bluuebunny/crossref_metadata_2025 huggingface dataset:
Education Differentially Buffers Cognitive Performance in Black and White Older Adults
Authors: Jean Kharine R , Lindbergh Cutter A , Mewborn Catherine M , Robinson Talia L , Gogniat Marissa A , Miller L Stephen
Published: October 2018

Objectives

Given that black American older adults are more likely to have lower educational attainment and perform worse on cognitive tests than white Americans, we examined whether increased education would confer greater cognitive advantage to black Americans on measures of global and specific domains of cognitive function.

Methods

The sample included 522 community-dwelling older adults from a larger study. An analysis of covariance was conducted with race and education as between-participant factors and global cognition as the dependent variable. A multivariate analysis of covariance was conducted with five cognitive domains (immediate memory, visuospatial/constructional ability, language, attention, and delayed memory) as the dependent variables.

Results

Significant main effects indicated that black Americans, F(1,516) = 29.18, p < .001, and individuals with less education, F(1,516) = 44.93, p < .001, evidenced lower cognitive functioning, controlling for age and overall health status, and the interaction term reached statistical significance, F(1,516) = 7.95, p = .005. The impact of education on global cognitive function for black participants was more than twice as large (Cohen’s d = 1.30) than for white participants (Cohen’s d = .52). There was a significant race × education interaction for the cognitive domain of attention (p < .001) and a composite measure of non-memory domains (i.e., language, visuospatial/constructional, and attention; p < .001).

Discussion

Our findings suggest that educational attainment is particularly important for black Americans with respect to global cognitive function, attention, and non-memory domains.
Mesopelagic fish avoidance from the vessel dynamic positioning system
Authors: Peña Marian
Published: October 2018

The study of marine organism behaviour and vertical distribution requires the use of techniques that do not disturb their natural state. This study analyses the mesopelagic fishes behaviour influenced by the presence of a research vessel. Acoustic data recorded on board the RV “Ángeles Alvariño” during the RAPROCAN 2017 survey showed a clear pattern of mesopelagic fishes migrating deeper in the water column at night when the DP system was connected. Details on how the scatterers changed their trajectory when migrating to the surface at night and the progressive increase in avoidance depth when dawn approached is shown. An experiment was carried out to discern fish reaction to vessel lights and to the DP system. While a dispersed diving was detected when the lights were switched on, a more acute reaction to the DP system was registered with not only vertical displacement, but also an increment in scattering produced by an aggregating behaviour. Both vessel DP-noise and light modify the mesopelagic fish behaviour, which needs to be accounted for when studying mesopelagic layers close to the surface. Surveys aiming at estimating abundance and biomass from these species are encouraged to do so at day time.
On the Probability That a Stationary Gaussian Process With Spectral Gap Remains Non-negative on a Long Interval
Authors: Feldheim Naomi , Feldheim Ohad , Jaye Benjamin , Nazarov Fedor , Nitzan Shahaf
Published: October 2018

Let $f$ be a zero mean continuous stationary Gaussian process on $\mathbb{R}$ whose spectral measure vanishes in a $\delta $-neighborhood of the origin. Then, the probability that $f$ stays non-negative on an interval of length $L$ is at most $e^{-c\delta ^2 L^2}$ with some absolute $c>0$ and the result is sharp without additional assumptions.
The effects of diesel price on regional trade in the USA
Authors: Szewerniak Wojciech W , Xu Yilan , Dall’erba Sandy
Published: October 2018

The abundant trade literature offers little insight on how diesel prices affect intranational trade. We fill this gap by calibrating a structural gravity model to recent U.S. interstate trade data. We discover that, for any distance, the elasticity of trade to diesel prices is much greater for low-valued commodities than for high-valued commodities. The general equilibrium result shows that a nationwide diesel price increase leads to heterogeneous decreases in trade across distances from the exporting state because of adjustments in multilateral costs and trade portfolio. Moreover, it increases the share of high-valued commodities in interstate trade.
Effect of Spinal Cord Stimulation on Early Disability Pension in 198 Failed Back Surgery Syndrome Patients: Case-Control Study
Authors: Kaijankoski Hanna , Nissen Mette , Ikäheimo Tiina-Mari , von Und Zu Fraunberg Mikael , Airaksinen Olavi , Huttunen Jukka
Published: October 2018

BACKGROUND

Spinal cord stimulation (SCS) has proven to be a cost-effective treatment for failed back surgery syndrome (FBSS). However, the effect on patients’ working capability remains unclear.

OBJECTIVE

To evaluate the impact of SCS on working capability and to identify the factors behind permanent disability in FBSS patients.

METHODS

The study group consisted of 198 working-age patients with SCS trialed or implanted for FBSS in a single center between 1996 and 2014. For each patient, 3 living controls, matched by age, gender, and birthplace, were otherwise randomly selected by the Population Register Center. The data on working ability were obtained from the Social Insurance Institution. Patients were divided into 3 groups: SCS trial only, SCS implanted permanently, and SCS implanted but later explanted.

