bluuebunny/crossref_metadata_2025 huggingface dataset:
Combined Transcranial Direct Current Stimulation and Vision Restoration Training in Subacute Stroke Rehabilitation: A Pilot Study
Authors: Alber Raimund , Moser Hermann , Gall Carolin , Sabel Bernhard A.
Published: January 2017

Background

Visual field defects after posterior cerebral artery stroke can be improved by vision restoration training (VRT), but when combined with transcranial direct current stimulation (tDCS), which alters brain excitability, vision recovery can be potentiated in the chronic stage. To date, the combination of VRT and tDCS has not been evaluated in postacute stroke rehabilitation.

Objectives

To determine whether combined tDCS and VRT can be effectively implemented in the early recovery phase following stroke, and to explore the feasibility, safety and efficacy of an early intervention.

Design

Open‐label pilot study including a case series of 7 tDCS/VRT versus a convenience sample of 7 control patients (ClinicalTrials.gov ID: NCT02935413).

Setting

Rehabilitation center.

Subjects

Patients with homonymous visual field defects following a posterior cerebral artery stroke.

Methods

Seven homonymous hemianopia patients were prospectively treated with 10 sessions of combined tDCS (2.mA, 10 daily sessions of 20 minutes) and VRT at 66 (±50) days on average poststroke. Visual field recovery was compared with the retrospective data of 7 controls, whose defect sizes and age of lesions were matched to those of the experimental subjects and who had received standard rehabilitation with compensatory eye movement and exploration training.

Results

All 7 patients in the treatment group completed the treatment protocol. The safety and acceptance were excellent, and patients reported occasional skin itching beneath the electrodes as the only minor side effect. Irrespective of their treatment, both groups (treatment and control) showed improved visual fields as documented by an increased mean sensitivity threshold in decibels in standard static perimetry. Recovery was significantly greater (P < .05) in the tDCS/VRT patients (36.73% ± 37.0%) than in the controls (10.74% ± 8.86%).

Conclusion

In this open‐label pilot study, tDCS/VRT in subacute stroke was demonstrated to be safe, with excellent applicability and acceptance of the treatment. Preliminary effectiveness calculations show that tDCS/VRT may be superior to standard vision training procedures. A confirmatory, larger‐sample, controlled, randomized, and double‐blind trial is now underway to compare real‐tDCS− versus sham‐tDCS−supported visual field training in the early vision rehabilitation phase.

Level of Evidence

IV
Patient‐Centered Goal Setting in a Hospital‐Based Outpatient Stroke Rehabilitation Center
Authors: Rice Danielle B. , McIntyre Amanda , Mirkowski Magdalena , Janzen Shannon , Viana Ricardo , Britt Eileen , Teasell Robert
Published: January 2017

Background

Goal‐setting can have a positive impact on stroke recovery during rehabilitation. Patient participation in goal formulation can ensure that personally relevant goals are set, and can result in greater satisfaction with the rehabilitation experience, along with improved recovery of stroke deficits. This, however, not yet been studied in a stroke outpatient rehabilitation setting.

Objective

To assess patient satisfaction of meeting self‐selected goals during outpatient rehabilitation following a stroke.

Design

Retrospective chart review.

Setting

Stroke patients enrolled in a multidisciplinary outpatient rehabilitation program, who set at least 1 goal during rehabilitation.

Participants

Patients recovering from a stroke received therapy through the outpatient rehabilitation program between January 2010 and December 2013.

Methods

Upon admission and discharge from rehabilitation, patients rated their satisfaction with their ability to perform goals that they wanted to achieve. Researchers independently sorted and labeled recurrent themes of goals. Goals were further sorted into International Classification of Functioning, Disability and Health (ICF) categories. To compare the perception of patients' goal satisfaction, repeated‐measures analysis of variance was conducted across the 3 ICF goal categorizations.

Main Outcome Measure

Goal satisfaction scores.

Results

A total of 286 patients were included in the analysis. Patient goals concentrated on themes of improving hand function, mobility, and cognition. Goals were also sorted into ICF categories in which impairment‐based and activity limitation−based goals were predominant. Compared to activity‐based and participation‐based goals, patients with impairment‐based goals perceived greater satisfaction with meeting their goals at admission and discharge (P < .001). Patient satisfaction in meeting their first‐, second‐, and third‐listed goals each significantly improved by discharge from the rehabilitation program (P < .001).

Conclusion

Within an outpatient stroke rehabilitation setting, patients set heterogeneous goals that were predominantly impairment based. Satisfaction in achieving goals significantly improved after receiving therapy. The type of goals that patients set were related to their goal satisfaction scores, with impairment‐based goals being rated significantly higher than activity‐based and participation‐based goals.

Level of Evidence

III
The Course of Concussion Recovery in Children 6‐12 Years of Age: Experience From an Interdisciplinary Rehabilitation Clinic
Authors: Risen Sarah R. , Reesman Jennifer , Yenokyan Gayane , Slomine Beth S. , Suskauer Stacy J.
Published: January 2017

Background

Current concussion evidence is derived largely from teenagers and adults. Concussion in younger children occurs within the context of neuromaturation, with differing age‐based pathophysiological responses to injury. Therefore, our current understanding of concussion in older children and adults is unlikely to directly apply to younger children.

Objective

To describe patient variables, clinical course, and factors associated with time to discharge from concussion care in children 6‐12 years of age with concussion treated in an interdisciplinary rehabilitation‐based concussion clinic.

