bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of heterotopic caesarean scar pregnancy complicated with post termination increase in size of residual mass and morbidly adherent placenta
Authors: Miyague Andre Hadyme , Chrisostomo Adriano Pienaro , Costa Sergio Luis , Nakatani Edson Tetsuya , Kondo William , Gomes Claudio Corrêa
Published: June 2017

We report a case of a secundipara with heterotopic cesarean scar pregnancy (HCSP) treated with potassium chloride injection into the ectopic embryo followed by sac aspiration. The remaining “mass” increased in size threefold and was surrounded by a rich vascular network. An arteriovenous malformation was suspected; however, appropriate treatment was precluded because of the viability of the ectopic gestation. Sonographic examination revealed a morbidly adherent placenta, and attempt to resect the mass laparoscopically was complicated by bleeding that required hysterectomy. This case illustrates a complication of the intervention performed to preserve the intrauterine gestation in case of HCSP. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 46:227–230, 2018
Region‐specific atrophy of precentral gyrus in patients with amyotrophic lateral sclerosis
Authors: Qin Yuanyuan , Zhang Shun , Jiang Rifeng , Gao Fei , Tang Xiaoying , Zhu Wenzhen
Published: June 2017

Purpose

To assess the region‐specific atrophy of precentral gyrus (PrCG) and its correlation to clinical function score in amyotrophic lateral sclerosis (ALS).

Materials and Methods

Twenty‐eight patients with sporadic ALS and 28 healthy controls underwent high‐resolution 3D T1‐BRAVO magnetic resonance imaging at 3T. The bilateral PrCG segmentations were automatically obtained from a validated segmentation pipeline based on diffeomorphic multi‐atlas likelihood fusion. Patients with ALS were further subclassified into early‐stage (ALS‐e, n = 22) and late‐stage (ALS‐l, n = 6) groups, with 12 months as a disease duration cutoff. Vertex‐based shape analysis was performed to quantify the region‐specific abnormalities of PrCG in ALS subgroups as compared to controls. In addition, we tested the statistical association between altered PrCG morphometry and clinical disability in ALS as evaluated by the revised ALS Functional Rating Scale (ALSFRS‐r).

Results

Compared to controls, vertex‐wise analysis showed that both ALS‐e and ALS‐l had significant atrophy of the dorsal‐lateral part of PrCG (P < 0.05, uncorrected). Importantly, atrophy in ALS‐e was not as widespread as that in ALS‐l; while atrophy in ALS‐e was mostly confined to the dorsal‐lateral region (P < 0.05, uncorrected, surface areas exhibiting significant difference at a level of P = 0.05: left 613.88 mm2, right 937.80 mm2), atrophy in ALS‐l occurred at the dorsal‐medial and ventral region as well (P < 0.05, uncorrected, surface areas exhibiting significant difference at a level of P = 0.05: left 1465.98 mm2, right 1253.89 mm2). Partial correlation analysis showed that the significant surface area atrophy of PrCG in ALS, especially that of the dorsal‐lateral portion, was found to link tightly with ALSFRS‐r (P < 0.05, uncorrected, surface areas exhibiting significant correlation: left 723.08 mm2, right 474.24 mm2).

Conclusion

Our findings suggest that an altered PrCG morphometry, especially atrophy of the surface area in the dorsal‐lateral portion, may be associated with the dysfunction that characterizes ALS. This study is an initial attempt to apply a validated statistical shape analysis pipeline to cortical gray matter structure like PrCG.

Level of Evidence: 1

Technical Efficacy Stage: 1

J. Magn. Reson. Imaging 2018;47:115–122.
A penetrating Raman probe with self‐referencing capability
Authors: Barco Ryan , Shimoji Yutaka , Djeu Nicholas
Published: June 2017

A penetrating Raman probe having a hypodermic needle probe head is desirable for measurements inside soft materials. The Raman probe reported in this paper not only is designed for penetration but also provides for self‐referencing. This is a significant advantage, because the measurement of Raman intensity relative to some standard is not always feasible with conventional probes. In the Raman probe described here, this capability is realized through the use of a c‐axis single‐crystal sapphire fiber as an interface between the probe body and the sample. As an illustration of how this probe can be put to use, the Raman spectrum from the interior of porcine fat has been obtained. Situations where this probe may be the preferred choice include subcutaneous and subterranean measurements as well as forensic investigations. Copyright © 2017 John Wiley & Sons, Ltd.
Laser perturbation two‐dimensional correlation Raman spectroscopy for quality control of bovine colostrum products
Authors: Zhang Zheng‐Yong , Sha Min , Wang Hai‐Yan
Published: June 2017