RESULTS

A rehabilitation subsidy was given to 68 patients and 8 controls for a mean of 5.2 (95% confidence interval [CI] 2.4-8.2) and 0.2 (95% CI 0.05-0.6) days per month (P < .05). At the end of follow-up, 16 (37%), 13 (33%), 25 (22%), and 27 (5%) subjects were on disability pension (DP) in the SCS trial, SCS explanted, SCS permanent, and control groups. Patients in the SCS trial-only group were significantly more often on DP than were patients with permanent SCS (odds ratio 2.6; 95% CI 1.2-5.9; P = .02)

CONCLUSION

Permanent SCS usage was associated with reduced sick leave and DP. Prospective study will be required to assess possible predictive value.
A review of ENSO theories
Authors: Wang Chunzai
Published: October 2018

The El Niño and the Southern Oscillation (ENSO) occurrence can be usually explained by two views of (i) a self-sustained oscillatory mode and (ii) a stable mode interacting with high-frequency forcing such as westerly wind bursts and Madden-Julian Oscillation events. The positive ocean–atmosphere feedback in the tropical Pacific hypothesized by Bjerknes leads the ENSO event to a mature phase. After ENSO event matures, negative feedbacks are needed to cease the ENSO anomaly growth. Four negative feedbacks have been proposed: (i) reflected Kelvin waves at the ocean western boundary, (ii) a discharge process due to Sverdrup transport, (iii) western-Pacific wind-forced Kelvin waves and (iv) anomalous zonal advections and wave reflection at the ocean eastern boundary. These four ENSO mechanisms are respectively called the delayed oscillator, the recharge–discharge oscillator, the western-Pacific oscillator and the advective–reflective oscillator. The unified oscillator is developed by including all ENSO mechanisms, i.e. all four ENSO oscillators are special cases of the unified oscillator. The tropical Pacific Ocean and atmosphere interaction can also induce coupled slow westward- and eastward-propagating modes. An advantage of the coupled slow modes is that they can be used to explain the propagating property of interannual anomalies, whereas the oscillatory modes produce a standing oscillation. The research community has recently paid attention to different types of ENSO events by focusing on the central-Pacific El Niño. All of the ENSO mechanisms may work for the central-Pacific El Niño events, with an addition that the central-Pacific El Niño may be related to forcing or processes in the extra-tropical Pacific.
Results of Early Virologic Monitoring May Facilitate Differentiated Care Monitoring Strategies for Clients on ART, Rakai, Uganda
Authors: Ssempijja Victor , Chang Larry W , Nakigozi Gertrude , Ndyanabo Anthony , Quinn Thomas C , Cobelens Frank , Wawer Maria , Gray Ronald , Serwadda David , Reynolds Steven J
Published: October 2018

Background

Viral load (VL) monitoring is standard of care in HIV-infected persons initiated on antiretroviral therapy (ART). We evaluated the predictive value of VL measurements at 6 and 12 months after initiation of firstline ART to estimate the future risk of virologic failure (VF).

Methods

HIV-infected persons with VL measurements at 6 and 12 months post-ART initiation and at least 2 additional VL measurements thereafter were assessed for risk of future VF, defined per World Health Organization guidelines. VL at 6 or 12 months post-ART was categorized into <400, 400–1000, 1001–2000, and >2000 copies/mL. Cox proportional hazard models were used to compare VF incidence associated with 6-month, 12-month, and a composite of 6- and 12-month VL prediction indicators.

Results

Overall, 1863 HIV-infected adults had a 6- and 12-month VL measurement, and 1588 had at least 2 additional VLs thereafter for predicting future VF. The majority (67%) were female (median age: females 33 years and males 37 years). At 12 months post-ART, 90% had VL<400 copies/mL (cumulative incidence of VF at 1.5%), 3% had 400–1000 copies/mL (VF 12%), 2% had 1001–2000 copies/mL (VF 22%), and 5% had >2000 copies/mL (VF 71%). The predictive value of the 12-month VL measurement was comparable to the composite of both the 6- and 12-month VL measurements and better than the 6-month VL measurement.

Conclusions

At 12 months after ART initiation, 90% of patients were virally suppressed with a low likelihood of future VF. VL measurement at 12 months post–ART initiation predicts risk of VF and could inform differentiated virologic monitoring strategies.
Facilitators and Barriers to Implementation of a Peer Support Intervention for Patients with Chronic Pain: A Qualitative Study
Authors: Shue Sarah A , McGuire Alan B , Matthias Marianne S
Published: October 2018

Objective

Pain self-management information and support, delivered by peers, are a potentially useful approach to help patients who are struggling to manage their chronic pain. Before implementation into clinical settings, it is important to understand factors that may influence the success of implementation. The purpose of this study was to explore facilitators and barriers to implementation of peer support for chronic pain.

Design

Semistructured interviews were conducted with clinicians who provide care to patients with chronic pain, regarding their perceptions of the proposed peer support intervention.

Setting

A single US Veterans Affairs Medical Center.

Subjects

Using maximum variation sampling, 15 providers were interviewed (11 women, four men). Clinicians’ disciplines included primary care, physical therapy, nursing, clinical psychology, social work, and pharmacy.

Results

Findings indicated that clinicians 1) had an overall positive perception of the intervention; 2) had specific intervention outcomes they wanted for patients; 3) anticipated that the intervention could positively influence their role; 4) anticipated barriers to intervention participation and maintenance; and 5) had concerns regarding peer coach selection. Findings are discussed in the context of the Consolidated Framework for Implementation Research.

