bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of surfactant on thermoelectric behaviors of organic-inorganic composites
Authors: Shin Sunmi , Roh Jong Wook , Kim Hyun-Sik , Chen Renkun
Published: May 2018

Hybrid organic/inorganic composites have recently attracted intensive interests as a promising candidate for flexible thermoelectric (TE) devices using inherently soft polymers as well as for increasing the degree of freedom to control TE properties. Experimentally, however, enhanced TE performance in hybrid composites has not been commonly observed, primarily due to inhomogeneous mixing between the inorganic and organic components which leads to limited electrical conduction in the less conductive component and consequently a low power factor in the composites compared to their single-component counterparts. In this study, we investigated the effects of different surfactants on the uniformity of mixing and the TE behaviors of the hybrid composites consisting of Bi0.5Sb1.5Te3 (BST) and poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS). We found that compared to dimethyl sulfoxide, which is the most widely used surfactant, Triton X-100 (TX-100) can lead to homogenous dispersion of BST in PEDOT:PSS. By systematically studying the effects of the surfactant concentration, we can attribute the better mixing capability of TX-100 to its non-ionic property, which results in homogenous mixing with a lower critical micelle concentration. Consequently, we observed simultaneous increase in electrical conductivity and Seebeck coefficient in the BST/PEDOT:PSS composites with the TX-100 surfactant.
Healthcare resource utilisation by patients with coronary heart disease receiving a lifestyle-focused text message support program: an analysis from the TEXT ME study
Authors: Thakkar Jay , Redfern Julie , Khan Ehsan , Atkins Emily , Ha Jeffrey , Vo Kha , Thiagalingam Aravinda , Chow Clara K.
Published: May 2018

The ‘Tobacco, Exercise and Diet Messages’ (TEXT ME) study was a 6-month, single-centre randomised clinical trial (RCT) that found a text message support program improved levels of cardiovascular risk factors in patients with coronary heart disease (CHD). The current analyses examined whether receipt of text messages influenced participants’ engagement with conventional healthcare resources. The TEXT ME study database (N=710) was linked with routinely collected health department databases. Number of doctor consultations, investigations and cardiac medication prescriptions in the two study groups were compared. The most frequently accessed health service was consultations with a General Practitioner (mean 7.1, s.d. 5.4). The numbers of medical consultations, biochemical tests or cardiac-specific investigations were similar between the study groups. There was at least one prescription registered for statin, ACEI/ARBs and β-blockers in 79, 66 and 50% of patients respectively, with similar refill rates in both the study groups. The study identified TEXT ME text messaging program did not increase use of Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) captured healthcare services. The observed benefits of TEXT ME reflect direct effects of intervention independent of conventional healthcare resource engagement.
Does the ecological quality of inherited campsites cause persistent inequalities and poverty in pastoral Mongolia?
Authors: Joly F. , Lefebvre G. , Sandoz A. , Hubert B.
Published: May 2018

Most socioeconomic surveys carried out in Mongolia since the regime change of the 1990s report persistent inequalities and poverty in pastoral communities. To understand the reasons for this phenomenon, we studied the relationships between livestock numbers and ecological characteristics of herders’ seasonal campsites in a community of the Mongolian Gobi. We classified herders with help of a regression tree into three categories, where herd size is correlated with the proportion of the Stipa glareosa and Psammochloa villosa grasses around campsites. We established in addition from livestock-based income estimations that poverty could affect the small herd category, owning on average less than 180 heads of livestock. We finally observed that herders mostly transmit their campsites to their descendants, particularly in the small herd category. Herders are hence durably associated with campsites whose quality is related to livestock numbers, which may be a factor of inequality and poverty persistence. To further understand these processes, the zootechnical influence of S. glareosa and P. villosa should be investigated, as well as historical and anthropological determinants of campsites repartition.
Histamine levels in longlined tuna in Fiji: A comparison of samples from two different body sites and the effect of storage at different temperatures.
Authors: Chamberlain T.
Published: May 2018

This paper examines histamine production in albacore, bigeye and yellowfin tuna caught by longliners operating in Fijian waters. The research was undertaken in collaboration with the Fijian Fisheries Division and the tuna industry. A comparison of histamine production between species, sampling location and temperatures was undertaken. The results reveal that histamine levels do increase with temperature but that there is no difference in histamine build-up between species at each temperature tested. There was no significant difference between the two sampling locations tested, one of which was taken from a low-value head region, and will potentially make a significant saving for operators. Histamine levels are well below the recommended maximum value when samples are stored at 6oC, which validates the recommended USFDA guidelines. A new ELISA test for determining histamine concentration (Veratox) and the AOAC fluorometric method were used. The Veratox ELISA kit was found to be inadequate for food safety monitoring as it tends to underestimate histamine levels.
Microtubules grow by the addition of bent guanosine triphosphate tubulin to the tips of curved protofilaments
Authors: McIntosh J. Richard , O’Toole Eileen , Morgan Garry , Austin Jotham , Ulyanov Evgeniy , Ataullakhanov Fazoil , Gudimchuk Nikita
Published: May 2018

