bluuebunny/crossref_metadata_2025_split huggingface dataset:
Defining Patient Safety Events in Inpatient Psychiatry
Authors: Marcus Steven C. , Hermann Richard C. , Cullen Sara Wiesel 
Published: July 2018

Objectives
The past 20 years have seen the emergence of a national movement to improve hospital-based healthcare safety in the United States. However, much of the foundational work and subsequent research have neglected inpatient psychiatry. The aim of this article was to advance a comprehensive approach for conceptualizing patient safety in inpatient psychiatry as framed by an application of the Institute of Medicine patient safety framework.

Methods
This article develops a framework for characterizing patient safety in hospital-based mental health care. We discuss some of the conceptual and methodological issues related to defining what constitutes a patient safety event in inpatient psychiatry and then enumerate a comprehensive set of definitions of the types of safety events that occur in this setting.

Results
Patient safety events in inpatient psychiatry are broadly categorized as adverse events and medical errors. Adverse events are composed of adverse drug events and nondrug adverse events, including self-harm or injury to self, assault, sexual contact, patient falls, and other injuries. Medical errors include medication errors and nonmedication errors, such as elopement and contraband. We have developed clear definitions that would be appropriate for use in epidemiological studies of inpatient mental health treatment.

Conclusions
Psychiatry has not been an integral part of the national safety movement. As a first step toward breaching this chasm, we have considered how psychiatric events fit into the safety framework adopted across much of medicine. Patient safety should become a key part of inpatient psychiatry’s mission and pursued rigorously as the subject of research and intervention efforts.
Horizontal Maxillary Osteotomy Stability Using Mandibular Outer Cortex Bone Grafts in Patients With Cleft Lip and Palate
Authors: Zheng Yilue , Yin Ningbei , Jiang Chanyuan , Song Tao 
Published: July 2018

Objective:
To investigate horizontal maxillary osteotomy stability after using bone grafts for the treatment of patients with unilateral cleft lip and palate (UCLP).

Design:
Retrospective cohort study.

Setting:
Plastic surgery hospital.

Patients:
Fifty-eight patients with UCLP and maxillary hypoplasia requiring a maxillary Le Fort I advancement of 6 to 9 mm.

Interventions:
The test group (TG) was comprised of 28 patients who underwent mandibular outer cortex bone grafting in the gaps created by a modified Le Fort I osteotomy. The control group (CG) was comprised of 30 patients who underwent a Le Fort I osteotomy without bone grafts.

Main Outcome Measures:
Maxillary horizontal advancement (recorded during the operation using a Vernier caliper) and horizontal relapse at 12 months after surgery (based on a manual cephalometric analysis of pre- and postoperative lateral teleradiographs).

Results:
In the TG, the mean maxillary horizontal advancement was 7.13 ± 0.7 mm (range: 6.01–8.23 mm), and the mean postoperative horizontal relapse was 25.07 ± 6.64%. In the CG, the mean maxillary horizontal advancement was 6.90 ± 0.55 mm (range: 6.05–7.39 mm), and the mean postoperative horizontal relapse was 24.89 ± 4.25%. There were no significant between-group differences in the mean horizontal relapses.

Conclusion:
The use of mandibular outer cortex bone grafts as physical barriers in patients with UCLP does not increase postoperative stability when the maxillary advancement is 6 to 9 mm.
Audiological Alterations in Patients With Cleft Palate
Authors: Rivelli Ramiro Adrian , Casadio Vanesa , Bennun Ricardo D. 
Published: July 2018

Introduction:
Chronic otitis media with effusion (OME) is a recurrent complication, usually found in cleft palate patients.
Conductive hearing loss is the result of the Eustachian tube dysfunction caused by the absence of fusion and the altered insertion of the muscles of the secondary palate. It is also the consequence of an ineffective muscular reconstruction after primary cleft palate repair.

Methods:
This is a cohort study to compare 4 groups of patients born with isolated cleft lip (ICL), unilateral cleft lip/palate (UCLP), bilateral cleft lip/palate (BCLP), and isolated cleft palate (ICP), received in our hospital between June 2015 to September 2017, operated by the same surgeon, using the same surgical technique and protocol.
Complete cleft palate repair was performed, in average, at 10 months, and placement of ventilation tubes, if necessary, was made in the same operatory act.
After palate repair, primary or secondary hearing loss was checked, joint to the connection with the type of used ventilation tubes, recurrences and complications also were considered.