Design

Retrospective chart review.

Setting

Interdisciplinary concussion clinic at an academically affiliated rehabilitation center.

Patients

Children aged 6‐12 years (n = 105; mean 10.8 years of age, 70% male) seen within 60 days of concussive injury.

Main Outcome Measurements

Descriptive statistics explored demographic, injury, and clinical features. The primary outcome measure, time to discharge from concussion care, was estimated with survival‐analysis methods based on the date of discharge from the clinic. Multivariate models were used to examine factors associated with longer time to discharge.

Results

Median time to discharge was 34 days postinjury (range 5‐192 days); 75% of children were discharged within 60 days of injury. A minority reported persisting symptoms at discharge. Younger age and increased symptom burden at initial evaluation predicted longer time to discharge.

Conclusions

Although children 6‐12 years old treated in a specialty concussion clinic show variability in time to discharge from concussion care, most were discharged within 2 months after injury. Risk factors for prolonged recovery, such as younger age and greater symptom burden at initial visit, can be used when counseling families and planning interventions. There may be varying contributions, including psychosocial stressors, to ongoing symptoms in children who experience persisting symptoms after other concussion‐related concerns have resolved. Future work focused on the subset of children who report persisting symptoms will be useful for developing an evidence base related to their care.

Level of Evidence

II
Long‐Term Dosing of Intrathecal Baclofen in the Treatment of Spasticity After Acquired Brain Injury
Authors: Maneyapanda Mithra B. , McCormick Zachary L. , Marciniak Christina , Reger Christopher
Published: January 2017

Background

Intrathecal baclofen (ITB) often is used to treat severe spasticity of cerebral origin. Although literature exists regarding the efficacy of ITB, there has been minimal investigation related to dosing in the adult‐acquired brain injury population, particularly at long‐term duration.

Objective

To investigate long‐term dosing of ITB in adult patients with spasticity of cerebral origin due traumatic brain injury (TBI), stroke, and hypoxic‐ischemic encephalopathy (HIE).

Design

Retrospective cohort study.

Setting

An academic outpatient rehabilitation clinic.

Patients

Forty‐two adult patients with spasticity secondary to TBI, stroke, or HIE treated with ITB for greater than 3 years.

Methods

Medical records and device manufacturer records of included patients were reviewed to obtain demographic data, dosing information, dates of pump and catheter placements, and revisions.

Main Outcome Measure

Average daily ITB doses and mean change in ITB dose over 1, 2, and 3 years. Goal of ITB treatment (active function versus comfort/care/positioning) also was compared.

Results

Of 42 total patients, spasticity was attributed to either TBI (n = 19), stroke (n = 11), or HIE (n = 12). The mean (standard deviation) age was 35.21 (10.17), 56.7 (13.1), and 35.1 (12.4) years for the TBI, stroke, and HIE groups, respectively (P < .001). There was a significant difference in the goal of therapy with “improving functional independence,” accounting for 27.8%, 72.8%, and 0% in the TBI, stroke, and HIE groups, respectively (P = .002). The mean duration of ITB therapy was 8.5 (5.0), 7.8 (3.4), and 9.1 (4.6) years in the TBI, stroke, and HIE groups, respectively (P = .79). The mean daily ITB dose was 596.9 (322.8) μg/d, 513.2 (405.7) μg/d, and 705.2 (271.7) μg/d for the TBI, stroke, and HIE groups, respectively (P = .39). In the subset of the cohort with ITB therapy for more than 5 years, the mean percent change in daily ITB dose between time of chart review and 1, 2, and 3 years previously was 7.3% (13.6), 12.7% (16), and 24.7% (50.3), respectively. A complex dosing pattern was used more frequently in those with stroke (36.4%) compared with the TBI and HIE (9.7%) groups (P = .04).

Conclusion

Despite the long‐term use of ITB therapy in this cohort, the mean daily dose of ITB continued to require adjustments. There was no significant difference in the mean daily dose between patients with a diagnosis of TBI, stroke, or HIE. A complex dosing pattern was used more frequently in patients with stroke.

Level of Evidence

III
Return to the Primary Acute Care Service Among Patients With Multiple Myeloma on an Acute Inpatient Rehabilitation Unit
Authors: Fu Jack B. , Lee Jay , Shin Ben C. , Silver Julie K. , Smith Dennis W. , Shah Jatin J. , Bruera Eduardo
Published: January 2017

Background

Pancytopenia, immunosuppression, and other factors may place patients with multiple myeloma at risk for medical complications. These patients often require inpatient rehabilitation. No previous studies have looked at risk factors for return to the primary acute care service of this patient population.

Objective

To determine the percentage of and factors associated with return to the primary acute care service of multiple myeloma rehabilitation inpatients.

Design

Retrospective review.

Setting

Acute inpatient rehabilitation unit within a National Cancer Institute Comprehensive Cancer Center.

Participants

All patients with multiple myeloma admitted to the inpatient rehabilitation unit between March 1, 2004, and February 28, 2015.

Main Outcome Measures

Return to the primary acute care service was analyzed with demographic information, multiple myeloma characteristics, medications, laboratory values, and hospital admission characteristics.

Results

One hundred forty‐three inpatient rehabilitation admissions were found during the study period. After we removed multiple admissions of the same patients and planned transfers to the primary acute care service, 122 admissions were analyzed. Thirty‐two (26%) patients transferred back to the primary acute care service for unplanned reasons. Multivariate analysis revealed male gender and thrombocytopenia as significantly associated with return to the primary acute care service. The median survival of patients who transferred back to the inpatient primary acute care service was 180 days versus 550 days for those who did not (P < .001).