We used electron tomography to examine microtubules (MTs) growing from pure tubulin in vitro as well as two classes of MTs growing in cells from six species. The tips of all these growing MTs display bent protofilaments (PFs) that curve away from the MT axis, in contrast with previously reported MTs growing in vitro whose tips are either blunt or sheetlike. Neither high pressure nor freezing is responsible for the PF curvatures we see. The curvatures of PFs on growing and shortening MTs are similar; all are most curved at their tips, suggesting that guanosine triphosphate–tubulin in solution is bent and must straighten to be incorporated into the MT wall. Variations in curvature suggest that PFs are flexible in their plane of bending but rigid to bending out of that plane. Modeling by Brownian dynamics suggests that PF straightening for MT growth can be achieved by thermal motions, providing a simple mechanism with which to understand tubulin polymerization.
GSDMD is critical for autoinflammatory pathology in a mouse model of Familial Mediterranean Fever
Authors: Kanneganti Apurva , Malireddi R.K. Subbarao , Saavedra Pedro H.V. , Vande Walle Lieselotte , Van Gorp Hanne , Kambara Hiroto , Tillman Heather , Vogel Peter , Luo Hongbo R. , Xavier Ramnik J. , Chi Hongbo , Lamkanfi Mohamed
Published: May 2018

Pyroptosis is an inflammasome-induced lytic cell death mode, the physiological role of which in chronic inflammatory diseases is unknown. Familial Mediterranean Fever (FMF) is the most common monogenic autoinflammatory disease worldwide, affecting an estimated 150,000 patients. The disease is caused by missense mutations in Mefv that activate the Pyrin inflammasome, but the pathophysiologic mechanisms driving autoinflammation in FMF are incompletely understood. Here, we show that Clostridium difficile infection of FMF knock-in macrophages that express a chimeric FMF-associated MefvV726A Pyrin elicited pyroptosis and gasdermin D (GSDMD)–mediated interleukin (IL)-1β secretion. Importantly, in vivo GSDMD deletion abolished spontaneous autoinflammatory disease. GSDMD-deficient FMF knock-in mice were fully protected from the runted growth, anemia, systemic inflammatory cytokine production, neutrophilia, and tissue damage that characterize this autoinflammatory disease model. Overall, this work identifies pyroptosis as a critical mechanism of IL-1β–dependent autoinflammation in FMF and highlights GSDMD inhibition as a potential antiinflammatory strategy in inflammasome-driven diseases.
Classically integral quadratic forms excepting at most two values
Authors: Barowsky Madeleine , Damron William , Mejia Andres , Saia Frederick , Schock Nolan , Thompson Katherine
Published: May 2018

Let

S
⊆

N

S \subseteq \mathbb {N}

be finite. Is there a positive definite quadratic form that fails to represent only those elements in

S
S

? For

S
=
∅

S = \emptyset

, this was solved (for classically integral forms) by the

15
15

-Theorem of Conway-Schneeberger in the early 1990s and (for all integral forms) by the

290
290

-Theorem of Bhargava-Hanke in the mid-2000s. In 1938 Halmos attempted to list all weighted sums of four squares that failed to represent

S
=
{
m
}

S=\{m\}

; of his

88
88

candidates, he could provide complete justifications for all but one. In the same spirit, we ask, “For which

S
=
{
m
,
n
}

S = \{m, n\}

does there exist a quadratic form excepting only the elements of

S
S

?” Extending the techniques of Bhargava and Hanke, we answer this question for quaternary forms. In the process, we provide a new proof of the original outstanding conjecture of Halmos, namely, that

x
2

+
2

y
2

+
7

z
2

+
13

w
2

x^2+2y^2+7z^2+13w^2

represents all positive integers except

5
5

. We develop new strategies to handle forms of higher dimensions, yielding an enumeration of and proofs for the

73
73

possible pairs that a classically integral positive definite quadratic form may except.
Concordance of PD-L1 Expression Detection in Non–Small Cell Lung Cancer (NSCLC) Tissue Biopsy Specimens Between OncoTect iO Lung Assay and Immunohistochemistry (IHC)
Authors: Young Stephen , Griego-Fullbright Christen , Wagner Aaron , Chargin Amanda , Patterson Bruce K , Chabot-Richards Devon
Published: May 2018

Objectives

We report on the validity of a fully quantitative technology to determine tumor cells’ PD-L1 expression compared with a standard immunohistochemical (IHC) assay in non–small cell lung cancer.

Methods

Nineteen fresh tissue specimens were processed into single-cell suspensions using the IncellPREP Kit. Cells were treated with the OncoTect iO Lung Assay, which quantitatively assessed tumor-infiltrating lymphocytes (TILs), DNA content, and PD-L1 expression on diploid and aneuploid tumor populations.

Results

Comparison of the OncoTect iO Lung Assay with IHC revealed a concordance of 95% overall (negative percent agreement, 97%; positive percent agreement, 89%). PD-L1 expression varied depending on the DNA content. The number of TILs and antigen-presenting cells (APCs) was significantly decreased in tumor compared with normal lung tissue.

Conclusions

The nonsubjective OncoTect iO Lung Assay has been shown to be at least as accurate and sensitive as IHC for the detection of PD-L1 expression while providing additional information to guide treatment.
The Orphan Receptor GPR35 Contributes to Angiotensin II–Induced Hypertension and Cardiac Dysfunction in Mice
Authors: Divorty Nina , Milligan Graeme , Graham Delyth , Nicklin Stuart A
Published: May 2018

BACKGROUND

The orphan receptor G protein–coupled receptor 35 (GPR35) has been associated with a range of diseases, including cancer, inflammatory bowel disease, diabetes, hypertension, and heart failure. To assess the potential for GPR35 as a therapeutic target in cardiovascular disease, this study investigated the cardiovascular phenotype of a GPR35 knockout mouse under both basal conditions and following pathophysiological stimulation.

