bluuebunny/crossref_metadata_2025_split huggingface dataset:
Change without Change? Assessing Medicare Reimbursement for Advance Care Planning
Authors: Wright Megan S. 
Published: May 2018

AbstractIn January 2016, Medicare began reimbursing clinicians for time spent engaging in advance care planning with their patients or patients’ surrogates. Such planning involves discussions of the care an individual would want to receive should he or she one day lose the capacity to make health care decisions or have conversations with a surrogate about, for example, end‐of‐life wishes. Clinicians can be reimbursed for face‐to‐face explanation and discussion of care and advance directives and for the completion of advance care planning forms. Although it seems that political barriers to reimbursement for such planning have largely faded, the Medicare policy's impact on provider billing practices appears to be limited, suggesting other barriers to clinician engagement in advance care planning. Additionally, the effects of this policy on patient behavior and the clinician‐patient relationship are not yet known.
Incidental Findings in Low‐Resource Settings
Authors: Sullivan Haley K. , Berkman Benjamin E. 
Published: May 2018

AbstractMuch new global genetic research employs whole genome sequencing, which provides researchers with large amounts of data. The quantity of data has led to the generation and discovery of more incidental or secondary findings and to vigorous theoretical discussions about the ethical obligations that follow from these incidental findings. After a decade of debate in the genetic research community, there is a growing consensus that researchers should, at the very least, offer to return incidental findings that provide high‐impact, medically relevant information, when it is not unduly burdensome to the research enterprise to do so.Much as genetic research has been limited to U.S. and European settings, the incidental findings debate has primarily focused on research conducted in high‐income countries. In a 2015 paper, Alberto Ortiz‐Osorno, Linda Ehler, and Judith Brooks note salient differences between the circumstances of research participants in low‐ and high‐resource settings that alter the analysis of when and why incidental findings should be offered to research participants. In this article, we expand on their analysis and present a framework for thinking about how investigators’ obligations to return genomic data might change in low‐resource settings, particularly in settings where participants do not have access to the medical care needed to treat, assess, or monitor incidental findings that are actionable in settings with plentiful resources.
Capacity for Preferences:Respecting Patients with Compromised Decision‐Making
Authors: Wasserman Jason Adam , Navin Mark Christopher 
Published: May 2018

AbstractWhen a patient lacks decision‐making capacity, then according to standard clinical ethics practice in the United States, the health care team should seek guidance from a surrogate decision‐maker, either previously selected by the patient or appointed by the courts. If there are no surrogates willing or able to exercise substituted judgment, then the team is to choose interventions that promote a patient's best interests. We argue that, even when there is input from a surrogate, patient preferences should be an additional source of guidance for decisions about patients who lack decision‐making capacity.Our proposal builds on other efforts to help patients who lack decision‐making capacity provide input into decisions about their care. For example, “supported,” “assisted,” or “guided” decision‐making models reflect a commitment to humanistic patient engagement and create a more supportive process for patients, families, and health care teams. But often, they are supportive processes for guiding a patient toward a decision that the surrogate or team believes to be in the patient's medical best interests. Another approach holds that taking seriously the preferences of such a patient can help surrogates develop a better account of what the patient's treatment choices would have been if the patient had retained decision‐making capacity; the surrogate then must try to integrate features of the patient's formerly rational self with the preferences of the patient's currently compromised self. Patients who lack decision‐making capacity are well served by these efforts to solicit and use their preferences to promote best interests or to craft would‐be autonomous patient images for use by surrogates. However, we go further: the moral reasons for valuing the preferences of patients without decision‐making capacity are not reducible to either best‐interests or (surrogate) autonomy considerations but can be grounded in the values of liberty and respect for persons. This has important consequences for treatment decisions involving these vulnerable patients.
Risk‐neutral moment‐based estimation of affine option pricing models
Authors: Feunou Bruno , Okou Cédric 
Published: May 2018

