bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute heart failure: heart failure surgery and transplantation
Authors: Visouli Aikaterini N , Pitsis Antonis A
Published: February 2018

Cardiac surgery should be considered in all cases of acute heart failure (AHF) or acutely decompensated chronic heart failure (ADCHF) caused, precipitated, or aggravated by surgically correctable causes. Mechanical circulatory support (MCS) and heart transplantation (HTx) may be considered when all conventional measures have failed.
Ventricular tachyarrhythmias and implantable cardioverter–defibrillator
Authors: Ehrlich Joachim R , Hohnloser Stefan H
Published: February 2018

Few scenarios in intensive coronary care are commonly associated with as much fear and apprehension as the event of a ventricular tachyarrhythmia. This chapter provides information to help successfully manage such situations. Residents, fellows, and physicians involved in providing acute cardiac care are in need of broad background knowledge regarding the diagnostic and therapeutic means, as well as the prognostic implications of such events, in order to provide adequate medical care to their patients. The present chapter summarizes information on the pathophysiological basis of ventricular tachyarrhythmias and teaches tools to detect and correctly differentiate a ventricular from a supraventricular arrhythmia on the surface electrocardiogram. The chapter provides the reader with a summary of specific treatment modalities and information on indications for treatment with an implantable cardioverter-defibrillator. Last, the chapter deals with the management of device interventions (appropriately delivered for ventricular tachyarrhythmias or inappropriately delivered for other reasons) within the increasing population of patients fitted with an implantable cardioverter-defibrillator.
Cardiac complications in trauma
Authors: Lam Lydia , Kobayashi Leslie , Demetriades Demetrios
Published: February 2018

Post-traumatic cardiac complications may occur after penetrating or blunt injuries to the heart or may follow severe extracardiac injuries. The majority of victims with penetrating injuries to the heart die at the scene and do not reach hospital care. For those patients who reach hospital care, an immediate operation, sometimes in the emergency room, cardiac injury repair, and cardiopulmonary resuscitation provide the only possibility of survival. Many patients develop perioperative cardiac complications such as acute cardiac failure, cardiac arrhythmias, coronary air embolism, and myocardial infarction. Some survivors develop post-operative functional abnormalities or anatomical defects, which may not manifest during the early post-operative period. It is essential that all survivors undergo detailed early and late cardiac evaluations. Blunt cardiac trauma encompasses a wide spectrum of injuries that includes asymptomatic myocardial contusion, arrhythmias, or cardiogenic shock to full-thickness cardiac rupture and death. Clinical examination, electrocardiograms, troponin measurements, and echocardiography are the cornerstone of diagnosis and monitoring of these patients. Lastly, some serious extracardiac traumatic conditions, such as traumatic pneumonectomy and severe traumatic brain injury, may result in cardiac complications. This may include tachyarrhythmias, cardiogenic shock, electrocardiographic changes, troponin elevations, heart failure, and cardiac arrest.
Bleeding and haemostasis disorders
Authors: Mannucci Pier Mannuccio , Lettino Maddalena
Published: February 2018

The main cause of haemostasis defects and related bleeding complications in patients with acute coronary syndromes admitted to the intensive cardiac care unit is the use of multiple antithrombotic drugs, alone or concomitantly with invasive procedures such as percutaneous coronary intervention with stent deployment and coronary artery bypass surgery. These drugs, that act upon several components of haemostasis (platelet function, coagulation, fibrinolysis), are associated with bleeding complications, particularly in elderly patients (more so in women than in men), those who are underweight, and those with comorbid conditions such as renal and liver insufficiency and diabetes. The identification of patients at higher risk of bleeding is the most important preventive strategy. Red cell and platelet transfusions, which may become necessary in patients with severe bleeding, should be used with caution, because transfused patients with acute coronary syndrome have a high rate of adverse outcomes (death, myocardial infarction, and stroke).
A new approach for measuring power spectra and reconstructing time series in active galactic nuclei
Authors: Li Yan-Rong , Wang Jian-Min
Published: February 2018

We provide a new approach to measure power spectra and reconstruct time series in active galactic nuclei (AGNs) based on the fact that the Fourier transform of AGN stochastic variations is a series of complex Gaussian random variables. The approach parametrizes a stochastic series in frequency domain and transforms it back to time domain to fit the observed data. The parameters and their uncertainties are derived in a Bayesian framework, which also allows us to compare the relative merits of different power spectral density models. The well-developed fast Fourier transform algorithm together with parallel computation enables an acceptable time complexity for the approach.
Generalized massive optimal data compression
Authors: Alsing Justin , Wandelt Benjamin
Published: February 2018

In this paper, we provide a general procedure for optimally compressing N data down to n summary statistics, where n is equal to the number of parameters of interest. We show that compression to the score function – the gradient of the log-likelihood with respect to the parameters – yields n compressed statistics that are optimal in the sense that they preserve the Fisher information content of the data. Our method generalizes earlier work on linear Karhunen–Loéve compression for Gaussian data whilst recovering both lossless linear compression and quadratic estimation as special cases when they are optimal. We give a unified treatment that also includes the general non-Gaussian case as long as mild regularity conditions are satisfied, producing optimal non-linear summary statistics when appropriate. As a worked example, we derive explicitly the n optimal compressed statistics for Gaussian data in the general case where both the mean and covariance depend on the parameters.
Examining, diagnosing, and treating benign anorectal conditions
Authors: Marsicovetere Priscilla
Published: February 2018

