bluuebunny/crossref_metadata_2025_split huggingface dataset:
Next Generation Telehealth
Authors: Gogia S.B. , Hartvigsen G. , Maeder A.J. 
Published: March 2018

SummaryTelehealth has long been seen as a means of increasing access and quality of care while decreasing costs and logistical burden for remote health care delivery. Underlying technology to support Telehealth has been developed commercially. However, its widespread adoption has been hindered by numerous clinical, social, political, economic and management factors. This paper examines trends which may help to address this situation.First we consider the current status of Telehealth based on some state-of-the-art reviews. Then we present some new future modes of Telehealth services, as described by various prominent authors. From these we identify some common directional themes and fundamental issues affecting the success of future Telehealth innovations.This position paper advances a view that Telehealth in the future will be much more driven by widespread pressure from two different drivers: more ubiquitous connectivity and related technological capabilities due to greater diversity in human communication practices, and new models of care emerging from diverse widespread movements towards health services reform.The IMIA Working Group on Telehealth work agenda will address some specific items within the areas described above.
Health Informatics 3.0 and other Increasingly Dispersed Technologies Require Even Greater Trust: Promoting Safe Evidence-based Health Informatics
Authors: Ammenwerth E. , Talmon J. , Nykänen P. , Brender J. , de Keizer N. , Rigby M. 
Published: March 2018

SummaryHealthinformaticsisgenerallylesscommittedtoascientific evidence-basedapproach than any other area of health science, which is an unsound position. Introducing the new Web 3.0 paradigms into health IT applications can unleash a further great potential, able to integrate and distribute data from multiple sources. The counter sideisthatitmakestheuserandthepatientevermoredependentonthe‘blackbox’ of the system, and the re-use of the data remote from the author and initial context. Thus anticipatory consideration of uses, and proactive analysis of evidenceof effects,are imperative,as only when a clinical technology can be proven to be trustworthy and safe should it be implementedwidely as is the case with other health technologies.Toargueforpromotingevidence-basedhealthinformatics assystemsbecomemorepowerfulandpro-activeyetmoredispersed andremote;andevaluationasthemeansofgeneratingthenecessaryscientific evidencebase.TopresentongoingIMIAandEFMIinitiativesinthisfield.Critical overview of recent developments in health informatics evaluation, alongside the precedents of other health technologies, summarising current initiatives and the new challenges presented by Health Informatics 3.0.Web3.0should betaken asanopportunitytomovehealth informatics from being largely unaccountable to one of being an ethical andresponsiblescience-baseddomain.Recentandplannedactivities ofthe EFMIandIMIAworkinggroupshavesignificantlyprogressedkeyinitiatives.Concurrent with the emergence of Web 3.0 as a means of new-generation diffuse health information systems comes an increasing need for an evidence-based culture in health informatics.
Alogliptin and Gliclazide Similarly Increase Circulating Endothelial Progenitor Cells in Type 2 Diabetes Patients
Authors: Negro Roberto , Greco Eupremio , Greco Giacomo 
Published: March 2018

Abstract
Aim We investigated the effect of alogliptin and gliclazide on endothelial progenitor cells (EPCs) in type 2 diabetes.
Methods Eighty patients with type 2 diabetes and HbA1c between 7.5% and 8.5% were randomized to receive either alogliptin (25 mg/daily) or gliclazide extended-release (30 mg/daily for HbA1c 7.5-8.0% and 60 mg/daily for HbA1c 8.0-8.5%) in combination with metformin for 4 months. At baseline and 4 months, clinical and laboratory parameters of EPCs were determined.
Results After 4 months of treatment, alogliptin and gliclazide resulted in a similar significant reduction in HbA1c (%) (8.0±0.3 vs. 7.1±0.2, and 8.0±0.3 vs. 7.0±0.2, respectively; P<0.05) and a similar and significant increase in EPC count (cells/106 WBC) (CD45−CD133+KDR+ : 2.2±1.2 vs. 3.7±1.6, CD45−CD34+KDR+: 3.3±1.8 vs. 4.9±1.8; P<0.05 for alogliptin; CD45−CD133+KDR+: 2.3±1.3 vs. 3.6±1.5, CD45−CD34+KDR+: 3.1±1.3 vs. 4.6±1.7; P<0.05 for gliclazide).
Conclusions Both alogliptin and gliclazide demonstrated a beneficial effect in increasing EPCs in poorly controlled type 2 diabetes. As alogliptin and gliclazide exhibit different mechanisms of action, the observed increase in EPCs seems to be due to their glucose-lowering effect.
Efficacy and tolerability of a complex homeopathic drug in children suffering from dry cough-A double-blind, placebo-controlled, clinical trial
Authors: Voß Hans , Michalsen Andreas , Brünjes Rainer 
Published: March 2018