Conclusion

Because of their medical fragility, clinicians caring for rehabilitation inpatients with multiple myeloma should maintain close contact with the primary oncology service. Factors associated with an increased risk of transfer back to the primary acute care service include male gender and thrombocytopenia.

Level of Evidence

IV
The Zadko Telescope: Exploring the Transient Universe
Authors: Coward D. M. , Gendre B. , Tanga P. , Turpin D. , Zadko J. , Dodson R. , Devogéle M. , Howell E. J. , Kennewell J. A. , Boër M. , Klotz A. , Dornic D. , Moore J. A. , Heary A.
Published: January 2017

The Zadko telescope is a 1 m f/4 Cassegrain telescope, situated in the state of Western Australia about 80-km north of Perth. The facility plays a niche role in Australian astronomy, as it is the only meter class facility in Australia dedicated to automated follow-up imaging of alerts or triggers received from different external instruments/detectors spanning the entire electromagnetic spectrum. Furthermore, the location of the facility at a longitude not covered by other meter class facilities provides an important resource for time critical projects. This paper reviews the status of the Zadko facility and science projects since it began robotic operations in March 2010. We report on major upgrades to the infrastructure and equipment (2012–2014) that has resulted in significantly improved robotic operations. Second, we review the core science projects, which include automated rapid follow-up of gamma ray burst (GRB) optical afterglows, imaging of neutrino counterpart candidates from the ANTARES neutrino observatory, photometry of rare (Barbarian) asteroids, supernovae searches in nearby galaxies. Finally, we discuss participation in newly commencing international projects, including the optical follow-up of gravitational wave (GW) candidates from the United States and European GW observatory network and present first tests for very low latency follow-up of fast radio bursts. In the context of these projects, we outline plans for a future upgrade that will optimise the facility for alert triggered imaging from the radio, optical, high-energy, neutrino, and GW bands.
MONOTONIC PHINOMIAL COEFFICIENTS
Authors: LUCA FLORIAN , STĂNICĂ PANTELIMON
Published: January 2017

We investigate the monotonic characteristics of the generalised binomial coefficients (phinomials) based upon Euler’s totient function. We show, unconditionally, that the set of integers for which this sequence is unimodal is finite and, assuming the generalised Riemann hypothesis, we find all the exceptions.
TWO NEW GENERALISED HYPERSTABILITY RESULTS FOR THE DRYGAS FUNCTIONAL EQUATION
Authors: AIEMSOMBOON LADDAWAN , SINTUNAVARAT WUTIPHOL
Published: January 2017

Let $X$ be a nonempty subset of a normed space such that $0\notin X$ and $X$ is symmetric with respect to $0$ and let $Y$ be a Banach space. We study the generalised hyperstability of the Drygas functional equation $$\begin{eqnarray}f(x+y)+f(x-y)=2f(x)+f(y)+f(-y),\end{eqnarray}$$ where $f$ maps $X$ into $Y$ and $x,y\in X$ with $x+y,x-y\in X$. Our first main result improves the results of Piszczek and Szczawińska [‘Hyperstability of the Drygas functional equation’, J. Funct. Space Appl.2013 (2013), Article ID 912718, 4 pages]. Hyperstability results for the inhomogeneous Drygas functional equation can be derived from our results.
Sequence stratigraphy, basin morphology and sea-level history for the Permian Kapp Starostin Formation of Svalbard, Norway
Authors: BOND DAVID P. G. , BLOMEIER DIERK P. G. , DUSTIRA ANNA M. , WIGNALL PAUL B. , COLLINS DANIEL , GOODE THOMAS , GROEN RALPH D. , BUGGISCH WERNER , GRASBY STEPHEN E.
Published: January 2017

Based on seven measured sections from Svalbard, the marine strata of the Permian Kapp Starostin Formation are arranged into seven transgressive–regressive sequences (TR1–TR7) ofc. 4–5 Ma average duration, each bound by a maximum regressive surface. Facies, including heterozoan-dominated limestones, spiculitic cherts, sandstones, siltstones and shales, record deposition within inner, middle and outer shelf areas. The lowermost sequence, TR1, comprises most of the basal Vøringen Member, which records a transgression across the Gipshuken Formation following a hiatus of unknown duration. Temperate to cold, storm-dominated facies established in inner to middle shelf areas between the latest Artinskian and Kungurian. Prolonged deepening during sequences TR2 and TR3 was succeeded by a long-term shallowing-upward trend that lasted until the latest Permian (TR4–TR7). A major depocentre existed in central and western Spitsbergen while to the north, Dickson Land remained a shallow platform, leading to a shallow homoclinal ramp in NE Spitsbergen and Nordaustlandet. The Middle Permian extinction (late Capitanian) is recorded near the base of TR6 in deeper parts of the basin only; elsewhere this sequence is not recorded. Likewise the youngest sequence, TR7, extending to the upper formational contact of latest Permian age, is found only in the basin depocentre. Comparison with age-equivalent strata in the Sverdrup Basin of Canada reveals a remarkably similar depositional history, with, for example, two (third-order) sea-level cycles recorded in the Late Permian of both regions, in keeping with the global record. Sequence stratigraphy may therefore be a powerful correlative tool for onshore and offshore Permian deposits across NW Pangaea.
Life history aspects of two species of the Squalus genus in the Eastern Ionian Sea
Authors: Anastasopoulou Aikaterini , Mytilineou Chryssi , Makantasi Panayiota , Smith Christopher J. , Kavadas Stefanos , Lefkaditou Eugenia , Papadopoulou Konstantia N.
Published: January 2017

