bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Seat at the Table: The Positioning of Families During Care Conferences in Nursing Homes
Authors: Puurveen Gloria , Cooke Heather , Gill Rupali , Baumbusch Jennifer 
Published: July 2018

AbstractBackground and ObjectivesCurrent nursing home policy emphasizes the need for collaborative, team-based care planning in which families and/or residents are actively involved. Resident care conferences are common where care providers, families, and/or residents discuss and coordinate resident care needs and evaluate care goals. This study critically examines the process, structure, and content of care conferences to expand our understanding of how resident care is negotiated among care providers and families in this context.Research Design and MethodsThis study was part of a larger critical ethnography examining the negotiation of care work among care providers, families, and residents in three purposively selected nursing homes in British Columbia, Canada. Thirty-seven care conferences were observed. Field notes and interview data were thematically analyzed with a focus on what was said, who said what and to whom, whose voice was privileged, and how power manifested between care providers, families, and/or residents.ResultsAs illustrated by three key themes, Exclusion by Process—Following Script, Exclusion by Content—Scripted Reports, and Exclusion through Devalued Knowledge, families were overtly and covertly excluded from contributing to the care conferences. As such, families’ presence did not guarantee open communication or active solicitation of their perspectives.Discussion and ImplicationsThe use of predetermined agendas and processes, clinically generic reporting, and technical jargon reproduced the structural inequality between care providers and families making collaboration difficult to effectively negotiate. For care conferences to meaningfully contribute to person-centered care, it is imperative that mutual exchange be promoted and families empowered to participate as equals.
By-catch in no-fed aquaculture: exploiting mussel seed persistently and extensively disturbs the accompanying assemblage
Authors: Piñeiro-Corbeira Cristina , Barrientos Sara , Olmedo Mercedes , Cremades Javier , Barreiro Rodolfo 
Published: July 2018

Abstract
Although aquaculture sometimes lessens the negative effects of fishing by lowering the need to capture wild animals and plants, some aquaculture practices still require the exploitation of wild populations. A largely overlooked case is the use of wild populations to provide seed to sea farms. Mussel farming in Northwest Spain involve the capture of thousands of tons of young mussels (0.5–2 cm long) from the nearby rocky intertidal every year to supply floating rafts. Despite its volume, the impact of this activity on other sessile organisms remains unassessed. To fill this gap in our knowledge, we monthly monitored the sessile intertidal assemblage of five protected and six exploited sites during the closed season in 2016 following a nested sampling plan. Like the by-catch typical of other fisheries, harvesting young mussels for aquaculture was detrimental to the abundance and diversity of the associated sessile assemblage not directly targeted by this activity. Coverage and richness were also significantly lowered by the exploitation of mussel seed, and the community structure of protected and exploited sites was significantly different. These differences continued until the next open season, suggesting that the closed season was too short for the recovery of the associated non-target sessile assemblage. Given the size of the local mussel industry, the incomplete recovery along the closed season implies that mussel aquaculture must be putting a sustained pressure on a sizeable portion of the rocky intertidal of Northwest Spain.
A convergent adaptive finite element method for elliptic Dirichlet boundary control problems
Authors: Gong Wei , Liu Wenbin , Tan Zhiyu , Yan Ningning 
Published: July 2018

Abstract
This paper concerns the adaptive finite element method for elliptic Dirichlet boundary control problems in the energy space. The contribution of this paper is twofold. First, we rigorously derive efficient and reliable a posteriori error estimates for finite element approximations of Dirichlet boundary control problems. As a by-product, a priori error estimates are derived in a simple way by introducing appropriate auxiliary problems and establishing certain norm equivalence. Secondly, for the coupled elliptic partial differential system that resulted from the first-order optimality system, we prove that the sequence of adaptively generated discrete solutions including the control, the state and the adjoint state, guided by our newly derived a posteriori error indicators, converges to the true solution along with the convergence of the error estimators. We give some numerical results to confirm our theoretical findings.
Machine learning for psychiatric patient triaging: an investigation of cascading classifiers
Authors: Singh Vivek Kumar , Shrivastava Utkarsh , Bouayad Lina , Padmanabhan Balaji , Ialynytchev Anna , Schultz Susan K 
Published: July 2018

Abstract

Objective
Develop an approach, One-class-at-a-time, for triaging psychiatric patients using machine learning on textual patient records. Our approach aims to automate the triaging process and reduce expert effort while providing high classification reliability.