In this paper, laser perturbation two‐dimensional correlation Raman spectroscopy was explored as a rapid and reliable determination method for the assessment of bovine colostrum products and their analogue, namely, milk powder. Compared with the traditional instrumental analytical methods, such as chromatography, Raman spectroscopy measurements can be realized easily without the need of sample preparation. Two‐dimensional correlation spectroscopy can enhance the spectral resolution and provide more useful information of samples. Laser perturbation technique is a new way, which has been developed in this work; additionally, only few minutes (<5 min) are in demand of the whole experiment process for one sample. Correlation coefficient method was employed to quantitatively analyze the similarities between bovine colostrum products and the other brands of milk powder that include bovine colostrum products containing some milk powder based on the developed two‐dimensional correlation Raman spectroscopy. The results showed that the correlation coefficients between each bovine colostrum product with their mean value could reach 0.991 ± 0.003, which indicated that there were high similarities between these products. Under the same experimental conditions, the correlation coefficients between the bovine colostrum product (mean) and the other brands of milk powder that include bovine colostrum products containing some milk powder were located in the range of 0.596–0.761, far below the 0.991 ± 0.003. Hence, these results clearly demonstrated the utility of the laser perturbation two‐dimensional correlation Raman spectroscopy combined with correlation coefficient as a rapid method for quality control of bovine colostrum products. Copyright © 2017 John Wiley & Sons, Ltd.
Efficient approach for the extraction of proanthocyanidins from Cinnamomum longepaniculatum leaves using ultrasonic irradiation and an evaluation of their inhibition activity on digestive enzymes and antioxidant activity in vitro
Authors: Liu Zaizhi , Mo Kailin , Fei Shimin , Zu Yuangang , Yang Lei
Published: June 2017

Proanthocyanidins were separated for the first time from Cinnamomum longepaniculatum leaves. An experiment‐based extraction strategy was used to research the efficiency of an ultrasound‐assisted method for proanthocyanidins extraction. The Plackett–Burman design results revealed that the ultrasonication time, ultrasonic power and liquid/solid ratio were the most significant parameters among the six variables in the extraction process. Upon further optimization of the Box–Behnken design, the optimal conditions were obtained as follows: extraction temperature, 100°C; ethanol concentration, 70%; pH 5; ultrasonication power, 660 W; ultrasonication time, 44 min; liquid/solid ratio, 20 mL/g. Under the obtained conditions, the extraction yield of the proanthocyanidins using the ultrasonic‐assisted method was 7.88 ± 0.21 mg/g, which is higher than that obtained using traditional methods. The phloroglucinolysis products of the proanthocyanidins, including the terminal units and derivatives from the extension units, were tentatively identified using a liquid chromatography with tandem mass spectrometry analysis. Cinnamomum longepaniculatum proanthocyanidins have promising antioxidant and anti‐nutritional properties. In summary, an ultrasound‐assisted method in combination with a response surface experimental design is an efficient methodology for the sufficient isolation of proanthocyanidins from Cinnamomum longepaniculatum leaves, and this method could be used for the separation of other bioactive compounds.
The complete genome sequence of Exiguobacterium arabatum W‐01 reveals potential probiotic functions
Authors: Cong Meinan , Jiang Qingling , Xu Xiaojin , Huang Lixing , Su Yongquan , Yan Qingpi
Published: June 2017

Shrimp is extensively cultured worldwide. Shrimp farming is suffering from a variety of diseases. Probiotics are considered to be one of the effective methods to prevent and cure shrimp diseases. Exiguobacterium arabatum W‐01, a gram‐positive and orange‐pigmented bacterium, was isolated from the intestine of a healthy Penaeus vannamei specimen. Whole‐genome sequencing revealed a genome of 2,914,854 bp, with 48.02% GC content. In total, 3,083 open reading frames (ORFs) were identified, with an average length of 843.98 bp and a mean GC content of 48.11%, accounting for 89.27% of the genome. Among these ORFs, 2,884 (93.5%) genes were classified into Clusters of Orthologous Groups (COG) families comprising 21 functional categories, and 1,650 ORFs were classified into 83 functional Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. A total of 27 rRNA operons and 68 tRNAs were identified, with all 20 amino acids represented. In addition, 91 genomic islands, 68 potential prophages, and 33 tandem repeats, but no clustered regularly interspaced short palindromic repeats (CRISPRs), were found. No resistance genes and only one virulence gene were identified. Among the 150 secreted proteins of E. arabatum W‐01, a variety of transport system substrate‐binding proteins, enzymes, and biosynthetic proteins, which play important roles in the uptake and metabolism of nutrients, were found. Two adherence‐related protein genes and 31 flagellum‐related protein genes were also identified. Taken together, these results indicate potential probiotic functions for E. arabatum W‐01.
Projection of the prevalence of Parkinson's disease in the coming decades: Revisited
Authors: Rossi Alexander , Berger Kristin , Chen Honglei , Leslie Douglas , Mailman Richard B. , Huang Xuemei
Published: June 2017

Objective

Previous studies have estimated future PD prevalence based on population aging. This study revisits that projection by accounting for the potential impact of declining rates of smoking.

Methods

The age‐ and gender‐stratified smoking prevalence in the United States from 2000 to 2040 were obtained from the U.S. Census Bureau and the U.S. Surgeon General's Smoking Report. PD prevalence was estimated based on population aging with and without an account of the impact of declining smoking rates. Relative risks of 0.56 and 0.78 were applied for current and former smokers, respectively.

Results

Accounting for aging alone, ∼700,000 PD cases are predicted by 2040. After accounting for the declining smoking prevalence, ∼770,000 cases, an increase of ∼10% over the estimate without smoking, is predicted.

Conclusions

If the epidemiological association of smoking and PD is causal, projecting future cases without considering smoking may underestimate disease burden, underscoring the urgency of adequate resource allocation. © 2017 International Parkinson and Movement Disorder Society
25‐Hydroxyvitamin D3 and its C‐3 epimer are elevated in the skin and serum of Skh‐1 mice supplemented with dietary vitamin D3
Authors: Teegarden Matthew D. , Campbell Amanda R. , Cooperstone Jessica L. , Tober Kathleen L. , Schwartz Steven J. , Oberyszyn Tatiana M.
Published: June 2017

Scope

UV exposure is a risk factor for keratinocyte carcinoma (KC) while critical for endogenous vitamin D production. We investigated dietary modulation of skin and serum 25‐hydroxyvitamin D3 (25OHD3) and its C‐3 epimer (C3epi) in a mouse model of KC. C3epi is an under‐investigated metabolite of vitamin D with respect to its biological implications.

