bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimizing bone health in adolescents
Authors: Monge Maria C. 
Published: August 2018

Purpose of reviewThe purpose is to provide a brief overview of factors that impact adolescent bone health and review special populations that deserve extra consideration of their bone health status.Recent findingsOptimization of modifiable factors is critical for adolescents to reach peak bone mass. Binge drinking, tobacco use, and certain medications all have accumulating evidence showing detrimental impacts on adolescent bone health and certain populations are more at risk for poorer bone health outcomes because of the nature of their conditions. Furthermore, very recent evidence suggests that in certain patients who have a history of insufficient nutritional and hormone status, ‘catch-up’ bone acquisition may not occur, underscoring the importance of early attention to these modifiable factors.SummaryProviders caring for adolescents should be aware of the many different populations at risk for poor bone health. Treatment that might further compromise bone health should be considered judiciously and providers should encourage optimization of any modifiable factor when possible.
Comparative Study of Ocular Pharmacokinetics of Gatifloxacin Between Continuous Lavage and Hourly Topical Instillation in Rabbits
Authors: Zhao Xin , Shen Xu , Zhang Xian , Chen Shichao , Lu Hong , Wang Mingwu 
Published: August 2018

Purpose:
To investigate the ocular pharmacokinetics and distribution of gatifloxacin between continuous lavage through the Morgan lens and repeated topical drop instillation in rabbits.

Methods:
Thirty-six healthy rabbits were randomly divided into 2 groups, and 0.3% gatifloxacin ophthalmic solution was instilled by continuous lavage using the Morgan lens onto the left eyes at 15 mL/h (or 50 μL of the same solution repeatedly administered topically every hour). The animals were killed at 2, 4, 8, and 12 hours in the Morgan lens group or at 12 and 24 hours in the topical instillation group. Aqueous humor specimens were collected from the anterior chamber first, and other ocular tissues and plasma were collected subsequently. Pharmacokinetic and pharmacodynamic indices, other than the minimum inhibitory concentration (MIC), were used as therapeutic parameters in ocular tissues.

Results:
The highest concentration was found in the corneas in both groups. With continuous lavage, gatifloxacin reached an efficacious high concentration in 4 hours in the cornea, which is equivalent to about 23 times the concentration reached in the same tissue by hourly topical instillation for 12 to 24 hours. Using historic data as references, C/MIC90 was 105 (>10) and AUC0–t/MIC90 was 194 h (>125) in the cornea in the continuous lavage group at 4 hours, whereas these values were 5 and 73 hours for the topical hourly instillation group.

Conclusions:
Compared with hourly topical instillation, continuous lavage through the Morgan lens could achieve significantly higher concentrations in ocular tissues within a short period, especially in the cornea. Continuous lavage may be a much more efficient way to treat recalcitrant corneal infections.
The Relationship Between Eyebrow and Eyelid Position in Patients With Ptosis, Dermatochalasis and Controls
Authors: Sinha Kunal R. , Al Shaker Sara , Yeganeh Amir , Moreno Tyler , Rootman Daniel B. 
Published: August 2018

Purpose:
The purpose of this study is to explore mechanical and co-innervational factors involved in both voluntary and involuntary brow elevation among people affected by ptosis and dermatochalasis.

Methods:
In this prospective cohort study of normal controls and eyelids with ptosis or dermatochalasis, marginal reflex distance (MRD1) and brow height were measured under the following conditions: neutral position, involuntary mechanical brow elevation, voluntary brow elevation, and maximal eyelid opening. The primary outcome measure was change in MRD1. Secondary outcome measures included brow height and coupling (mm brow height change per mm MRD1 change). Analysis of variance and t tests were performed for intra- and intercondition comparisons, respectively.

Results:
Mechanical (involuntary) brow elevation significantly raised MRD1 in control eyelids and eyelids with dermatochalasis, but not in eyelids with ptosis. Voluntary brow elevation produced significantly greater brow height than maximal eyelid opening in controls and eyelids with dermatochalasis, but not in eyelids with ptosis. Maximal eyelid opening increased MRD1 greater than voluntary brow elevation significantly in control eyelids, but not in eyelids with dermatochalasis or ptosis. Coupling of the brow and eyelid margin during maximal eyelid opening was significantly greater in eyelids with ptosis relative to controls.