Abstract
Background A randomised, placebo-controlled clinical trial in children suffering from acute dry cough was performed to assess the efficacy and tolerability of a complex homeopathic drug (Drosera, Coccus cacti, Cuprum Sulfuricum, Ipecacuanha=Monapax syrup, short: verum).
Methods 89 children received verum and 91 received placebo daily for 7 days (age groups 0.5–3, 4–7 and 8–12 years). The primary efficacy variable was the improvement of the Cough Assessment Score. Tolerability and compliance were also assessed. A confirmatory statistical analysis was performed for the primary efficacy variable and a descriptive analysis for the secondary parameters.
Results The Cough Assessment Score showed an improvement of 5.2±2.6 points for children treated with verum and 3.2±2.6 points in the placebo group (p<0.0001). The difference of the least square means of the improvements was 1.9±0.4. The effect size of Cohen´s d was d=0.77. In all secondary parameters the patients in the verum group showed higher rates of improvement and remission than those in the placebo group. In 15 patients (verum: n=6; placebo: n=9) 18 adverse drug reactions of mild or moderate intensity were observed.
Conclusions Administering verum resulted in a statistically significantly greater improvement of the Cough Assessment Score than the placebo. The tolerability was good and not inferior to that of the placebo.
Multiplicative mixing of object identity and image attributes in single inferior temporal neurons
Authors: Ratan Murty N. Apurva , Arun S. P. 
Published: March 2018

Significance
Vision is a challenging problem because the same object can produce a variety of images on the retina, mixing signals related to its identity with signals related to its viewing attributes, such as size, position, rotation, etc. Precisely how the brain separates these signals to form an efficient representation is unknown. Here, we show that single neurons in high-level visual cortex encode object identity and attribute multiplicatively and that doing so allows for better decoding of each signal.
Multigenerational memory and adaptive adhesion in early bacterial biofilm communities
Authors: Lee Calvin K. , de Anda Jaime , Baker Amy E. , Bennett Rachel R. , Luo Yun , Lee Ernest Y. , Keefe Joshua A. , Helali Joshua S. , Ma Jie , Zhao Kun , Golestanian Ramin , O’Toole George A. , Wong Gerard C. L. 
Published: March 2018

Significance
Bacteria use multigenerational memory based on coupled oscillations of cAMP levels and type IV pili (TFP) activity to adaptively adhere to surfaces. These oscillations create cells with a “surface-sentient” state intermediate between planktonic and sessile, characterized by coordinated surface motility suppression. This intermediate state drastically increases the number of surface nonmotile cells and correlates with a transition in family tree architectures toward exponential surface population growth. Our data support the idea that reversible attachment is vital for irreversible attachment. That is, repeated sensing, division, and detachment cycles create a planktonic population with robust cAMP–TFP-based memory of the surface, allowing cells to return to the surface progressively better adapted for sensing and attachment, ultimately dominating the surface ecology via exponential surface population increase.
The search forBrachyspiraouter membrane proteins that interact with the host
Authors: Trott Darren J. , Alt David P. , Zuerner Richard L. , Wannemuehler Michael J. , Stanton Thaddeus B. 
Published: March 2018

AbstractLittle is known about the outer membrane structure ofBrachyspira hyodysenteriae and Brachyspira pilosicolior the role of outer membrane proteins (OMPs) in host colonization and the development of disease. The isolation of outer membrane vesicles fromB. hyodysenteriaehas confirmed that cholesterol is a significant outer membrane constituent and that it may impart unique characteristics to the lipid bilayer structure, including a reduced density. Unique proteins that have been identified in theB. hyodysenteriaeouter membrane include the variable surface proteins (Vsp) and lipoproteins such as SmpA and BmpB. While the function of these proteins remains to be determined, there is indirect evidence to suggest that they may be involved in immune evasion. These data may explain the ability of the organism to initiate chronic infection. OMPs may be responsible for the unique attachment ofB. pilosicolito colonic epithelial cells; however, the onlyB. pilosicoliOMPs that have been identified to date are involved in metabolism. In order to identify furtherB. pilosicoliOMPs we have isolated membrane vesicle fractions from porcine strain 95–1000 by osmotic lysis and isopycnic centrifugation. The fractions were free of contamination by cytoplasm and fla-gella and contained outer membrane. Inner membrane contamination was minimal but could not be completely excluded. An abundant 45-kDa, heat-modifiable protein was shown to have significant homology withB. hyodysenteriaeVsp, and monoclonal antibodies were produced that reacted with fiveB. pilosicoli-specificmembrane protein epitopes. The first of these proteins to be characterized is a unique surface-exposed lipoprotein.
Human intestinal spirochetosis diagnosed with colonoscopy and analysis of partial 16S rDNA sequences of involved spirochetes
Authors: Kraatz Wolfgang , Thunberg Ulf , Pettersson Bertil , Fellström Claes 
Published: March 2018

