bluuebunny/crossref_metadata_2025_split huggingface dataset:
An overview on the identification of MAIT cell antigens
Authors: Kjer‐Nielsen Lars , Corbett Alexandra J , Chen Zhenjun , Liu Ligong , Mak Jeffrey YW , Godfrey Dale I , Rossjohn Jamie , Fairlie David P , McCluskey James , Eckle Sidonia BG 
Published: April 2018

AbstractMucosal associated invariant T (MAIT) cells are restricted by the monomorphic MHC class I‐like molecule, MHC‐related protein‐1 (MR1). Until 2012, the origin of the MAIT cell antigens (Ags) was unknown, although it was established that MAIT cells could be activated by a broad range of bacteria and yeasts, possibly suggesting a conserved Ag. Using a combination of protein chemistry, mass spectrometry, cellular biology, structural biology and small molecule chemistry, we discovered MR1 ligands derived from folic acid (vitamin B9) and from an intermediate in the microbial biosynthesis of riboflavin (vitamin B2). While the folate derivative 6‐formylpterin generally inhibited MAIT cell activation, two riboflavin pathway derivatives, 5‐(2‐oxopropylideneamino)‐6‐D‐ribitylaminouracil and 5‐(2‐oxoethylideneamino)‐6‐D‐ribitylaminouracil, were potent MAIT cell agonists. Other intermediates and derivatives of riboflavin synthesis displayed weak or no MAIT cell activation. Collectively, these studies revealed that in addition to peptide and lipid‐based Ags, small molecule natural product metabolites are also ligands that can activate T cells expressing αβ T‐cell receptors, and here we recount this discovery.
Strangers in the dark: behavioral and biochemical evidence for trail pheromones in Hawaiian tree snails
Authors: Holland Brenden S. , Gousy‐Leblanc Marianne , Yew Joanne Y. 
Published: April 2018

AbstractThe importance of pheromones in insect and mammal social systems is well documented, but few studies have addressed the role of pheromones in land snail behavior. In this investigation, we used a series of behavioral trials and direct analysis in real time mass spectrometry (MS) to test the hypothesis that land snails use mucous trails in orientation and chemical communication. We worked with six endemic Hawaiian land snail species in four genera, three subfamilies, and two families. We tested conspecific trail following in five of these species, and trail following occurred at a statistically significant frequency for each of the species tested (n=181, p‐values ranged <0.0001–0.0494). Percentage of conspecific trials that showed trail following ranged 66.7–94.1%. None of the interspecific tests revealed evidence of trail following among species (n=105, with p‐values of 0.0577–0.5000). Juvenile achatinelline snails did not follow trails of conspecific juveniles (n=30, p=0.5722) or adults (n=30, p=0.4278), nor did adults follow juvenile trails (n=30, p=0.5722). ComparativeMSanalysis of adult and juvenile trails showed distinct chemical signatures in the two groups. Signals corresponding to medium‐ and long‐chain fatty acids and other unidentified small molecules were present in adult but not in juvenile trails. Considered together, these results support the hypotheses that trail following could serve an important social and reproductive function. This discovery provides evidence for the presence of an ephemeral tree snail pheromone, which could have important implications for the conservation of these increasingly rare and threatened species.
The effects of Facebook and WhatsApp on success in English vocabulary instruction
Authors: Çetinkaya Levent , Sütçü Selim Soner 
Published: April 2018

AbstractThe purpose of this study is to determine the effects of Facebook and WhatsApp on success in English vocabulary instruction and the learners' opinions about the implementation process. In the study, mixed method model, which combines both quantitative and qualitative data, was used. The success of the students in Facebook, WhatsApp, and control group showed a significant difference between the pretest and posttest, meaning that the learning environments had different effects on the increase of success of students. The analysis revealed that the difference in the mean scores of the students in WhatsApp, Facebook, and control group was significant, and WhatsApp has been more effective in the increase of the success. Although more increase in the mean scores of Facebook group was observed compared with control group, this increase was not found significant. Furthermore, students expressed their willingness to go on the practice not only in their present course, but also in their other courses as well. They also opined positive opinions that learning could also take place unconsciously. However, a few students reacted negatively against the unnecessary messages and the timing of some messages. The results indicated that, compared with Facebook, WhatsApp is more effective in teaching vocabulary.
Enhancing multimodal learning through personalized gesture recognition
Authors: Junokas M.J. , Lindgren R. , Kang J. , Morphew J.W. 
Published: April 2018