Materials and Methods
The One-class-at-a-time approach is a multistage cascading classification technique that achieves higher triage classification accuracy compared to traditional multiclass classifiers through 1) classifying one class at a time (or stage), and 2) identification and application of the highest accuracy classifier at each stage. The approach was evaluated using a unique dataset of 433 psychiatric patient records with a triage class label provided by “I2B2 challenge,” a recent competition in the medical informatics community.

Results
The One-class-at-a-time cascading classifier outperformed state-of-the-art classification techniques with overall classification accuracy of 77% among 4 classes, exceeding accuracies of existing multiclass classifiers. The approach also enabled highly accurate classification of individual classes—the severe and mild with 85% accuracy, moderate with 64% accuracy, and absent with 60% accuracy.

Discussion
The triaging of psychiatric cases is a challenging problem due to the lack of clear guidelines and protocols. Our work presents a machine learning approach using psychiatric records for triaging patients based on their severity condition.

Conclusion
The One-class-at-a-time cascading classifier can be used as a decision aid to reduce triaging effort of physicians and nurses, while providing a unique opportunity to involve experts at each stage to reduce false positive and further improve the system’s accuracy.
Evolving role of genetic testing for the clinical management of autosomal dominant polycystic kidney disease
Authors: Lanktree Matthew B , Iliuta Ioan-Andrei , Haghighi Amirreza , Song Xuewen , Pei York 
Published: July 2018

Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is caused primarily by mutations of two genes, PKD1 and PKD2. In the presence of a positive family history of ADPKD, genetic testing is currently seldom indicated as the diagnosis is mostly based on imaging studies using well-established criteria. Moreover, PKD1 mutation screening is technically challenging due to its large size, complexity (i.e. presence of six pseudogenes with high levels of DNA sequence similarity) and extensive allelic heterogeneity. Despite these limitations, recent studies have delineated a strong genotype–phenotype correlation in ADPKD and begun to unravel the role of genetics underlying cases with atypical phenotypes. Furthermore, adaptation of next-generation sequencing (NGS) to clinical PKD genetic testing will provide a high-throughput, accurate and comprehensive screen of multiple cystic disease and modifier genes at a reduced cost. In this review, we discuss the evolving indications of genetic testing in ADPKD and how NGS-based screening promises to yield clinically important prognostic information for both typical as well as unusual genetic (e.g. allelic or genic interactions, somatic mosaicism, cystic kidney disease modifiers) cases to advance personalized medicine in the era of novel therapeutics for ADPKD.
Biomimetic twisted plywood structural materials
Authors: Chen Si-Ming , Gao Huai-Ling , Zhu Yin-Bo , Yao Hong-Bin , Mao Li-Bo , Song Qi-Yun , Xia Jun , Pan Zhao , He Zhen , Wu Heng-An , Yu Shu-Hong 
Published: July 2018

Abstract
Biomimetic designs based on micro/nanoscale manipulation and scalable fabrication are expected to develop new-style strong, tough structural materials. Although the mimicking of nacre-like ‘brick-and-mortar’ structure is well studied, many highly ordered natural architectures comprising 1D micro/nanoscale building blocks still elude imitation owing to the scarcity of efficient manipulation techniques for micro/nanostructural control in practical bulk counterparts. Herein, inspired by natural twisted plywood structures with fascinating damage tolerance, biomimetic bulk materials that closely resemble natural hierarchical structures and toughening mechanisms are successfully fabricated through a programmed and scalable bottom-up assembly strategy. By accurately engineering the arrangement of 1D mineral micro/nanofibers in biopolymer matrix on the multiscale, the resultant composites display optimal mechanical performance, superior to many natural, biomimetic and engineering materials. The design strategy allows for precise micro/nanostructural control at the macroscopic 3D level and can be easily extended to other materials systems, opening up an avenue for many more micro/nanofiber-based biomimetic designs.
Astaxanthin mitigates subarachnoid hemorrhage injury primarily by increasing sirtuin 1 and inhibiting the Toll‐like receptor 4 signaling pathway
Authors: Zhang Xiangsheng , Lu Yue , Wu Qi , Dai Haibin , Li Wei , Lv Shengyin , Zhou Xiaoming , Zhang Xin , Hang Chunhua , Wang Jian 
Published: July 2018