Methods and results

Male and female Skh‐1 mice were supplemented with 25, 150 or 1000 IU/kg diet vitamin D3 for 25 weeks, with some exposed to UV light. Skin and serum vitamin D metabolites were quantitated using HPLC‐MS/MS (n = 3 per dose/sex/UV treatment). Serum and skin 25OHD3 and C3epi significantly increased with dose (P<0.0001), but with different response patterns. UV exposure significantly attenuated serum, but not skin, levels of both metabolites (P<0.001, P = 0.0287), while up‐regulating expression of renal Cyp24a1 (P < 0.01). A dose by sex interaction trended toward significance with serum and skin levels of C3epi, wherein male mice attained higher levels of C3epi with higher dietary vitamin D3. This reflected a similar, but non‐significant pattern in average tumor size.

Conclusion

The complex relationship between vitamin D and KC requires further investigation. This study provides insight into modulation of local and systemic vitamin D status with dietary supplementation.
Effects of repeated abobotulinumtoxinA injections in upper limb spasticity
Authors: Gracies Jean‐Michel , O'Dell Michael , Vecchio Michele , Hedera Peter , Kocer Serdar , Rudzinska‐Bar Monika , Rubin Bruce , Timerbaeva Sofiya L. , Lusakowska Anna , Boyer François Constant , Grandoulier Anne‐Sophie , Vilain Claire , Picaut Philippe ,   for the International AbobotulinumtoxinA Adult Upper Limb Spasticity Study Group
Published: June 2017

Introduction: The efficacy of single injections of abobotulinumtoxinA (Dysport) is established in adults with upper limb spasticity. In this study we assessed the effects of repeated injections of abobotulinumtoxinA over 1 year. Methods: Patients (n = 258, safety population) received 500 U, 1,000 U, or 1,500 U (1,500‐U dose included 500‐U shoulder injections) for up to 4 or 5 treatment cycles. Assessments included treatment‐emergent adverse events (TEAEs), muscle tone, passive and active range of motion (XV1, XA), angle of catch (XV3), Disability Assessment Scale (DAS) score, Modified Frenchay Scale (MFS) score, and Physician Global Assessment (PGA) score. Results: The incidence of TEAEs decreased across cycles. Muscle tone reduction and XV1 remained stable across cycles, whereas XV3 and XA continued to improve at the finger, wrist, and elbow flexors. DAS and PGA improved across cycles. MFS improved best with 1,500 U. Discussion: A favorable safety profile and continuous improvements in active movements and perceived and active function were associated with repeated abobotulinumtoxinA injections in upper limb muscles. Muscle Nerve 57: 245–254, 2018
The periosteal requirement and temporal dynamics of BMP2‐induced middle phalanx regeneration in the adult mouse
Authors: Dawson Lindsay A. , Yu Ling , Yan Mingquan , Marrero Luis , Schanes Paula P. , Dolan Connor , Pela Maegan , Petersen Britta , Han Manjong , Muneoka Ken
Published: June 2017

Regeneration of mammalian limbs is restricted to amputation of the distal digit tip, the terminal phalanx (P3). The adjacent skeletal element, the middle phalanx (P2), has emerged as a model system to investigate regenerative failure and as a site to test approaches aimed at enhancing regeneration. We report that exogenous application of bone morphogenetic protein 2 (BMP2) stimulates the formation of a transient cartilaginous callus distal to the amputation plane that mediates the regeneration of the amputated P2 bone. BMP2 initiates a significant regeneration response during the periosteal‐derived cartilaginous healing phase of P2 bone repair, yet fails to induce regeneration in the absence of periosteal tissue, or after boney callus formation. We provide evidence that a temporal component exists in the induced regeneration of P2 that we define as the “regeneration window.” In this window, cells are transiently responsive to BMP2 after the amputation injury. Simple re‐injury of the healed P2 stump acts to reinitiate endogenous bone repair, complete with periosteal chondrogenesis, thus reopening the “regeneration window” and thereby recreating a regeneration‐permissive environment that is responsive to exogenous BMP2 treatment.
Synthesis of 2‐Organylchalcogenyl–benzo[b]selenophenes: 1‐(2,2‐Dibromovinyl)‐2‐butylselenanylbenzenes as Precursors to Access Alkynes Susceptible to Cyclization
Authors: Perin Gelson , Roehrs Juliano A. , Hellwig Paola S. , Stach Guilherme , Barcellos Thiago , Lenardão Eder J. , Jacob Raquel G. , Luz Eduardo Q.
Published: June 2017