Conclusions

Understanding clinician perceptions of a peer support intervention is critical for successful implementation. The feedback collected in this study will facilitate implementation of the intervention on a broader scale, allowing more patients to benefit.
Associations Among Sleep Latency, Subjective Pain, and Thermal Pain Sensitivity in Gynecologic Cancer
Authors: Kirsch Janae L , Robinson Michael E , McCrae Christina S , Kacel Elizabeth L , Wong Shan S , Patidar Seema , Sannes Timothy S , Garey Stephanie , Castagno Jacqueline C , Pereira Deidre B
Published: October 2018

Objective

Pain is common among women with gynecologic cancer and contributes to depressed mood, sleep disturbances, and likelihood of future chronic pain. Little is known about how psychosocial factors are associated with central sensitization of pain in gynecologic cancer. This study examined relations among depressive symptoms, sleep, subjective pain, and aftersensation pain (a proxy for central sensitization of pain) in gynecologic cancer.

Methods

Participants were 42 women (mean age [SD] = 59.60 [10.11] years) enrolled in a randomized clinical trial examining psychological intervention effects on sleep, pain, mood, and stress hormones/cytokines in gynecologic cancer. Six to eight weeks after surgery, participants completed an assessment of depressive symptoms, sleep, and subjective pain and a temporal summation of pain protocol via quantitative sensory testing (QST).

Results

Controlling for recent chemotherapy, history of chronic pain, and analgesic medication use, regression analyses revealed that longer sleep onset latency (SOL; B = 3.112, P = 0.039, bias-corrected and accelerated (BCa) 95% confidence interval [CI] = 0.371 to 6.014) and greater sensory pain (B = 0.695, P = 0.023, BCa 95% CI = 0.085 to 1.210) were associated with greater aftersensation pain at 15 seconds. Greater sensory pain scores were associated with greater aftersensation pain at 30 seconds (B = 0.286, P = 0.045, BCa 95% CI = 0.008 to 0.513). Depression was not associated with aftersensation pain. The overall models accounted for 44.5% and 40.4% of the variance in aftersensation pain at 15 and 30 seconds, respectively. Conclusions. Longer SOL and higher subjective sensory pain were related to greater aftersensation of experimentally induced pain in women postsurgery for gynecologic cancers. Interventions that improve sleep and subjective sensory pain during the perisurgical period may reduce risk for central sensitization of pain.
Medical Marvels and Professional Medicine: Establishing Scientific Authority in Enlightenment France
Authors: Haas Angela C
Published: October 2018

This article examines the investigation of medical marvels—principally reported cases of human bodies that could spontaneously produce rocks, needles, animals or other objects—in Enlightenment France. It argues that published accounts of these investigations served both a pedagogical and propagandistic purpose as they highlighted the benevolence, extensive knowledge, and sceptical approach of the ideal medical practitioner. At a time when medical knowledge was often challenged and the medical community remained insecure about its ability to cure diseases, these accounts provided crucial evidence that medicine was a useful and reliable science. This article examines a critical moment in the professionalisation of medicine when elite physicians in Paris were able to exploit a growing antipathy for the marvellous in order to prove the utility and reliability of medical knowledge, while inextricably linking medical practice with rationalism, scientific reasoning and the Enlightenment campaign against superstition.
Achieved Gain and Subjective Outcomes for a Wide-Bandwidth Contact Hearing Aid Fitted Using CAM2
Authors: Arbogast Tanya L. , Moore Brian C. J. , Puria Sunil , Dundas Drew , Brimacombe Judith , Edwards Brent , Carr Levy Suzanne
Published: October 2018

Objectives:

The objective of this study was to test the ability to achieve, maintain, and subjectively benefit from extended high-frequency amplification in a real-world use scenario, with a device that restores audibility for frequencies up to 10 kHz.

Design:

A total of 78 participants (149 ears) with mild to moderately-severe sensorineural hearing loss completed one of two studies conducted across eight clinical sites. Participants were fitted with a light-driven contact hearing aid (the Earlens system) that directly drives the tympanic membrane, allowing extended high-frequency output and amplification with minimal acoustic feedback. Cambridge Method for Loudness Equalization 2 - High Frequency (CAM2)-prescribed gains for experienced users were used for initial fitting, and adjustments were made when required according to participant preferences for loudness and comfort or when measures of functional gain (FG) indicated that more or less gain was needed. Participants wore the devices for an extended period. Prescribed versus adjusted output and gain, frequency-specific FG, and self-perceived benefit assessed with the Abbreviated Profile of Hearing Aid Benefit, and a custom questionnaire were documented. Self-perceived benefit results were compared with those for unaided listening and to ratings with participants’ own acoustic hearing aids.

Results:

The prescribed low-level insertion gain from 6 to 10 kHz averaged 53 dB across all ears, with a range from 26 to 86 dB. After adjustment, the gain from 6 to 10 kHz decreased to an average of 45 dB with a range from 16 to 86 dB. Measured FG averaged 39 dB from 6 to 10 kHz with a range from 11 to 62 dB. Abbreviated Profile of Hearing Aid Benefit results revealed a significant improvement in communication relative to unaided listening, averaging 28 to 32 percentage points for the background noise, reverberation, and ease of communication subscales. Relative to participants’ own hearing aids, the subscales ease of communication and aversiveness showed small but significant improvements for Earlens ranging from 6 to 7 percentage points. For the custom satisfaction questionnaire, most participants rated the Earlens system as better than their own hearing aids in most situations.