Conclusions:
In eyelids with ptosis, mechanical brow elevation does not change eyelid position; however, voluntary brow elevation raises eyelid position to a similar position as maximal eyelid opening. These results argue against the contention that the brow is elevated to mechanically lift the eyelid in ptosis and instead suggest that the brow elevation is driven by efforts to raise the eyelid, possibly via co-innervation.
Melancholic Symptoms in Bipolar II Depression and Responsiveness to Lamotrigine in an Exploratory Pilot Study
Authors: Peters Evyn M. , Bowen Rudy , Balbuena Lloyd 
Published: August 2018

Abstract

Background
In this exploratory pilot study we reanalyzed data from a previous randomized, double-blind, placebo-controlled trial of lamotrigine for bipolar II depression in which lamotrigine was not superior to placebo to determine if splitting the sample into melancholic and nonmelancholic subgroups revealed a significant treatment effect.

Methods
Adult outpatients (n = 150) in an acute bipolar II depressive episode completed 8 weeks of treatment with lamotrigine (titrated to 200 mg/d) or placebo. Depressive symptoms were assessed at baseline and weekly with the 17-item Hamilton Depression Rating Scale (HAMD-17) and the Montgomery-Åsberg Depression Rating Scale (MADRS). The presence of melancholic depression was determined by baseline responses to the HAMD-17 and MADRS according to the Diagnostic and Statistical Manual of Mental Disorders criteria. Cox regression models stratified by melancholic status were used to predict HAMD-17 and MADRS treatment response. Analysis-of-variance models were used to compare HAMD-17 and MADRS change scores between lamotrigine and placebo groups while testing for interactions by melancholic status.

Results
Lamotrigine was associated with higher odds of treatment response compared with placebo in the melancholic subgroup but not in the nonmelancholic subgroup. However, the melancholic subgroup-treatment interactions from the analysis-of-variance models were nonsignificant.

Conclusions
Further research is warranted to test the hypothesis that bipolar depression with melancholic symptoms is more responsive to lamotrigine over placebo than nonmelancholic bipolar depression.
Sequential Imaging in Patient With Suspected Menière's Disease Identifies Endolymphatic Sac Tumor
Authors: Kirsh Elliana R. , Kozin Elliott D. , Knoll Renata M. , Wong Kevin , Faquin William , Reinshagen Katherine L. , Kieff David , Rauch Steven D. , Jung David H. 
Published: August 2018

Objective:
The standard evaluation of patients with suspected Menière's disease (MD) includes initial imaging to rule out tumors of the temporal bone. Few guidelines, however, advocate sequential imaging. We propose that sequential imaging may reveal other etiologies of auditory and vestibular symptoms as demonstrated in a patient with an endolymphatic sac tumor that was originally diagnosed Menière's after initial imaging.

Patients:
One patient with MD and initially unremarkable imaging. Repeat imaging several years after diagnosis after additional symptoms demonstrated interval development of an endolymphatic sac tumor (ELST).

Interventions:
Resection of endolymphatic sac tumor.

Main Outcome Measures:
1) Audiometry, 2) temporal bone imaging, and 3) otopathology

Results:
A 45-year-old man with diagnosis of asymmetric sensorineural hearing loss and intermittent vertigo underwent temporal bone magnetic resonance imaging that did not demonstrate any causative lesions. After an episode of sudden sensorineural hearing loss 4 years after initial presentation, repeat imaging was obtained. Magnetic resonance imaging and surgical resection confirmed diagnosis of ELST. The patient had no history of von Hippel-Lindau disease.

Conclusions:
A patient with a longstanding diagnosis of MD demonstrated interval development of an ELST. While ELSTs are rare, the study raises the question regarding whether interval imaging is indicated in patients with MD.
Primary Endoscopic Stapes Surgery: Audiologic and Surgical Outcomes
Authors: Nassiri Ashley M. , Yawn Robert J. , Dedmon Matthew M. , Tolisano Anthony M. , Hunter Jacob B. , Isaacson Brandon , Rivas Alejandro 
Published: August 2018

Objective:
Evaluate outcomes following primary endoscopic stapes surgery.

Study Design:
Retrospective case series.