Results:
The study sample was integrated by 69 patients, 2 of 11 patients with ICL (18.18%), 30 of 34 patients with UCLP (88.23%), 17 of 19 patients with BCLP (89.47%), and 4 of 5 patients with ICP (80.00%) were diagnosed with OME requiring ventilation tubes at the time of surgery. It can be established that the average hearing loss in patients with diabolos in the postoperative period is 19.4 db and in those patients with T tubes it is 14.2 db, the difference being statistically significant (P < 0.05).

Conclusion:
Hearing improvement prior to language acquisition is essential for a proper speech development. Early trans tympanic tubes implantation during cleft palate repair contributes to a correct short-term ventilation of the middle ear, being the T tubes the best option.
Tetrahydrocannabinol/Cannabidiol Oromucosal Spray in Patients With Multiple Sclerosis: A Pilot Study on the Plasma Concentration-Effect Relationship
Authors: Contin Manuela , Mancinelli Luca , Perrone Alessandro , Sabattini Loredana , Mohamed Susan , Scandellari Cinzia , Foschi Matteo , Vacchiano Veria , Lugaresi Alessandra , Riva Roberto 
Published: July 2018

Objectives
We aimed to assess the potential relationship between intrasubject 9-tetrahydrocannabinol/cannabidiol (THC/CBD) oromucosal spray plasma profiles and clinical effects elicited by subacute dosing in chronically treated patients with multiple sclerosis (MS).

Methods
The study design was pilot, single center, open, and prospective. The patients were challenged with a morning test dose of 2 THC/CBD sprays at a 15-minute interval. Venous blood samples were collected before the first spray administration and every 30 minutes after the second spray, until 240 minutes postdosing. Patients rated their spasticity by the Numerical Rating Scale (NRS) simultaneously with blood drawings. Postural and motor tests were performed before the first spray and 90 and 180 minutes thereafter.

Results
Twelve patients were recruited. Peak plasma concentrations of THC/CBD largely varied among patients, from 0.60 to 13.29 ng/mL for THC and 0.55 to 11.93 ng/mL for CBD. Time to peak plasma concentrations ranged from 150 to 240 minutes for THC and 90 to 240 minutes for CBD. Patients' NRS serial scores decreased after dosing, from a median value of 6 to 3.5 (P < 0.001). A significant inverse correlation was observed between median intrasubject repeated NRS scores and corresponding median values of both THC (P < 0.01) and CBD (P < 0.002) plasma concentrations. No significant effect of cannabinoids dosing could be appreciated according to posturographic and motor tests.

Conclusions
Our kinetic dynamic findings from THC/CBD oromucosal spray are the first obtained in real MS patients. Although preliminary, they suggest that subacute dosing might elicit a subjective clinically significant effect on MS-related spasticity, paralleling cannabinoids measurable plasma concentrations.
The merits of sustaining pneumococcal vaccination after transitioning from Gavi support – a modelling and cost-effectiveness study for Kenya
Authors: Ojal John , Griffiths Ulla , Hammitt Laura L. , Adetifa Ifedayo , Akech Donald , Tabu Collins , Scott Anthony G. , Flasche Stefan 
Published: July 2018

