bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of a Parent-Administered Exercise Program in the Neonatal Intensive Care Unit: Dose Does Matter—A Randomized Controlled Trial
Authors: Øberg Gunn Kristin , Girolami Gay L , Campbell Suzann K , Ustad Tordis , Heuch Ivar , Jacobsen Bjarne K , Kaaresen Per Ivar , Aulie Vibeke Smith , Jørgensen Lone 
Published: January 2020

Abstract

Background
Despite the risk of delayed motor development in infants born preterm, knowledge about interventions in the neonatal intensive care unitt (NICU) and the effects of dosing is sparse.

Objective
The objectives of this study were to examine the effectiveness of a parent-administered exercise program in the NICU on motor outcome at 3 months corrected age (CA) and the effect of dosing on motor performance.

Design
This was a randomized clinical trial.

Setting
The study was conducted at 3 university hospitals in Tromsø, Trondheim, and Oslo, Norway.

Participants
A total of 153 infants with gestational age &lt;32 weeks at birth were randomly assigned to intervention or control groups.

Intervention
A 3-week parent-administered intervention designed to facilitate movements in preterm infants was performed in the NICU. Parents were asked to administer the intervention 10 minutes twice a day.

Measurements
Test of Infant Motor Performance (TIMP) was used to assess short-term outcome at 3 months CA.

Results
No significant difference in the TIMP z-score was found between intervention and control groups at follow-up 3 months CA, but a significant positive relationship was found between total intervention dose and TIMP z-scores. The adjusted odds of having a clinical z-score &lt; 0 at 3 months CA was about 6 times higher for infants with less than median intervention time than for infants with a longer intervention time.

Limitations
The number of infants born before 28 weeks was small. A spillover effect in favor of the control group was possible. We do not know if the infants received physical therapy after discharge from the hospital.

Conclusions
There was no difference in motor performance between the intervention group and the control group at 3 months CA. However, an increased intervention dose was positively associated with improved motor outcome.
Negotiating a Better Future: How Interpersonal Skills Facilitate Intergenerational Investment*
Authors: Ashraf Nava , Bau Natalie , Low Corinne , McGinn Kathleen 
Published: January 2020

AbstractUsing a randomized controlled trial, we study whether a negotiation skills training can improve girls’ educational outcomes in a low-resource environment. We find that a negotiation training given to eighth-grade Zambian girls significantly improved educational outcomes over the next three years, and these effects did not fade out. To better understand mechanisms, we estimate the effects of two alternative treatments. Negotiation had much stronger effects than an informational treatment, which had no effect. A treatment designed to have more traditional girls’ empowerment effects had directionally positive but insignificant educational effects. Relative to this treatment, negotiation increased enrollment in higher-quality schooling and had larger effects for high-ability girls. These findings are consistent with a model in which negotiation allows girls to resolve incomplete contracting problems with their parents, yielding increased educational investment for those who experience sufficiently high returns. We provide evidence for this channel through a lab-in-the-field game and follow-up survey with girls and their guardians.
Progenitor cell niche senescence reflects pathology of the parotid salivary gland in primary Sjögren’s syndrome
Authors: Wang Xiaoyan , Bootsma Hendrika , Terpstra Janneke , Vissink Arjan , van der Vegt Bert , Spijkervet Fred K L , Kroese Frans G M , Pringle Sarah 
Published: January 2020