Conclusions:

Participants used and reported subjective benefit from the Earlens system. Most participants preferred slightly less gain at 6 to 10 kHz than prescribed for experienced users by CAM2, preferring similar gains to those prescribed for inexperienced users, but gains over the extended high frequencies were high relative to those that are currently available with acoustic hearing aids.
How to Optimize Cancer Treatment in Older Patients
Authors: Pamoukdjian Frédéric , Liuu Evelyne , Caillet Philippe , Herbaud Stéphane , Gisselbrecht Mathilde , Poisson Johanne , Boudou-Rouquette Pascaline , Zelek Laurent , Paillaud Elena
Published: October 2018

Cancer is a disease of older people, but this age group has often been excluded from clinical trials of cancer, which leads to poor transportability of standardized treatments in older cancer patients. One of the main reasons for the exclusion is the heterogeneity of older people in several domains: social environment, comorbidities, dependency, functional status, nutritional status, cognition status, and mood status. Comprehensive geriatric assessment aims to assess this heterogeneity and has identified frequent health problems often unknown before therapeutic decisions, which allows for targeted geriatric interventions with or without follow-up and appropriate cancer treatment selection. Several tools and scores have been developed for a complementary approach. These tools have the following characteristics: they screen for vulnerability to select patients who may benefit from a comprehensive geriatric assessment; are predictive tools for survival, postoperative complications, or chemotherapy-related toxicity; are decisional algorithms for cancer treatment; or define a core set of geriatric data to be collected in clinical cancer trials. Here, we present an overview of the geriatric tools that were published in PubMed from 2000 to 2017, that could help in the therapeutic decision-making for older cancer patients.
Risperidone But Not Quetiapine Treatment Is Associated With Increased Appetite But Not Satiety Hormones in Children During An Oral Glucose Tolerance Test
Authors: Ngai Ying Fai , Devlin Angela M. , Panagiotopoulos Constadina
Published: October 2018

Background

Second-generation antipsychotics (SGAs) are commonly used to treat children with mental health conditions (MHCs) but are associated with adverse effects including obesity, hypertension, dyslipidemia, and type 2 diabetes. The mechanisms underlying these complications are unknown, but it has been suggested that SGAs increase appetite leading to weight gain. The present objective was to perform a pilot study to investigate appetite and satiety hormones in SGA-treated (risperidone or quetiapine) and SGA-naive children with similar mental health conditions.

Methods

Oral glucose tolerance tests (OGTTs) were conducted in SGA-naive (n = 18), risperidone-treated (n = 20), and quetiapine-treated (n = 16) children recruited from the British Columbia Children's Hospital Psychiatry Department. Over 5 time-points during the OGTT, appetite questionnaires using a visual analogue scale were administered, and blood was collected to measure ghrelin, peptide YY, glucose-dependent insulinotropic polypeptide, glucagon-like protein 1, leptin, and adiponectin. Mixed model analyses were conducted to examine between-group differences.

Results

The children were similar in age, psychiatric diagnosis, and global assessment of functioning scores. Body mass index z-scores were also similar between groups. Appetite was increased during the OGTT in the risperidone-treated compared with the SGA-naive group for 2 questions (“How strong is your desire to eat”; P = 0.003 and “How much food do you think you can eat”; P = 0.028). No differences in satiety hormones were observed between the 3 groups.

Conclusions

Risperidone treatment in youth is associated with elevated appetite during an OGTT, with no differences in gut peptides or adipocytokines to explain risperidone's effect on appetite. Further research is needed to explore other mediators of weight gain and metabolic dysfunction in SGA-treated youth.
Vitamin D
Authors: Miraglia del Giudice Michele , Indolfi Cristiana , Strisciuglio Caterina
Published: October 2018

Vitamin D is a group of liposoluble prohormones consisting of 5 different vitamins, the most important forms being vitamin D2 and vitamin D3. The ergocalciferol (vitamin D2) is less efficacious and derives from irradiated fungi, while colecalciferol (vitamin D3), derived from cholesterol, is synthesized via ultraviolet B rays in animal organisms. Only the ultraviolet B rays (290 to 315 nm) portion of the solar ray photolyzes 7-dehydrocholesterol in the skin to previtamin D3, which is converted subsequently to vitamin D3. Moreover, the skin makes little vitamin D from the sun at latitudes above 37 degrees north or below 37 degrees south of the equator. Calcidiol [25(OH)D] is the more stable metabolite of vitamin D in serum and the best indicator of the vitamin D status. Optimal values range are >30 ng/mL. Calcitriol [1,25(OH)2D] is the active hormone form of vitamin D. The 1,25(OH)2D binds to its nuclear receptor (vitamin D receptor), expressed in many tissues, regulating the expression of genes involved in calcium metabolism, cell differentiation, apoptosis, and immunity. About immunity, calcitriol stimulates innate immune responses by enhancing the chemotactic and phagocytotic responses of macrophages as well as the production of antimicrobial peptides. 1,25(OH)2D strongly enhances production of interleukine-10 by stimulating T regulatory cells and inhibiting Th1 and Th17 cell differentiation. Furthermore, several studies suggest that lower 25(OH)D serum levels are associated with an increased risk of respiratory infection at all ages in a dose-response manner.
Clinical Features and Therapeutic Response in Women Meeting Criteria for Presumptive Treatment for Pelvic Inflammatory Disease Associated With Mycoplasma genitalium
Authors: Latimer Rosie L. , Read Tim R.H. , Vodstrcil Lenka A. , Goller Jane L. , Ong Jason J. , Fairley Christopher K. , Hocking Jane S. , Bradshaw Catriona S.
Published: October 2018

Background

There are limited published data describing clinical features and therapeutic response in women meeting the criteria for presumptive treatment of pelvic inflammatory disease associated with Mycoplasma genitalium (MG-PID). The MG-PID has been reported to respond poorly to standard PID treatment regimens and while moxifloxacin is recommended in several treatment guidelines, published data to support its use are scant.