Data on life history aspects of two species of Squalus genus were collated from five different studies carried out in the Eastern Ionian Sea from 1995 to 2014. Data were collected from 948 longnose spurdogs Squalus blainville (Risso, 1827) and 65 spiny dogfish Squalus acanthias Linnaeus, 1758 caught by trawl and longlines. The mean length of both species increased with depth. Sexual segregation was observed for S. blainville, whereas a segregation of immature and mature individuals was detected for S. acanthias. The length–weight relationship for S. blainville indicated positive allometry (b > 3) for both sexes, whereas a negative allometry (b < 3) was found for S. acanthias for the combined sexes. The sex ratio of both species was in favour of males. For S. blainville, the gonadosomatic and hepatosomatic indices differed significantly between sexes but not between seasons with the maturity data supporting the hypothesis of continuous reproduction throughout the year. Length at first maturity (L50) for female and male S. blainville was 603 and 413 mm respectively. For S. acanthias, males collected in autumn had finished their spawning activity; the single specimen caught in summer was reproductively active. Females, caught only in summer, were all gravid. Prey identified in the stomachs of S. blainville belonged to three major groups: fish, cephalopods and shrimps. Other groups such as echinoderms and ascidians were also found. Identified prey in the stomachs of S. acanthias belonged to two main groups, fish and cephalopods, although other groups (including echinoderms and polychaetes) were also present.
Social preferences for adaptation measures to conserve Australian birds threatened by climate change
Authors: Garnett Stephen T. , Zander Kerstin K. , Hagerman Shannon , Satterfield Terre A. , Meyerhoff Jürgen
Published: January 2017

Debate about climate change adaptation for biodiversity, and the ethics and consequences of assisted colonization in particular, has polarized professional opinion but the views of the wider community are unknown. We tested four hypotheses about the acceptability of adaptation strategies among a sample of the Australian general public using a combination of direct questions and a choice experiment. We found that (1) among the 80% who wanted extinction avoided, increased in situ management of wild populations was preferred to captive breeding or assisted colonization, (2) preferences for adaptation strategies were not explained by gender, income, education or knowledge about birds, (3) genetically distinctive taxa were not actively preferred, (4) > 60% of respondents were content for conservation managers to make decisions about strategies rather than local communities or the general public. The results provide Australian policy makers with a mandate to bolster efforts to retain existing populations but suggest that assisted colonization and captive breeding could be accepted if essential.
Tracking Hate Speech Acts as Incitement to Genocide in International Criminal Law
Authors: FYFE SHANNON
Published: January 2017

In this article, I argue that we need a better understanding of the theoretical underpinnings of the current debates in international law surrounding hate speech and inchoate crimes. I construct a theoretical basis for speech acts as incitement to genocide, distinguishing these speech acts from speech as genocide and speech denying genocide by integrating international law with concepts drawn from speech act theory and moral philosophy. I use the case drawn on by many commentators in this area of international criminal law, the trial of media executives for the roles they played in the Rwandan genocide through public speech acts by media entities insulting an ethnic group or advocating violence against an ethnic group. Each of these men were institutional leaders and were charged with using their positions within Rwandan society to distribute what I call genocidal hate speech, genocidal incitement speech, and genocidal participation speech. I argue for a distinction between these three types of speech, and a difference in individual criminal liability for the dissemination of each type of speech. I also argue that there should be a difference in individual criminal liability for speech acts within the context of an ongoing or recent genocide, and speech acts that can be separated from a site of mass violence.
Australia's National Notifiable Diseases Surveillance System 1991–2011: expanding, adapting and improving
Authors: GIBNEY K. B. , CHENG A. C. , HALL R. , LEDER K.
Published: January 2017

We reviewed key attributes (flexibility, data quality and timeliness) of Australia's National Notifiable Diseases Surveillance System (NNDSS) over its first 21 years. Cases notified to NNDSS from 1991 to 2011 were examined by jurisdiction (six states and two territories) and sub-period to describe changes in the number of notifiable diseases, proportion of cases diagnosed using PCR tests, data quality (focusing on data completeness), and notification delays. The number of notifiable diseases increased from 37 to 65. The proportion of cases diagnosed by PCR increased from 1% (1991–1997) to 49% (2005–2011). Indigenous status was complete for only 44% notifications (jurisdictional range 19–87%). Vaccination status was complete for 62% (jurisdictional range 32–100%) and country of acquisition for 24% of relevant cases. Data completeness improved over the study period with the exception of onset date. Median time to notification was 8 days (interquartile range 4–17 days, jurisdictional range 5–15 days); this decreased from 11 days (1991–1997) to 5 days (2005–2011). NNDSS expanded during the study period. Data completeness and timeliness improved, likely related to mandatory laboratory reporting and electronic data transfer. A nationally integrated electronic surveillance system, including electronic laboratory reporting, would further improve infectious disease surveillance in Australia.
Long-term effectiveness of plasma-derived hepatitis B vaccine 22–28 years after immunization in a hepatitis B virus endemic rural area: is an adult booster dose needed?
Authors: LI H. , LI G. J. , CHEN Q. Y. , FANG Z. L. , WANG X. Y. , TAN C. , YANG Q. L. , WANG F. Z. , WANG F. , ZHANG S. , BI S. L. , SHEN L. P.
Published: January 2017