A convenient synthesis of 1‐(2‐organylchalcogenylethynyl)‐2‐butylselenanylbenzenes was established taking advantage of the selective reaction of 1‐(2,2‐dibromovinyl)‐2‐butylselenanylbenzenes with thiols or diorganyl diselenides. The new 1‐(2‐chalcogenylethynyl)‐2‐butylselenanylbenzenes were prepared in good yields and used as precursors of 2‐organylchalcogenylbenzo[b]selenophenes via electrophilic cyclization using I2, Br2 or PhSeBr as electrophiles. Different classes of new 3‐substituted‐ (3‐iodo, 3‐bromo, 3‐phenylselenanyl) benzo[b]selenophenes were prepared in good yields. The synthetic application of the obtained products was demonstrated employing the benzo[b]selenophenes in Suzuki and Sonogashira cross‐coupling reactions.
Who is afraid of ISIS? ISIS anxiety and its correlates
Authors: Hoffman Yaakov
Published: June 2017

Islamic State of Iraq and the Levant (ISIS) is a relatively small organization, yet it wields its terror and media campaigns efficiently. Its presence has altered security measures in many western counties. In the current study, I assess anxiety of the ISIS threat and its correlates in a convenience sample of 1,007 adult Israelis (mean age = 29.61, SD = 7.16). Findings show that being female, a lower socioeconomic status, and having elevated post‐traumatic stress disorder (PTSD) symptom levels were all associated with ISIS anxiety. Likewise, exposure to ISIS media, as well as having low resilience, was also correlated with ISIS anxiety. The correlations between ISIS anxiety on the one hand and ISIS media exposure, PTSD symptoms, and resilience on the other hand remained significant even after controlling for general anxiety symptoms. Finally, the PTSD‐ ISIS anxiety relationship was especially pronounced when resources (resilience/optimism) were low. This critical interaction also remained significant after controlling for general anxiety. Theoretical and practical ramifications of ISIS anxiety are discussed. Both resources for addressing current tasks (resilience), as well as those aimed at future outcomes (optimism), may be required for addressing ISIS anxiety, especially when PTSD symptoms are high.
Motion characteristics of a charged metal particle in insulating oil under flow state
Authors: Tang Ju , Ma Shouxiao , Zhang Mingjun , Liu Zhiyuan , Li Xingxing
Published: June 2017

Problems due to discharge by charged metal particles in insulating oil under flow state are examined in this study. The motion characteristics of a charged metal particle in a horizontal transformer oil tract are investigated, and a mechanical model of a charged metal particle under flowing oil and an AC field is proposed. The particle's equations of motion are numerically solved using the fourth‐order Runge–Kutta computational algorithm. The trajectory of a spherical iron particle in typical motion state under flowing oil and AC field is simulated. The influence on the motion characteristics of a charged metal particle in terms of the oil flow rate, electric field strength of the oil tract, particle scale, initial state, and particle rotation is analyzed. Results reveal that when a charged metal particle is moving fast along the direction of oil tract flow, reciprocating oscillation simultaneously occurs in the vertical direction. Its trajectory is significantly affected by the oil flow rate, the electric field strength of the oil tract, particle scale, initial state, and particle rotation. Moreover, the degree of oscillation of the charged metal particle may be the main cause of degradation of the insulating oil under flow state. © 2017 Institute of Electrical Engineers of Japan. Published by John Wiley & Sons, Inc.
Evaluation of metal release from battery and electronic components in soil using SR‐TXRF and EDXRF
Authors: Rodrigues dos Santos Felipe , de Almeida Eduardo , da Cunha Kemerich Pedro Daniel , Melquiades Fábio Luiz
Published: June 2017

Potentially toxic elements may be leached contaminating the soil, surface, and ground water due to the improper disposal of batteries and electronic devices. The objective of this study was to evaluate metal release from batteries and electronic components deposited in specific receptacles filled with soil in which acid rain was simulated. The leachate solution and the soil were analyzed by synchrotron radiation total reflection x‐ray fluorescence and benchtop energy dispersive x‐ray fluorescence, respectively. Results indicate that batteries released K, Mn, Fe, Cu, Zn, and Pb and electronic component released Ti, Mn, Fe, Cu, Zn, and Pb. For batteries' leachate test samples, higher amounts of Fe, Cu, Mn, Zn, and Pb have been released compared with electronic component ones under same the experimental conditions. The Fe, Cu, and Pb concentrations in battery leachate test samples were above their National Environment Council maximum permitted values (MPV) and in the electronic waste leachate ones, only the Pb concentrations was above MPV. For soil sample containing batteries K, Mn and Zn presented higher concentrations, mainly at the 10‐cm topsoil, ranging from 0.16 to 0.50, 0.27 to 8.67, and 0.03 to 1.26, in % (% w/w), respectively. The Zn–C battery soil samples present similar behavior to the alkaline ones. The impact due to the Pb release was higher in the soil test samples with electronic components, in which their concentrations ranged from 51 to 394 mg/kg, above its MPV up to 28‐cm soil layer. The X‐ray fluorescence techniques employed were suitable for water and soil environmental evaluation.
Reproducible Synthesis of a Monofluorinated Trimesate: A Versatile Linking Ligand for the Construction of Lanthanide Coordination Polymers
Authors: Krautwurst John , Lamann Rainer , Ruschewitz Uwe
Published: June 2017