AbstractIntroductionMany low income countries soon will need to consider whether to continue pneumococcal conjugate vaccine (PCV) use at full costs as they transition from Gavi support. Using Kenya as a case study we assessed the incremental cost-effectiveness of continuing PCV use.MethodsWe fitted a dynamic compartmental model of pneumococcal carriage to annual carriage prevalence surveys and invasive pneumococcal disease (IPD) incidence in Kilifi, Kenya, and predicted disease incidence and related mortality for either continuing PCV use beyond 2022, the start of Kenya’s transition from Gavi support, or its discontinuation. We calculated the costs per disability-adjusted-life-year (DALY) averted and associated prediction intervals (PI).ResultsWe predicted that overall IPD incidence will increase by 93% (PI: 72% - 114%) from 8.5 in 2022 to 16.2 per 100,000 per year in 2032, if PCV use is discontinued. Continuing vaccination would prevent 15,355 (PI: 10,196–21,125) deaths and 112,050 (PI: 79,620– 130,981) disease cases during that time. Continuing PCV after 2022 will require an estimated additional US$15.6 million annually compared to discontinuing vaccination. The incremental cost per DALY averted of continuing PCV was predicted at $142 (PI: 85 - 252) in 2032.ConclusionContinuing PCV use is essential to sustain its health gains. Based on the Kenyan GDP per capita of $1445, and in comparison to other vaccines, continued PCV use at full costs is cost-effective. These arguments support an expansion of the vaccine budget, however, affordability may be a concern.FundingFunded by the Wellcome Trust.
Implementation of the Water Framework Directive: Lessons learned and future perspectives for an ecologically meaningful classification of the status of Greek lakes, Mediterranean region
Authors: Moustaka-Gouni Maria , Sommer Ulrich , Economou-Amilli Athena , Arhonditsis George B. , Katsiapi Matina , Papastergiadou Eva , Kormas Konstantinos A. , Vardaka Elisabeth , Karayanni Hera , Papadimitriou Theodoti 
Published: July 2018

ABSTRACTThe enactment of the Water Framework Directive (WFD) initiated scientific efforts to develop reliable methods for comparing prevailing lake conditions againstreference(or non-impaired) states, using the state of a set biological elements. Drawing a distinction between impaired and natural conditions can be a challenging exercise, as it stipulates the robust delineation of reference conditions along with the establishment of threshold values for key environmental variables used as proxies for the degree of system impairment. Another important aspect is to ensure that water quality assessment is comparable among the different Member States. In this context, the present paper offers a constructive critique of the practices followed during the WFD implementation in Greece by pinpointing methodological weaknesses and knowledge gaps that undermine our ability to classify the ecological status of Greek lakes. One of the pillars of WDF is a valid lake typology that sets ecological standards transcending geographic regions and national boundaries. The national typology of Greek lakes has failed to take into account essential components (e.g. surface area, altitude, salinity). WFD compliance assessments based on descriptions of phytoplankton communities are oversimplified and as such should be revisited. Exclusion of most chroococcal species from the analysis of cyanobacteria biovolume in Greek lakes and most reservoirs in the Mediterranean Geographical Intercalibration Group (Greece, Spain, Portugal and Cyprus) is not consistent with the distribution of those taxa in lakes. Similarly, the total biovolume reference values and the indices used in their classification schemes reflect misunderstandings of WFD core principles. This hampers the comparability of ecological status across Europe and leads to quality standards that are too relaxed to provide an efficient target especially for the protection and management of Greek/transboundary lakes such as Lake Megali Prespa, one of the oldest lakes in Europe.
Systems analysis by mass cytometry identifies susceptibility of latent HIV-infected T cells to targeting of p38 and mTOR pathways
Authors: Fong Linda E. , Bass Victor L. , Spudich Serena , Miller-Jensen Kathryn 
Published: July 2018

AbstractEfforts to cure HIV are hindered by viral persistence in latently infected memory CD4+ T cells. Targeting T cell death pathways dysregulated by HIV infection offers a novel approach for eradication of the latent reservoir. To identify potential therapeutic targets, we compared signaling and apoptosis in uninfected and latently infected primary cultured CD4+ central memory T cells by mass cytometry following T cell receptor stimulation. We found that HIV-infected cells were sensitized to activation of pro-apoptotic p38 kinase signaling via p53, and to inhibition of anti-apoptotic mTOR kinase signaling, even without HIV protein expression. Simultaneous targeting of p38 and mTOR kinases in resting CD4+ T cells from virally-suppressed HIV+ patientsex vivoreduced cell-associated HIV RNA and DNA. Our results demonstrate how systems biology approaches are useful for identifying novel therapeutic approaches to treat HIV latency, and further suggest that it may be possible to deplete latent HIV-infected T cells without viral reactivation.
Phase-dependent suppression of beta oscillations in Parkinson’s disease patients
Authors: Holt Abbey B. , Kormann Eszter , Gulberti Alessandro , Pötter-Nerger Monika , McNamara Colin G. , Cagnan Hayriye , Little Simon , Köppen Johannes A. , Buhmann Carsten , Westphal Manfred , Gerloff Christian , Engel Andreas K. , Brown Peter , Hamel Wolfgang , Moll Christian K.E. , Sharott Andrew 
Published: July 2018