SummaryThis paper provides a novel methodology for estimating option pricing models based on risk‐neutral moments. We synthesize the distribution extracted from a panel of option prices and exploit linear relationships between risk‐neutral cumulants and latent factors within the continuous time affine stochastic volatility framework. We find that fitting the Andersen et al. (Journal of Financial Economics, 2015, 117(3), 558–584) option valuation model to risk‐neutral moments captures the bulk of the information in option prices. Our estimation strategy is effective, easy to implement, and robust, as it allows for a direct linear filtering of the latent factors and a quasi‐maximum likelihood estimation of model parameters. From a practical perspective, employing risk‐neutral moments instead of option prices also helps circumvent several sources of numerical errors and substantially lessens the computational burden inherent in working with a large panel of option contracts.
Identification of a novel long noncoding RNA that promotes osteoblast differentiation
Authors: Nardocci Gino , Carrasco Margarita E. , Acevedo Elvis , Hodar Christian , Meneses Claudio , Montecino Martín 
Published: May 2018

AbstractLong noncoding RNAs (lncRNAs) are a heterogeneous class of transcripts, longer than 200 nucleotides, 5′‐capped, polyadenylated, and poorly conserved among mammalian species. Several studies have shown the contribution of lncRNAs to different cellular processes, including regulation of the chromatin structure, control of messenger RNA translation, regulation of gene transcription, regulation of embryonic pluripotency, and differentiation. Although limited numbers of functional lncRNAs have been identified so far, the immense regulatory potential of these RNAs is already evident, indicating that a functional characterization of lncRNAs is needed. In this study, mouse preosteoblastic cells were induced to differentiate into osteoblasts. At 3 sequential differentiation stages, total RNA was isolated and libraries were constructed for Illumina sequencing. The resulting sequences were aligned and transcript abundances were determined. New lncRNA candidates that displayed differential expression patterns during osteoblast differentiation were identified by combining bioinformatics and reverse transcription polymerase chain reaction analyses. Among these, lncRNA‐1 that exhibited increased expression during osteogenesis and was downregulated during myogenesis. Importantly, knockdown of lncRNA‐1 expression in primary mouse preosteoblasts was found to inhibit osteogenic differentiation, reflected by a reduced transcription of the Runx2/p57 and Sp7 bone master genes. Together, our results indicate that lncRNA‐1 represents a new regulatory RNA that plays a relevant role during the early stages of osteogenesis.
Temperature fluctuations and maternal estrogens as critical factors for understanding temperature‐dependent sex determination in nature
Authors: Bowden Rachel M. , Paitz Ryan T. 
Published: May 2018

AbstractVertebrates with temperature‐dependent sex determination (TSD) have justifiably received a lot of attention when it comes to the potential effects of climate change. Freshwater turtles have long been used to characterize the physiological and genetic mechanisms underlying TSD and provide a great system to investigate how changing climatic conditions will affect vertebrates with TSD. Unfortunately, most of what we know about the mechanisms underlying TSD comes from laboratory conditions that do not accurately mimic natural conditions (i.e., constant incubation temperatures and supraphysiological steroid manipulations). In this paper, we review recent advances in our understanding of how TSD operates in nature that arose from studies using more natural fluctuating incubation temperatures and natural variation in maternal estrogens within the yolk. By incorporating more natural conditions into laboratory studies, we are better able to use these studies to predict how changing climatic conditions will affect species with TSD.
Factors associated with appointment non‐attendance at a medical imaging department in regional Australia: a retrospective cohort analysis
Authors: Mander Gordon T. W. , Reynolds Lorraine , Cook Aiden , Kwan Marcella M. 
Published: May 2018

AbstractIntroductionAppointment non‐attendance contributes added cost to the healthcare sector through wasted resource allocations. Medical imaging departments commonly schedule appointments for most modalities; however, no study has quantified patient attendance rates in the Australian regional setting. This is despite evidence that regional, rural and remote Australians tend to demonstrate poorer health than metropolitan counterparts. This study aims to identify the factors that influence appointment non‐attendance at a teaching hospital in regional Australia.MethodsCategories restricted to age, gender, indigenous status, distance from investigation site, referral source and imaging modality were collected for all appointments (N = 13,458) referred to the medical imaging department in 2015. The likelihood of each of these factors correlating with a patient not attending a scheduled appointment was calculated using the chi‐squared analysis and binary logistic regression.ResultsGender, indigenous status as well as specific imaging modalities, referral sources and age categories were significantly associated with non‐attendance. Overall, male patients were 1.57 (P < 0.001) times more likely to miss a scheduled appointment than female patients. Patients who identified as Aboriginal and Torres Strait Islander were 2.66 (P < 0.001) times more likely to miss a scheduled appointment than patients who did not identify as Aboriginal and Torres Strait Islander.ConclusionsSeveral key factors appear to affect medical imaging appointment non‐attendance. Key factors include indigenous status, gender, image modality, referral source and age. Further improvement is required to better meet the needs of underrepresented patient demographics.
Preparation of Environmentally Friendly Amino Acid‐Based Anionic Surfactants and Characterization of Their Interfacial Properties for Detergent Products Formulation
Authors: Yea DaNan , Lee SuMin , Jo SeonHui , Yu HyonPil , Lim JongChoo 
Published: May 2018