METHODS

Blood pressure was monitored in male wild-type and GPR35 knockout mice over 7–14 days using implantable telemetry. Cardiac function and dimensions were assessed using echocardiography, and cardiomyocyte morphology evaluated histologically. Two weeks of angiotensin II (Ang II) infusion was used to investigate the effects of GPR35 deficiency under pathophysiological conditions. Gpr35 messenger RNA expression in cardiovascular tissues was assessed using quantitative polymerase chain reaction.

RESULTS

There were no significant differences in blood pressure, cardiac function, or cardiomyocyte morphology in GPR35 knockout mice compared with wild-type mice. Following Ang II infusion, GPR35 knockout mice were protected from significant increases in systolic, diastolic, and mean arterial blood pressure or impaired left ventricular systolic function, in contrast to wild-type mice. There were no significant differences in Gpr35 messenger RNA expression in heart, kidney, and aorta following Ang II infusion in wild-type mice.

CONCLUSIONS

Although GPR35 does not appear to influence basal cardiovascular regulation, these findings demonstrate that it plays an important pathological role in the development of Ang II–induced hypertension and impaired cardiac function. This suggests that GPR35 is a potential novel drug target for therapeutic intervention in hypertension.
Versatile interactions and bioinformatics analysis of noncoding RNAs
Authors: Chen Qi , Meng Xianwen , Liao Qi , Chen Ming
Published: May 2018

Advances in RNA sequencing technologies and computational methodologies have provided a huge impetus to noncoding RNA (ncRNA) study. Once regarded as inconsequential results of transcriptional promiscuity, ncRNAs were later found to exert great roles in various aspects of biological functions. They are emerging as key players in gene regulatory networks by interacting with other biomolecules (DNA, RNA or protein). Here, we provide an overview of ncRNA repertoire and highlight recent discoveries of their versatile interactions. To better investigate the ncRNA-mediated regulation, it is necessary to make full use of innovative sequencing techniques and computational tools. We further describe a comprehensive workflow for in silico ncRNA analysis, providing up-to-date platforms, databases and tools dedicated to ncRNA identification and functional annotation.
PEA: an integrated R toolkit for plant epitranscriptome analysis
Authors: Zhai Jingjing , Song Jie , Cheng Qian , Tang Yunjia , Ma Chuang
Published: May 2018

Motivation

The epitranscriptome, also known as chemical modifications of RNA (CMRs), is a newly discovered layer of gene regulation, the biological importance of which emerged through analysis of only a small fraction of CMRs detected by high-throughput sequencing technologies. Understanding of the epitranscriptome is hampered by the absence of computational tools for the systematic analysis of epitranscriptome sequencing data. In addition, no tools have yet been designed for accurate prediction of CMRs in plants, or to extend epitranscriptome analysis from a fraction of the transcriptome to its entirety.

Results

Here, we introduce PEA, an integrated R toolkit to facilitate the analysis of plant epitranscriptome data. The PEA toolkit contains a comprehensive collection of functions required for read mapping, CMR calling, motif scanning and discovery and gene functional enrichment analysis. PEA also takes advantage of machine learning (ML) technologies for transcriptome-scale CMR prediction, with high prediction accuracy, using the Positive Samples Only Learning algorithm, which addresses the two-class classification problem by using only positive samples (CMRs), in the absence of negative samples (non-CMRs). Hence PEA is a versatile epitranscriptome analysis pipeline covering CMR calling, prediction and annotation and we describe its application to predict N6-methyladenosine (m6A) modifications in Arabidopsis thaliana. Experimental results demonstrate that the toolkit achieved 71.6% sensitivity and 73.7% specificity, which is superior to existing m6A predictors. PEA is potentially broadly applicable to the in-depth study of epitranscriptomics.

Availability and implementation

PEA Docker image is available at https://hub.docker.com/r/malab/pea, source codes and user manual are available at https://github.com/cma2015/PEA.

Supplementary information

Supplementary data are available at Bioinformatics online.
The size matters? A computational tool to design bivalent ligands
Authors: Pérez-Benito Laura , Henry Andrew , Matsoukas Minos-Timotheos , Lopez Laura , Pulido Daniel , Royo Miriam , Cordomí Arnau , Tresadern Gary , Pardo Leonardo
Published: May 2018

Motivation

Bivalent ligands are increasingly important such as for targeting G protein-coupled receptor (GPCR) dimers or proteolysis targeting chimeras (PROTACs). They contain two pharmacophoric units that simultaneously bind in their corresponding binding sites, connected with a spacer chain. Here, we report a molecular modelling tool that links the pharmacophore units via the shortest pathway along the receptors van der Waals surface and then scores the solutions providing prioritization for the design of new bivalent ligands.

Results

Bivalent ligands of known dimers of GPCRs, PROTACs and a model bivalent antibody/antigen system were analysed. The tool could rapidly assess the preferred linker length for the different systems and recapitulated the best reported results. In the case of GPCR dimers the results suggest that in some cases these ligands might bind to a secondary binding site at the extracellular entrance (vestibule or allosteric site) instead of the orthosteric binding site.