AbstractSynchronized oscillations within and between brain areas facilitate normal processing, but are often amplified in disease. A prominent example is the abnormally sustained beta-frequency (~20Hz) oscillations recorded from the cortex and subthalamic nucleus of Parkinson’s Disease patients. Computational modelling suggests that the amplitude of such oscillations could be modulated by applying stimulation at a specific phase. Such a strategy would allow selective targeting of the oscillation, with relatively little effect on other activity parameters. Here we demonstrate in awake, parkinsonian patients undergoing functional neurosurgery, that electrical stimulation arriving on consecutive cycles of a specific phase of the subthalamic oscillation can suppress its amplitude and coupling to cortex. Stimulus-evoked changes in spiking did not have a consistent time course, suggesting that the oscillation was modulated independently of net output. Phase-dependent stimulation could thus be a valuable strategy for treating brain diseases and probing the function of oscillations in the healthy brain.
A global genomic approach uncovers novel components for twitching motility-mediated biofilm expansion in Pseudomonas aeruginosa
Authors: Nolan Laura M. , Whitchurch Cynthia B. , Barquist Lars , Katrib Marilyn , Boinett Christine J. , Mayho Matthew , Goulding David , Charles Ian G. , Filloux Alain , Parkhill Julian , Cain Amy K. 
Published: July 2018

AbstractPseudomonas aeruginosa is an extremely successful pathogen able to cause both acute and chronic infections in a range of hosts, utilizing a diverse arsenal of cell-associated and secreted virulence factors. A major cell-associated virulence factor, the Type IV pilus (T4P), is required for epithelial cell adherence and mediates a form of surface translocation termed twitching motility, which is necessary to establish a mature biofilm and actively expand these biofilms. P. aeruginosa twitching motility-mediated biofilm expansion is a coordinated, multicellular behaviour, allowing cells to rapidly colonize surfaces, including implanted medical devices. Although at least 44 proteins are known to be involved in the biogenesis, assembly and regulation of the T4P, with additional regulatory components and pathways implicated, it is unclear how these components and pathways interact to control these processes. In the current study, we used a global genomics-based random-mutagenesis technique, transposon directed insertion-site sequencing (TraDIS), coupled with a physical segregation approach, to identify all genes implicated in twitching motility-mediated biofilm expansion in P. aeruginosa. Our approach allowed identification of both known and novel genes, providing new insight into the complex molecular network that regulates this process in P. aeruginosa. Additionally, our data suggests a differential effect on twitching motility by flagellum components based upon their cellular location. Overall the success of our TraDIS approach supports the use of this global genomic technique for investigating virulence genes in bacterial pathogens.
Adaptation of ant supercolony behavior to solve route assignment problem in integers
Authors: Idres Lahna , Radjef Mohammed Said 
Published: July 2018

Purpose
Until now, the algorithms used to compute an equilibrate route assignment do not return an integer solution. This disagreement constitutes a non-negligible drawback. In fact, it is shown in the literature that a fractional solution is not a good approximation of the integer one. The purpose of this paper is to find an integer route assignment.

Design/methodology/approach
The static route assignment problem is modeled as an asymmetric network congestion game. Then, an algorithm inspired from ant supercolony behavior is constructed, in order to compute an approximation of the Pure Nash Equilibrium (PNE) of the considered game. Several variants of the algorithm, which differ by their initializing steps and/or the kind of the provided algorithm information, are proposed.

Findings
An evaluation of these variants over different networks is conduced and the obtained results are encouraging. Indeed, the adaptation of ant supercolony behavior to solve the problem under consideration shows interesting results, since most of the algorithm’s variants returned high-quality approximation of PNE in more than 91 percent of the treated networks.