ABSTRACTInflammation plays a key role in the progression of subarachnoid hemorrhage (SAH). Here, we examined the effects of astaxanthin (ATX) on the inflammatory response and secondary damage after SAH and the underlying mechanisms of action. In vivo, a prechiasmatic cistern injection model was established in rats and mice. In addition, neuron‐microglia cocultures were exposed to oxyhemoglobin to mimic SAH in vitro. Western blotting revealed that protein expression of TLR4 was markedly increased in microglia at 24 h after SAH, with consequent increases in the downstream molecules myeloid differentiation factor 88 and NF‐κB. Treatment with ATX significantly inhibited the TLR4 activation, increased sirtuin 1 expression, and inhibited the subsequent inflammatory response both in vivo and in vitro. ATX also significantly decreased high‐mobility group box 1 nuclear translocation and secretion in neurons, an effect that was reversed by the sirtuin 1‐specific inhibitor sirtinol. ATX administered 4 h after SAH ameliorated cerebral inflammation, brain edema, and neuronal death and improved neurologic function. ATX reduced neuronal death but did not improve neurologic function in TLR4 knockout mice. These results suggest that ATX reduces the proinflammatory response and secondary brain injury after SAH, primarily by increasing sirtuin 1 levels and inhibiting the TLR4 signaling pathway.—Zhang, X., Lu, Y., Wu, Q., Dai, H., Li, W., Lv, S., Zhou, X., Zhang, X., Hang, C., Wang, J. Astaxanthin mitigates subarachnoid hemorrhage injury primarily by increasing sirtuin 1 and inhibiting the Toll‐like receptor 4 signaling pathway. FASEB J. 33, 722–737 (2019). www.fasebj.org
Assessment of Lung Aeration and Recruitment by CT Scan and Ultrasound in Acute Respiratory Distress Syndrome Patients*
Authors: Chiumello Davide , Mongodi Silvia , Algieri Ilaria , Vergani Giordano Luca , Orlando Anita , Via Gabriele , Crimella Francesco , Cressoni Massimo , Mojoli Francesco 
Published: July 2018

Objectives:
Lung ultrasound is commonly used to evaluate lung morphology in patients with acute respiratory distress syndrome. Aim of this study was to determine lung ultrasound reliability in assessing lung aeration and positive end-expiratory pressure–induced recruitment compared with CT.

Design:
Randomized crossover study.

Setting:
University hospital ICU.

Patients:
Twenty sedated paralyzed acute respiratory distress syndrome patients: age 56 years (43–72 yr), body mass index 25 kg/m2 (22–27 kg/m2), and Pao
2/Fio
2 160 (113–218).

Interventions:
Lung CT and lung ultrasound examination were performed at positive end-expiratory pressure 5 and 15 cm H2O.

Measurements and Main Results:
Global and regional Lung Ultrasound scores were compared with CT quantitative analysis. Lung recruitment (i.e., decrease in not aerated tissue as assessed with CT) was compared with global Lung Ultrasound score variations. Global Lung Ultrasound score was strongly associated with average lung tissue density at positive end-expiratory pressure 5 (R
2 = 0.78; p < 0.0001) and positive end-expiratory pressure 15 (R
2 = 0.62; p < 0.0001). Regional Lung Ultrasound score strongly correlated with tissue density at positive end-expiratory pressure 5 (r
s = 0.79; p < 0.0001) and positive end-expiratory pressure 15 (r
s = 0.79; p < 0.0001). Each step increase of regional Lung Ultrasound score was associated with significant increase of tissue density (p < 0.005). A substantial agreement was found between regional Lung Ultrasound score and CT classification at positive end-expiratory pressure 5 (k = 0.69 [0.63–0.75]) and at positive end-expiratory pressure 15 (k = 0.70 [0.64–0.75]). At positive end-expiratory pressure 15, both global Lung Ultrasound score (22 [16–27] vs 26 [21–29]; p < 0.0001) and not aerated tissue (42% [25–57%] vs 52% [39–67%]; p < 0.0001) decreased. However, Lung Ultrasound score variations were not associated with lung recruitment (R
2 = 0.01; p = 0.67).