AbstractGestural recognition systems are important tools for leveraging movement‐based interactions in multimodal learning environments but personalizing these interactions has proven difficult. We offer an adaptable model that uses multimodal analytics, enabling students to define their physical interactions with computer‐assisted learning environments. We argue that these interactions are foundational to developing stronger connections between students' physical actions and digital representations within a multimodal space. Our model uses real time learning analytics for gesture recognition, training a hierarchical hidden‐Markov model with a “one‐shot” construct, learning from user‐defined gestures, and accessing 3 different modes of data: skeleton positions, kinematics features, and internal model parameters. Through an empirical comparison with a “pretrained” model, we show that our model can achieve a higher recognition accuracy in repeatability and recall tasks. This suggests that our approach is a promising way to create productive experiences with gesture‐based educational simulations, promoting personalized interfaces, and analytics of multimodal learning scenarios.
Long‐term single‐center comparison of ICD lead survival: Evidence for premature Linox lead failure
Authors: O'Connor Matthew , Hooks Darren , Webber Matthew , Shi Bijia , Morrison Stephanie , Harding Scott , Larsen Peter 
Published: April 2018

AbstractIntroductionICD lead failure is a potential source of significant morbidity and mortality. This study investigates the survival rates of Sprint Quattro, Endotak Reliance, and Linox ICD leads.Methods and resultsA retrospective cohort study of all patients with an ICD implanted between January 2007 and December 2012 from the Wellington Hospital region, New Zealand, a tertiary referral center. Lead and patient details were established by review of clinical notes and the PaceArt Optima database. We analyzed a total of 287 implants using Sprint Quattro (n = 92), Endotak Reliance (n = 37), Linox (n = 151), Riata (n = 4), and Sprint Fidelis (n = 2) leads. Median follow‐up was 61.6 (26.0–81.6) months for Sprint Quattro leads, 66.7 (53.3–88.8) months for Linox leads, and 82.9 (45.9–107.4) months for Endotak Reliance leads. There were 20 cases of lead failure of which 19 were in Linox leads. The 4‐, 6‐, and 8‐year survival for Linox leads was 97% (92.6–99.1), 93% (85.5–96.5), and 76% (62.3–85.5), respectively. The predominant abnormality was detection of nonphysiological electrical signals. Linox lead failure was associated with a younger age of patient (49.2 vs. 57.7 years, P = 0.007).ConclusionsThe 7‐year survival of Linox leads was significantly worse than shown in Biotronik surveillance reports, but in line with other single‐center studies from around the world.
Of lamp posts, keys, and fabled drunkards: A perspectival tale of 4 guidelines
Authors: Greenhalgh Trisha 
Published: April 2018

AbstractBackgroundEvidence‐based medicine is the application of research findings to inform individual clinical decisions. There is a tension—both philosophical and practical—between the average result from a population study and the circumstances and needs of an individual patient. This personal account of “evidence‐based” trauma care illustrates and explores this tension.The caseThe author, a keen athlete, describes her experience of a high‐impact cycle accident that led to limb fractures (which were diagnosed and treated according to evidence‐based guidelines) and also an occult injury to the cervical spine (which was not diagnosed at the time). Some evidence‐based guidelines are reviewed and applied to the case.The clinical record described the cycle accident as a “fall.” Initial assessment directed the clinicians' gaze to the obvious injuries, whose treatment was straightforward. On admission, the patient (aged 55 years at the time) was offered “falls prevention” via a guideline‐based checklist. Several months later, neurological sequelae indicated possible damage to the cervical spine. But the NICE Guideline recommending cervical spine imaging in cases of high‐impact trauma had not been considered—perhaps because the clinical narrative had been prematurely assigned to the script of “older person with fall.” Furthermore, the author, who was (appropriately) treated with neurosurgery, was surprised at the response of clinical colleagues, based on application of an irrelevant section of a guideline, that her cervical discectomy was “nonevidence based.” Nonsteroidal anti‐inflammatory drugs for postoperative pain were indicated in this patient even though they were not recommended for the average patient.ConclusionAs Sir John Grimley Evans' warned, we should avoid using evidence‐based guidelines in the manner of the fabled drunkard who searched under the lamp post for his key because that was where the light was, even though he knew he had lost his key somewhere else.
Opioid Prescriptions in Older Medicare Beneficiaries After the 2014 Federal Rescheduling of Hydrocodone Products
Authors: Kuo Yong‐Fang , Raji Mukaila A. , Liaw Victor , Baillargeon Jacques , Goodwin James S. 
Published: April 2018