Availability and implementation

Freely accessible from the Molecular Operating Environment svl exchange server (https://svl.chemcomp.com/).

Supplementary information

Supplementary data are available at Bioinformatics online.
LncADeep: anab initiolncRNA identification and functional annotation tool based on deep learning
Authors: Yang Cheng , Yang Longshu , Zhou Man , Xie Haoling , Zhang Chengjiu , Wang May D , Zhu Huaiqiu
Published: May 2018

Motivation

To characterize long non-coding RNAs (lncRNAs), both identifying and functionally annotating them are essential to be addressed. Moreover, a comprehensive construction for lncRNA annotation is desired to facilitate the research in the field.

Results

We present LncADeep, a novel lncRNA identification and functional annotation tool. For lncRNA identification, LncADeep integrates intrinsic and homology features into a deep belief network and constructs models targeting both full- and partial-length transcripts. For functional annotation, LncADeep predicts a lncRNA’s interacting proteins based on deep neural networks, using both sequence and structure information. Furthermore, LncADeep integrates KEGG and Reactome pathway enrichment analysis and functional module detection with the predicted interacting proteins, and provides the enriched pathways and functional modules as functional annotations for lncRNAs. Test results show that LncADeep outperforms state-of-the-art tools, both for lncRNA identification and lncRNA–protein interaction prediction, and then presents a functional interpretation. We expect that LncADeep can contribute to identifying and annotating novel lncRNAs.

Availability and implementation

LncADeep is freely available for academic use at http://cqb.pku.edu.cn/ZhuLab/lncadeep/ and https://github.com/cyang235/LncADeep/.

Supplementary information

Supplementary data are available at Bioinformatics online.
mEBT: multiple-matching evidence-based translator of murine genomic responses for human immunity studies
Authors: Tae Donghyun , Seok Junhee
Published: May 2018

In this paper, we introduce multiple-matching Evidence-based Translator (mEBT) to discover genomic responses from murine expression data for human immune studies, which are significant in the given condition of mice and likely have similar responses in the corresponding condition of human. mEBT is evaluated over multiple datasets and shows improved inter-species agreement. mEBT is expected to be useful for research groups who use murine models to study human immunity.

Availability and implementation

http://cdal.korea.ac.kr/mebt/

Supplementary information

Supplementary data are available at Bioinformatics online.
A fast, sensitive and cost-effective method for nucleic acid detection using non-radioactive probes
Authors: Viterbo David , Marchal Astrid , Mosbach Valentine , Poggi Lucie , Vaysse-Zinkhöfer Wilhelm , Richard Guy-Franck
Published: May 2018

Nucleic acid detection and quantification using a labeled DNA probe is a very common molecular biology procedure. Here, we describe a new method, based on commonly used laboratory solutions, for nucleic acid hybridization and detection with digoxigenin-labeled DNA probes. The protocol described is faster, more sensitive and much cheaper than a standard protocol using commercial solutions. Comparison with a classical radioactive detection method shows that the latter exhibits less background and shows a greater linear response. Hence, the proposed protocol may be routinely performed for qualitative detection of nucleic acid, but when precise signal quantitation needs to be obtained, radioactive probe hybridization associated to phosphorimaging technology is more reliable.
Duality of graphical models and tensor networks
Authors: Robeva Elina , Seigal Anna
Published: May 2018

In this article we show the duality between tensor networks and undirected graphical models with discrete variables. We study tensor networks on hypergraphs, which we call tensor hypernetworks. We show that the tensor hypernetwork on a hypergraph exactly corresponds to the graphical model given by the dual hypergraph. We translate various notions under duality. For example, marginalization in a graphical model is dual to contraction in the tensor network. Algorithms also translate under duality. We show that belief propagation corresponds to a known algorithm for tensor network contraction. This article is a reminder that the research areas of graphical models and tensor networks can benefit from interaction.
Chromatic Numbers of Stable Kneser Hypergraphs via Topological Tverberg-Type Theorems
Authors: Frick Florian
Published: May 2018

Kneser’s 1955 conjecture—proven by Lovász in 1978—asserts that in any partition of the $k$-subsets of $\{1, 2, \dots , n\}$ into $n-2k+1$ parts, one part contains two disjoint sets. Schrijver showed that one can restrict to significantly fewer $k$-sets and still observe the same intersection pattern. Alon, Frankl, and Lovász proved a different generalization of Kneser’s conjecture for $r$ pairwise disjoint sets. Dolnikov generalized Lovász’ result to arbitrary set systems, while Kříž did the same for the $r$-fold extension of Kneser’s conjecture. Here we prove a common generalization of all of these results. Moreover, we prove additional strengthenings by determining the chromatic number of certain sparse stable Kneser hypergraphs, and further develop a general approach to establishing lower bounds for chromatic numbers of hypergraphs using a combination of methods from equivariant topology and intersection results for convex hulls of points in Euclidean space.
Measurement equivalence of patient safety climate in Chinese hospitals: can we compare across physicians and nurses?
Authors: Zhu Junya
Published: May 2018

Objective

Self-report instruments have been widely used to better understand variations in patient safety climate between physicians and nurses. Research is needed to determine whether differences in patient safety climate reflect true differences in the underlying concepts. This is known as measurement equivalence, which is a prerequisite for meaningful group comparisons. This study aims to examine the degree of measurement equivalence of the responses to a patient safety climate survey of Chinese hospitals and to demonstrate how the measurement equivalence method can be applied to self-report climate surveys for patient safety research.