Conclusions:
Lung Ultrasound score is a valid tool to assess regional and global lung aeration. Global Lung Ultrasound score variations should not be used for bedside assessment of positive end-expiratory pressure–induced recruitment.
An LC-MS/MS Method for Absolute Quantification of Nivolumab in Human Plasma: Application to Clinical Therapeutic Drug Monitoring
Authors: Irie Kei , Okada Akira , Yamasaki Yuta , Kokan Chiyuki , Hata Akito , Kaji Reiko , Fukushima Keizo , Sugioka Nobuyuki , Okada Yutaka , Katakami Nobuyuki , Fukushima Shoji 
Published: July 2018

Background:
Nivolumab is a fully humanized IgG4 monoclonal antibody that targets the programmed death-1 (PD-1) receptor, disrupting PD-1–mediated signaling and restoring antitumor immunity. The objective of this study was to develop a nivolumab quantification method using liquid chromatography-tandem mass spectrometry (LC-MS/MS) and to evaluate its application in clinical therapeutic drug monitoring.

Methods:
Nivolumab was purified from human plasma using rProtein A resin and then digested with trypsin. The ASGITFSNSGMHWVR peptide (multiple reaction monitoring transition: m/z 550.6→661.4) was detected as a surrogate peptide of nivolumab by triple quadrupole mass spectrometry. Plasma samples (126) were collected from 14 patients with non–small cell lung cancer who were undergoing clinical dosing regimen with nivolumab. The pharmacokinetic data were analyzed using Phoenix NLME software (Version 7.0, Certara, St. Louis, MO) based on a previously reported population pharmacokinetics (PPK) model of nivolumab.

Results:
Nivolumab was selectively detected in human plasma and the linear range was 5–200 mcg/mL (R2 = 0.99). The accuracy and intraday and interday imprecision were within ±15% of the quality control values of 5 (lower limit of quantification), 10 (low), 80 (medium), and 160 (high) mcg/mL. The nivolumab concentrations measured using LC-MS/MS were consistent with those of previously reported PPK models, and the pharmacokinetic parameters could be adequately predicted from a single trough concentration using a Bayesian approach.

Conclusions:
An absolute quantification method for nivolumab using LC-MS/MS was successfully developed and validated. Combined with PPK analysis, this method should be useful for the therapeutic drug monitoring of nivolumab in clinical practice.
PSEUDOXANTHOMA ELASTICUM: SUCCESSFUL LONG-TERM MANAGEMENT OF CHOROIDAL NEOVASCULARIZATION SECONDARY TO ANGIOID STREAKS WITH PRO RE NATA INTRAVITREAL BEVACIZUMAB INJECTIONS
Authors: Kim Jiyeon , Dalziel David 
Published: July 2018

Purpose:
To demonstrate how a patient with recurrent episodes of choroidal neovascularization (CNV), secondary to angioid streaks, can be managed successfully with a pro re nata regime of intravitreal bevacizumab injection over an eight-year period.

Method:
A 32-year-old white woman with pseudoxanthoma elasticum has been followed up over an eight-year period for management of recurrent episodes of CNV in both eyes. She was educated to recognize the early signs and symptoms of CNV. Physical examination including visual acuity and slit-lamp examination as well as investigations such as macula optical coherence tomography and optical coherence tomography angiography were performed. Bevacizumab injections were given to her when she was diagnosed with CNV.

Results:
Multiple episodes of CNV were successfully treated with pro re nata regimes of intravitreal bevacizumab injections. The patient was able to maintain excellent visual acuity of 0 logarithm of the minimum angle of resolution even after suffering recurrent episodes of CNV.

Conclusion:
This case report supports that a pro re nata regime of intravitreal bevacizumab injection therapy can be used successfully to treat recurrent episodes of CNV in a patient with pseudoxanthoma elasticum over an eight-year period. Early diagnosis through patient education and the use of appropriate diagnostic tools such as optical coherence tomography angiography have enabled us to deliver early treatment, resulting in an excellent outcome for this patient.
INTRAVITREAL MELPHALAN FOR TREATMENT OF VITREOUS SEEDING FROM CHOROIDAL MELANOMA
Authors: Masoomian Babak , Mashayekhi Arman , Malik Kunal , Shields Carol L. 
Published: July 2018

Purpose:
To report treatment of vitreous seeding of choroidal melanoma with monthly injections of intravitreal melphalan.