AbstractIn this study, 2 types of amino acid‐based biosurfactants such as potassium cocoyl glycinate (CGK) and sodium cocoyl glycinate (CGN) were synthesized from coconut oil. Their chemical structures were identified using FT‐IR, 1H NMR, and 13C NMR spectroscopies. Characterization of their interfacial properties has shown that both CGK and CGN surfactants are surface‐active and effective in reducing interfacial free energy. Washing test results indicated relatively good detergency compared with surfactants commonly employed in detergent applications. From environmental compatibility tests, both CGK and CGN are found to be readily biodegradable, nontoxic, nonirritating, and very mild. In particular, the CGK surfactant was found to be more efficient in reducing interfacial free energy since a larger number of CGK molecules are preferentially adsorbed at the air–water interface due to higher hydrophobicity and larger mobility of CGK than CGN, indicating possible uses in detergent applications.
Electrospun Heparin‐Loaded Core–Shell Nanofiber Sutures for Achilles Tendon Regeneration In Vivo
Authors: Ye Ya‐Jing , Zhou Ya‐Qing , Jing Zhuo‐Yuan , Liu Yang‐Yang , Yin Da‐Chuan 
Published: May 2018

AbstractAchilles tendon reconstruction surgery is the primary clinical method for repairing acute Achilles tendon ruptures. However, the efficacy of the postoperative healing process and the recovery of physiological function are inadequate. This study examines the healing mechanism of ruptured rat Achilles tendons seamed with heparin‐loaded core–shell fiber sutures fabricated via near‐field electrospinning. High‐heparin‐concentration sutures (PPH3.0) perform better than the low‐heparin‐concentration sutures and commercial sutures (CSs). The PPH3.0 suture recruits fewer inflammatory cells and shows good histocompatibility in peritoneal implantation experiments. Staining of the Achilles tendon rupture repair zone demonstrates that a high heparin concentration in sutures reduces immune‐inflammatory responses. Immunohistochemical analysis reveals that the transforming growth factor‐β staining scores of the PPH3.0 sutures are not significantly different from those of the corresponding control group but are significantly different from those of the CSs and non‐heparin‐loaded‐suture groups. According to vascular endothelial growth factor (VEGF) analysis, the concentration of VEGF in the group treated with the PPH3.0 suture increases by 37.5% compared with that in its control group. No significant difference in tension strength is observed between the PPH3.0 group and healthy Achilles tendons. These findings illustrate that this novel method effectively treats Achilles tendon rupture and promotes healing and regeneration.
Cross‐Linkable Modified Nanocellulose/Polyester Resin‐Based Composites: Effect of Unsaturated Fatty Acid Nanocellulose Modification on Material Performances
Authors: Rusmirović Jelena D. , Rančić Milica P. , Pavlović Vladimir B. , Rakić Vesna M. , Stevanović Sanja , Djonlagić Jasna , Marinković Aleksandar D. 
Published: May 2018