Anorectal pain and discomfort are common complaints in the general population, and can stem from a number of possible causes. Often, the complaints present in the primary care setting and can be adequately evaluated, diagnosed, and treated without the need for referral to a colorectal specialist. Proper evaluation and diagnosis can result in prompt, effective patient care. Recognition of red flags should prompt immediate referral to a colorectal specialist for further evaluation.
Ivabradine for systolic heart failure
Authors: Meade Courtney M. , Clements Jennifer N.
Published: February 2018

Ivabradine works in the sinoatrial node to prolong diastolic depolarization and reduce heart rate. In patients with chronic systolic heart failure, this drug has reduced the risk of hospitalization when used in combination with other optimal pharmacotherapy.
ED Visits for Self-Harm by Girls Are on the Rise
Authors: Stockwell Serena
Published: February 2018

A nearly 20% increase since 2008 worries experts, as the behavior is a suicide risk factor.
The CDC's HI-5 Initiative
Authors: Nelson Roxanne
Published: February 2018

A plan to improve community health in five years.
The Ethical and Legal Implications of a Nurse's Arrest in Utah
Authors: Olsen Douglas P. , Brous Edie
Published: February 2018

Editor's note: On July 26, 2017, Alex Wubbels, the charge nurse on the burn unit at the University of Utah Hospital in Salt Lake City, was arrested for refusing to allow a police officer to draw blood from an unconscious patient in her care. Her arrest, during which she was forcefully placed in handcuffs and dragged out of the hospital, was documented on body camera video and drew national attention. We asked our ethical and legal contributing editors to provide some insight on the issues of this case.
Great Conversations: A Nurse Tackles the Puberty Talk
Authors: Szulecki Diane
Published: February 2018

For three decades, Julie Metzger has fostered dialogue between preteens and parents.
Teaching Wound Care to Family Caregivers
Authors: Kirkland-Kyhn Holly , Generao Stefanie Anne , Teleten Oleg , Young Heather M.
Published: February 2018

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home.

The articles in this new installment of the series provide simple and useful instructions that nurses should reinforce with family caregivers who perform wound care tasks. Each article also includes an informational tear sheet—Information for Family Caregivers—that contains links to instructional videos. To use this series, nurses should read the article first, so they understand how best to help family caregivers, and then encourage caregivers to watch the videos and ask questions. For additional information, see Resources for Nurses.
Continuous vs. Interrupted Chest Compressions for Cardiac Arrest
Authors: Barrett David
Published: February 2018

Editor's note: This is a summary of a nursing care–related systematic review from the Cochrane Library. For more information, see http://nursingcare.cochrane.org.
Death with Dignity (and Love)
Authors: Barkin Laurie
Published: February 2018

A nurse takes on a challenging new role at her ailing father's request.
Mechanical Ventilation Induces Desensitization of Lung Axl Tyrosine Kinase Receptors
Authors: Otulakowski Gail , Engelberts Doreen , Post Martin , Masterson Claire , Kavanagh Brian P.
Published: February 2018

Background

Lower tidal volumes are increasingly used in acute respiratory distress syndrome, but mortality has changed little in the last 20 yr. Therefore, in addition to ventilator settings, it is important to target molecular mediators of injury. Sepsis and other inflammatory states increase circulating concentrations of Gas6, a ligand for the antiinflammatory receptor Axl, and of a soluble decoy form of Axl. We investigated the effects of lung stretch on Axl signaling.

Methods

We used a mouse model of early injury from high tidal volume and assessed the effects of inhibiting Axl on in vivo lung injury (using an antagonist R428, n = 4/group). We further determined the effects of stretch on Axl activation using in vitro lung endothelial cells.

Results

High tidal volume caused mild injury (compliance decreased 6%) as intended, and shedding of the Axl receptor (soluble Axl in bronchoalveolar fluid increased 77%). The Axl antagonist R428 blocked the principal downstream Axl target (suppressor of cytokine signaling 3 [SOCS3]) but did not worsen lung physiology or inflammation. Cyclic stretch in vitro caused Axl to become insensitive to activation by its agonist, Gas6. Finally, in vitro Axl responses were rescued by blocking stretch-activated calcium channels (using guanidinium chloride [GdCl3]), and the calcium ionophore ionomycin replicated the effect of stretch.

Conclusions

These data suggest that lung endothelial cell overdistention activates ion channels, and the resultant influx of Ca2+ inactivates Axl. Downstream inactivation of Axl by stretch was not anticipated; preventing this would be required to exploit Axl receptors in reducing lung injury.
Regional Cerebral Oxygen Saturation Changes After Decompressive Craniectomy for Malignant Cerebral Venous Thrombosis: A Prospective Cohort Study
Authors: Venkateswaran Pavithra , Sriganesh Kamath , Chakrabarti Dhritiman , Srinivas Deepti B. , Rao Ganne S. Umamaheswara
Published: February 2018

Background:

Decompressive craniectomy (DC) is a life-saving intervention for malignant cerebral venous thrombosis (CVT). Earlier studies have shown increase in cerebral oxygenation after DC in traumatic brain injury but similar studies are lacking in CVT. We hypothesized that regional cerebral (tissue) oxygen saturation (rSO2) on the side of CVT is lower than the contralateral side and improves after DC.