Longan County is considered a highly endemic area for hepatitis B virus (HBV). The plasma-derived vaccine has been used in newborns in this area since 1987. A cross-sectional survey was conducted to evaluate the long-term effectiveness of this vaccine. In total, 1634 participants born during 1987–1993 and who had received a series of plasma-derived HB vaccinations at ages 0, 1, and 6 months were enrolled. Serological HBV markers were detected and compared with previous survey data. Overall the prevalence of hepatitis B surface antigen (HBsAg) in all participants was 3·79%; 3·47% of subjects who had received the first dose within 24 h were HBsAg positive, and 8·41% of subjects who had received a delayed first dose were also HBsAg positive. There were 1527 subjects identified who had received the first dose within 24 h and whose HBsAg and anti-HBc prevalence increased yearly after immunization, while the anti-HBs-positive rate and vaccine effectiveness declined. The geometric mean concentration of antibody in the anti-HB-positive participants was 55·13 mIU/ml and this declined after immunization. Fewer than 2·0% of participants had anti-HB levels ⩾1000 mIU/ml. The data show that the protective efficacy of the plasma-derived vaccinations declined and administration of HB vaccine within 24 h of birth was very important. To reduce the risk of HBV infection in this highly endemic area, a booster dose might be necessary if anti-HBs levels fall below 10 mIU/ml after age 18 years. Furthermore, studies on the immune memory induced by plasma-derived HB vaccine are needed.
Using Positive Deviance in the prevention and control of MRSA infections in a Colombian hospital: a time-series analysis
Authors: ESCOBAR N. M. OLARTE , MÁRQUEZ I. A. VALDERRAMA , QUIROGA J. AVILA , TRUJILLO T. GORETTY , GONZÁLEZ F. , AGUILAR M. I. GARZÓN , ESCOBAR-PÉREZ J.
Published: January 2017

Positive Deviance (PD) is a process to achieve a social and cultural change. This strategy has been used for the control of methicillin-resistant Staphylococcus aureus (MRSA) infection in some health institutions in the United States, but has rarely been adopted in institutions from developing countries where resources are limited. We describe our experience of PD in the control of healthcare-associated infections (HAIs) due to MRSA in a Colombian hospital with the aim of reducing HAI rates through a cultural change in processes. A time-series study was conducted based on the MRSA-HAI rate and the number of months with zero MRSA infections before and after application of PD (2001–2012). On comparing the pre-intervention and intervention periods, the mean overall rates of MRSA-HAI was 0·62 and 0·36, respectively (P = 0·0005); the number of months with zero MRSA-HAIs were 3/70 and 12/74 (odds ratio 0·264, 95% confidence interval 0·078–0·897); the percentage of MRSA-HAIs was 53·2% and 41·0%. These results are consistent with other published data. Implementation of PD was associated with a significant reduction of MRSA-HAIs, it did not involve high costs and the changes have been lasting.
Zoonotic diseases in South American camelids in England and Wales
Authors: HALSBY K. , TWOMEY D. F. , FEATHERSTONE C. , FOSTER A. , WALSH A. , HEWITT K. , MORGAN D.
Published: January 2017

The number of South American camelids (SACs) in England and Wales is increasing and with this comes a risk of new and emerging infections. Although classified as livestock, these animals are also treated as pets and may be in regular contact with humans. This paper reviews zoonotic diseases that have been identified in SACs in England and Wales, and which pose a potential risk to human health. We also highlight the importance of surveillance continuing to capture information on infections in SACs for the protection of both public and animal health.
Incidence of surgical site infections cannot be derived reliably from point prevalence survey data in Dutch hospitals
Authors: MEIJS A. P. , FERREIRA J. A. , DE GREEFF S. C. , VOS M. C. , KOEK M. B. G.
Published: January 2017

Thorough studies on whether point prevalence surveys of healthcare-associated infections (HAIs) can be used to reliably estimate incidence of surgical site infections (SSIs) are scarce. We examined this topic using surveillance data of 58 hospitals that participated in two Dutch national surveillances; HAI prevalence and SSI incidence surveillance, respectively. First, we simulated daily prevalences of SSIs from incidence data. Subsequently, Rhame & Sudderth's formula was used to estimate SSI incidence from prevalence. Finally, we developed random-effects models to predict SSI incidence from prevalence and other relevant variables. The prevalences simulated from incidence data indicated that daily prevalence varied greatly. Incidences calculated with Rhame & Sudderth's formula often had values below zero, due to the large number of SSIs occurring post-discharge. Excluding these SSIs, still resulted in poor correlation between calculated and observed incidence. The two models best predicting total incidence and incidence during initial hospital stay both performed poorly (proportion of explained variance of 0·25 and 0·10, respectively). In conclusion, incidence of SSIs cannot be reliably estimated from point prevalence data in Dutch hospitals by any of the applied methods. We therefore conclude that prevalence surveys are not a useful measure to give reliable insight into incidence of SSIs.
Investigating the role of anticipatory reward and habit strength in obsessive-compulsive disorder
Authors: Ferreira Gabriela M. , Yücel Murat , Dawson Andrew , Lorenzetti Valentina , Fontenelle Leonardo F.
Published: January 2017

Aims

To determine the rates and associated illness characteristics of obsessive-compulsive disorder (OCD) patients who describe their symptoms as either rewarding or habitual.