AbstractUnsaturated fatty acid (FA)–modified nanocellulose (m‐NC) shows potential application in improving mechanical properties of unsaturated polyester/m‐NC nanocomposites (UPe/m‐NC). A polyester matrix is obtained by polycondensation of maleic anhydride and products of poly(ethylene terephthalate) depolymerization with propylene glycol. Two methods of NC modification are performed: direct esterification with oleic acid, linseed, or sunflower oil FAs, and esterification/amidation with maleic acid/ethylene diamine (MA/EDA) bridging group followed by amidation with methyl ester of FAs. Increases of stress at break in the ranges from 148.8% to 181.4% and from 155.8% to193.0% for UPe/m‐NC composites loaded with 1 wt% of NC modified directly or via MA/EDA cross‐linker, respectively, are obtained. Results of the modeling of tensile modulus, by using the Cox–Krenchel model, show good agreement with experimentally obtained data. The effect of FAs' cross‐linking capabilities on the dynamic‐mechanical and thermal properties of the UPe/m‐NC is studied. Cross‐linking density, modulus, and Tg of the nanocomposite show appropriate relation with the unsaturation extent/structure of NC modification.
Dual‐Responsive SPMA‐Modified Polymer Photonic Crystals and Their Dynamic Display Patterns
Authors: Gao Zewen , Gao Dongsheng , Huang Chao , Zhang Hanbing , Guo Jinbao , Wei Jie 
Published: May 2018

AbstractLight and electrothermal responsive polymer photonic crystals (PCs) modified with 1′‐acryloyl chloride‐3′,3′‐dimethyl‐6‐nitro‐spiro(2H‐1‐benzopyran‐2,2′‐indoline) (SPMA) are proposed, and their dynamic display patterns are achieved through the combination of the SPMA‐modified PCs and a patterned graphite layer. These PCs exhibit fluorescence under UV light irradiation because of the isomerization of the SPMA, which is restricted in the shell of the polymer colloidal spheres. After a voltage is applied to the patterned graphite layer, the fluorescence of PCs in the specific area disappears, and dynamic display patterns are obtained. Under UV light irradiation, the PCs change from the “partial‐fluorescence” state to the initial “fluorescence” state, and the patterns disappear. Using this technique, the PC pattern “M L N” on the glass substrate and PC patterns from “0” to “9” on the paper substrate are fabricated. Thus, these dual‐responsive PCs have potential applications in information recording, anticounterfeiting, dynamic display, and photoelectric devices.
First clinical implementation of real‐time, real anatomy tracking and radiation beam control
Authors: Green Olga L. , Rankine Leith J. , Cai Bin , Curcuru Austen , Kashani Rojano , Rodriguez Vivian , Li H. Harold , Parikh Parag J. , Robinson Clifford G. , Olsen Jeffrey R. , Mutic Sasa , Goddu S. M. , Santanam Lakshmi 
Published: May 2018

PurposeWe describe the acceptance testing, commissioning, periodic quality assurance, and workflow procedures developed for the first clinically implemented magnetic resonance imaging‐guided radiation therapy (MR‐IGRT) system for real‐time tracking and beam control.MethodsThe system utilizes real‐time cine imaging capabilities at 4 frames per second for real‐time tracking and beam control. Testing of the system was performed using an in‐house developed motion platform and a commercially available motion phantom. Anatomical tracking is performed by first identifying a target (a region of interest that is either tissue to be treated or a critical structure) and generating a contour around it. A boundary contour is also created to identify tracking margins. The tracking algorithm deforms the anatomical contour (target or a normal organ) on every subsequent cine frame and compares it to the static boundary contour. If the anatomy of interest moves outside the boundary, the radiation delivery is halted until the tracked anatomy returns to treatment portal. The following were performed to validate and clinically implement the system: (a) spatial integrity evaluation; (b) tracking accuracy; (c) latency; (d) relative point dose and spatial dosimetry; (e) development of clinical workflow for gating; and (f) independent verification by an outside credentialing service.ResultsThe spatial integrity of the MR system was found to be within 2 mm over a 45‐cm diameter field‐of‐view. The tracking accuracy for geometric targets was within 1.2 mm. The average system latency was measured to be within 394 ms. The dosimetric accuracy using ionization chambers was within 1.3% ± 1.7%, and the dosimetric spatial accuracy was within 2 mm. The phantom irradiation for the outside credentialing service had satisfactory results, as well.ConclusionsThe first clinical MR‐IGRT system was validated for real‐time tracking and gating capabilities and shown to be reliable and accurate. Patient workflow methods were developed for efficient treatment. Periodic quality assurance tests can be efficiently performed with commercially available equipment to ensure accurate system performance.
Modelling the time‐dependent behaviour of granular material with hypoplasticity
Authors: Wang Shun , Wu Wei , Yin Zhen‐Yu , Peng Chong , He Xuzhen 
Published: May 2018