Materials and Methods:

In this prospective cohort study, rSO2 was monitored using near-infrared spectroscopy technique, before and after DC on both cerebral hemispheres. Data regarding factors likely to affect rSO2 such as systolic blood pressure, partial pressure of oxygen and carbon dioxide in blood (PaO2 and PaCO2), and hemoglobin were simultaneously collected. The primary outcome measure was pre-post change in rSO2 on the ipsilateral cerebral hemisphere. The secondary outcomes were in-hospital mortality and duration of postoperative hospital stay.

Results:

Seventeen patients underwent DC during the 6-month study period. Their mean age was 39.2±12.4 years. The pre-post DC change in rSO2 on the hemisphere with CVT was significant (mean difference=3.6%; 95% confidence interval, 1.5-5.7; P=0.002). One patient died in the hospital. There was no difference in the duration of postoperative hospital stay (10 d [range, 6 to 21 d] vs. 14 d [range, 1 to 30 d], P=0.92) between patients with preoperative ipsilateral rSO2 <60% and >60%. There was no correlation between PaO2, PaCO2, systolic blood pressure, and hemoglobin with rSO2.

Conclusions:

Patients with malignant CVT had a lower rSO2 on ipsilateral side of the lesion, which improved significantly after DC. Preoperative rSO2 was not correlated with the duration of hospital stay.
Word Learning in Children With Cochlear Implants: Examining Performance Relative to Hearing Peers and Relations With Age at Implantation
Authors: Pimperton Hannah , Walker Elizabeth A.
Published: February 2018

Objectives:

This study had two key objectives. First, to examine whether children who receive cochlear implants (CIs) before the age of 3 years and who are experienced implant users (mean length of CI use = 6 years; range = 4 to 9 years) show deficits on a word learning task relative to their hearing peers. Second, to examine whether variation in age at implantation within the first 3 years of life relates to later word learning abilities.

Design:

Twenty-one 6- to 10-year-old children with CIs, 21 chronological age-matched (AM) hearing children, and 21 vocabulary-matched hearing children completed an auditory word learning task in which they were required to learn the names of eight rare animals. Comprehension and production probes tested their learning of these unfamiliar words.

Results:

The children with CIs performed similarly to AM peers on the comprehension phase of the word learning task. Their production performance was significantly poorer than the AM group but was in line with that of their younger vocabulary-matched hearing peers. Differences between the CI and AM groups were accounted for by differences between the groups in terms of their existing vocabulary knowledge. Within the CI group, there was no evidence of an association between age at implantation and performance on the word learning task, but existing vocabulary size showed strong positive correlations with word learning performance, after adjustment for chronological age.

Conclusions:

When implanted by the age of 3 years, and with over 4 years CI experience, 6- to 10-year-old children are able to perform similarly to their AM hearing peers in terms of their comprehension of newly learned words. Producing accurate phonological forms of newly learned words may be a more challenging task for children with CIs, but their production performance is consistent with their vocabulary size. This cross-sectional study provides support for a relationship between existing vocabulary size and novel word learning skills in children with CIs; future longitudinal studies should test the hypothesis that this relationship is developmentally reciprocal.
Optimal colonoscopy surveillance interval period for the adenoma patients who had an adequate polypectomy at baseline colonoscopy
Authors: Dong Jian , Wu Minman , Miao Jiarong , Zhi Tao , Zhang Tianmei , Yang Gang , Chen Yarong , Zhang Lei , Nan Qiong
Published: February 2018

The role of surveillance colonoscopy has long been established: it reduces both the incidence and the mortality of colorectal cancer. We aimed to assess the optimal colonoscopy surveillance interval period for the adenoma patients who underwent an adequate polypectomy at baseline colonoscopy to avoid overuse or underuse of colonoscopy. A retrospective study was carried out on the baseline adenoma patients who had had at least two completed colonoscopy examinations during the years 2000–2013 in the Digestive Endoscopy Center of the First Affiliated Hospital of Kunming Medical University. All the patients had a complete polypectomy of adenomas at baseline. Data on the patients’ demographics and colorectal findings were extracted from a specially designed colonoscopy database. The end point was the finding of adenoma during the subsequent surveillance colonoscopy; an analysis was carried out to identify recurrence factors and the optimal colonoscopy surveillance interval period. A total of 765 (463 men, 302 women, average age 56.51±11.95) eligible patients were included in the study. Three hundred and twelve patients had adenoma and 453 had no adenoma after surveillance colonoscopies (the frequency of repeat colonoscopy is 1-10, average 1.73±1.24). The diameter of adenomas found on the follow-up colonoscopy was 0.2–3.0 cm (average 0.54±0.30 cm). The number of adenomas was 1–11 (2.21±1.53) and the surveillance adenoma interval period was 0.5–13 years (2.64±2.36 years). A total of 576 patients had baseline nonadvanced adenomas. Male sex, age older than 50 years, and more than two different intestine segment adenomas were the risk factors for recurrence. The optimal colonoscopy surveillance interval period is 2.85 years (95% confidence interval: 2.53–3.17) according to the recurrence rate of 5% adenomas. One hundred and eighty-nine patients had baseline advanced adenomas. Male sex, diameter of adenomas less than 1.0 cm, and adenomas in the right colon or the whole colon were the risk factors for recurrence. The optimal colonoscopy surveillance interval period is 2.06 years (95% confidence interval: 1.71–2.45) according to the recurrence rate of 5% adenomas. The optimal colonoscopy surveillance interval period is 3 years or so for the adenoma patients who had an adequate polypectomy at baseline colonoscopy. Male sex, age older than 50 years, less than 1.0 cm adenomas diameter and the right colon, or multisegment intestine adenomas were the risk factors for recurrence. This has significance for guiding the follow-up colonoscopy interval time of the patients with intestine adenomas.
ASSOCIATION BETWEEN EARLY ANATOMIC RESPONSE TO ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY AND LONG-TERM OUTCOME IN DIABETIC MACULAR EDEMA
Authors: Dugel Pravin U. , Campbell Joanna H. , Kiss Szilárd , Loewenstein Anat , Shih Vanessa , Xu Xiaoshu , Holekamp Nancy M. , Augustin Albert J. , Ho Allen C. , Gonzalez Victor H. , Whitcup Scott M.
Published: February 2018