Methods

Using data from the Chinese Hospital Survey of Patient Safety Climate from six Chinese hospitals in 2011, we constructed two groups: physicians and nurses (346 per group). We used multiple-group confirmatory factor analyses to examine progressively more stringent restrictions for measurement equivalence.

Results

We identified weak factorial equivalence across the two groups. Strong factorial equivalence was found for Organizational Learning, Unit Management Support for Safety, Adequacy of Safety Arrangements, Institutional Commitment to Safety, Error Reporting and Teamwork. Strong factorial equivalence, however, was not found for Safety System, Communication and Peer Support and Staffing. Nevertheless, further analyses suggested that nonequivalence did not meaningfully affect the conclusions regarding physician–nurse differences in patient safety climate.

Conclusions

Our results provide evidence of at least partial equivalence of the survey responses between nurses and physicians, supporting mean comparisons of its constructs between the two groups. The measurement equivalence approach is essential to ensure that conclusions about group differences are valid.
Gravitational wave signals from the first massive black hole seeds
Authors: Hartwig Tilman , Agarwal Bhaskar , Regan John A
Published: May 2018

Recent numerical simulations reveal that the isothermal collapse of pristine gas in atomic cooling haloes may result in stellar binaries of supermassive stars with $M_*\gtrsim 10^4\,\mathrm{M}_{\odot }$. For the first time, we compute the in-situ merger rate for such massive black hole remnants by combining their abundance and multiplicity estimates. For black holes with initial masses in the range $10^{4-6} \,\mathrm{M}_{\odot }$ merging at redshifts z ≳ 15 our optimistic model predicts that Laser Interferometer Space Antenna (LISA) should be able to detect 0.6 mergers yr−1. This rate of detection can be attributed, without confusion, to the in-situ mergers of seeds from the collapse of very massive stars. Equally, in the case where LISA observes no mergers from heavy seeds at z ≳ 15 we can constrain the combined number density, multiplicity, and coalescence times of these high-redshift systems. This letter proposes gravitational wave signatures as a means to constrain theoretical models and processes that govern the abundance of massive black hole seeds in the early Universe.
Real-world Efficacy of Direct-Acting Antiviral Therapy for HCV Infection Affecting People Who Inject Drugs Delivered in a Multidisciplinary Setting
Authors: Alimohammadi Arshia , Holeksa Julie , Thiam Astou , Truong David , Conway Brian
Published: May 2018

Background

Many clinicians and insurance providers are reluctant to embrace recent guidelines identifying people who inject drugs (PWID) as a priority population to receive hepatitis C virus (HCV) treatment. The aim of this study was to evaluate the efficacy of direct-acting antiviral (DAA) HCV therapy in a real-world population comprised predominantly of PWID.

Methods

A retrospective analysis was performed on all HCV-infected patients who were treated at the Vancouver Infectious Diseases Centre between March 2014 and December 2017. All subjects were enrolled in a multidisciplinary model of care, addressing medical, psychological, social, and addiction-related needs. The primary outcome was achievement of sustained virologic response (undetectable HCV RNA) 12 or more weeks after completion of HCV therapy (SVR-12).

Results

Overall, 291 individuals were enrolled and received interferon-free DAA HCV therapy. The mean age was 54 years, 88% were PWID, and 20% were HCV treatment experienced. At data lock, 62 individuals were still on treatment and 229 were eligible for evaluation of SVR by intent-to-treat (ITT) analysis. Overall, 207 individuals achieved SVR (90%), with 13 losses to follow-up, 7 relapses, and 2 premature treatment discontinuations. ITT SVR analysis show that active PWID and treatment-naïve patients were less likely to achieve SVR (P = .0185 and .0317, respectively). Modified ITT analysis of active PWID showed no difference in achieving SVR (P = .1157) compared with non-PWID.

Conclusion

Within a multidisciplinary model of care, the treatment of HCV-infected PWID with all-oral DAA regimens is safe and highly effective. These data justify targeted efforts to enhance access to HCV treatment in this vulnerable and marginalized population.
Market integration and transformation of business politics: diverging trajectories of corporatisms in Mexico and Turkey
Authors: Özel Işik D
Published: May 2018

Transformation of interest politics in the context of globalization has been widely studied with respect to advanced countries. In a similar vein, this article examines the recent transformations and diverging national trajectories against the backdrop of global market integration, focusing on business politics in upper-middle-income countries. Tackling the ways in which domestic political arrangements refract the impact of global forces, the article indicates that the market integration process engenders diverging effects in national settings contingent upon executive–legislative relations. Where power is concentrated in the executive, market integration upholds a form of corporatism; and where legislative power increases, it promotes a form of pluralism. Based on the empirics of Mexico and Turkey, this article shows the links between increasing legislative power and emerging legislative lobbying in Mexico in contrast to increasing executive power and centralization and concentration of interest politics in Turkey. It delineates a major variation in national trajectories in business politics in the age of globalization—the rise of ‘elite-pluralism’ dominated by large firms in the former, and ‘competitive corporatism’ vastly controlled by the executive branch in the latter.
Leveraging the Continuum: A Novel Approach to Meeting Quality Improvement and Patient Safety Competency Requirements Across a Large Department of Medicine
Authors: Myers Jennifer S. , Bellini Lisa M.
Published: May 2018

Problem

Quality improvement (QI) and patient safety (PS) are now core competencies across the medical education continuum. A major challenge to developing and implementing these new curricular requirements is the lack of faculty expertise.