The synthesis of monofluorinated trimesic acid (H3mfBTC = 2‐fluoro‐1,3,5‐benzene‐tricarboxylic acid) described in the literature leads in fact to its monopotassium salt K(H2mfBTC) (1), which was identified by a single crystal structure analysis (Pc, Z = 2). It is obtained as a single‐phase product and shows good solubility in water so that from aqueous solutions fourteen new coordination polymers with LnIII cations were synthesized and structurally characterized. Depending on the size of the cations three different structure types with different water contents were observed. For LnIII = La3+ – Nd3+ and Sm3+ – Gd3+ the composition 1∞[LnIII(mfBTC)3/3(H2O)6] was found and confirmed by a structural analysis (Cc, Z = 4; CN = 9). For LnIII = Tb3+ – Ho3+ the composition 2∞[LnIII(mfBTC)3/3(H2O)3]·H2O was obtained and confirmed by X‐ray single crystal structure analysis (C2/c, Z = 8; CN = 9). Finally, for LnIII = Er3+ – Lu3+ the composition 1∞[LnIII(mfBTC)2/2(H2O)5]·2H2O was found and again confirmed by X‐ray single crystal structure analysis (P1, Z = 2; CN = 8). Subtle changes of the cationic radii lead to different coordination spheres and thus to different compositions. The thermal stability of selected compounds representing all three structure types was investigated by DTA/TGA measurements. All compounds are stable up to at least 100 °C, before the release of water molecules starts. The EuIII and TbIII compounds show the expected intense red and green luminescence.
The crystal structure of Ac-AChBP in complex with α-conotoxin LvIA reveals the mechanism of its selectivity towards different nAChR subtypes
Authors: Xu Manyu , Zhu Xiaopeng , Yu Jinfang , Yu Jinpeng , Luo Sulan , Wang Xinquan
Published: June 2017

The α3* nAChRs, which are considered to be promising drug targets for problems such as pain, addiction, cardiovascular function, cognitive disorders etc., are found throughout the central and peripheral nervous system. The α-conotoxin (α-CTx) LvIA has been identified as the most selective inhibitor of α3β2 nAChRs known to date, and it can distinguish the α3β2 nAChR subtype from the α6/α3β2β3 and α3β4 nAChR subtypes. However, the mechanism of its selectivity towards α3β2, α6/α3β2β3, and α3β4 nAChRs remains elusive. Here we report the co-crystal structure of LvIA in complex with Aplysia californica acetylcholine binding protein (Ac-AChBP) at a resolution of 3.4 Å. Based on the structure of this complex, together with homology modeling based on other nAChR subtypes and binding affinity assays, we conclude that Asp-11 of LvIA plays an important role in the selectivity of LvIA towards α3β2 and α3/α6β2β3 nAChRs by making a salt bridge with Lys-155 of the rat α3 subunit. Asn-9 lies within a hydrophobic pocket that is formed by Met-36, Thr-59, and Phe-119 of the rat β2 subunit in the α3β2 nAChR model, revealing the reason for its more potent selectivity towards the α3β2 nAChR subtype. These results provide molecular insights that can be used to design ligands that selectively target α3β2 nAChRs, with significant implications for the design of new therapeutic α-CTxs.
Person‐centered trajectories of cultural values and behaviors among Chinese American adolescents
Authors: Syed Moin , Juang Linda P.
Published: June 2017

This study examined change in acculturation values and behavior among 310 Chinese American adolescents, and how patterns of change were related to key demographic variables and indicators of positive youth development. Dual process group‐based trajectory models of change in U.S. and Chinese values and behaviors indicated a six‐group solution for each. The results showed that acculturation value patterns were not related to gender, nativity, or parent education, but were related to family cohesion, self‐esteem, general and academic self‐efficacy, and GPA. Acculturation behavior patterns were not related to gender but were related to nativity and parent education, and were also related to general self‐efficacy and family cohesion. Taken together, our findings suggest that most trajectories of acculturation are associated with positive outcomes, but there are small groups of adolescents that function very well (those who maintain higher behavioral involvement in both) and some not very well, especially those whose behaviors are becoming more disparate over time.

Special Issue: Explaining Positive Adaptation of Immigrant Youth across Cultures.
U-shaped relationship between depression and body mass index in the Korean adults
Authors: Lee J.-H. , Park S.K. , Ryoo J.-H. , Oh C.-M. , Choi J.-M. , McIntyre R.S. , Mansur R.B. , Kim H. , Hales S. , Jung J.Y.
Published: June 2017

Background:

Although a number of studies have examined the relationship between depression and obesity, it is still insufficient to establish the specific pattern of relationship between depression and body mass index (BMI) categories. Thus, this study was aimed to investigate the relationship between depression and BMI categories.

Methods:

A cross-sectional study was conducted for a cohort of 159,390 Korean based on Kangbuk Samsung Health Study (KSHS). Study participants were classified into 5 groups by Asian-specific cut-off of BMI (18.5, 23, 25 and 30 kg/m2). The presence of depression was determined by Center for Epidemiologic Studies-Depression scales (CES-D) = 16 and = 25. The adjusted odd ratios (ORs) for depression were evaluated by multiple logistic regression analysis, in which independent variable was 5 categories of BMI and dependent variable was depression. Subgroup analysis was conducted by gender and age.

Results:

When normal group was set as a reference, the adjusted ORs for depression formed U-shaped pattern of relationship with BMI categories [underweight: 1.31 (1.14–1.50), overweight: 0.94 (0.85–1.04), obese group: 1.01 (0.91–1.12), severe obese group: 1.28 (1.05–1.54)]. This pattern of relationship was more prominent in female and young age group than male and elderly subgroup. BMI level with the lowest likelihood of depression was 18.5 kg/m2 to 25 kg/m2 in women and 23 kg/m2 to 25 kg/m2 in men.