Methods

We conducted a retrospective study of women at Melbourne Sexual Health Centre between 2006 and 2017, who met the Centers for Disease Control and Prevention criteria for presumptive treatment of PID, and had MG detected as the sole pathogen. Clinical and laboratory characteristics of MG-PID were compared to cases of chlamydial PID (CT-PID) by multivariable analysis. Microbiological and clinical cure following moxifloxacin and standard PID treatment was determined for women with MG-PID who returned for test of cure between 14 and 120 days.

Results

Ninety-two patients with MG-PID were compared with 92 women with CT-PID. The MG-PID was associated with increased lower abdominal tenderness (adjusted odds ratio, 2.29; 95% confidence interval [CI], 1.14–4.60), but a lesser vaginal polymorphonuclear response compared to CT-PID by multivariable analysis. Of the 92 women with MG-PID, 54/92 (59%) received moxifloxacin (10–14 days) and 37/54 had a test of cure between 14 and 120 days; 27/37 (73%) cases had a median of 7 days of a standard regimen containing doxycycline and metronidazole +/− azithromycin before moxifloxacin. Microbial cure following moxifloxacin was 95% (95% CI, 82–99%) and did not differ from standard therapy (P = 0.948), however clinical cure was significantly higher following moxifloxacin (89%; 95% CI, 75–97%; P = 0.004)] although adverse effects were more common.

Conclusions

Women meeting Centers for Disease Control and Prevention criteria for presumptive treatment of MG-PID did not significantly differ to those with CT-PID. Moxifloxacin was associated with higher rates of symptom resolution in women with PID, and although microbial cure was high, it did not differ between regimens.
The Effects of Electrical Stimulation Parameters in Managing Spasticity After Spinal Cord Injury
Authors: Bekhet Amira Hassan , Bochkezanian Vanesa , Saab Ibtissam M. , Gorgey Ashraf S.
Published: October 2018

Controversial findings about the effects of neuromuscular electrical stimulation and functional electrical stimulation in managing spasticity have been raised after spinal cord injury. A systematic review was conducted to identify the range of the stimulation parameters that may alleviate spasticity. Three independent reviewers searched Medline (PubMed), web of knowledge, Scopus, Cochrane Central, Virtual Health Library, and Physiotherapy Evidence Database until January 2018. Inclusion criteria were applications of neuromuscular electrical stimulation/functional electrical stimulation on the lower limb muscles, stimulation parameters (frequency, pulse duration, and amplitude of current), and measures of spasticity after spinal cord injury. The primary outcome was spasticity as measured by the Modified Ashworth Scale and the secondary outcome was spasticity assessed by other indirect measures. Twenty-three clinical and nonclinical trials were included with 389 subjects. Neuromuscular electrical stimulation/functional electrical stimulation provided reductions in spasticity by 45%–60% with decrease in electromyography activity and increase in range of motion after spinal cord injury. The identified stimulation parameters were frequency of 20–30 Hz, pulse duration of 300–350 μs, and amplitude of the current greater than 100 mA. Neuromuscular electrical stimulation/functional electrical stimulation provides an effective rehabilitation strategy in managing spasticity. However, a recommendation of the stimulation parameters cannot be accurately assumed because of high variability in the methodology, design, and heterogeneity of the included studies.
Predictors of Antiretroviral Adherence Self-efficacy Among People Living With HIV/AIDS in a Canadian Setting
Authors: Lee William K. , Milloy Michael John. S. , Nosova Ekaterina , Walsh John , Kerr Thomas
Published: October 2018

Background:

Suboptimal adherence to antiretroviral therapy (ART) among people living with HIV/AIDS (PLWHA) who use illicit drugs remains an ongoing health concern. Although health outcomes associated with adherence self-efficacy have been well-documented, there is dearth research exploring the predictors of this construct. This study sought to identify possible determinants of adherence self-efficacy among a cohort of PLWHA who use illicit drugs.

Methods:

From December 2004 to May 2014, we collected data from the AIDS Care Cohort to evaluate Exposure to Survival Services, a prospective cohort of adult PLWHA who use illicit drugs in Vancouver, Canada. We used multivariate generalized estimating equation analyses to identify longitudinal factors independently associated with higher adherence self-efficacy.

Results:

Among 742 participants, 493 (66.4%) identified as male and 406 (54.7%) reported white ancestry. In multivariate generalized estimating equation analysis, older age at ART initiation (adjusted odds ratio [AOR] = 1.02, 95% confidence interval [CI]: 1.00 to 1.03) and recent year of baseline interview (AOR = 1.08, 95% CI: 1.05 to 1.11) were independently associated with higher adherence self-efficacy, whereas homelessness (AOR = 0.78, 95% CI: 0.65 to 0.94), ≥daily crack smoking (AOR = 0.81, 95% CI: 0.68 to 0.96), experienced violence (AOR = 0.82, 95% CI: 0.69 to 0.98), and childhood abuse (AOR = 0.75, 95% CI: 0.60 to 0.92) were negatively associated.