Setting:
Two tertiary otologic centers.

Patients:
Eighty-one ears with surgically confirmed stapes fixation.

Interventions:
Total endoscopic stapedotomy or stapedectomy.

Main Outcome Measures:
Surgical and audiologic outcomes.

Results:
Eighty-one subjects were included (60% women) with a median age of 47.6 years (range, 19.1–73.6 yr). Etiologies of hearing loss included otosclerosis (96.3%), stapedial ankylosis (2.5%), and congenital stapes fixation (1.2%). The median follow-up was 5.3 months (range, 1.2–50.4 mo). 74.1% required scutum removal, and the chorda tympani nerve was sacrificed in 7.4%. Two techniques were used: 51.9% underwent stapedectomy and 48.1% underwent stapedotomy (with use of laser, drill, or both in 74.4, 20.5, and 5.1% of cases, respectively). The median air-bone gap (ABG) improved from 31.3 dB preoperatively to 6.25 dB postoperatively at last follow-up (p < 0.0001). The ABG closed to less than 15 dB in 96.3% of patients and less than 10 dB in 84%. There were no instances of postoperative sensorineural hearing loss (defined as >15 dB change from baseline) or facial nerve injury. Postoperatively, 29.6% of patients reported dysgeusia, of which 8.3% was persistent at last follow-up. Postoperative disequilibrium was reported in 17.3% of cases, with 100% resolution at last follow-up. Comparison of the stapedotomy and stapedectomy groups revealed no significant differences in audiologic or surgical outcomes.

Conclusions:
Endoscopic stapedotomy and stapedectomy are effective techniques to manage stapes fixation resulting in a median postoperative ABG of 6.25 dB and ABG closure to within 10 dB in 84% of patients.
The Bone Mineral Density of the Lateral Skull Base and its Relation to Obesity and Spontaneous Cerebrospinal Fluid Leaks
Authors: Hatch Jonathan L. , Schopper Heather , Boersma Isabel M. , Rizk Habib G. , Nguyen Shaun A. , Lambert Paul R. , McRackan Theodore R. , Meyer Ted A. 
Published: August 2018

Objectives:
Evaluate the bone mineral density (BMD) of the lateral skull base by thin sliced computed tomography (CT) scans.
Determine the BMD and its relation in patients who are obese or who have spontaneous cerebrospinal fluid (CSF) leaks.

Study Design:
Blinded retrospective case control series.

Setting:
Tertiary care university setting.

Patients:
A control group consisting of age and sex matched non-obese patients were compared with obese and CSF leak patients.

Interventions:
Three blinded reviewers measured the BMD at multiple locations along the lateral skull base using thin sliced high-resolution CT scans. Additional BMD measurements were obtained from the temporal bone squamosal and otic capsule. The BMD was compared between the groups.

Main Outcome Measure:
Lateral skull base BMD in patients who are obese or have CSF leaks as compared with non-obese controls.

Results:
Sixty-five (n = 65) patients were included in the study. The control group (n = 21) had a median density along the tegmen of 499.4 (178.8) HU, obese (n = 26) had an average HU of 559.5 (207.2), and CSF leak group (n = 18) had an average 472.9 (154.9), respectively (p = 0.35). The BMD in the temporal bone squamosa (p = 0.07) was not significantly different, however, the otic capsule was denser in the CSF leak group (p = 0.01) compared with the control group or the obese group. The intraclass correlation coefficient of the CT reviewers’ measurements were moderate to strong (k = 0.69–0.99).

Conclusion:
There appears to be no difference between the BMD of the lateral skull base as it relates to obesity or spontaneous CSF leaks compared with normal weight controls. These findings suggest the BMD does not have a significant role in the development of lateral skull base thinning or dehiscence leading to CSF leaks.
Narcissism and Interpersonal Problems Among Psychiatric Outpatients
Authors: Mielimaka Michal , Ogrodniczuk John S. , Kealy David , Cheek Joanna , Joyce Anthony S. 
Published: August 2018