Conclusions:

There was a U-shaped relationship between depression and BMI categories. This finding suggests that both underweight and severe obesity are associated with the increased risk for depression.
Checking the predictive accuracy of basic symptoms against ultra high-risk criteria and testing of a multivariable prediction model: Evidence from a prospective three-year observational study of persons at clinical high-risk for psychosis
Authors: Hengartner M.P. , Heekeren K. , Dvorsky D. , Walitza S. , Rössler W. , Theodoridou A.
Published: June 2017

Background:

The aim of this study was to critically examine the prognostic validity of various clinical high-risk (CHR) criteria alone and in combination with additional clinical characteristics.

Methods:

A total of 188 CHR positive persons from the region of Zurich, Switzerland (mean age 20.5 years; 60.2% male), meeting ultra high-risk (UHR) and/or basic symptoms (BS) criteria, were followed over three years. The test battery included the Structured Interview for Prodromal Syndromes (SIPS), verbal IQ and many other screening tools. Conversion to psychosis was defined according to ICD-10 criteria for schizophrenia (F20) or brief psychotic disorder (F23).

Results:

Altogether n = 24 persons developed manifest psychosis within three years and according to Kaplan–Meier survival analysis, the projected conversion rate was 17.5%. The predictive accuracy of UHR was statistically significant but poor (area under the curve [AUC] = 0.65, P < .05), whereas BS did not predict psychosis beyond mere chance (AUC = 0.52, P = .730). Sensitivity and specificity were 0.83 and 0.47 for UHR, and 0.96 and 0.09 for BS. UHR plus BS achieved an AUC = 0.66, with sensitivity and specificity of 0.75 and 0.56. In comparison, baseline antipsychotic medication yielded a predictive accuracy of AUC = 0.62 (sensitivity = 0.42; specificity = 0.82). A multivariable prediction model comprising continuous measures of positive symptoms and verbal IQ achieved a substantially improved prognostic accuracy (AUC = 0.85; sensitivity = 0.86; specificity = 0.85; positive predictive value = 0.54; negative predictive value = 0.97).

Conclusions:

We showed that BS have no predictive accuracy beyond chance, while UHR criteria poorly predict conversion to psychosis. Combining BS with UHR criteria did not improve the predictive accuracy of UHR alone. In contrast, dimensional measures of both positive symptoms and verbal IQ showed excellent prognostic validity. A critical re-thinking of binary at-risk criteria is necessary in order to improve the prognosis of psychotic disorders.
Modelling a budgetary impact analysis for funding drug-based smoking cessation therapies for patients with major depressive disorder in Spain
Authors: Rejas-Gutiérrez J. , Bruguera E. , Cedillo S.
Published: June 2017

Background:

Smoking is associated with high healthcare resource utilisation and cost to society. Patients with major depressive disorder (MDD) exhibit high susceptibility to nicotine dependence. Varenicline, bupropion and nicotine replacement therapy are all indicated for smoking cessation; however funding by the Spanish national health system (SNHS) is limited. We modelled a budgetary impact analysis (BIA) to estimate the impact of the SNHS funding drug-based therapies for smoking cessation in smokers with MDD.

Methods:

The BIA compared the current unfunded scenario versus a funded scenario (varenicline, bupropion, nicotine replacement therapy combined with medical follow-up and counselling) using the Spanish SNHS and societal perspectives. The BIA design was a hybrid model using a decision tree algorithm (population size: smokers with MDD) and Markov chains (smoking cessation attempts) over a 5-year horizon. Smoking cessation drug efficacy was derived from clinical trials, and smoking cessation costs avoided were taken from an analysis of the Spanish National Health Survey. Results were shown as incremental cost savings. Scenarios and threshold univariate sensitivity analyses tested model robustness.

Results:

The funded scenario resulted in an increase of 43,478 cessation attempts and 8930 fewer smokers after 5 years compared to the unfunded scenario. The cost of funding was €25.3 million and costs avoided were €26.5 million. There was a cumulative 5-year incremental cost saving of €1.2 million to Spanish society. Results were robust using alternative scenarios.

Conclusions:

Funding smoking cessation drugs in patients with MDD is of economic benefit to Spain and could produce net savings from the third year of implementation.
Objective features of subjective cognitive decline in a United States national database
Authors: Kielb Stephanie , Rogalski Emily , Weintraub Sandra , Rademaker Alfred
Published: June 2017

Introduction

Functional and cognitive features of subjective cognitive decline (SCD) were identified in a longitudinal database from the National Alzheimer's Coordinating Center.

Methods

Cognitively normal older adults with (SCD+) and without (SCD−) self‐reported memory complaints (N = 3915) were compared on (1) baseline Functional Assessment Questionnaire ratings, (2) baseline scores and longitudinal rate of change estimates from nine neuropsychological tests, and (3) final clinical diagnoses.

Results

SCD+ had higher baseline ratings of functional impairment, reduced episodic memory practice effects and poorer performance on neuropsychological tests of psychomotor speed and language, and higher frequencies of mild cognitive impairment and dementia diagnoses at the end of follow‐up compared with the SCD‐group.

Discussion

Subtle clinical features of SCD identified in this large cohort are difficult to detect at the individual level. More sensitive tests are needed to identify those with SCD who are vulnerable to cognitive decline and dementia.
Head or brain injuries and Alzheimer's disease: A nested case‐control register study
Authors: Tolppanen Anna‐Maija , Taipale Heidi , Hartikainen Sirpa
Published: June 2017

Introduction

Many previous studies have been limited by self‐ or proxy‐reported injury or short follow‐up. We investigated whether head or brain injuries are associated with Alzheimer's disease (AD), possible modifying factors and dose‐response relationship.