Approach

In 2015, the authors developed a centralized, vertically integrated, competency-based approach to meet QI/PS educational requirements across the continuum of graduate medical education in the Department of Medicine, Perelman School of Medicine, University of Pennsylvania. By leveraging the QI/PS expertise of one individual, the authors identified and trained core QI/PS faculty members and sequentially deployed QI/PS activities that were tailored to the learner level and specialty. The curriculum includes PS event reporting, systems thinking and root causes analysis skills, adverse event disclosure, and a QI workshop series and project.

Outcomes

PS event reporting, an indication of engagement in PS culture, increased by 186% among interns, 384% among postgraduate year 2 and 3 residents, and 613% among fellows between academic years (AYs) 2013–2014 and 2016–2017. In AY 2017–2018, 9 faculty members and 40 fellows from 9 fellowships participated in the QI workshop series, and 53 fellows from 7 fellowships participated in the adverse event disclosure simulation activity. All educational activities were rated highly.

Next Steps

The authors are expanding the adverse event disclosure activity to include residents and the remaining fellowship programs, identifying fellowships to pilot curricular efforts related to clinical quality metrics, developing introductory activities in basic QI/PS concepts for medical students, and evaluating the impact of efforts on participating faculty members.
Asking for Less and Getting More: The Impact of Broadening a Rater’s Focus in Formative Assessment
Authors: Tavares Walter , Sadowski Alexander , Eva Kevin W.
Published: May 2018

Purpose

There may be unintended consequences of broadening the competencies across which health professions trainees are assessed. This study was conducted to determine whether such broadening influences the formative guidance assessors provide to trainees and to test whether sequential collection of competency-specific assessment can overcome setbacks of simultaneous collection.

Method

A randomized between-subjects experimental design, conducted in Toronto and Halifax, Canada, in 2016–2017 with paramedic educators experienced in observing/rating, in which observers’ focus was manipulated. In the simultaneous condition, participants rated four unscripted (i.e., spontaneously generated) clinical performances using a six-dimension global rating scale and provided feedback. In three sequential conditions, participants were asked to rate the same performances and provide feedback but for only two of the six dimensions. Participants from these conditions were randomly merged to create a “full score” and set of feedback statements for each candidate.

Results

Eighty-seven raters completed the study; 23 in the simultaneous condition and 21 or 22 for each pair of dimensions in the sequential conditions. After randomly merging participants, there were 21 “full scores” in the sequential condition. Compared with the sequential condition, participants in the simultaneous condition demonstrated reductions in the amount of unique feedback provided, increased likelihood of ignoring some dimensions of performance, lessened variety of feedback, and reduced reliability.

Conclusions

Sequential or distributed assessment strategies in which raters are asked to focus on less may provide more effective assessment by overcoming the unintended consequences of asking raters to spread their attention thinly over many dimensions of competence.
Medicaid Innovations and the Role of Academic Health Centers
Authors: Retchin Sheldon M. , Xu Wendy Yi
Published: May 2018

Although they represent less than 8% of all U.S. hospitals, academic health centers (AHCs) deliver almost 40% of the inpatient care for Medicaid beneficiaries. However, because of low Medicaid reimbursement rates, AHCs have had to rely on supplemental funding sources, such as disproportionate share hospital (DSH) payments and upper payment limit (UPL) payments. Recent legislative efforts and changes to payment structures have made these sources vulnerable to severe reductions. For instance, DSH payments are scheduled to be cut by $8 billion by 2021, and UPL payments are a diminishing resource for many states because the program is based on a fee-for-service model and most states are moving to managed care.

In this Invited Commentary, the authors argue that cuts to supplemental funding sources would harm AHCs. They advocate instead for restructuring traditional supplemental payments to accommodate novel reimbursement models. They cite Medicaid’s Delivery System Reform Incentive Payment program as an example of work to leverage supplemental payments to transform the delivery of care for Medicaid beneficiaries. AHCs should be at the epicenter of such innovations in population health for Medicaid beneficiaries. To that end, the authors encourage AHCs to build new partnerships with community-based primary care physicians and community health centers to balance the specialty composition of their faculty providers to assume the risk for Medicaid beneficiaries and other vulnerable populations.
Faculty Development Revisited: A Systems-Based View of Stakeholder Development to Meet the Demands of Entrustable Professional Activity Implementation
Authors: Lupi Carla S. , Ownby Allison R. , Jokela Janet A. , Cutrer William B. , Thompson-Busch Angela K. , Catallozzi Marina , Noble James M. , Amiel Jonathan M.
Published: May 2018

In 2015, the Association of American Medical Colleges implemented an interinstitutional pilot of 13 core entrustable professional activities (EPAs) for entering residency, activities that entering residents should be expected to perform with indirect supervision. The pilot included a concept group on faculty development; this group previously offered a shared mental model focused on the development of faculty who devote their efforts to clinical teaching and assessment for learning and entrustment decision making. In this article, the authors draw from the literature of competency-based education to propose what is needed in overall approaches to faculty development to prepare institutions for undergraduate EPA implementation.