Abstract
A growing body of evidence points to significant interpersonal problems associated with narcissism in clinical samples. Less well understood are the mechanisms by which narcissism negatively impacts one’s interpersonal functioning. The present study investigated defensive style as a possible mediator of the relationship between narcissism and interpersonal problems. A sample of 53 adult psychiatric outpatients completed measures of narcissism, defensive style, interpersonal problems, and current symptom distress. Mediation analysis was conducted, controlling for current symptom distress, using 95% bootstrapped confidence intervals to examine the indirect effect of narcissism on interpersonal problems via defensive style. Narcissism was significantly associated with immature and neurotic defensive styles. Although narcissism was not directly related to interpersonal problems, a significant indirect effect was observed for narcissism on interpersonal problems via neurotic defensive style. This finding suggests that narcissism contributes to the use of neurotic defenses, which in turn influence one’s interpersonal functioning.
Predictors of Sustained Employment Among Individuals With Serious Mental Illness
Authors: Russinova Zlatka , Bloch Philippe , Wewiorski Nancy , Shappell Heather , Rogers E. Sally 
Published: August 2018

Abstract
Despite decades of research, understanding of the employment trajectories of individuals with serious mental illnesses remains elusive. We conducted a 5-year prospective, longitudinal study using a geographically broad sample of individuals who met established criteria for sustained competitive employment (N = 529). We collected data on an annual basis with a specifically designed survey instrument. Despite stable employment at study entry, more than half of the participants experienced work interruptions during the 5-year follow-up period. Predictors of sustained employment included the absence of a trauma diagnosis, Social Security disability income, psychiatric hospitalizations, and difficulties with daily functioning. The presence of a higher quality of life, workplace supports, and a flexible job were also predictive. Results dispel the myth that people with serious mental illnesses cannot be employed for prolonged periods. Interruptions in work trajectories, however, suggest that longer-term supports may increase individuals' capacity to maintain stable employment.
Long-Term Effects of Experimental Human Endotoxemia on Immune Cell Function: Similarities and Differences With Sepsis
Authors: Rodriguez-Rosales Yessica Alina , Kox Matthijs , van Rijssen Esther , van Cranenbroek Bram , van Welie Marina , Pickkers Peter , Joosten Irma , Koenen Hans J.P.M. 
Published: August 2018

ABSTRACT
Sepsis is the cause of more than 5.3 million deaths per year, and novel immunotherapeutic strategies are highly warranted. Human models that mirror sepsis immunology are instrumental to this aim. The response to endotoxin in humans during the first 24 h captures many hallmarks of the inflammatory response observed in sepsis. However, the long-term immunologic effects of human experimental endotoxemia have been sparsely studied and could be determinant for the use of this model in sepsis therapy research. In the present work, we studied the immune-composition of healthy subjects challenged with endotoxin (1 ng/kg) 4 h, 2 days, and 20 days post administration by flow cytometry to study the effects on innate and adaptive immune system, and compared it with the immune-composition in patients during the first 9 days after onset of septic shock. We found several differences and similarities between these groups. Experimental endotoxemia resulted in an increase in absolute numbers of intermediate monocytes, which also displayed lower human leucocyte antigen expression 20 days post endotoxin. These changes differed with those observed in septic shock patients. Another long-term effect of experimental endotoxemia was elevated numbers of effector CD8+ cells and an increased percentage of proliferating and cytokine expressing CD8+ cells, and these phenomena were also present in sepsis patients. In conclusion, despite considerable differences, experimental endotoxemia captures several long-term aspects of sepsis immunology, specifically the behavior of CD8+ T cells, which may eventually aid the development of new therapies for sepsis patients.
Surgical Risk Is Not Linear: Derivation and Validation of a Novel, User-friendly, and Machine-learning-based Predictive OpTimal Trees in Emergency Surgery Risk (POTTER) Calculator
Authors: Bertsimas Dimitris , Dunn Jack , Velmahos George C. , Kaafarani Haytham M. A. 
Published: August 2018

Introduction:
Most risk assessment tools assume that the impact of risk factors is linear and cumulative. Using novel machine-learning techniques, we sought to design an interactive, nonlinear risk calculator for Emergency Surgery (ES).