ObjectivesTo examine how an October 2014 Drug Enforcement Administration policy reclassified hydrocodone product from schedule III to II has affected older adults, who are among the largest consumers of prescription opioids in the United States.DesignRetrospective cohort study.SettingUnited States.ParticipantsA 20% sample of Medicare Part D beneficiaries aged 65 and older from 2013 through 2015 (> 2,500,000 beneficiaries each year)MeasurementsFrom January 2013 to December 2015, we calculated the monthly prevalence of opioid prescriptions and the prevalence of individuals who received prescriptions for a 90‐day supply or longer (prolonged), as well as hospitalizations related to opioid toxicity in 2013 and 2015.ResultsFrom 2013 to 2015, the proportion of Medicare Part D enrollees who received a hydrocodone prescription in a year decreased from 21.9% to 18.3%. Monthly rates for hydrocodone prescriptions declined significantly in 2014. The risk of receiving prolonged opioid prescriptions decreased by approximately 7% in the multivariable analyses comparing 2015 to 2013 (prevalence ratio=0.93, 95% confidence interval (CI)=0.93–0.94). Medicare enrollees with an original entitlement because of disability or with Medicaid eligibility had smaller decreases in prolonged prescriptions and, unexpectedly, small increases in high‐dose prescriptions. Opioid‐related hospitalizations did not change significantly, but opioid‐related hospitalizations without a documented opioid prescription increased (odds ratio=1.24, 95% CI=1.03–1.50).ConclusionThe 2014 change in hydrocodone from schedule III to schedule II was associated with modest decreases in rates of opioid use in the elderly. The unexpected increase in opioid‐related hospitalizations without documented opioid prescriptions may represent an increase in illegal use.
Differences Between Skilled Nursing Facilities in Risk of Subsequent Long‐Term Care Placement
Authors: Goodwin James S. , Li Shuang , Middleton Addie , Ottenbacher Kenneth , Kuo Yong‐Fang 
Published: April 2018

ObjectivesTo determine how the risk of subsequent long‐term care (LTC) placement varies between skilled nursing facilities (SNFs) and the SNF characteristics associated with this risk.DesignPopulation‐based national cohort study with participants nested in SNFs and hospitals in a cross‐classified multilevel model.SettingSNFs (N=6,680).ParticipantsFee‐for‐service Medicare beneficiaries (N=552,414) discharged from a hospital to a SNF in 2013.MeasurementsParticipant characteristics from Medicare data and the Minimum Data Set. SNF characteristics from Medicare and Nursing Home Compare. Outcome was a stay of 90 days or longer in a LTC nursing home within 6 months of SNF admission.ResultsWithin 6 months of SNF admission, 10.4% of participants resided in LTC. After adjustments for participant characteristics, the SNF where a participant received care explained 7.9% of the variance in risk of LTC, whereas the prior hospital explained 1.0%. Individuals in SNFs with excellent quality ratings had 22% lower odds of transitioning to LTC than those in SNFs with poor ratings (odds ratio=0.78, 95% confidence interval=0.74–0.84). Variation between SNFs and associations with quality markers were greater in sensitivity analyses limited to individuals least likely to require LTC. Results were essentially the same in a number of other sensitivity analyses designed to reduce potential confounding.ConclusionRisk of subsequent LTC placement, an important and negatively viewed outcome for older adults, varies substantially between SNFs. Individuals in higher‐quality SNFs are at lower risk.
Exercise training abrogates age‐dependent loss of hypothalamic oxytocinergic circuitry and maintains high parasympathetic activity
Authors: Santos C. R. , Ruggeri A. , Ceroni A. , Michelini L. C. 
Published: April 2018