Purpose:

This post hoc analysis explores the relationship between early retinal anatomical response and long-term anatomical and visual outcomes with ranibizumab in center-involved diabetic macular edema.

Methods:

Eyes randomized to the ranibizumab plus prompt laser and ranibizumab plus deferred laser treatment arms in the Protocol I study were categorized according to their proportional reduction (<20 vs. ≥20%) in central retinal thickness (CRT) after 12 weeks. Adjusted and unadjusted analyses assessed the association between early (Week 12) anatomical response and long-term (Weeks 52 and 156) anatomical and best-corrected visual acuity outcomes.

Results:

Of 335 study eyes, 118 showed limited (<20%) and 217 showed strong (≥20%) CRT reduction at Week 12. In unadjusted and adjusted analyses, limited early CRT response was negatively and significantly associated with strong CRT response at Weeks 52 and 156. Sensitivity analyses indicated that this association was robust and unrelated to any “floor effect.” In unadjusted analyses, a strong early CRT response was associated with greater long-term improvement in best-corrected visual acuity; after controlling for confounders, the association lost statistical significance.

Conclusion:

Early CRT response to ranibizumab is a significant prognostic indicator of medium- to long-term anatomical outcome in center-involved diabetic macular edema.
DIFFERENTIAL DIAGNOSIS FOR VITREORETINAL LYMPHOMA WITH VITREORETINAL FINDINGS, IMMUNOGLOBULIN CLONALITY TESTS, AND INTERLEUKIN LEVELS
Authors: Lee Junwon , Kim Seung WOO , Kim Hyesun , Lee Christopher SEUNGKYU , Kim Min , Lee Sung CHUL
Published: February 2018

Purpose:

To analyze vitreoretinal findings, immunoglobulin clonality tests, and interleukin (IL) levels for diagnosing vitreoretinal lymphoma (VRL).

Methods:

Forty-three patients who underwent diagnostic vitrectomy for suspected VRL were retrospectively reviewed. Of those patients finally diagnosed with VRL and nonlymphoma, ophthalmic evaluation and cytology results, IL-6 and IL-10 levels, and immunoglobulin heavy chain and immunoglobulin kappa light chain clonality assays were compared.

Results:

Sub-retinal pigment epithelium infiltration and veil-pattern vitreous opacity were specific vitreoretinal findings in patients with VRL. The area under the receiver operating characteristic curve of the IL-10-to-IL-6 ratio and of IL-10 levels was 0.972 and 0.931, respectively. A combined immunoglobulin heavy chain and immunoglobulin kappa light chain assay showed increased sensitivity, whereas the determined specificity of immunoglobulin kappa light chain, at 94.12%, was much higher than the 78.95% of immunoglobulin heavy chain. Patients with VRL with atypically elevated IL-6 levels showed extensive and severe sub-retinal pigment epithelium infiltration.

Conclusion:

Newly screened immunoglobulin kappa light chain clonality assays may be useful to distinguish VRL from uveitis with high specificity. When sub-retinal pigment epithelium or retinal infiltration is severe and extensive, the IL-10-to-IL-6 ratio may not be typical and should be carefully interpreted.
Etiology of Acute Otitis Media and Characterization of Pneumococcal Isolates After Introduction of 13-Valent Pneumococcal Conjugate Vaccine in Japanese Children
Authors: Ubukata Kimiko , Morozumi Miyuki , Sakuma Megumi , Takata Misako , Mokuno Eriko , Tajima Takeshi , Iwata Satoshi
Published: February 2018

Background:

Acute otitis media is a leading cause of childhood morbidity and antibiotic prescriptions. We examined etiologic changes in acute otitis media after introduction of 13-valent pneumococcal conjugate vaccine as routine immunization for Japanese children in 2014. Serotypes, resistance genotypes, antibiotic susceptibilities and multilocus sequence typing of pneumococcal isolates were also characterized.

Methods:

Otolaryngologists prospectively collected middle ear fluid from 582 children by tympanocentesis or sampling through a spontaneously ruptured tympanic membrane between June 2016 and January 2017. Causative pathogens were identified by bacterial culture and real-time polymerase chain reaction for bacteria. Serotypes, resistance genotypes, sequence types and susceptibilities to 14 antimicrobial agents were determined for pneumococcal isolates.