Conclusions:

These findings highlight the potential role that personal and contextual factors can play in predicting levels of ART adherence self-efficacy. Future research should seek to identify and validate strategies to optimize adherence self-efficacy.
Application of Concatenated Arterialized Venous Flaps in Finger Reconstruction
Authors: Lin Yu-Te , Loh Charles Yuen Yung
Published: October 2018

Venous flaps from the distal volar forearm are said to be suitable flaps for finger reconstruction. The pliability of the forearm venous flap makes it easy to follow the curvature of the finger contour. The thickness of the flap makes it appropriate as a flap for finger resurfacing. Following the venous network at the palmar forearm, diverse patterns of the venous flaps can be designed. This article describes the use of a 2-concatenated paddle, flow-through arterialized venous flap design for simultaneous resurfacing of 2 separate defects on a single digit. A technique that can be used to reduce postoperative venous congestion will be highlighted in this article.
Technology for improving accessibility of end-of-life care: Extension for Community Healthcare Outcomes Project
Authors: Píriz Alvarez Gabriela
Published: October 2018

Purpose of review

To describe how Project ECHO works and to analyze what has been published on Project ECHO Palliative Care (Project ECHO PC) over the last 18 months.

Recent findings

Only two articles on Project ECHO PC have been published over the last 18 months: a descriptive study of experiences in seven health centers of the United States, the United Kingdom, Uruguay and India; and a quantitative and qualitative study of the impact of the teleECHO clinic on physicians and nurses in Northern Ireland, which reports a significant boost in knowledge acquisition and self-efficacy.

Project ECHO is an innovative telemedicine strategy, which creates learning communities, which use a standardized methodology and benefits healthcare professionals, particularly primary care providers or practitioners based on remote or rural areas.

Since 2011, Project ECHO PC has been implemented in 12 health centers in 4 different countries, with greater growth in 2017. It has facilitated a wider access to professional education, improvements in clinical practice and knowledge acquisition, the development of professional curricula and more confidence and self-efficacy among healthcare professionals. Project ECHO PC is engaged in several international initiatives to aid countries with different degrees of palliative care development.
The role of day care in supporting older people living with long-term conditions
Authors: Lunt Catherine , Dowrick Christopher , Lloyd-Williams Mari
Published: October 2018

Purpose of review

For older people with long-term conditions, regular structured activities within a community setting meeting others are thought to improve well being and quality of life. Historically local authority-run day care centres were widely available, but austerity measures have meant that in many areas, such provision has been markedly reduced and different models of day care services are being developed. There is little known about outcomes of day care provision for older people with long-term conditions.

Recent findings

This review has critically examined the recent evidence on outcomes of day care provision for older people with long-term conditions and will focus on three areas – physical functioning, intergenerational provision and measurement of outcomes. In terms of interventions to improve physical functioning for older people with long-term conditions attending day care, there are few studies and it is difficult to generalize but there appears to be a trend for positive impact on physical functioning when activities are incorporated into a day care programme. There is a paucity of research on intergenerational provision, however, the small number of studies suggest positive benefits. Studies measuring outcomes for older people with long-term conditions attending day care services are very limited in terms of outcome data with the exception of a Canadian study, which suggested that attendance at day care could reduce hospital attendance and admissions.

This review reveals a lack of research of day care provision for older people with long-term conditions. There is a suggestion in the small number of articles included in this review that there can be benefits both in terms of global outcomes of attendance and in improved physical functioning; there is limited evidence of the value of intergenerational provision. Robust research with collection of meaningful outcomes is required to ensure that the increasing number of older people with long-term conditions are enabled to access high-quality day care provision.
Predictors of reliably high-value end-of-life care
Authors: Ankuda Claire K. , Meier Diane E.
Published: October 2018

Purpose of review

Care near the end of life is expensive and frequently not aligned with the expressed preferences of decedents, creating an opportunity to improve value, or increase quality while lowering cost. This review examines publications from 2017 and 2018 on interventions and policies associated with high-value end-of-life care. Innovations in video and web-based advance care planning are promising to improve preference-congruent care at low cost.

Recent findings

The patterns of care within hospice and in particular increased investment in patient care in hospice are shown to improve value. A meta-analysis demonstrated the role of inpatient palliative care consultations in decreasing hospitalization costs, as did several studies on inpatient palliative care units. Internationally, a range of home-based palliative care programs, implemented at the population level, demonstrated cost savings and reduced intensive care near the end of life. Finally, public policies that funded medical and long-term care and address broader inequalities were demonstrated to decrease low-value care near the end of life.

This review demonstrates the efficacy of a range of approaches to improve value of care at the end of life, both within the health system and across public policy sectors.
Emerging Ethical Challenges Raised by the Evolution of Vascularized Composite Allotransplantation
Authors: Caplan Arthur L. , Parent Brendan , Kahn Jeffrey , Dean Wendy , Kimberly Laura L. , Lee W.P, Andrew , Rodriguez Eduardo D.
Published: October 2018

Background.