Taking a systems-based view that defines the necessary tasks of EPA implementation, the authors move beyond the variably used term “faculty” and enumerate a comprehensive list of institutional stakeholders who can meaningfully support and/or engage in the relationships and organizational processes required for EPA learning and assessment. They consider each group’s responsibilities and development needs according to five domains delineated by Steinert: teaching improvement, leadership and management, research-building capacity, academic career building, and organizational change.

The authors argue that the EPA framework addresses barriers posed with the use of a competency-based framework. By facilitating the communication required for organizational change, enabling valid assessment with comprehensive yet feasible levels of faculty development, and incorporating all relevant data on student professional behavior into summative assessment decisions, EPAs may offer a clearer path toward the goal of competency-based education.
Perioperative Hyperchloremia and its Association With Postoperative Acute Kidney Injury After Craniotomy for Primary Brain Tumor Resection: A Retrospective, Observational Study
Authors: Oh Tak Kyu , Kim Chae-Yong , Jeon Young-Tae , Hwang Jung-Won , Do Sang-Hwan
Published: May 2018

Background:

Hyperchloremia is known to influence postoperative outcomes and may result in postoperative acute kidney injury (AKI). This study sought to investigate whether hyperchloremia was associated with postoperative AKI in patients who underwent surgery for primary brain tumor resection.

Materials and Methods:

This is a retrospective, observational study of patients who underwent craniotomy for primary brain tumor resection at a single tertiary care hospital between January 2005 and October 2017. Maximum levels of serum chloride (mmol/L) measured on postoperative days (PODs) 0 to 3 and increase in serum chloride (mmol/L), (maximum serum chloride−baseline serum chloride before surgery) were measured. We examined whether perioperative hyperchloremia was associated with postoperative AKI during PODs 0 to 3. Univariate and multivariate logistic regression analyses were used in this study.

Results:

A total of 726 patients were included in the analysis; of these, 39 (5.4%) were diagnosed with postoperative AKI during PODs 0 to 3. The risk of postoperative AKI was associated with maximum chloride levels (odds ratio, 1.10; 95% confidence interval, 1.02-1.19; P=0.015) and with an increase in serum chloride levels during PODs 0 to 3 (odds ratio, 1.11; 95% confidence interval, 1.04-1.19; P=0.004).

Conclusions:

Our study shows that perioperative hyperchloremia during PODs 0 to 3 was associated with an increased risk of postoperative AKI during this period after craniotomy for primary brain tumor resection.
Heritability of Age-Related Hearing Loss in Middle-Aged and Elderly Chinese: A Population-Based Twin Study
Authors: Duan Haiping , Zhang Dongfeng , Liang Yajun , Xu Chunsheng , Wu Yili , Tian Xiaocao , Pang Zengchang , Tan Qihua , Li Shuxia , Qiu Chengxuan
Published: May 2018

Objectives:

The heritability of age-related hearing loss has been studied mostly in developed countries. The authors aimed to estimate the heritability of better ear hearing level (BEHL), defined as hearing level of the better ear at a given frequency, and pure-tone averages at the middle (0.5, 1.0, and 2.0 kHz) and high (4.0, 8.0, and 12.5 kHz) frequencies among middle-aged and elderly Chinese twins, and to explore their genetic correlations.

Design:

This population-based twin study included 226 monozygotic and 132 dizygotic twin-pairs and 1 triplet (age range, 33 to 80 years; mean age, 51.55 years). Pure-tone air-conducted hearing thresholds in each ear were measured at the frequencies of 0.5, 1.0, 2.0, 4.0, 8.0, and 12.5 kHz with a diagnostic audiometer. Univariate and multivariate twin models were fitted to evaluate heritability and genetic correlations.

Results:

Our data showed a reverse J-shaped pattern of BEHLs at six frequencies by age and sex. Univariate analysis showed that the heritability of BEHLs at the frequencies between 2.0 and 12.5 kHz ranged from 47.08 to 54.20%, but the heritability at the frequencies of 0.5 and 1.0 kHz was 1.65% and 18.68%, respectively. The heritability of pure-tone average at the middle and high frequencies was 34.77% and 43.26%, respectively. Multivariate analysis showed significant genetic correlations among BEHLs at all six frequencies, with the correlation coefficients ranging from 0.48 to 0.83 at middle frequencies, and from 0.46 to 0.75 at high frequencies.

Conclusions:

This population-based twin study suggests that genetic factors are associated with age-related hearing loss at middle and high frequencies among middle-aged and elderly Chinese.
Imaging Comparison Between Chinese and Japanese Patients With Cervical Ossification of the Posterior Longitudinal Ligament
Authors: Xiao Bin , Nagoshi Narihito , Takeuchi Ayano , Mao Jianping , Liu Bo , Tian Wei , Tsuji Osahiko , Okada Eijiro , Fujita Nobuyuki , Yagi Mitsuru , Nakamura Masaya , Matsumoto Morio , Ishii Ken , Watanabe Kota
Published: May 2018

Study Design.

A retrospective study.

Objective.

To identify the radiographic differences between Chinese and Japanese patients with cervical ossification of the posterior longitudinal ligament (OPLL) using computed tomography (CT) and magnetic resonance imaging (MRI), and to compare the characteristics of OPLL between the two nationalities.

Summary of Background Data.

OPLL has a high prevalence in East Asia. However, the differences between Chinese and Japanese OPLL patients are poorly known.

Methods.