Results:

At least 1 bacterial pathogen was identified in 473 of the samples (81.3%). Nontypeable Haemophilus influenzae (54.8%) was detected most frequently, followed by Streptococcus pneumoniae (25.4%), Streptococcus pyogenes (2.9%) and others. Pneumococci of current vaccine serotypes have decreased dramatically from 82.1% in 2006 to 18.5% (P < 0.001). Commonest serotypes were 15A (14.8%), 3 (13.9%) and 35B (11.1%). Serotype 3 was significantly less frequent among children receiving 13-valent pneumococcal conjugate vaccine compared with 7-valent pneumococcal conjugate vaccine (P = 0.002). Genotypic penicillin-resistant S. pneumoniae accounted for 28.7%, slightly less than in 2006 (34.2%; P = 0.393); the penicillin-resistant serotypes 15A and 35B had increased. Serotypes 15A, 3 and 35B most often belonged to sequence types 63, 180 and 558.

Conclusions:

Our findings are expected to assist in development of future vaccines, and they underscore the need for appropriate clinical choice of oral agents based on testing of causative pathogens.
High Prevalence of Extensively Drug-resistant Acinetobacter baumannii at a Children Hospital in Bolivia
Authors: Cerezales Mónica , Ocampo-Sosa Alain A. , Álvarez Montes Laura , Díaz Ríos Catalina , Bustamante Zulema , Santos Jazmín , Martínez-Martínez Luis , Higgins Paul G. , Gallego Lucía
Published: February 2018

Acinetobacter baumannii causes serious hospital-acquired infections and has been positioned as a priority organism by the World Health Organization. This study includes 36 A. baumannii isolates from a children hospital recovered between March 2014 and May 2015 in Cochabamba. The majority of the isolates were recovered from blood cultures (n = 10, 31.3%) and respiratory samples (n = 11, 34.4%); 53% of the patients were younger than 1 month old. Most of these isolates (n = 30, 80.6%) were extremely drug resistant and 8.3% were multidrug resistant. The circulation of 2 predominant clones including 25 isolates was determined by pulsed-field gel electrophoresis; 9 of the isolates were considered sporadic strains. The isolates grouped in the predominant clones and 5 of the unrelated sporadic strains were single-locus variant or double locus variant of clonal complex (CC110), belonging to international clone 7; the rest of the isolates were single-locus variant or double locus variant of another clonal complex. All the carbapenem-resistant isolates (88.9%) carried the bla
OXA-23-like in a similar structure to Tn2008 located on the chromosome, and the aac(3)-IIa gene was present in all the aminoglycoside-resistant isolates (86.1%). Strong biofilm producers were found among these isolates, being the strongest ones those recovered from the hospital environment, catheter, blood and cerebrospinal fluid (CSF) all of them belonged to the unrelated sporadic strains. The present study demonstrated the predominance and spread of closely related extremely drug-resistant A. baumannii isolates, what confers increasing risk to children and is of major concern because of the kind of infections and the lack of therapeutic alternatives to treat them.
Protein Content of Cervicovaginal Fluid Is Altered During Bacterial Vaginosis
Authors: Ferreira Carolina Sanitá Tafner , da Silva Márcia Guimarães , de Pontes Letícia Gomes , dos Santos Lucilene Delazari , Marconi Camila
Published: February 2018

Objectives

The aim of the study was to compare, using a proteomic approach, cervicovaginal fluid (CVF) proteins of women with bacterial vaginosis (BV) with those presenting normal microbiota.

Materials and Methods

A total of 309 reproductive-aged women were cross-sectionally enrolled. Participants were tested for vaginal candidosis, Trichomonas vaginalis, Chlamydia trachomatis, and Neisseria gonorrhoeae and excluded if positive. Vaginal microbiota was classified microscopically according to Nugent criteria in normal, intermediate, and BV. Randomly selected CVF samples of 29 women with BV and an equal number with normal microbiota were subjected to proteomic analysis. Thus, a total of 58 CVF samples were evaluated using shotgun liquid chromatography-tandem mass spectrometry in a Q-Tof PREMIER API mass spectrometer (MicroMass/Waters) for peptide detection and relative quantification.

Results

Of the 309 women enrolled, 63 (20.4%) were excluded after testing positive for at least one of the tested co-infections or because of low-quality samples. Microscopic classification of vaginal microbiota on the remaining 246 samples revealed that 132 women (53.6%) had normal microbiota, 33 (13.4%) had intermediate microbiota, and 81 (33.0%) had BV. Proteomic analysis of CVF of 58 randomly selected women with normal microbiota (n = 29) or BV (n = 29) successfully identified 74 proteins. In addition, the comparison of abundance of those proteins between the groups showed that the following five (6.7%) were enriched in BV: neutrophil elastase, kaliocin-1, neutrophil defensin-1, Ig lambda-2 chain C regions, and protein S100-A7. All of which have a recognized role in host's immunity.

Conclusions

Exclusive finding of BV affects immunity-related CVF components of reproductive-aged women.
Expert Review of Cervical Cytology: Does it Affect Patient Care?
Authors: Mark Jaron , Morrell Kayla , Eng Kevin , Alfiero Alexandra , Frederick Peter J.
Published: February 2018

Objectives

The aim of the study was to evaluate whether expert review of outside cervical cytology affects patient care.