AbstractDNA was extracted from colonic biopsies of 33 patients with and three without evidence of intestinal spirochetosis (IS) in the large bowel. The biopsies were subjected to PCR. A pair of primers, generating a 207 bp fragment, were designed to detect specifically the 16S rDNA gene ofBrachyspira. PCR products of the expected size were obtained from 33 samples with histologic evidence of IS. The PCR amplicons were used for sequencing. The sequences obtained were aligned to the corresponding 16S rRNA sequences of five type strains ofBrachyspira. The sequences of 23 PCR products were 99–100% identical with the correspond-ingB.aalborgitype strain sequence. Two cases showed 99–100% sequence similarity with the type strain ofB.pilosicoliP43/6/78. Six cases could not be referred to any of the known species ofBrachyspira. Two PCR products gave incomplete sequences.
Amount of Naloxone Used to Reverse Opioid Overdoses outside of Medical Practice in a City with Increasing Illicitly Manufactured Fentanyl in Illicit Drug Supply
Authors: Bell Alice , Bennett Alex S. , Jones T. Stephen , Doe-Simkins Maya , Williams Leslie D. 
Published: March 2018

Background: Illicitly manufactured fentanyl (IMF) prevalence has increased. However, there is uncertainty about naloxone dose(s) used by nonmedical bystanders to reverse opioid overdoses in the context of increasing IMF. Methods: We used community naloxone distribution program data about naloxone doses and fatal opioid overdoses from the Allegheny County Medical Examiner. From January 2013 to December 2016, staff interviewed participants who administered naloxone in response to 1072 overdoses. We calculated frequencies, percentages, and conducted a 1-way analysis of variance (ANOVA). Results: Despite increases in fentanyl-contributed deaths, there were no statistically significant differences between any of the 4 years (2013–2016) on average number of naloxone doses used by participants to reverse an overdose ( F = 0.88; P = .449). Conclusion: Even though IMF is more potent than heroin and is a rapidly increasing contributor to drug overdose deaths in Allegheny County, the average dose of naloxone administered has not changed. Our findings differ from studies in different areas also experiencing increasing IMF prevalence. Additional investigations are needed to clarify the amount of naloxone needed to reverse opioid overdoses in the community caused by new synthetic opioids.
Pyloroplasty may reduce weight loss 1 year after esophagectomy
Authors: Harada K , Yoshida N , Baba Y , Nakamura K , Kosumi K , Ishimoto T , Iwatsuki M , Miyamoto Y , Sakamoto Y , Ajani J A , Watanabe M , Baba H 
Published: March 2018

SUMMARYWeight loss after esophagectomy is common and is associated with unfavorable prognosis. However, the clinical features and surgical methods that influence postesophagectomy weight loss are not well characterized. This study aims to determine those features (especially the surgical methods) that may affect postoperative weight loss. We reviewed 221 esophageal cancer patients who had undergone esophagectomy at Kumamoto University Hospital (Kumamoto, Japan) between November 2012 and June 2015. Among these, we recruited 106 patients who had undergone transthoracic esophagectomy with gastric conduit reconstruction, had no cancer recurrence within 1 year, and no missing follow-up data. We tabulated the body weight changes and risk factors associated with weight loss exceeding 10% at 1-year postesophagectomy. The mean body weights at baseline and 1-year postsurgery were 60.3 kg (standard error (SE): 0.91) and 52.6 (SE: 0.91), respectively. One year postsurgery, the body weights had changed as follows: mean: −12.2%; median: −12.9%; standard deviation: 9.06; range: −36.1–18.56%; interquartile range: −10.5 to −14.0%. In the multivariate logistic regression analysis, the absence of pyloroplasty was the sole risk factor for more than 10% weight loss (OR: 3.22; 95% CI: 1.08–11.9; P = 0.036). Our data suggest that pyloroplasty with esophagectomy can overcome the post-surgical weight loss.
The VIX, the Variance Premium, and Expected Returns*
Authors: Osterrieder Daniela , Ventosa-Santaulària Daniel , Vera-Valdés J Eduardo 
Published: March 2018