Neuroanatomical studies associating neuronal tract tracing and immunohistochemistry identified reciprocal (ascending noradrenergic/descending oxytocinergic; OTergic) connections between brainstem cardiovascular nuclei and the paraventricular hypothalamic nucleus (PVN). Previous functional studies indicated that exercise training (T) augmented the expression/activity of the OTergic pathway and improved the autonomic control of the heart. Knowing that ageing is associated with autonomic dysfunction and also that sinoaortic denervation blocked T‐induced beneficial effects, we hypothesised that T was able to reduce age‐dependent impairment by improving the afferent signalling to PVN and augmenting OTergic modulation of cardiovascular control. We evaluated the combined effects of T and age on plastic remodelling of ascending dopamine β‐hydroxylase (DBH)+ and descending oxytocin (OT)+ pathways and correlated them with cardiovascular parameters. Male Wistar rats were submitted to T or kept sedentary for 8 weeks. After evaluating arterial pressure, heart rate (HR), their variabilities and spectral components in conscious rats at rest, brains were harvested to analyse the plastic remodelling of brain autonomic nuclei (immunofluorescence + confocal microscopy). The density of DBH+ neurones within the nucleus of solitary tract (NTS) and caudal ventrolateral medulla, the number of DBH+ terminals overlapping OT+ neurones in PVN preautonomic nuclei, as well as the density of OT+ neurones and their projections to the NTS and dorsal motor nucleus of the vagus, were markedly reduced in sedentary rats during 8 weeks of inactivity. By contrast, these effects were completely blocked by T and reversed to a large augmentation of DBH+ and OT+ densities in both cell bodies and terminals within autonomic nuclei and target areas. All plastic changes observed correlated positively with parasympathetic activity to the heart (high frequency pulse interval, but not with low frequency pulse interval) and negatively with resting HR. Data indicate that T, by increasing beneficial neuroplastic adaptive changes within the brainstem‐PVN reciprocal network, abrogates age‐dependent deleterious remodelling and augments parasympathetic modulation of the heart, therefore improving autonomic function.
Absence of human skin irritation and allergenic potential after repeated patch applications of a lamellar moisturizer
Authors: Nisbet Stephanie J 
Published: April 2018

SummaryBackgroundNew cosmetic products should undergo clinical evaluation for skin sensitization potential.ObjectivesTo assess the irritation and sensitization potential of a moisturizer containing lamellar structured lipids after repeated patch application in humans, using human repeated insult patch test methodology.MethodsThis 6‐week, single‐center, open‐label study compared a lamellar moisturizer with negative saline control in human subjects aged 18‐70 years and skin phototype (Fitzpatrick) classification I–IV. During an initial induction phase, semi‐occlusive multi‐test patches were applied to the skin of participants’ backs three times per week for 3 consecutive weeks; clinical assessments were performed per International Contact Dermatitis Research Group criteria. Participants subsequently underwent a challenge phase, where a new patch was applied to a contact‐naïve area of the skin to assess sensitization to the moisturizer.ResultsThe study commenced with 233 voluntary participants, 214 of whom completed the study and underwent the final dermatological assessment. Most participants (232/233; 99.6%) demonstrated negative patch test results. One participant had a positive reaction at the lamellar moisturizer application site, with visible erythema and edema (classified as an adverse event [AE]); however, this reaction was observed 24 hours after a reaction to another product in the patch test panel (a prototype cleanser). Importantly, no skin reactions were detected during the challenge phase. Two participants had AEs of mild contact dermatitis in the area of patch adhesive application during the induction phase. No serious AEs occurred during the study.ConclusionsThese findings suggest that the lamellar moisturizer has low irritant and allergenic potential.
Oral health knowledge, attitudes, and practices (KAP) in rural Haiti: a 40‐year follow‐up study
Authors: Katz Ralph V. , Prophete Samuel E. , Lafontant Christina , Gebrian Bette , Bourdeau Louis C. , Joseph JR Ernst , Lafontant Gladys J. , St. Jean H. Ludwig , Rundberg Paul E. 
Published: April 2018