Despite early skepticism, the field of vascularized composite allotransplantation (VCA) has demonstrated feasibility. The ethics of VCA have moved past doubts about the morality of attempting such transplants to how to conduct them ethically.

Methods.

Leaders of each program performing and/or evaluating VCA in the United States were invited to participate in a working group to assess the state and future of VCA ethics and policy. Four meetings were held over the course of 1 year to describe key challenges and potential solutions.

Results.

Working group participants concluded that VCA holds great promise as treatment for patients with particular injuries or deficits, but the field faces unique challenges to adoption as standard of care, which can only be overcome by data sharing and standardization of evaluation and outcome metrics.

Conclusions.

Adequate attention must be given to concerns including managing the uniquely intense physician-patient relationship, ethical patient selection, ensuring patients have adequate representation, informing and earning the trust of the public for donation, standardizing metrics for success, and fostering an environment of data sharing. These steps are critical to transitioning VCA from research to standard of care and to its insurance coverage inclusion.
Nonalcoholic Fatty Liver Disease: Basic Pathogenetic Mechanisms in the Progression From NAFLD to NASH
Authors: Pierantonelli Irene , Svegliati-Baroni Gianluca
Published: October 2018

Nonalcoholic fatty liver disease (NAFLD) represents a growing cause of chronic liver injury, especially in western countries, where it is becoming the most frequent indication for liver transplantation. Nonalcoholic fatty liver disease encompasses a spectrum of diseases that from simple steatosis (pure NAFLD) can progress to nonalcoholic steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma. The pathogenesis of NAFLD and the mechanisms behind its progression to NASH have been extensively studied. However, although the processes that determine fat accumulation are mostly clear, the mechanisms associated with the progression of the disease are not fully characterized. In predisposed patients, lipid accumulation can promote lipotoxicity and mitochondrial dysfunction, thus triggering hepatocyte death, inflammation and fibrosis. The specific role of different lipids has been identified and free fatty acids as well as free cholesterol have been identified as toxic species. To make the picture more complex, the pathogenesis of NAFLD involves pathological connections between several organs, including the adipose tissue and the gut, with the liver. The “inflamed” adipose tissue plays a key role in the release of toxic lipids, whereas alterations in the gut-liver axis have been associated with the progression from NAFLD to NASH mediated by dysbiosis, alteration of intestinal barrier, and finally bacterial translocation, which can trigger proinflammatory and profibrogenetic pathways, finally leading to cirrhosis development.
AnIn-SilicoMammalian Whole-Cell Model Reveals the Influence of Spatial Organization on RNA Splicing Efficiency
Authors: Ghaemia Zhaleh , Peterson Joseph R. , Gruebele Martin , Luthey-Schulten Zaida
Published: October 2018

Spatial organization is a characteristic of eukaryotic cells, achieved by utilizing both membrane-bound and non-bound organelles. We model the effects of this organization and of organelle heterogeneity on RNA splicing (the process of making translationally-ready messenger RNA) and on splicing particles (the building blocks of splicing machinery) in mammalian cells. We constructed a spatially-resolved whole HeLa cell model from various experimental data and developed reaction networks to describe the RNA splicing processes. We incorporated these networks into our whole-cell model and performed stochastic simulations for up to 15 minutes of biological time. We find that the number of nuclear pore complexes affects the number of assembled splicing particles; that a slight increase of splicing particle localization in nuclear speckles (non-membrane-bound or- ganelles) leads to disproportionate enhancement in the mRNA splicing and reduction in the transcript noise; and that compartmentalization is critical for a correctly-assembled particle yield. Our model also predicts that the distance between genes and speckles has a considerable effect on effective mRNA production rate, further emphasizing the importance of genome organization around speckles. The HeLa cell model, including organelles and subcompartments, provides an adaptable foundation to study other cellular processes which are strongly modulated by spatio-temporal heterogeneity.

Significance Statement

The spliceosome is one of the most complex cellular machineries that cuts and splices the RNA code in eukaryotic cells. It dynamically assembles, disassembles, and its components are formed in multiple compartments. The efficiency of splicing process depends on localization of its components in nuclear membrane-less organelles. Therefore, a computational model of spliceosomal function must contain a spatial model of the entire cell. However, building such a model is a challenging task, mainly due to the lack of homogeneous experimental data and a suitable computational framework. Here, we overcome these challenges and present a whole HeLa cell model, with nuclear, subnuclear, and extensive cytoplasmic structures. The three-dimensional model is supplemented by reaction-diffusion processes to shed light on the function of the spliceosome.
Tau accumulation activates STAT1 triggering memory deficits via suppressing NMDA receptor expression
Authors: Li Xiao-Guang , Hong Xiao-Yue , Wang Ya-li , Zhang Shu-Juan , Zhang Jun-Fei , Li Xia-Chun , Liu Yan-Chao , Sun Dong-Shen , Feng Qiong , Ye Jin-Wang , Gao Yuan , Ke Dan , Wang Qun , Li Hong-lian , Ye Keqiang , Liu Gong-Ping , Wang Jian-Zhi
Published: October 2018