Materials and Methods

A retrospective study was conducted of 424 new patient referrals for cervical dysplasia between 2004 and 2016 at Roswell Park Cancer Institute. Records were analyzed for outside cervical cytology reports and compared with expert cervical cytology review. Differences between expert review and outside reports were documented. Charts with a difference were then assessed for additional evaluation and procedures performed. We specifically analyzed the data for cytology being upgraded or downgraded after expert review.

Results

Two hundred forty-six patient charts were eligible for this study. We identified 165 patients with congruent pathology reports. Of the 81 different reports, 41 led to significant pathologic differences. Twenty-four reports with different pathology were low-grade squamous intraepithelial lesions (LSIL) upgraded to high-grade squamous intraepithelial lesions (HSIL). Six were HSIL downgraded to LSIL, 4 LSIL downgraded to negative, 3 AGC upgraded to HSIL, 2 AGC upgraded to cancer, 1 each for HSIL downgraded to negative, and AGC downgraded to negative. Of the 24 patients whose cytology changed from low grade to high grade, 17 underwent an excisional procedure and 1 had a laser ablative procedure. Cervical intraepithelial neoplasia 2 or 3 was found in 11 specimens. Cervical intraepithelial neoplasia 1 was found in 4 of excisional specimens and no dysplasia found in 2.

Conclusions

Expert review of cervical cytology significantly impacts patient management at a tertiary referral center, resulting in both upgrading and downgrading of community cytology reports.
Trends in Cervical Cancer Screening in California's Family Planning Program
Authors: Thiel de Bocanegra Heike , Navarro Sandy K. , Nonzee Narissa J. , Vangala Sitaram , Zhou Xinkai , Chang Charlene , Moscicki Anna-Barbara
Published: February 2018

Objective

Guidelines recommend 3-year cervical cancer screening intervals to avoid unnecessary invasive procedures; however, regular testing remains critical. We evaluated trends in cervical cancer screening among low-income women receiving family planning–related services and their association with patient and provider characteristics.

Materials and Methods

Using claims and enrollment data from California's publicly funded family planning program, we identified 540,026 women with a clinician visit at 216 sites between 2011 and 2015. We calculated guideline adherent cervical cancer testing rates for 6-month periods among women aged 21 to 24, 25 to 29, and 30 to 64 years. We also calculated guideline adherent chlamydia testing for women aged 21 to 24 years.

Results

Having a 3-year cervical cancer screening test declined for all age groups. The odds of cervical cancer screening declined for women aged 21 to 24 years by an estimated 11% every 6 months (odds ratio [OR] = 0.90, 95% confidence interval [CI] = 0.89–0.90), a significantly greater decline than for the other age groups. Among women aged 21 to 29 years, the decrease was significantly larger for Latina (ratio of ORs = 0.95, 95% CI = 0.95–0.96) and Spanish-speaking (ratio of ORs = 0.95, 95% CI = 0.95–0.96) women compared with non-Latina and non-Spanish–speaking women. A smaller decline was seen for chlamydia screening.

Conclusions

Changes in screening interval guidelines are associated with overall decreased screening. This trend was strongest among women aged 21 to 24 years, even as they continued to be screened appropriately for chlamydia, suggesting many missed opportunities. Efforts to reduce unnecessary cervical cancer screening should be monitored to maintain appropriate screening rates to avoid advanced-stage diagnoses and higher health care costs.
Male Depression Subtypes and Suicidality
Authors: Rice Simon M. , Oliffe John L. , Kealy David , Ogrodniczuk John S.
Published: February 2018

Assessment of men's externalizing symptoms has been theorized to assist in the identification of those at risk of suicide. A nationally representative sample of Canadian men (N = 1000; mean, 49.63 years) provided data on internalizing and externalizing symptoms, and history of recent suicide planning and attempt (previous 4 weeks). Latent profile analysis indicted three classification subtypes. Robust effects were observed regarding history of recent suicide planning and attempt. Men with a marked externalizing profile (12.7% of sample), which included substance use, anger, and risk taking, were significantly more likely to have had a recent suicide plan (risk ratio, 14.47; p < 0.001) or to have attempted suicide within the previous 4 weeks (risk ratio, 21.32; p < 0.001) relative to asymptomatic men (67.7% of sample). Because recent suicide attempt was a rare event in the present sample (n = 13), findings need to be replicated in higher-risk populations. Results support primary care screening for both men's internalizing and externalizing depression symptoms.
CDC's 6|18 Initiative: A Cross-Sector Approach to Translating Evidence Into Practice
Authors: Seeff Laura C. , McGinnis Tricia , Heishman Hilary
Published: February 2018

Context:

As the US health care system continues to undergo dynamic change, the increased alignment between health care quality and payment has provided new opportunities for public health and health care sectors to work together.

Program:

The Centers for Disease Control and Prevention's 6|18 Initiative accelerates cross-sector collaboration between public health and health care purchasers, payers, and providers and highlights 6 high-burden conditions and 18 associated interventions with evidence of cost reduction/neutrality and improved health outcomes. This evidence can inform payment, utilization, and quality of prevention and control interventions.