Methods

Seventy-three treatment-seeking OCD patients had their dominant compulsive behavior assessed with a structured interview (the Temporal Impulsive-Compulsive Scale–Revised) to track the progression of rewarding (ie, gain in positive affect), aversive (ie, decrease in negative affect), and neutral (or non-affective) states and a self-report scale (the Self-Report Habit Index) to evaluate their habitual features. Additional measures included structured diagnostic interviews for axis I and II disorders, measures of OCD symptoms severity, and a battery of instruments to comprehensively assess relevant aspects of sensitivity to reward and fear.

Results

Almost half (49%) of our OCD patients (particularly washers) endorsed that they anticipated obtaining a reward (ie, positive affect) from the enactment of their dominant compulsive behavior. Washers stood out in that their positive affects during and after compulsive behaviors were highly (and positively) correlated with duration of illness. In contrast, habit strength did not differ between washers, checkers, and arrangers, although it also correlated with duration of illness among checkers. Furthermore, the severity of OCD and comorbidity with impulse control disorders predicted up to 35% of the variance in the habit strength of OCD behaviors.

Conclusion

Compulsive washing may be more clearly characterized by problems in reward processing. In contrast, duration of checking, severity of OCD, and comorbidity with impulse control disorders shape compulsive behaviors by imparting them with habitual tendencies.
Study of dual-band inline mixed coupled BPF design and two transmission zero pairs controlling mechanism
Authors: Lu Di , Yan Teng-Fei , Tang Xiao-Hong
Published: January 2017

In this letter, a passive high-selectivity dual-band filter with two controllable transmission zero (TZ) pairs is proposed, while synthesis method and control mechanism of the two TZ pairs are investigated. Specifically, by employing the magnetic/electric mixed coupling (MEMC), source–load coupling (S–L coupling) and stepped-impedance resonators, a dual-band bandpass filter with two pairs of controllable TZs is constructed. Two controllable TZ pairs can be independently adjusted by re-modifying the associated coupling structures. To validate the synthesizability and controllability of the TZ pairs, mathematical synthesis, and EM simulations are carried out. Two demonstrative filters with identical passband performance and different central TZ distributions for GSM (0.9/1.8 GHz) are designed and measured. The analysis and experimental results show that the synthesis-controllable TZ pair (fz2, fz3) introduced by MEMC can be synthesized and controlled using inline mixed coupling synthesis, and the optimization-controllable TZ pair (fz1, fz4) because of S–L coupling is controlled by S–L coupling strength optimization procedure.
Behavioural and psychological symptoms in general hospital patients with dementia, distress for nursing staff and complications in care: results of the General Hospital Study
Authors: Hessler J. B. , Schäufele M. , Hendlmeier I. , Junge M. N. , Leonhardt S. , Weber J. , Bickel H.
Published: January 2017

Aims.

Little is known about how behavioural and psychological symptoms of dementia (BPSD) manifest in the general hospital. The aim was to examine the frequency of BPSD in general hospitals and their associations with nursing staff distress and complications in care.

Methods.

Cross-sectional representative study with 1469 patients aged ≥65, including 270 patients with dementia, of 33 randomly selected general hospitals in Germany. BPSD and complications were reported by nurses.

Results.

Overall frequency of BPSD was higher in patients with dementia (76%) than without (38%). The most frequent symptoms in patients with dementia were nighttime disturbances (38%), depression (29%) and aberrant motor behaviour (28%) and the most distressing symptoms for nursing staff were delusions, aggression and nighttime disturbances. The overall frequency of BPSD increased from 67% in mild dementia, to 76% in moderate dementia and to 88% in severe dementia. The most frequent symptoms in patients without dementia were depression (19%), nighttime disturbances (13%) and irritability (13%). The most distressing symptoms were aggression and delusions, while the same symptoms were consistently rated as less distressing than in patients with dementia. Factor analysis revealed three independent groups of BPSD that explained 45% of the total variance. First, expansive symptoms (aggression, irritability, nighttime disturbances, aberrant motor behaviour and disinhibition) were frequent, distressing for nursing staff and associated with many complications. Second, psychotic symptoms (delusions and hallucinations) were infrequent, distressing and associated with some complications. Third, affective symptoms (apathy, anxiety and depression) were frequent, non-distressing and associated with few complications. The results did not change when cases with delirium were excluded from both groups.

Conclusions.

BPSD are common in older hospital patients with dementia and associated with considerable distress in nursing staff, as well as a wide range of special treatments needs and additional behavioural and medical complications. Management strategies are needed to improve the situation for both patients and hospital staff.
Mental health and psychosocial problems in the aftermath of the Nepal earthquakes: findings from a representative cluster sample survey
Authors: Kane J. C. , Luitel N. P. , Jordans M. J. D. , Kohrt B. A. , Weissbecker I. , Tol W. A.
Published: January 2017

Aims.

Two large earthquakes in 2015 caused widespread destruction in Nepal. This study aimed to examine frequency of common mental health and psychosocial problems and their correlates following the earthquakes.

Methods.

