this pilot study was to investigate the efficacy and safety of a topical cream containing small concentrations of three vasodilators with different mechanisms of action in treating FSD.

Methods

In this randomized, controlled pilot trial, premenopausal (n = 30) and postmenopausal (n = 30) cases of 21- to 62-year age range with FSD were allocated randomly into 15 given placebo or 15 given active cream in each group. The women included had FSD for more than a 6-month duration and a total score of Female Sexual Distress Scale-Revised of at least 15. Assessing sexual function by measuring female sexual function index (FSFI) during five clinic visits, one at the end of baseline week and at the end of each week of the 4-week treatment period. The primary end point was changed from baseline FSFI total scores to week 4 treatment. Secondary end point included the changes from baseline arousal, desire, orgasm, and satisfaction scores to week 4 treatment.

Findings/Results

The sexual problem reported by patients was orgasmic or/and arousal disorders. In premenopausal cases, active cream led to a high significant increase in mean change FSFI total score from the baseline to week 4 compared with placebo (1.7 ± 1.886 vs 13.35 ± 4.646, respectively; P < 0.0001). Greater improvement of mean change of orgasm and arousal domain score was also observed (0.3 ± 0.45 and 0.35 ± 0.39 vs. 2.66 ± 0.63 and 1.87 ± 0.168, respectively; P < 0.0001). In postmenopausal cases, there were significantly greater improvements with active cream in all sexual functions compared with placebo cream (P < 0.0001). In triple cream, mean change of FSFI total score, orgasm domain score, and arousal score domain were 14.85 ± 6.33, 1.87 ± 0.168 and 2.66 ± 1.182, whereas in the placebo cream, they were 1.54 ± 2.1,0.7 ± 0.76 and 0.22 ± 0.44, respectively. Meanwhile, orgasm scores increased significantly after the use of placebo cream. No serious adverse effects were reported during treatment.

Implications/Conclusions

The results of the pilot trial suggest that topical cream containing small concentrations of three vasodilators may act synergistically, and was effective in improving arousal, orgasmic, and satisfaction disorder with a safer profile for premenopausal and postmenopausal women with FSD. Further studies are recommended to be conducted using a large number of nondepressive and depressive patients.
Utilization of Research Findings and Barriers in Pediatric Surgical Nurses in Turkey
Authors: Esenay Figen Isik , Calik Ceren , Doru Ozlem , Gedik Gamze
Published: November 2017

Background

The aim of this study was to investigate the utilization of research and perceived barriers to research utilization in nurses employed in pediatric surgery departments.

Method

The study population included all nurses employed in pediatric surgery departments in Turkey, whereas the study sample consisted of 102 pediatric surgical nurses selected by stratified random sampling method by region. A questionnaire on demographic features and research activities of the nurses and the Barriers to Research Utilization Scale were used as data collection tools. The data were collected online and analyzed by using the SPSS program.

Results

In this study, the “greatest barrier” for the nurses working in pediatric surgery departments was detected as “The nurse feels results are not generalizable to own setting” (37.3%). In the subgroups of Barriers to Research Utilization Scale, the items in the characteristics of workplace subscale were perceived as the greatest barriers.

Conclusion

Utilization of research in pediatric surgical nursing practice was found to be mostly affected by the features of workplace (settings). We think that research utilization might be increased by making necessary institutional arrangements, developing strategies for the use of clinical research, and providing nurses with educational and research opportunities.
Appropriate use of laboratory test requests in the emergency department: a multilevel intervention
Authors: Nazerian Peiman , Vanni Simone , Fanelli Alessandra , Fallai Linda , Duranti Cesare , Ognibene Agostino , Rapi Stefano , Betti Laura , Tomaiuolo Matteo , Calamai Monica , Grifoni Stefano
Published: November 2017

Objective

Laboratory test requests in the emergency department (ED) are increasing worldwide. We evaluated whether a multilevel intervention on the basis of the optimization of test profiles and educational meetings with physicians could reduce the number of tests ordered.

Patients and methods

In a single-center before and after study design, the 8-month intervention period was compared with the 8-month preintervention period. Laboratory test profiles were reduced from 6 to 2 and the number of tests in each profile was reduced by 50%. All physicians received education about the costs and appropriate use of the tests. Primary outcomes were the number of laboratory blood tests and their costs, with a focus on high-cost tests. Secondary outcomes were ED and laboratory performances (patients’ waiting time, number of deaths in ED, re-entry, laboratory turn-around time, and add-on tests).

Results

Overall, 61 976 and 61 154 patients were evaluated, respectively, during the intervention and the preintervention period. Laboratory blood test requests were decreased by 207 637 (−36.3%) in the intervention period (P < 0.05), which corresponds to a reduction of 337.3 tests/100 patients. Costs were decreased by 608 079€ ( − 29.6%, P < 0.05), leading to a cost reduction of 981.2€/100 patients. High-cost test requests decreased by 11 457 ( − 27.3%) and contributed toward the overall reduction in costs with 197 206€ ( − 30.5%). No significant differences were found in ED and laboratory performances between intervention and preintervention periods.

Conclusions

Optimization of test profiles and education on the costs and appropriate use of the tests significantly reduced laboratory test ordering and costs without affecting ED and laboratory performances.
Changes in Case-Mix and Health Outcomes of Medicare Fee-for-Service Beneficiaries and Managed Care Enrollees During the Years 1992–2011
Authors: Koroukian Siran M. , Basu Jayasree , Schiltz Nicholas K. , Navale Suparna , Bakaki Paul M. , Warner David F. , Dor Avi , Given Charles W. , Stange Kurt C.
Published: November 2017

Background:

Recent studies suggest that managed care enrollees (MCEs) and fee-for-service beneficiaries (FFSBs) have become similar in case-mix over time; but comparisons of health outcomes have yielded mixed results.

Objective:

To examine changes in differentials between MCEs and FFSBs both in case-mix and health outcomes over time.

Design:

Temporal study of the linked Health and Retirement Study (HRS) and Medicare data, comparing case-mix and health outcomes between MCEs and FFSBs across 3 time periods: 1992–1998, 1999–2004, and 2005–2011. We used multivariable analysis, stratified by, and pooled across the study periods. The unit of analysis was the person-wave (n=167,204).

Subjects:

HRS participants who were also enrolled in Medicare.

Measures:

Outcome measures included self-reported fair/poor health, 2-year self-rated worse health, and 2-year mortality. Our main covariate was a composite measure of multimorbidity (MM), MM0–MM3, defined as the co-occurrence of chronic conditions, functional limitations, and/or geriatric syndromes.

Results:

The case-mix differential between MCEs and FFSBs persisted over time. Results from multivariable models on the pooled data and incorporating interaction terms between managed care status and study period indicated that MCEs and FFSBs were as likely to die within 2 years from the HRS interview (P=0.073). This likelihood remained unchanged across the study periods. However, MCEs were more likely than FFSBs to report fair/poor health in the third study period (change in probability for the interaction term: 0.024, P=0.008), but less likely to rate their health worse in the last 2 years, albeit at borderline significance (change in probability: −0.021, P=0.059).

Conclusions:

Despite the persistence of selection bias, the differential in self-reported fair/poor status between MCEs and FFSBs seems to be closing over time.