AbstractThis paper reports the changed findings over a 40‐year period on oral health knowledge, attitudes, and practices (KAP) of a very remote and rural population living the Jeremie region of Haiti. The far‐sighted investigators of that original 1970 survey stated in their published 1972 paper that our “…findings are descriptive, but have to be accepted tentatively rather than definitively because time was short, transportation was difficult, and the small sample that had to be used could not random.” They further insightfully stated their hopes that their “…results may be regarded as an anthropological cultural baseline from which to review further findings concerning Haitian dental beliefs.” The two follow‐up surveys in 1997 and 2010 using the same exact KAP questionnaire on the same population of rural Haitians living in the Jeremie region fulfilled the extraordinary vision of those two initial investigators, Dr. Wesley Young (a nationally renowned U.S. public health dental academician) and Paul Rundberg (then a dental student at the University of Kentucky).
Rural‐Urban Differences in Costs of End‐of‐Life Care for the Last 6 Months of Life Among Patients with Breast, Lung, or Colorectal Cancer
Authors: Crouch Elizabeth , Eberth Jan M. , Probst Janice C. , Bennett Kevin , Adams Swann A. 
Published: April 2018

AbstractPurposeThe purpose of this study was to examine rural‐urban differences in utilization and expenditures in the last 6 months of life for patients with breast, lung, or colorectal cancer.MethodsThe study used a 5% sample of the 2013 Medicare Research Identifiable Files to study utilization and expenditures for beneficiaries with breast, lung, or colorectal cancer during the last 6 months before death (n = 6,214). End of life expenditures were calculated as the sum of total Medicare expenditures for inpatient, outpatient, physician, home health, hospice, and skilled nursing facility costs during the last 6 months of life.FindingsFor each type of cancer, total Medicare expenditures in the last 6 months of life were lower for rural decedents compared to their urban counterparts. During the last 6 months of life, median Medicare expenditures were lower for rural decedents for breast cancer ($21,839 vs $25,698), lung cancer ($22,814 vs $27,635), and colorectal cancer ($24,156 vs $28,035; all differences significant atP< .05). In adjusted models, care for rural decedents was less costly than urban decedents for breast, lung, and colorectal cancer, respectively.ConclusionsOur findings indicate that Medicare expenditures are lower for rural beneficiaries with each type of cancer than urban beneficiaries, even after adjusting for age, gender, race, dual eligibility, region, chronic conditions, and type of service utilization. The findings from this study can be useful for policymakers in developing programs and resource allocation decisions that impact rural beneficiaries.
Rural Health Networks: How Network Analysis Can Inform Patient Care and Organizational Collaboration in a Rural Breast Cancer Screening Network
Authors: Prusaczyk Beth , Maki Julia , Luke Douglas A. , Lobb Rebecca 
Published: April 2018

AbstractPurposeRural health networks have the potential to improve health care quality and access. Despite this, the use of network analysis to study rural health networks is limited. The purpose of this study was to use network analysis to understand how a network of rural breast cancer care providers deliver services and to demonstrate the value of this methodology in this research area.MethodsLeaders at 47 Federally Qualified Health Centers and Rural Health Clinics across 10 adjacent rural counties were asked where they refer patients for mammograms or breast biopsies. These clinics and the 22 referral providers that respondents named comprised the network. The network was analyzed graphically and statistically with exponential random graph modeling.FindingsMost (96%, n = 45) of the clinics and referral sites (95%, n = 21) are connected to each other. Two clinics of the same type were 62% less likely to refer patients to the same providers as 2 clinics of different types (OR = 0.38, 95% CI = 0.29‐0.50). Clinics in the same county have approximately 8 times higher odds of referring patients to the same providers compared to clinics in different counties (OR = 7.80, CI = 4.57‐13.31).ConclusionsThis study found that geographic location of resources is an important factor in rural health care providers’ referral decisions and demonstrated the usefulness of network analysis for understanding rural health networks. These results can be used to guide delivery of patient care and strengthen the network by building resources that take location into account.
Materialism, emergentism, and social structure: A response to Wendt's Quantum Mind
Authors: Porpora Douglas V. 
Published: April 2018

AbstractThis paper is a response to the new book by Alexander Wendt (2015) entitled Quantum Mind. The paper commends Wendt on the book's contribution to our understanding, particularly of quantum mechanics, panpsychism, and externalism in the philosophy of mind. At the same time, it takes issue with Wendt's overall thesis, particularly as it relates to materialism, emergentism, and social structure.