A stratified multi-stage cluster sampling design was employed to randomly select 513 participants (aged 16 and above) from three earthquake-affected districts in Nepal: Kathmandu, Gorkha and Sindhupalchowk, 4 months after the second earthquake. Outcomes were selected based on qualitative preparatory research and included symptoms of depression and anxiety (Hopkins Symptom Checklist-25); post-traumatic stress disorder (PTSD Checklist-Civilian); hazardous alcohol use (AUDIT-C); symptoms indicating severe psychological distress (WHO-UNHCR Assessment Schedule of Serious Symptoms in Humanitarian Settings (WASSS)); suicidal ideation (Composite International Diagnostic Interview); perceived needs (Humanitarian Emergency Settings Perceived Needs Scale (HESPER)); and functional impairment (locally developed scale).

Results.

A substantial percentage of participants scored above validated cut-off scores for depression (34.3%, 95% CI 28.4–40.4) and anxiety (33.8%, 95% CI 27.6–40.6). Hazardous alcohol use was reported by 20.4% (95% CI 17.1–24.3) and 10.9% (95% CI 8.8–13.5) reported suicidal ideation. Forty-two percent reported that ‘distress’ was a serious problem in their community. Anger that was out of control (symptom from the WASSS) was reported by 33.7% (95% CI 29.5–38.2). Fewer people had elevated rates of PTSD symptoms above a validated cut-off score (5.2%, 95% CI 3.9–6.8), and levels of functional impairment were also relatively low. Correlates of elevated symptom scores were female gender, lower caste and greater number of perceived needs. Residing in Gorkha and Sindhupalchowk districts and lower caste were also associated with greater perceived needs. Higher levels of impaired functioning were associated with greater odds of depression and anxiety symptoms; impaired functioning was less strongly associated with PTSD symptoms.

Conclusions.

Four months after the earthquakes in Nepal, one out of three adults experienced symptoms of depression and distressing levels of anger, one out of five engaged in hazardous drinking, and one out of ten had suicidal thoughts. However, posttraumatic stress symptoms and functional impairment were comparatively less frequent. Taken together, the findings suggest that there were significant levels of psychological distress but likely low levels of disorder. The findings highlight the importance of indicated prevention strategies to reduce the risk of distress progressing to disorder within post-disaster mental health systems of care.
Marine origin of retroviruses in the early Palaeozoic Era
Authors: Aiewsakun Pakorn , Katzourakis Aris
Published: January 2017

Very little is known about the ancient origin of retroviruses, but owing to the discovery of their ancient endogenous viral counterparts, their early history is beginning to unfold. Here we report 36 lineages of basal amphibian and fish foamy-like endogenous retroviruses (FLERVs). Phylogenetic analyses reveal that ray-finned fish FLERVs exhibit an overall co-speciation pattern with their hosts, while amphibian FLERVs might not. We also observe several possible ancient viral cross-class transmissions, involving lobe-finned fish, shark and frog FLERVs. Sequence examination and analyses reveal two major lineages of ray-finned fish FLERVs, one of which had gained two novel accessory genes within their extraordinarily large genomes. Our phylogenetic analyses suggest that this major retroviral lineage, and therefore retroviruses as a whole, have an ancient marine origin and originated together with, if not before, their jawed vertebrate hosts >450 million years ago in the Ordovician period, early Palaeozoic Era.
Observational evidence for cloud cover enhancement over western European forests
Authors: Teuling Adriaan J. , Taylor Christopher M. , Meirink Jan Fokke , Melsen Lieke A. , Miralles Diego G. , van Heerwaarden Chiel C. , Vautard Robert , Stegehuis Annemiek I. , Nabuurs Gert-Jan , de Arellano Jordi Vilà-Guerau
Published: January 2017

Forests impact regional hydrology and climate directly by regulating water and heat fluxes. Indirect effects through cloud formation and precipitation can be important in facilitating continental-scale moisture recycling but are poorly understood at regional scales. In particular, the impact of temperate forest on clouds is largely unknown. Here we provide observational evidence for a strong increase in cloud cover over large forest regions in western Europe based on analysis of 10 years of 15 min resolution data from geostationary satellites. In addition, we show that widespread windthrow by cyclone Klaus in the Landes forest led to a significant decrease in local cloud cover in subsequent years. Strong cloud development along the downwind edges of larger forest areas are consistent with a forest-breeze mesoscale circulation. Our results highlight the need to include impacts on cloud formation when evaluating the water and climate services of temperate forests, in particular around densely populated areas.
Increased impedance near cut-off in plasma-like media leading to emission of high-power, narrow-bandwidth radiation
Authors: Hur M. S. , Ersfeld B. , Noble A. , Suk H. , Jaroszynski D. A.
Published: January 2017

Ultra-intense, narrow-bandwidth, electromagnetic pulses have become important tools for exploring the characteristics of matter. Modern tuneable high-power light sources, such as free-electron lasers and vacuum tubes, rely on bunching of relativistic or near-relativistic electrons in vacuum. Here we present a fundamentally different method for producing narrow-bandwidth radiation from a broad spectral bandwidth current source, which takes advantage of the inflated radiation impedance close to cut-off in a medium with a plasma-like permittivity. We find that by embedding a current source in this cut-off region, more than an order of magnitude enhancement of the radiation intensity is obtained compared with emission directly into free space. The method suggests a simple and general way to flexibly use broadband current sources to produce broad or narrow bandwidth pulses. As an example, we demonstrate, using particle-in-cell simulations, enhanced monochromatic emission of terahertz radiation using a two-colour pumped current source enclosed by a tapered waveguide.
Characterization of Pairwise Correlations from Multiple Quantum Correlated Beams Generated from Cascaded Four-Wave Mixing Processes
Authors: Wang Hailong , Cao Leiming , Jing Jietai
Published: January 2017