AbstractObjectiveSalivary gland (SG) progenitor cells (SGPCs) maintain SG homeostasis. We have previously shown that in primary Sjögren’s syndrome (pSS), SGPCs are likely to be senescent, and may underpin SG dysfunction. This study assessed the extent of senescence of cells in a SGPC niche in pSS patients’ SGs, and its correlation with functional and clinical parameters.MethodsThe expression of p16 and p21 as markers of senescence in both total SG epithelium and a SGPC niche (basal striated duct cells, BSD) was examined in SGs of pSS (n = 35), incomplete pSS (n = 13) (patients with some signs of pSS, but not fulfilling all classification criteria) and non-SS sicca control (n = 21) patients. This was correlated with functional and clinical parameters.ResultspSS patient SGs contained significantly more p16+ cells both in the epithelium in general (P &lt;0.01) and in the BSD layer (P &lt;0.001), than non-SS SGs. Significant correlations were found in pSS patients between p16+ BSD cells and secretion of unstimulated whole saliva, stimulated whole saliva, stimulated parotid saliva, CD45+ infiltrate, ultrasound total score and ACR-EULAR classification score, but not with EULAR Sjögren’s syndrome disease activity index (ESSDAI) and EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI) scores. Correlations with total epithelium p16+ cells were weaker. Incomplete pSS patients also had increased numbers of p16+ epithelial and BSD cells. Based on protein and mRNA expression, p21+ appears not to play a significant role in the SG in pSS.ConclusionThese findings suggest SGPC senescence may be an early feature of primary Sjögren’s syndrome and may contribute to defective SG function in pSS but not to systemic disease activity.
Vaginal dryness in primary Sjögren’s syndrome: a histopathological case–control study
Authors: van Nimwegen Jolien F , van der Tuuk Karin , Liefers Silvia C , Verstappen Gwenny M , Visser Annie , Wijnsma Robin F , Vissink Arjan , Hollema Harry , Mourits Marian J E , Bootsma Hendrika , Kroese Frans G M 
Published: January 2020

Abstract

Objective
The aim was to study clinical, histopathological and immunological changes in the vagina and cervix of women with primary SS, which might explain vaginal dryness.

Methods
We included 10 pre-menopausal female primary SS patients with vaginal dryness and 10 pre-menopausal controls undergoing a laparoscopic procedure. The vaginal health index was recorded. Multiplex immunoassays and flow cytometry were performed on endocervical swab and cervicovaginal lavage samples to evaluate cellular and soluble immune markers. Mid-vaginal and endocervical biopsies were taken and stained for various leucocyte markers, caldesmon (smooth muscle cells), avian V-ets erythroblastosis virus E26 oncogene homologue (ERG; endothelial cells) and anti-podoplanin (lymphatic endothelium). The number of positive pixels per square micrometre was calculated.

Results
One patient was excluded because of Clamydia trachomatis, and two controls were excluded because of endometriosis observed during their laparoscopy. Vaginal health was impaired in primary SS. CD45+ cells were increased in vaginal biopsies of women with primary SS compared with controls. Infiltrates were predominantly located in the peri-epithelial region, and mostly consisted of CD3+ lymphocytes. In the endocervix, CD45+ infiltrates were present in patients and in controls, but a higher number of B lymphocytes was seen in primary SS. Vascular smooth muscle cells were decreased in the vagina of primary SS patients. No differences were found in leucocyte subsets in the vaginal and endocervical lumen. CXCL10 was increased in endocervical swab samples of primary SS patients.

Conclusion
Women with primary SS show impaired vaginal health and increased lymphocytic infiltration in the vagina compared with controls. Vaginal dryness in primary SS might be caused by vascular dysfunction, possibly induced by IFN-mediated pathways.
Does the Market Correctly Value Investment Options?*
Authors: Lyandres Evgeny , Matveyev Egor , Zhdanov Alexei 
Published: January 2020

Abstract
This paper shows that the stock market misprices firms’ investment options. We build a real options model of optimal investment under uncertainty to estimate the value of firms’ investment options. We show that firms with valuable investment options have a higher likelihood of being mispriced. Importantly, this mispricing is not one-sided, as such firms are equally likely to be undervalued or overvalued. Our paper adds to the debate on whether public equity markets are myopic and systematically undervalue innovative firms. We show that this is not necessarily the case.
Psychotic Experiences in Schizophrenia and Sensitivity to Sensory Evidence
Authors: Weilnhammer Veith , Röd Lukas , Eckert Anna-Lena , Stuke Heiner , Heinz Andreas , Sterzer Philipp 
Published: January 2020