Intracellular tau accumulation forming neurofibrillary tangles is hallmark pathology of Alzheimer's disease (AD), but how tau accumulation induces synapse impairment is elusive. By overexpressing human full-length wildtype tau (termed hTau) to mimic tau abnormality as seen in the brain of sporadic AD patients, we found that hTau accumulation activated JAK2 to phosphorylate STAT1 (Signal Transducer and Activator of Transcription 1) at Tyr701 leading to STAT1 dimerization, nuclear translocation and its activation. STAT1 activation suppressed expression of N-methyl-D-aspartate receptors (NMDARs) through direct binding to the specific GAS element of GluN1, GluN2A and GluN2B promoters, while knockdown STAT1 by AAV-Cre in STAT1flox/floxmice or expressing dominant negative Y701F-STAT1 efficiently rescued hTau-induced suppression of NMDARs expression with amelioration of synaptic functions and memory performance. These findings indicate that hTau accumulation impairs synaptic plasticity through JAK2/STAT1-induced suppression of NMDARs expression, revealing a novel mechanism for hTau-associated synapse and memory deficits.
D-GPM: a deep learning method for gene promoter methylation inference
Authors: Pan Xingxin , Liu Biao , Wen Xingzhao , Liu Yulu , Zhang Xiuqing , Li Shengbin , Li Shuaicheng
Published: October 2018

Background

Gene promoter methylation plays a critical role in a wide range of biological processes, such as transcriptional expression, gene imprinting, X chromosome inactivation,etc. Whole-genome bisulfite sequencing generates a comprehensive profiling of the gene methylation levels but is limited by a high cost. Recent studies have partitioned the genes into landmark genes and target genes and suggested that the landmark gene expression levels capture adequate information to reconstruct the target gene expression levels. Moreover, the methylation level of the promoter is usually negatively correlated with its corresponding gene expression. This result inspired us to propose that the methylation level of the promoters might be adequate to reconstruct the promoter methylation level of target genes, which would eventually reduce the cost of promoter methylation profiling.

Results

Here, we developed a deep learning model (D-GPM) to predict the whole-genome promoter methylation level based on the methylation profile of the landmark genes. We benchmarked D-GPM against three machine learning methods, namely, linear regression (LR), regression tree (RT) and support vector machine (SVM), based on two criteria: the mean absolute deviation (MAE) and the Pearson correlation coefficient (PCC). After profiling the methylation beta value (MBV) dataset from the TCGA, with respect to MAE and PCC, we found that D-GPM outperforms LR by 9.59% and 4.34%, RT by 27.58% and 22.96% and SVM by 6.14% and 3.07% on average, respectively. For the number of better-predicted genes, D-GPM outperforms LR in 92.65% and 91.00%, RT in 95.66% and 98.25% and SVM in 85.49% and 81.56% of the target genes.

Conclusions

D-GPM acquires the least overall MAE and the highest overall PCC on MBV-te compared to LR, RT, and SVM. For a genewise comparative analysis, D-GPM outperforms LR, RT, and SVM in an overwhelming majority of the target genes, with respect to the MAE and PCC. Most importantly, D-GPM predominates among the other models in predicting a majority of the target genes according to the model distribution of the least MAE and the highest PCC for the target genes.
Stereotyped Terminal Axon Branching of Leg Motor Neurons Mediated by IgSF Proteins DIP-α and Dpr10
Authors: Venkatasubramanian Lalanti , Guo Zhenhao , Xu Shuwa , Tan Liming , Xiao Qi , Nagarkar-Jaiswal Sonal , Mann Richard S.
Published: October 2018

The ability of animals to perform coordinated movements depends on the precise organization of neural circuits controlling motor function. Motor neurons (MNs), which are key components of these circuits, must project their axons out of the central nervous system and form precise terminal branching patterns at specific muscles in the periphery. By focusing on theDrosophilaadult leg neuromuscular system we show that the stereotyped terminal branching of a subset of leg MNs is mediated by interacting transmembrane Ig superfamily (IgSF) proteins DIP-α and Dpr10, present in MNs and target muscles, respectively. Importantly, the DIP-α/Dpr10 interaction is needed only after MN axons reach the vicinity of their muscle targets. Live imaging of this process suggests that precise terminal branching patterns are gradually established by DIP-α/Dpr10-dependent interactions between fine axon filopodia and developing muscles. Further, different leg MNs depend on the DIP-α and Dpr10 interaction to varying degrees that correlate with the morphological complexity of the MNs and their muscle targets, suggesting that some MNs depend upon multiple sets of interacting proteins to establish terminal axon branching.
Aggression and discrimination among closely versus distantly related species of Drosophila
Authors: Gupta Tarun , Howe Sarah E. , Zorman Marlo L. , Lockwood Brent L.
Published: October 2018

Fighting between different species is widespread in the animal kingdom, yet this phenomenon has been relatively understudied in the field of aggression research. Particularly lacking are studies that test the effect of genetic distance, or relatedness, on aggressive behavior between species. Here we characterized male-male aggression within and between species of fruit flies across the Drosophila phylogeny. We show that male Drosophila discriminate between conspecifics and heterospecifics and show a bias for the target of aggression that depends on the genetic relatedness of opponent males. Specifically, males of closely related species treated conspecifics and heterospecifics equally, whereas males of distantly related species were overwhelmingly aggressive toward conspecifics. To our knowledge, this is the first study to quantify aggression between Drosophila species and to establish a behavioral bias for aggression against conspecifics versus heterospecifics. Our results suggest that future study of heterospecific aggression behavior in Drosophila is warranted to investigate the degree to which these trends in aggression among species extend to broader behavioral, ecological, and evolutionary contexts.