We theoretically characterize the performance of the pairwise correlations (PCs) from multiple quantum correlated beams based on the cascaded four-wave mixing (FWM) processes. The presence of the PCs with quantum corre- lation in these systems can be verified by calculating the degree of intensity difference squeezing for any pair of all the output fields. The quantum correlation characteristics of all the PCs under different cascaded schemes are also discussed in detail and the repulsion effect between PCs in these cascaded FWM processes is theoretically predicted. Our results open the way for the classification and application of quantum states generated from the cascaded FWM processes.
An optimistic protein assembly from sequence reads salvaged an uncharacterized segment of mouse picobirnavirus
Authors: Gonzalez Gabriel , Sasaki Michihito , Burkitt-Gray Lucy , Kamiya Tomonori , Tsuji Noriko M. , Sawa Hirofumi , Ito Kimihito
Published: January 2017

Advances in Next Generation Sequencing technologies have enabled the generation of millions of sequences from microorganisms. However, distinguishing the sequence of a novel species from sequencing errors remains a technical challenge when the novel species is highly divergent from the closest known species. To solve such a problem, we developed a new method called Optimistic Protein Assembly from Reads (OPAR). This method is based on the assumption that protein sequences could be more conserved than the nucleotide sequences encoding them. By taking advantage of metagenomics, bioinformatics and conventional Sanger sequencing, our method successfully identified all coding regions of the mouse picobirnavirus for the first time. The salvaged sequences indicated that segment 1 of this virus was more divergent from its homologues in otherPicobirnaviridaespecies than segment 2. For this reason, only segment 2 of mouse picobirnavirus has been detected in previous studies. OPAR web tool is available athttp://bioinformatics.czc.hokudai.ac.jp/opar/.
Pre-trauma Methylphenidate in rats reduces PTSD-like reactions one month later
Authors: Ritov G , Richter-Levin G
Published: January 2017

In basic research, the etiology of fear-related pathologies, such as post-traumatic stress disorder (PTSD), is conceptualized using fear-conditioning protocols that pair environmental stimuli (that is, a conditioned stimulus—CS) with an aversive, unconditioned stimulus (US) to elicit an assessable conditioned fear response. Although pathophysiological models agree that regulatory dysfunctions in this associative process may instigate fear-related pathology, current opinions differ in regard to the nature of these dysfunctions. Primarily derived from studies in rodents, the prevailing perspective proposes that pathological fear-reactions develop from intensified and overly consolidated CS-US associations. Alternatively, models derived from studies in humans suggest that tempospatial inaccuracies in representations of associative fear might precipitate pathology by engendering failure to differentiate present experiences and past memories of threat. To test this concept in rodents, we administered rats with cognition enhancing doses of Methylphenidate before or after fear conditioning and measured long-term alterations in their conditioned fear behaviors and PTSD-like reactions. The administration of Methylphenidate before fear-memory formation indeed reduced anxious-like responses during fear-memory retrieval one month later. An individual profiling analysis revealed that Methylphenidate onset had opposing effects on the risk for PTSD-like classification. The modulation of initial learning and formation of associative fear normalized the risk for developing PTSD-like reaction. In contrast, when the effects of Methylphenidate were exerted only over later consolidation this risk increased markedly. When examined under current psychiatric and neuropharmacologic literature, these results reveal a possible strategy of using low-dose Methylphenidate for the prevention of PTSD in high risk populations.
Small molecule carbazole-based diketopyrrolopyrroles with tetracyanobutadiene acceptor unit as a non-fullerene acceptor for bulk heterojunction organic solar cells
Authors: Patil Yuvraj , Misra Rajneesh , Keshtov M. L. , Sharma Ganesh D.
Published: January 2017

Herein, we investigated the photovoltaic properties of carbazole-based diketopyrrolopyrroles with tetracyanobutadiene acceptor units as highly efficient non-fullerene acceptors together with a D–A conjugated polymer, P, as a donor for polymer solar cells.
Biomass based hydrogel as an adsorbent for the fast removal of heavy metal ions from aqueous solutions
Authors: Zhang Mingyue , Song Lihua , Jiang Haifeng , Li Shu , Shao Yifei , Yang Jiaqi , Li Junfeng
Published: January 2017

In order to achieve the reutilization of waste biomass soybean dregs, a low-cost hydrogel, soybean dregs–poly(acrylic acid) (SESD–PAA) was prepared through a one-step reaction.
Efficient thermally activated delayed fluorescence of functional phenylpyridinato boron complexes and high performance organic light-emitting diodes
Authors: Shiu Yi-Jiun , Chen Yi-Ting , Lee Wei-Kai , Wu Chung-Chih , Lin Tzu-Chieh , Liu Shih-Hung , Chou Pi-Tai , Lu Chin-Wei , Cheng I-Chen , Lien Yi-Jyun , Chi Yun
Published: January 2017

A new series of functional phenylpyridinato boron complexes possessing thermally activated delayed fluorescence (TADF) has been strategically designed and synthesized.
An ab initio investigation of photoswitches adsorbed onto metal oxide surfaces: the case of donor–acceptor Stenhouse adduct photochromes on TiO2anatase
Authors: Belhboub Anouar , Boucher Florent , Jacquemin Denis
Published: January 2017

We study at the DFT and TD-DFT levels how DASA switches are modified by anchoring onto a surface.