This was a retrospective study of Chinese (n = 300) and Japanese (n = 102) consecutive patients who received a diagnosis of cervical OPLL between January 2010 and December 2014. All patients underwent CT and MRI. The type and distribution of OPLL were determined. Spinal compression was assessed by MRI. OPLL type, distribution, comorbidity, and compression of the spinal cord were examined. The ossification index (OP-index) was used to evaluate the OPLL. Factors contributing to the OP-index were examined by multivariate analysis.

Results.

The Chinese patients were younger than the Japanese patients (P < 0.0001), and there were more women among the Chinese patients (P = 0.0002). The OP-index was higher among the Japanese patients (median, 5 vs. 4, P = 0.003). Among men, OPLL lesions were more frequent in the under 55-year-old Japanese at C7 (P = 0.04), in the 55 to 64-year-old Japanese at C4, C5, and C6 (all P < 0.05), and in the over 64-year-old Japanese at C3/4 (P = 0.01), compared with their Chinese counterparts. Among women, OPLL lesions were more frequent in the 55 to 64-year-old Japanese at C6 (P = 0.04). The multivariate analysis showed that only age was independently associated with the OP-index (odds ratio [OR] = 1.023, 95% confidence interval [CI]: 1.002–1.045, P = 0.034).

Conclusion.

Japanese patients had a higher frequency of OPLL lesions at C5, C6, and C7. Age was independently associated with OPLL.

Level of Evidence: 3
Opioid Dependence and Prolonged Length of Stay in Lumbar Fusion
Authors: Tank Allyson , Hobbs Jonathan , Ramos Edwin , Rubin Daniel S.
Published: May 2018

Study Design.

Retrospective cohort utilizing the National Inpatient Sample (NIS) 2003 to 2014.

Objective.

To investigate the association of opioid dependence with prolonged length of stay (LOS), costs, and surgical complications in elective one-to-two level lumbar fusion.

Summary of Background Data.

Opioids are the most commonly prescribed drug class to treat back pain. Few studies have examined the impact of opioid dependence on spinal fusion outcomes. The data available show inconsistent conclusions regarding the association between opioid dependence and LOS.

Methods.

Data from 1,826,868 adult elective one-to-two level lumbar fusion discharges in the NIS from 2003 to 2014 were included. Discharges were categorized into an opioid-dependent or unaffected cohort based on the presence or absence of an International Classification of Disease, Ninth Revision-Clinical Modification (ICD-9-CM) code for opioid dependence. Incidence of opioid dependence was compared between 2003 and 2014 via adjusted Wald tests. Patient and surgical characteristics, costs, and complications were compared between cohorts via chi-square tests or adjusted Wald tests for categorical and continuous variables, respectively. Patient and surgical factors were tested for association with prolonged LOS via univariable logistic regressions, and significant (P ≤ 0.01) factors were included in a multivariable logistic regression.

Results.

Seven thousand nine hundred sixty-four (0.44%) discharges included a diagnosis of opioid dependence. The incidence of opioid dependence increased from 2003 to 2014. Opioid dependence was associated with an adjusted 2.11 times higher odds of prolonged LOS. Opioid-dependent discharges accrued higher costs and had higher frequencies of infection, device-related complications, hematoma- or seroma-related complications, acute posthemorrhagic anemia, and pulmonary insufficiency.

Conclusion.

This nationally-representative study suggests that opioid dependence is associated with prolonged LOS in lumbar fusion, as well as higher costs and higher frequencies of surgical complications. Further investigations are needed to determine the optimal method to treat opioid-dependent patients who require lumbar fusion.

Level of Evidence: 3
Early Interventions for the Prevention of Posttraumatic Stress Symptoms in Survivors of Critical Illness: A Qualitative Systematic Review
Authors: Roberts Michael B. , Glaspey Lindsey J. , Mazzarelli Anthony , Jones Christopher W. , Kilgannon Hope J. , Trzeciak Stephen , Roberts Brian W.
Published: May 2018

Objectives:

Posttraumatic stress disorder among survivors of critical illness is of public health importance, as it is common and reduces patient quality of life. The objective of this systematic review was to collate the world’s literature on interventions aimed at preventing posttraumatic stress disorder among survivors of critical illness.

Data Sources:

We performed a search of CENTRAL, MEDLINE, EMBASE, CINAHL, and clinical trials registry platforms, with no restriction to language using a comprehensive strategy.

Study Selection:

Study inclusion criteria were as follows: 1) adult human subjects, 2) patients treated in an ICU setting, 3) intervention arm aimed at reducing posttraumatic stress disorder symptoms, 4) use of a control arm, and 5) an outcome measure assessing development of acute stress or posttraumatic stress disorder symptoms.

Data Extraction:

We performed a qualitative analysis to collate and summarize effects of identified interventions according to the recommended methodology from the Cochrane Handbook.

Data Synthesis:

Seventeen studies met all inclusion and no exclusion criteria. There was heterogeneity in interventions and outcome measures used. All studies had some concern for risk of bias as per the Cochrane tool for assessing risk of bias. In eight of 12 studies (67%) testing early interventions (i.e., initiated in the ICU course) and one of five studies (20%) testing delayed interventions following ICU discharge, posttraumatic stress disorder symptoms were decreased among the intervention group compared with controls.

Conclusions:

Despite a paucity of high-quality clinical investigations, the preponderance of evidence to date suggests that 1) posttraumatic stress disorder among survivors of critical illness may be preventable and 2) early interventions may be the most effective.