Implementation:

The Centers for Disease Control and Prevention focused initially on public payer health insurance interventions for asthma control, unintended pregnancy prevention, and tobacco cessation. Nine state Medicaid and public health agency teams—in Colorado, Georgia, Louisiana, Massachusetts, Michigan, Minnesota, New York, Rhode Island, and South Carolina—participated in the initiative because they had previously prioritized the health condition(s) and specific intervention(s) and had secured state-level leadership support for state agency collaboration. The Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Center for Health Care Strategies, the Robert Wood Johnson Foundation, and other partners supported state implementation and dissemination of early lessons learned.

Evaluation:

The Centers for Disease Control and Prevention conducted exploratory interviews to guide improvement of the 6|18 Initiative and to understand facilitators, barriers, and complementary roles played by each sector. Monthly technical assistance calls conducted with state teams documented collaborative activities between state Medicaid agencies and health departments and state processes to increase coverage and utilization.

Discussion:

The 6|18 Initiative is strengthening partnerships between state health departments and Medicaid agencies and contributing to state progress in helping improve Medicaid coverage and utilization of effective prevention and control interventions. This initiative highlights early successes for others interested in strengthening collaboration between state agencies and between public and private sectors to improve payment, utilization, and quality of evidence-based interventions.
Finding Hidden HIV Clusters to Support Geographic-Oriented HIV Interventions in Kenya
Authors: Waruru Anthony , Achia Thomas N. O. , Tobias James L. , Ng'ang'a James , Mwangi Mary , Wamicwe Joyce , Zielinski-Gutierrez Emily , Oluoch Tom , Muthama Evelyn , Tylleskär Thorkild
Published: February 2018

Background:

In a spatially well known and dispersed HIV epidemic, identifying geographic clusters with significantly higher HIV prevalence is important for focusing interventions for people living with HIV (PLHIV).

Methods:

We used Kulldorff spatial-scan Poisson model to identify clusters with high numbers of HIV-infected persons 15–64 years old. We classified PLHIV as belonging to either higher prevalence or lower prevalence (HP/LP) clusters, then assessed distributions of sociodemographic and biobehavioral HIV risk factors and associations with clustering.

Results:

About half of survey locations, 112/238 (47%) had high rates of HIV (HP clusters), with 1.1–4.6 times greater PLHIV adults observed than expected. Richer persons compared with respondents in lowest wealth index had higher odds of belonging to a HP cluster, adjusted odds ratio (aOR) 1.61 [95% confidence interval (CI): 1.13 to 2.3], aOR 1.66 (95% CI: 1.09 to 2.53), aOR 3.2 (95% CI: 1.82 to 5.65), and aOR 2.28 (95% CI: 1.09 to 4.78) in second, middle, fourth, and highest quintiles, respectively. Respondents who perceived themselves to have greater HIV risk or were already HIV-infected had higher odds of belonging to a HP cluster, aOR 1.96 (95% CI: 1.13 to 3.4) and aOR 5.51 (95% CI: 2.42 to 12.55), respectively; compared with perceived low risk. Men who had ever been clients of female sex worker had higher odds of belonging to a HP cluster than those who had never been, aOR 1.47 (95% CI: 1.04 to 2.08); and uncircumcised men vs circumcised, aOR 3.2 (95% CI: 1.74 to 5.8).

Conclusions:

HIV infection in Kenya exhibits localized geographic clustering associated with sociodemographic and behavioral factors, suggesting disproportionate exposure to higher HIV risk. Identification of these clusters reveals the right places for targeting priority-tailored HIV interventions.
Perspectives on Integrated HIV and Hepatitis C Virus Testing Among Persons Entering a Northern California Jail: A Pilot Study
Authors: Ly Wilson , Cocohoba Jennifer , Chyorny Alexander , Halpern Jodi , Auerswald Colette , Myers Janet
Published: February 2018

Background:

Providing HIV and hepatitis C virus (HCV) testing on an “opt-out” basis is often considered the “gold standard” because it contributes to higher testing rates when compared with “opt-in” strategies. Although rates are crucial, an individual's testing preferences are also important, especially in correctional settings where legal and social factors influence a person's capacity to freely decide whether or not to test. Our study explored factors influencing HIV and HCV testing decisions and individuals' preferences and concerns regarding opt-in vs. opt-out testing at the time of jail entry.

Methods:

We conducted semistructured interviews to explore individuals' previous testing experiences, reasons to test, understanding of their health care rights, HIV and HCV knowledge, and preferences for an opt-out vs. an opt-in testing script.

Results:

We interviewed 30 individuals detained in the Santa Clara County Jail at intake. Participants reported that their testing decisions were influenced by their level of HIV and HCV knowledge, self-perceived risk of infection and stigma associated with infection and testing, the degree to which they felt coerced, and understanding of testing rights in a correctional setting. Most preferred the opt-in script because they valued the choice of whether or not to be tested. Participants who did prefer the opt-out script did so because they felt that the script was less likely to make people feel “singled out” for testing.