Methods

Nested register‐based case‐control study of all community dwellers who received clinically verified AD diagnosis in Finland in 2005 to 2011 (n = 70,719) and one to four matched controls for each case (n of controls = 282,862).

Results

The magnitude of association between hospital‐treated head and/or brain injuries was strongly dependent on the lag time between exposure and outcome. With a 5‐year lag time, head injury (adjusted odds ratio; 95% confidence interval 1.19; 1.15–1.23) or brain injury (1.23; 1.18–1.29) was associated with higher risk of AD. Dose‐response relationship with number and severity of injuries was observed. Associations were stronger in those with earlier onset of AD.

Conclusions

Stronger associations with shorter lag times indicate that head and/or brain injuries may also reflect the ongoing AD disease process.
Percepción de maltrato durante la residencia médica en México: medición y análisis bioético
Authors: Derive Stéphanie , Casas Martínez M. De la Luz , Obrador Vera Gregorio T. , R. Villa Antonio , Contreras Daniela
Published: June 2017

Introducción: Entre los múltiples retos que enfrenta un residente se encuentran las relaciones intrahospitalarias. En estas relaciones se han identificado maltratos hacia el residente que  interfieren con su aprendizaje. Sin embargo, se conoce poco sobre este fenómeno en México.

Objetivo: Medir la percepción de diferentes tipos de maltrato en residentes y hacer un análisis bioético de los resultados.

Método: Se aplicó una encuesta electrónica de 107 preguntas a residentes del Estado de México para medir la percepción de maltratos psicológicos, físicos, académicos y sexuales. Se preguntó sobre quiénes ejercían los maltratos y sus consecuencias. El análisis estadístico incluyó la descripción de maltrato y sus tipos específicos, así como la frecuencia de variables sociodemográficas. Se realizó regresión logística para estimar la probabilidad de maltrato en función de variables de riesgo.

Resultados: Se obtuvieron 143 respuestas (tasa de respuesta: 8.2%), 84% de los residentes refirió haber sufrido maltratos, siendo el más frecuente el psicológico (humillaciones en el 78%), seguido por el académico (guardias de castigo en 50% y negación de la enseñanza en 40%) y por el físico (16% recibieron golpes, 35% fueron privados de alimentación y  1% de ir al baño durante sus guardias, como castigo). Además 21% fue presionado a consumir alcohol contra su voluntad. Los maltratos psicológicos y físicos fueron más frecuentes en especialidades quirúrgicas que médicas. Como consecuencia de los maltratos, el 89% de los residentes reportaron burnout, 71% depresión, 78% ansiedad y 58% mala atención a sus pacientes. Los principales responsables de los maltratos fueron residentes de jerarquía superior y médicos de base.

Conclusiones: Los maltratos durante la residencia son muy frecuentes y afectan los derechos humanos y la dignidad de los residentes. También reducen la capacidad de  aprendizaje y la eficiencia de la educación médica de especialidad, en un país con alta demanda de atención de salud que requiere optimizar recursos económicos y humanos.
Uso docente de las tecnologías de la información y comunicación como material didáctico en Medicina Humana
Authors: Mendoza Rojas Hubert James , Placencia Medina Maritza Dorila
Published: June 2017

Introducción: Hoy en día, las tecnologías de la información y la comunicación (TIC) se han integrado en la vida cotidiana de tal manera que la han transformado, y que han permitido acceder al conocimiento, a la información y al aprendizaje.

Objetivo: Describir el estado actual del uso docente de las TIC como material didáctico en las asignaturas de pregrado de Medicina Humana de la Universidad Nacional Mayor de San Marcos, Lima, Perú.

Método: Se realizó un estudio descriptivo, transversal y observacional. Fueron seleccionados 81 docentes mediante un muestreo no probabilístico por conveniencia de tipo accidental. Se recolectaron los datos mediante un cuestionario mixto. Se realizó la tabulación y análisis de datos mediante Microsoft Excel 2013. Se realizó un análisis descriptivo mediante medidas de frecuencia y porcentajes.

Resultados: El 70.4% de losdocentes utiliza TIC en sus clases, lo hizo por iniciativa propia (56.8%) y de forma autodidacta (35.8%), usa herramienta de audio (44.4%), imagen (69.1%) y video (64.2%). El PowerPoint es el material didáctico TIC más utilizado (93.8%), además utilizan biblioteca digital (35.8%), YouTube (39.5%), red social (43.7%). El 49.4% utiliza aula virtual. Los docentes refieren una falta de capacitación en TIC (38.3%) y solicitan capacitación en diseño de aulas virtuales (50.6%).
Aptitudes y educación médica en tiempos oscuros. Parte I
Authors: Viniegra-Velázquez Leonardo
Published: June 2017