Originality/value
The asymmetric network congestion game is used to model route assignment problem. An algorithm with several variants inspired from ant supercolony behavior is developed. Unlike the classical ant colony algorithms where there is one nest, herein, several nests are considered. The deposit pheromone of an ant from a given nest is useful for the ants of the other nests.
Research on coordination mechanism for fresh agri-food supply chain with option contracts
Authors: Zhou Linan , Zhou Gengui , Qi Fangzhong , Li Hangying 
Published: July 2018

PurposeThis paper aims to develop a coordination mechanism that can be applied to achieve the channel coordination and information sharing simultaneously in the fresh agri-food supply chain with uncertain demand. It seeks to elucidate how the producer can use an option contract to transfer the risk caused by uncertain demand, impel the retailer to share demand information and improve the performance of supply chain.Design/methodology/approachAn option contract model based on the basic model of fresh agri-food supply chain is introduced to compare the production, profit, risk and information sharing condition of the supply chain in different cases. In addition, a case study focusing on the sale of autumn peaches produced by a local producer is investigated, which provides evidence of the applicability of the authors’ approach.FindingsThe optimal option contract can help the supply chain achieve channel coordination and reach Pareto improvement. In the meantime, such a contract will encourage the retailer to share market demand information with producer spontaneously and help maintain the strategic cooperation between two parties.Research limitations/implicationsThis paper considers a single-producer, single-retailer system and both of them are risk neutral.Practical implicationsPresented results can be used as suggestions for improving the contract design of fresh agri-food supply chain in China and can also provide references for other countries with similar experiences as China in fresh agri-food production.Originality/valueThis research introduces the option contract into fresh agri-food supply chain and takes information sharing and the risk caused by uncertain demand into consideration.
Impact of processing temperature on production of milk protein permeate during microfiltration of skim or whole milk
Authors: Jarto Iswandi , Lucey John A , Smith Karen E 
Published: July 2018

Microfiltration of skim or whole milk was compared at two processing temperatures (5 and 13 °C) and several weight concentration factors (WCFs). Permeate flux for whole milk was slightly lower than flux for skim milk at both temperatures and all WCFs due to its higher viscosity. Following the initial start‐up period, permeate flux was constant for either skim or whole milk processed at constant conditions of a WCF of 2 and 13 °C for 6 h. The concentration of whey proteins in permeate was similar for both skim and whole milk. Whole milk could be used for the production of milk permeate.
Debt Contract Enforcement and Conservatism: Evidence from a Natural Experiment
Authors: AGHAMOLLA CYRUS , LI NAN 
Published: July 2018

ABSTRACTThis study provides evidence that the use of conservative accounting in debt contracting depends on the enforceability of the contract. To test the effect of debt contract enforcement on borrowers' timely loss recognition, we exploit the staggered introduction of enhanced debt contract enforcement in Indian states as a natural experiment, where the implementation of the enforcement is exogenous to the accounting choices and borrowing behavior of firms. The main results show that enhanced enforcement has a significant positive effect on the timeliness of loss recognition of borrowing firms. We find that the effect is strongest for firms that increased their overall borrowing and for firms with high levels of tangible assets, consistent with a collateral‐based explanation. This study also provides causal evidence that firms adopt conservative accounting due to lenders' demand.
Effects of insect infestation on rodent‐mediated dispersal of Quercus aliena: results from field and enclosure experiments
Authors: ZHANG Bo , CHEN Xiaoning , STEELE Michael A. , LI Jingang , CHANG Gang 
Published: July 2018

AbstractRodents influence plant establishment and regeneration by functioning as both seed predators and dispersers. However, these rodent–plant interactions can vary significantly due to various environmental conditions and the activity of other insect seed predators. Here, we use a combination of both field and enclosure (i.e. individual cage and semi‐natural enclosure) experiments, to determine whether rodents can distinguish sound seeds from those infested with insects. We also demonstrate how such responses to insects are influenced by food abundance and other environmental factors. We presented rodents with 2 kinds of Quercus aliena seeds (sound and insect‐infested seeds) in a subtropical forest in the Qinling Mountains, central China, from September to November of 2011 to 2013. The results showed that rodents preferred to hoard and eat sound seeds than infested seeds in the field and semi‐natural enclosure, while they preferred to eat infested seeds over sound seeds in the individual cages. In addition, both hoarding and eating decisions were influenced by food abundance. Rodents hoarded more sound seeds in years of high food abundance while they consumed more acorns in years of food shortage. Compared with field results, rodents reduced scatter‐hoarding behavior in semi‐natural enclosures and ate more insect‐infested seeds in smaller individual cages. These results further confirm that rodents distinguish infested seeds from non‐infested seeds but demonstrate that this behavior varies with conditions (i.e. environment and food abundance). We suggest that such interactions will influence the dispersal and natural regeneration of seeds as well as predation rates on insect larvae.