Methods:
All ES patients in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) 2007 to 2013 database were included (derivation cohort). Optimal Classification Trees (OCT) were leveraged to train machine-learning algorithms to predict postoperative mortality, morbidity, and 18 specific complications (eg, sepsis, surgical site infection). Unlike classic heuristics (eg, logistic regression), OCT is adaptive and reboots itself with each variable, thus accounting for nonlinear interactions among variables. An application [Predictive OpTimal Trees in Emergency Surgery Risk (POTTER)] was then designed as the algorithms’ interactive and user-friendly interface. POTTER performance was measured (c-statistic) using the 2014 ACS-NSQIP database (validation cohort) and compared with the American Society of Anesthesiologists (ASA), Emergency Surgery Score (ESS), and ACS-NSQIP calculators’ performance.

Results:
Based on 382,960 ES patients, comprehensive decision-making algorithms were derived, and POTTER was created where the provider's answer to a question interactively dictates the subsequent question. For any specific patient, the number of questions needed to predict mortality ranged from 4 to 11. The mortality c-statistic was 0.9162, higher than ASA (0.8743), ESS (0.8910), and ACS (0.8975). The morbidity c-statistics was similarly the highest (0.8414).

Conclusion:
POTTER is a highly accurate and user-friendly ES risk calculator with the potential to continuously improve accuracy with ongoing machine-learning. POTTER might prove useful as a tool for bedside preoperative counseling of ES patients and families.
Fluctuations in Arctic sea-ice extent: comparing observations and climate models
Authors: Agarwal Sahil , Wettlaufer John S. 
Published: August 2018

The fluctuation statistics of the observed sea-ice extent during the satellite era are compared with model output from CMIP5 models using a multifractal time series method. The two robust features of the observations are that on annual to biannual time scales the ice extent exhibits white noise structure, and there is a decadal scale trend associated with the decay of the ice cover. It is shown that (i) there is a large inter-model variability in the time scales extracted from the models, (ii) none of the models exhibits the decadal time scales found in the satellite observations, (iii) five of the 21 models examined exhibit the observed white noise structure, and (iv) the multi-model ensemble mean exhibits neither the observed white noise structure nor the observed decadal trend. It is proposed that the observed fluctuation statistics produced by this method serve as an appropriate test bed for modelling studies.
This article is part of the theme issue ‘Modelling of sea-ice phenomena’.
Three-dimensional time-domain scattering of waves in the marginal ice zone
Authors: Meylan M. H. , Bennetts L. G. 
Published: August 2018

Three-dimensional scattering of ocean surface waves in the marginal ice zone (MIZ) is determined in the time domain. The solution is found using spectral analysis of the linear operator for the Boltzmann equation. The method to calculate the scattering kernel that arises in the Boltzmann model from the single-floe solution is also presented along with new identities for the far-field scattering, which can be used to validate the single-floe solution. The spectrum of the operator is computed, and it is shown to have a universal structure under a special non-dimensionalization. This universal structure implies that under a scaling wave scattering in the MIZ has similar properties for a large range of ice types and wave periods. A scattering theory solution using fast Fourier transforms is given to find the solution for directional incident wave packets. A numerical solution method is also given using the split-step method and this is used to validate the spectral solution. Numerical calculations of the evolution of a typical wave field are presented.
This article is part of the theme issue ‘Modelling of sea-ice phenomena’.
Friction of sea ice
Authors: Schulson Erland M. 
Published: August 2018

Static and kinetic friction play a fundamental role in sea-ice mechanics. The coefficient of static friction increases with hold time under normal load and is modelled in terms of creep and fracture of asperities in contact. The coefficient of kinetic friction exhibits velocity strengthening at lower speeds and velocity weakening at intermediate speeds. Strengthening is modelled in terms of asperity creep and hardness; weakening is modelled in terms of a progressive increase in the true area of contact wetted by meltwater produced through frictional heating. The concept is introduced of contact size distribution in which the smallest contacts melt first, leading to the onset of weakening; the largest melt last, leading to a third regime of kinetic friction and again to strengthening where hydrodynamics governs. Neither the static nor the kinetic coefficient is significantly affected by the presence of sea water. The paper closes with a few implications for sea-ice mechanics. The paper is based largely upon a critical review of the literature, but includes a more quantitative, physics-based analysis of velocity strengthening and a new analysis of velocity weakening that incorporates parameters that describe the (proposed) fractal character of the sliding interface.This article is part of the theme issue ‘Modelling of sea-ice phenomena’.