Abstract
Perceptual inference depends on an optimal integration of current sensory evidence with prior beliefs about the environment. Alterations of this process have been related to the emergence of positive symptoms in schizophrenia. However, it has remained unclear whether delusions and hallucinations arise from an increased or decreased weighting of prior beliefs relative to sensory evidence. To investigate the relation of this prior-to-likelihood ratio to positive symptoms in schizophrenia, we devised a novel experimental paradigm which gradually manipulates perceptually ambiguous visual stimuli by disambiguating stimulus information. As a proxy for likelihood precision, we assessed the sensitivity of individual participants to sensory evidence. As a surrogate for the precision of prior beliefs in perceptual stability, we measured phase duration in ambiguity. Relative to healthy controls, patients with schizophrenia showed a stronger increment in congruent perceptual states for increasing levels of disambiguating stimulus evidence. Sensitivity to sensory evidence correlated positively with the individual patients’ severity of perceptual anomalies and hallucinations. Moreover, the severity of such experiences correlated negatively with phase duration. Our results indicate that perceptual anomalies and hallucinations are associated with a shift of perceptual inference toward sensory evidence and away from prior beliefs. This reduced prior-to-likelihood ratio in sensory processing may contribute to the phenomenon of aberrant salience, which has been suggested to give rise to the false inferences underlying psychotic experiences.
Opposing Changes in the Functional Architecture of Large-Scale Networks in Bipolar Mania and Depression
Authors: Russo Daniel , Martino Matteo , Magioncalda Paola , Inglese Matilde , Amore Mario , Northoff Georg 
Published: January 2020

Abstract

Objective
Manic and depressive phases of bipolar disorder (BD) show opposite symptoms in psychomotor, thought, and affective dimensions. Neuronally, these may depend on distinct patterns of alterations in the functional architecture of brain intrinsic activity. Therefore, the study aimed to characterize the spatial and temporal changes of resting-state activity in mania and depression, by investigating the regional homogeneity (ReHo) and degree of centrality (DC), in different frequency bands.

Methods
Using resting-state functional magnetic resonance imaging (fMRI), voxel-wise ReHo and DC were calculated—in the standard frequency band (SFB: 0.01–0.10 Hz), as well as in Slow5 (0.01–0.027 Hz) and Slow4 (0.027–0.073 Hz)—and compared between manic (n = 36), depressed (n = 43), euthymic (n = 29) patients, and healthy controls (n = 112). Finally, clinical correlations were investigated.

Results
Mania was mainly characterized by decreased ReHo and DC in Slow4 in the medial prefrontal cortex (as part of the default-mode network [DMN]), which in turn correlated with manic symptomatology. Conversely, depression was mainly characterized by decreased ReHo in SFB in the primary sensory-motor cortex (as part of the sensorimotor network [SMN]), which in turn correlated with depressive symptomatology.

Conclusions
Our data show a functional reconfiguration of the spatiotemporal structure of intrinsic brain activity to occur in BD. Mania might be characterized by a predominance of sensorimotor over associative networks, possibly driven by a deficit of the DMN (reflecting in internal thought deficit). Conversely, depression might be characterized by a predominance of associative over sensorimotor networks, possibly driven by a deficit of the SMN (reflecting in psychomotor inhibition).
Social democracy and the relative price of investment: left governments, indirect taxation and the division of corporate income in affluent democracies
Authors: Huo Jingjing 
Published: January 2020

AbstractWhile indirect taxes can fall on both consumption and investment spending, there has been little discussion on how governments may tax these two types of expenditure differentially. This article shows that the choice between taxing consumption and investment spending has important distributive implications for left governments as the traditional defenders of redistribution. In particular, when left governments increase taxes on investment relative to consumption expenditure, the higher price of investment relative to consumption goods drives up the labor share of corporate income, lowers corporate saving and reduces corporate net lending. Because this labor share strategy of redistribution is likely to antagonize capital, left governments tend to pursue it more intensely when corporatism has declined. I test these arguments using data across 12–14 Organisation for Economic Cooperation and Development (OECD) countries from the 1970s to 2010.
Patients as Consumers in the Market for Medicine: The Halo Effect of Hospitality
Authors: Young Cristobal , Chen Xinxiang 
Published: January 2020