SummaryThis paper presents a constitutive model for time‐dependent behaviour of granular material. The model consists of 2 parts representing the inviscid and viscous behaviour of granular materials. The inviscid part is a rate‐independent hypoplastic constitutive model. The viscous part is represented by a rheological model, which contains a high‐order term denoting the strain acceleration. The proposed model is validated by simulating some element tests on granular soils. Our model is able to model not only the non‐isotach behaviour but also the 3 creep stages, namely, primary, secondary, and tertiary creep, in a unified way.
Effect of body position on reflex and voluntary pelvic floor muscle contraction during a distraction task
Authors: Dewaele Pauline , Deffieux Xavier , Villot Anne , Billecocq Sylvie , Amarenco Gérard , Thubert Thibault 
Published: May 2018

AimsTo explore the impact of body position (sitting vs standing) on voluntary and reflex pelvic floor muscle (PFM) contraction during a mental distraction task (DT).MethodsInformed consent was obtained from 19 healthy women. The electromyographic (EMG) activity of the external anal sphincter (EAS) was recorded during voluntary and reflex contraction. Reflex contraction of the EAS was induced by means of coughing. The trials were carried out with and without a mental DT (paced auditory serial additional test). PFM contraction was recorded in two different postures: standing and sitting. During voluntary PFM contraction, reaction time (RT1), defined as latency between the stimulus and the onset of EAS EMG activity, was measured. During reflex PFM contraction, latency between the onset of external intercostal (EIC) muscle EMG activity and EAS EMG activity was measured (RT3).ResultsConcerning voluntary pelvic floor muscle contraction, there was no difference between the two positions with and without DT, except for RT1 without DT. RT1 was shorter (353.99 mv/s; 263.89‐425.03) in a standing position than in a sitting position (409.86 mv/s; 361.86‐461.90) (ratio 0.86, P = 0.014). Concerning reflex PFM contraction, there was no difference between standing position RT3 (−96 ms; IQR: −114: −62) and sitting position RT3 (−80 ms; IQR: −100; −51) (ratio 1.2, P = 0.225) without DT. With DT, reflex PFM was also not different (−36 vs −34 ms, ratio 1.06, P = 0.86).ConclusionsBody position did not influence the timing of voluntary and reflex PFM contraction during DT.
Relaxin‐2 therapy reverses radiation‐induced fibrosis and restores bladder function in mice
Authors: Ikeda Youko , Zabbarova Irina V. , Birder Lori A. , Wipf Peter , Getchell Samuel E. , Tyagi Pradeep , Fry Christopher H. , Drake Marcus J. , Kanai Anthony J. 
Published: May 2018

AimTo determine the efficacy of human relaxin‐2 (hRLX2) in reversing radiation‐induced bladder fibrosis and lower urinary tract dysfunction (LUTD). Radiation cystitis is a consequence of radiotherapy for pelvic malignancies. Acutely, irradiation leads to reactive oxygen/nitrogen species in urothelial cells, apoptosis, barrier disruption, and inflammation. Chronically, this results in collagen deposition, bladder fibrosis, and attenuated storage and voiding functions. In severe cases, cystectomies are performed as current therapies do not reverse fibrosis.MethodsWe developed a mouse model for selective bladder irradiation (10 Gray; 1 Gy = 100 rads) resulting in chronic fibrosis within 6 weeks, with decreased bladder compliance, contractility, and overflow incontinence. Seven weeks post‐irradiation, female C57Bl/6 mice were continuously infused with hRLX2 (400 μg/kg/day/14 days) or vehicle (saline) via subcutaneous osmotic pumps. Mice were evaluated in vivo using urine spot analysis, cystometrograms and external urethral sphincter electromyograms; and in vitro using length‐tension measurements, Western blots, histology, and immunohistochemistry.ResultshRLX2 reversed fibrosis, decreased collagen content, improved bladder wall architecture, and increased bladder compliance, detrusor smooth muscle Cav1.2 expression and detrusor contractility in mice with chronic radiation cystitis. hRLX2 treatment outcomes were likely caused by the activation of RXFP1/2 receptors which are expressed on the detrusor.ConclusionhRLX2 may be a new therapeutic option for rescuing bladders with chronic radiation cystitis.