Methods:
Case report.

Results:
A 70-year-old white woman noted floaters in her left eye, and further examination revealed visual acuity of 20/30 in both eyes. Funduscopically, there was a mushroom-shaped choroidal melanoma in her left eye, measuring 9 mm in basal dimension and 4.8 mm in thickness. Notably, there was apical retinal invasion of melanoma with mild vitreous hemorrhage, without vitreous seeding. The tumor was treated with iodine-125 plaque radiotherapy using an apex dose of 70 Gy over 99 hours, designed to include the retinal invasion. The melanoma demonstrated complete regression into a nearly flat scar of 1 mm and remained stable over 4 years. Five years after radiotherapy, there were diffuse vitreous pigmented seeds of presumed melanoma origin, emanating from the site of retinal necrosis. This progressively worsened over the following 18 months, suspicious for viable melanoma cells, as visual acuity concurrently declined to 20/100. Treatment with intravitreal melphalan (10 μg/0.05 mL) was delivered on a monthly basis for 12 cycles, resulting in vitreous seeds regression, and preservation of the eye. Final visual acuity was 20/200. There were no treatment-related complications.

Conclusion:
Intravitreal melphalan can be considered in cases of vitreous seeding from uveal melanoma.
SUCCESSFUL SURGICAL OUTCOME OF FULL-THICKNESS MACULAR HOLE WITH CHOROIDAL COLOBOMA
Authors: Venkatesh Ramesh , Yadav Naresh Kumar , Sinha Shivani , Mohan Ashwin 
Published: July 2018

Purpose:
To report a case of successful closure of macular hole after surgery in a patient with choroidal coloboma.

Methods:
Interventional case report.

Case description:
A 17-year-old boy developed a full-thickness macular hole at the edge of an inferior choroidal coloboma in the right eye. Visual acuity in the right eye was 20/200. Surgical management with 25-G pars plana vitrectomy, internal limiting membrane peeling, and silicone oil tamponade was performed. At 6 weeks after surgery, the macular hole closed with Type 1 closure. After silicone oil removal, the vision in the right eye improved to 20/60.

Conclusion:
Macular hole in the presence of choroidal coloboma is quite uncommon. With better understanding of the etiopathogenesis of macular hole formation and advances in vitreoretinal surgery, it is safe and useful in attempting surgery in these patients.
Efficacy of Trial Fitting and Software Fitting for Orthokeratology Lens: One-Year Follow-Up Study
Authors: Lu Daqian , Gu Tianpu , Lin Weiping , Li Na , Gong Boteng , Wei Ruihua 
Published: July 2018

Objective:
To observe and compare the clinical efficacy of 1-year trial fitting and software fitting orthokeratology lenses.

Methods:
One hundred myopes who received vision correction with the use of orthokeratology lenses form July 2016 to September 2017 were included in this study. Subjects were assigned randomly into the two groups: the trial fitting group (group A) and the software fitting group (group B). For the right eye of each subject, measurements, such as uncorrected visual acuity (UCVA, logarithm of minimal angle of resolution), refractive error, corneal topography, ocular health status, and the fitting situation, were obtained at baseline, 1 week, 1 month, 3 months, 6 months, and 12 months after lens wear. Axial length and corneal endothelium cells (CECs) were also measured at baseline and 12 months after wearing the lens.

Results:
Compared with the baseline, the spherical equivalent refraction, UCVA, and central corneal curvature changed significantly after orthokeratology (OK) lens wear (all P<0.05). Between groups A and B, the parameters aforementioned were insignificant at each time point (all P>0.05). Axial length and CECs showed no significant changes during the first year of OK treatment (all P>0.05). Rate of corneal staining between two groups revealed no difference during 1-year visit (P<0.05).

Conclusion:
Both the trial lens fitting and software fitting approaches were effective in temporarily reducing myopia, providing good UCVA and delaying the elongation of axial length for moderate and high myopic adolescents. Both the two approaches can be combined in OK lens fitting.