AbstractConsumer-driven health care is often heralded as a new quality paradigm in medicine. However, patients-as-consumers face difficulties in judging the quality of their medical treatment. With a sample of 3,000 U.S. hospitals, we find that neither medical quality nor patient survival rates have much impact on patient satisfaction with their hospital. In contrast, patients are very sensitive to the “room and board” aspects of care that are highly visible. Quiet rooms have a larger impact on patient satisfaction than medical quality, and communication with nurses affects satisfaction far more than the hospital-level risk of dying. Hospitality experiences create a halo effect of patient goodwill, while medical excellence and patient safety do not. Moreover, when hospitals face greater competition from other hospitals, patient satisfaction is higher but medical quality is lower. Consumer-driven health care creates pressures for hospitals to be more like hotels. These findings lend broader insight into unintended consequences of marketization.
Support vector machine prediction of obstructive sleep apnea in a large-scale Chinese clinical sample
Authors: Huang Wen-Chi , Lee Pei-Lin , Liu Yu-Ting , Chiang Ambrose A , Lai Feipei 
Published: January 2020

AbstractStudy ObjectivesPolysomnography is the gold standard for diagnosis of obstructive sleep apnea (OSA) but it is costly and access is often limited. The aim of this study is to develop a clinically useful support vector machine (SVM)-based prediction model to identify patients with high probability of OSA for nonsleep specialist physician in clinical practice.MethodsThe SVM model was developed using the features routinely collected at the clinical evaluation from 6,875 Chinese patients referred to sleep clinics for suspected OSA. Three apnea-hypopnea index (AHI) cutoffs, ≥5/h, ≥15/h, and ≥30/h were used to define the severity of OSA. The continuous and categorized features were selected separately and were further selected through stepwise forward feature selection. The modeling was achieved through fivefold cross-validation. The model discriminative ability was evaluated for the whole data set and four subgroups categorized with gender and age (&lt;65 versus ≥65 years old [y/o]).ResultsTwo features were selected to predict AHI cutoff ≥5/h with six features selected for ≥15/h, and six features selected for ≥30/h, respectively, to reach Area under the Receiver Operating Characteristic (AUROC) 0.82, 0.80, and 0.78, respectively. The sensitivity was 74.14%, 75.18%, and 70.26%, while the specificity was 74.71%, 68.73%, and 70.30%, respectively. Compared to logistic regression, Berlin questionnaire, NoSAS Score, and Supersparse Linear Integer Model (SLIM) scoring system, the SVM model performs better with a more balanced sensitivity and specificity. The discriminative ability was best for male &lt;65 y/o and modest for female ≥65 y/o.ConclusionOur model provides a simple and accurate modality for early identification of patients with OSA and may potentially help prioritize them for sleep study.
Impact of Prenatal Exposure to Opioids, Cocaine, and Cannabis on Eye Disorders in Children
Authors: Auger Nathalie , Rhéaume Marc-André , Low Nancy , Lee Ga Eun , Ayoub Aimina , Luu Thuy Mai 
Published: January 2020

Objectives:
Prenatal substance exposure is associated with abnormal visual evoked potentials in offspring, but whether ocular abnormalities are present past infancy is unclear. We determined the association between prenatal substance exposure and hospitalizations for eye disorders in childhood.

Methods:
We conducted a longitudinal cohort study of 794,099 infants born between 2006 and 2016 in all hospital centers in Quebec, Canada. We identified infants prenatally exposed to opioids, cocaine, cannabis, and other illicit substances and followed them over time to assess eye disorders that required in-hospital treatment, including retinal detachment and breaks, strabismus, and other ocular pathologies. We calculated incidence rates and hazard ratios (HR) with 95% confidence intervals (CI) for the association of prenatal substance exposure with risk of eye disorders, adjusted for patient characteristics.

Results:
Infants exposed to substances prenatally had a higher incidence of hospitalizations for eye disorders compared with unexposed infants (47.0 vs 32.0 per 10,000 person-years). Prenatal substance exposure was associated with 1.23 times the risk of hospital admission for any eye disorder during childhood compared with no exposure (95% CI 1.04–1.45). Risks were greatest for strabismus (HR 1.55, 95% CI 1.16–2.07) and binocular movement disorders (HR 1.96, 95% CI 1.00–3.83). Opioid use was strongly associated with the risk of ocular muscle disorders (HR 3.15, 95% CI 1.98–5.01).