Conclusions:

Our findings demonstrate that people care about how testing is offered and suggest a need for further research to see how much this influences their decision about whether to test.
Effects of rogue ryanodine receptors on Ca
2+
sparks in cardiac myocytes
Authors: Chen Xudong , Feng Yundi , Huo Yunlong , Tan Wenchang
Published: February 2018

Ca
2+
sparks and Ca
2+
quarks, arising from clustered and rogue ryanodine receptors (RyRs), are significant Ca
2+
release events from the junctional sarcoplasmic reticulum (JSR). Based on the anomalous subdiffusion of Ca
2+
in the cytoplasm, a mathematical model was developed to investigate the effects of rogue RyRs on Ca
2+
sparks in cardiac myocytes. Ca
2+
quarks and sparks from the stochastic opening of rogue and clustered RyRs are numerically reproduced and agree with experimental measurements. It is found that the stochastic opening Ca
2+
release units (CRUs) of clustered RyRs are regulated by free Ca
2+
concentration in the JSR lumen (i.e. [Ca
2+
]
lumen
). The frequency of spontaneous Ca
2+
sparks is remarkably increased by the rogue RyRs opening at high [Ca
2+
]
lumen
, but not at low [Ca
2+
]
lumen
. Hence, the opening of rogue RyRs contributes to the formation of Ca
2+
sparks at high [Ca
2+
]
lumen
. The interplay of Ca
2+
sparks and Ca
2+
quarks has been discussed in detail. This work is of significance to provide insight into understanding Ca
2+
release mechanisms in cardiac myocytes.
Direct amidation of non-activated phenylacetic acid and benzylamine derivatives catalysed by NiCl
2
Authors: Cheng Lidan , Ge Xiaoping , Huang Longjiang
Published: February 2018

This paper describes an eco-friendly and efficient direct amidation of benzylamine and phenylacetic acid derivatives in the presence of 10 mol% NiCl
2
as catalyst without any drying agent. For the different phenylacetic acid and benzylamine derivatives, the direct catalysed amidation gave moderate-to-excellent yields in toluene. The steric and electronic effects of substituent groups on the phenyl ring of acid were crucial to the yields of the direct amidation. The catalyst NiCl
2
can be recycled three times without loss of activity.
Rogue periodic waves of the focusing nonlinear Schrödinger equation
Authors: Chen Jinbing , Pelinovsky Dmitry E.
Published: February 2018

Rogue periodic waves
stand for rogue waves on a periodic background. The nonlinear Schrödinger equation in the focusing case admits two families of periodic wave solutions expressed by the Jacobian elliptic functions
dn
and
cn
. Both periodic waves are modulationally unstable with respect to long-wave perturbations. Exact solutions for the rogue periodic waves are constructed by using the explicit expressions for the periodic eigenfunctions of the Zakharov–Shabat spectral problem and the Darboux transformations. These exact solutions generalize the classical rogue wave (the so-called Peregrine’s breather). The magnification factor of the rogue periodic waves is computed as a function of the elliptic modulus. Rogue periodic waves constructed here are compared with the rogue wave patterns obtained numerically in recent publications.
Utilizing ExAC to Assess the Hidden Contribution of Variants of Unknown Significance to Sanfilippo Type B Incidence
Authors: Clark Wyatt T. , Yu G. Karen , Aoyagi-Scharber Mika , LeBowitz Jonathan H.
Published: February 2018

Given the large and expanding quantity of publicly available sequencing data, it should be possible to extract incidence information for monogenic diseases from allele frequencies, provided one knows which mutations are causal. We tested this idea on a rare, monogenic, lysosomal storage disorder, Sanfilippo Type B (Mucopolysaccharidosis type IIIB).

Sanfilippo Type B is caused by mutations in the gene encoding α-N-acetylglucosaminidase (NAGLU). There were 189 NAGLU missense variants found in the ExAC dataset that comprises roughly 60,000 individual exomes. Only 24 of the 189 missense variants were known to be pathogenic; the remaining 165 variants were of unknown significance (VUS), and their potential contribution to disease is unknown.

To address this problem, we measured enzymatic activities of 164 NAGLU missense VUS in the ExAC dataset and developed a statistical framework for estimating disease incidence with associated confidence intervals. We found that 25% of VUS decreased the activity of NAGLU to levels consistent with Sanfilippo Type B pathogenic alleles. We found that a substantial fraction of Sanfilippo Type B incidence (67%) could be accounted for by novel mutations not previously identified in patients, illustrating the utility of combining functional activity data for VUS with population-wide allele frequency data in estimating disease incidence.
hRBPome: a central repository of all known human RNA-binding proteins
Authors: Ghosh Pritha , Murugavel Pavalam , Sowdhamini Ramanathan
Published: February 2018

Background

RNA-binding proteins (RBPs) have been extensively studied in humans over the past few years. Multiple reports have been made in the literature for genome-wide survey for this class of proteins in the human genome using different tools and techniques. Due to the inherent difference in the nature of the methods used in identifying human RBPs, as well as the diverse sources for data collection in each of these studies, there exists immense heterogeneity (including diversity in data formats) and poor intersection among the datasets available from the different studies.

Description

hRBPome is a comprehensive database of human RBPs known from six different studies. We have introduced considerable uniformity in the data, by mapping the various data formats reported by the different studies to gene names. This makes comparison across studies (datasets) easier than was possible before. We also provide confidence scores to each of these known RBPs, on the basis of their presence across studies.

Conclusion

This database presents a set of 837 high confidence RBP genes, identified in three or more resources, out of the six studies considered. Hence, it forms a “gold standard” for RBPs in the human genome. It also provides information for all the human RBPs from multiple resources, known to the best of our knowledge, on a common platform. The database can be accessed from the following URL: http://caps.ncbs.res.in/hrbpome