La parte I del ensayo sobre aptitudes y educación médica en esta época oscura, inicia con una afirmación, entender la educación realmente existente supone descifrar nuestro tiempo y reconocer, en principio, que el orden cultural (lo que nos hizo «humanos») subordinó al orden biológico y dio forma a cada periodo histórico hasta el actual caracterizado como: el agotamiento y la ruina de una civilización basada en el lucro sin límites que mercantiliza lo más sublime y lo más vil de la condición humana, y hace rentable las peores atrocidades y la devastación planetaria. ¿Cómo calificar a la educación que coexiste «en silencio» con tal degradación?, como pasiva y permisiva al tener que cumplir su papel social (real, no idealizado) de reproducir las ideas y prácticas dominantes, y ahora los atributos degradantes: pasividad, individualismo, competitividad, consumismo que subyacen al colapso civilizatorio.La educación prevalente es pasiva porque al desestimar la experiencia vital de los educandos, propicia un tipo de aprendizaje sin sentido y efímero cuya base es una idea de conocimiento como consumo y retención de información. Se especifican los caracteres de la educación pasiva en términos de programas, perfiles, actividades escolares, evaluación, idea de progreso y consecuencias sociales (cuya faz de moda son las competencias profesionales) y que, lejos de impulsar la superación espiritual, intelectual y moral de la condición humana, es «cómplice involuntaria» del colapso. Al final se hacen consideraciones acerca de la educación de los médicos y se argumenta por qué, a pesar de numerosas iniciativas de mejora, permanece presa de la educación pasiva y es arrastrada por la degradación.
Factores relacionados con la elección de una especialidad en medicina
Authors: Gutiérrez-Cirlos Carlos , Naveja J. Jesús , Sánchez-Mendiola Melchor
Published: June 2017

La elección de una especialidad médica es un proceso que está determinado por múltiples factores, tales como las características demográficas, necesidades y valores del estudiante o su percepción de las distintas especialidades. La elección de la especialidad es importante tanto para los estudiantes como para los sistemas de salud, pues desde los años 90 se ha observado un incremento en la cantidad de subespecialistas y una tendencia a elegir  de forma menos frecuente especialidades relacionadas con la atención primaria (medicina general, medicina familiar, medicina interna o pediatría). Otras opciones de formación al terminar la carrera de medicina (investigación,  docencia, otro posgrado), dependen fuertemente de la exposición del estudiante a estas opciones durante los años clínicos, al igual que optar por opciones menos conocidas (médicas o quirúrgicas) depende de haber rotado por las mismas durante la formación clínica. En algunos casos el estudiante ya ha tomado la decisión desde el principio (o antes) de la formación médica, como en el caso de aquellos que seleccionan especialidades quirúrgicas, pero en el resto la elección parece tomarse posteriormente. En esta revisión evaluamos los factores relacionados con la elección de una especialidad (con un énfasis particular en México y América Latina), de acuerdo con el modelo de elección de Bland-Meurer.
ARCHAEOLOGICAL PARASITES AS INDICATORS OF ENVIRONMENTAL CHANGE IN URBANIZING LANDSCAPES: IMPLICATIONS FOR HEALTH AND SOCIAL STATUS
Authors: Trigg Heather B. , Jacobucci Susan A. , Mrozowski Stephen A. , Steinberg John M.
Published: June 2017

Using archaeological data of two human intestinal parasites from seventeenth- to early twentieth-century contexts, we explore the intersection of biological and cultural variables that shaped the ecology of cities in northeastern North America during the modern period. These parasites are useful because they require a developmental period in the soil, thus providing a link between human activities and changing environments. Prior to the last decades of the eighteenth century, Trichuris eggs dominate the archaeoparasitological assemblage. Around 1800, there is a shift to increasing proportions of Ascaris eggs, which appears to be largely complete by 1850—a period of increasing urbanization in the northeast United States. Both environmental and behavioral factors play a role in this shift and include the relationship between parasite biology and changing microenvironments, attempts to deal with waste, and use of urban spaces. During this period, poorer households would likely have been at greater risk of parasites because of the ways they used yard spaces, their delayed access to sanitary technology, and the changing nature of urban vegetation in densely occupied neighborhoods.
Super- and sub-rotating equatorial jets in shallow water models of Jovian atmospheres: Newtonian cooling versus Rayleigh friction
Authors: Warneford Emma S. , Dellar Paul J.
Published: June 2017

Numerical simulations of the shallow water equations on rotating spheres produce mixtures of robust vortices and alternating zonal jets, as seen in the atmospheres of the gas giant planets. However, simulations that include Rayleigh friction invariably produce a sub-rotating (retrograde) equatorial jet for Jovian parameter regimes, whilst observations of Jupiter show a super-rotating (prograde) equatorial jet that has persisted over several decades. Super-rotating equatorial jets have recently been obtained in shallow water simulations that include a Newtonian relaxation of perturbations to the layer thickness to model radiative cooling to space, and in simulations of the thermal shallow water equations that include a similar relaxation term in their temperature equation. Simulations of global quasigeostrophic forms of these different models produce equatorial jets in the same directions as the parent models, suggesting that the mechanism responsible for setting the direction lies within quasigeostrophic theory. We provide such a mechanism by calculating the effective force acting on the thickness-weighted zonal mean flow due to the decay of an equatorially trapped Rossby wave. Decay due to Newtonian cooling creates an eastward zonal mean flow at the equator, consistent with the formation of a super-rotating equatorial jet, while decay due to Rayleigh friction leads to a westward zonal mean flow at the equator, consistent with the formation of a sub-rotating equatorial jet. In both cases the meridionally integrated zonal mean of the absolute zonal momentum is westward, consistent with the standard result that Rossby waves carry westward pseudomomentum, but this does not preclude the zonal mean flow being eastward on and close to the equator.