Conclusions:
Prenatal substance exposure is significantly associated with future hospitalizations for eye disorders in childhood. Efforts to minimize substance use in women of reproductive age are needed in light of the current opioid epidemic.
Modern Results of Functional Bracing of Humeral Shaft Fractures: A Multicenter Retrospective Analysis
Authors: Serrano Rafael , Mir Hassan R. , Sagi Henry C. , Horwitz Daniel S. , Ketz John P. , Kistler Brian J. , Quade Jonathan H. , Beebe Michael J. , Au Brigham K. , Sanders Roy W. , Shah Anjan R. 
Published: January 2020

Objectives:
To evaluate the rate of, and reasons for, conversion of closed treatment of humeral shaft fractures using a fracture brace, to surgical intervention.

Design:
Multicenter, retrospective analysis.

Setting:
Nine Level 1 trauma centers across the United States.

Patients:
A total of 1182 patients with a closed humeral shaft fracture initially managed nonoperatively with a functional brace from 2005 to 2015 were reviewed retrospectively from 9 institutions.

Intervention:
Functional brace.

Main outcome measurements:
Conversion to surgery.

Results:
A total of 344 fractures (29%) ultimately underwent surgical intervention. Reasons for conversion included nonunion (60%), malalignment beyond acceptable parameters (24%), inability to tolerate functional bracing (12%), and persistent signs of radial nerve palsy requiring exploration (3.7%). Univariate comparisons showed that females and whites were significantly (P < 0.05) more likely to be converted to surgery. The multivariate logistic regression identified females as being 1.7 times more likely and alcoholics to be 1.4 times more likely to be converted to surgery (P < 0.05). Proximal shaft as well as comminuted, segmental, and butterfly fractures were also linked to a higher rate of conversion.

Conclusions:
This large multicenter study identified a 29% surgical conversion rate, with nonunion as the most common reason for surgical intervention after the failure of functional brace. These results are markedly different than previously reported. These results may be helpful in the future when counseling patients on the choice between functional bracing and surgical intervention in managing humeral shaft fractures.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Atrial fibrillation and the risk of cardiovascular disease and mortality in the Hypertension in the Very Elderly Trial
Authors: Antikainen Riitta L. , Peters Ruth , Beckett Nigel S. , Rajkumar Chakravarthi , Bulpitt Christopher J. 
Published: January 2020

Objective:
To assess the prognostic value of electrocardiographic atrial fibrillation in older hypertensive people in the randomized, placebo-controlled Hypertension in the Very Elderly Trial.

Methods:
Hypertension in the Very Elderly Trial randomized 3845 hypertensive people aged 80 years and over, 3273 with electrographic data on the presence or absence of atrial fibrillation at baseline and without established cardiovascular disease. Multivariate Cox proportional hazard models were used to estimate hazard ratios with 95% confidence intervals (CIs) for all-cause mortality, incident fatal and nonfatal major cardiovascular events, all-stroke and all-heart failure. The mean follow-up time was 2.1 years.

Results:
Baseline prevalence of atrial fibrillation was 5.8%. Compared with people without atrial fibrillation at baseline, after adjustments the presence of atrial fibrillation was associated with increased risk of mortality (hazard ratio = 2.49, 95% CI = 1.80–3.44, P < 0.001), of nonfatal and fatal cardiovascular events (hazard ratio = 2.47, 95% CI = 1.71–3.55, P < 0.001), all-stroke (hazard ratio = 2.47, 95% CI = 1.34–4.56, P = 0.004) and all-heart failure (hazard ratio 2.33, 95% CI = 1.10–4.93, P = 0.027).

Conclusion:
Atrial fibrillation is an important risk factor to consider when assessing older hypertensive adults as it is associated with increased risk of mortality, nonfatal and fatal cardiovascular events, stroke and heart failure.