AbstractExisting studies find conflicting estimates of the risk–return relation. We show that the trade-off parameter is inconsistently estimated when observed or estimated conditional variances measure risk. The inconsistency arises from misspecified, unbalanced, and endogenous return regressions. These problems are eliminated if risk is captured by the variance premium (VP) instead; it is unobservable, however. We propose a 2SLS estimator that produces consistent estimates without observing the VP. Using this method, we find a positive risk–return trade-off and long-run return predictability. Our approach outperforms commonly used risk–return estimation methods, and reveals a significant link between the VP and economic uncertainty.
Three-dimensional Printed Surgical Simulator for Kirschner Wire Placement in Hand Fractures
Authors: Brichacek Michal , Diaz-Abele Julian , Shiga Sarah , Petropolis Christian 
Published: March 2018

Summary:
Closed reduction and percutaneous pinning (CRPP) of hand fractures can be a deceptively challenging procedure that requires significant hands-on time to teach and learn. We created a realistic three-dimensional simulator that can be used for teaching junior residents the CRPP. Computer-aided design and computer-aided manufacturing (CAD/CAM) software was used to create a three-dimensional hand model incorporating several common hand fractures: Bennett’s fracture, transverse fifth metacarpal neck, and transverse second proximal phalanx. Three-dimensional printing was used to create molds in which the bones and soft tissue were poured. A polyurethane foam was utilized for the bones with iron incorporated to render them radiopaque, whereas silicone of varying viscosities was used for the soft tissues. Five plastic surgery residents and 5 consultants evaluated the model. Individuals then completed an anonymous 12-question survey evaluating the model based on realism, educational utility, and overall usefulness. Survey responses obtained from both residents and consultants were strongly in favor of the simulator. Average realism was graded as 4.48/5 by residents and 4.68/5 by consultants. Average educational utility was graded as 5/5 by residents and 4.95/5 by consultants. Average overall usefulness was graded as 5/5 by both groups. We created an anatomically accurate and realistic simulator for CRPP of hand fractures that was low cost and easily reproducible. Initial feedback was encouraging in regard to realism, educational utility, and overall usefulness.
Prevalence of Ocular Hypertension and Glaucoma as Well as Associated Factors in Graves' Orbitopathy
Authors: Kim Ji Won , Ko JaeSang , Woo Young Jun , Bae Hyoung Won , Yoon Jin Sook 
Published: March 2018

Purpose:
The purpose of this study was to determine the prevalence of ocular hypertension (OHT) and open-angle glaucoma (OAG) in patients with Graves' orbitopathy (GO) and to investigate the associations between clinical features of the disease and the prevalence of OHT and OAG.

Methods:
A cross-sectional analytic study was conducted among a total of 1128 patients with GO. A complete ophthalmic examination was performed, including intraocular pressure, optic disc photography, visual field testing using a Humphrey visual field analyzer, and retinal nerve fiber layer thickness measured by optical coherence tomography. The results were analyzed by univariate and multivariate logistic regression.

Results:
A 6.8% prevalence of OHT (77/1128) and a 1.6% prevalence of OAG (18/1128) were observed. When considering only patients older than 40 years, the prevalence of OHT and OAG was 9.5% and 3.4%, respectively. Twenty-nine of the 1128 patients (2.6%) developed compressive optic neuropathy. Of the factors evaluated, male sex [odds ratio (OR), 1.83; 95% confidence interval (CI), 1.08-3.10], duration of GO (6 to 24 mo; OR, 2.08; 95% CI, 1.17-3.71; 24 to 60 mo; OR, 3.45; 95% CI, 1.66-7.18), clinical activity score ≥3 (OR, 1.76; 95% CI, 1.03-3.01), extraocular muscle involvement (OR, 4.65; 95% CI, 2.54-8.50), and lid retraction (OR, 2.17; 95% CI, 1.19-3.96) were associated with the prevalence of OHT in GO. The prevalence of OAG was associated with male sex (OR, 4.29; 95% CI, 1.60-11.51) and duration of GO (≥60 mo; OR, 4.28; 95% CI, 1.11-16.47).

Conclusions:
The prevalence of OHT in patients with GO was higher and the prevalence of OAG was similar to that in the general population.
Glaucoma With Crouzon Syndrome
Authors: Alshamrani Abdulaziz A. , Al-Shahwan Sami 
Published: March 2018

Background:Crouzon syndrome is the most common form of craniosynostosis, and mutations in the fibroblast growth factor receptor 2 and 3 (FGFR2andFGFR3) genes are implicated in its pathogenesis.Observation:A 10-year-old female patient with Crouzon syndrome and congenital glaucoma treated with trabeculectomy and ocular hypotensive medications was examined. The patient had proptosis, exposure keratopathy, megalocornea, thin central corneal thickness, a shallow anterior chamber, mild anterior subcapsular cataract, and a cup-to-disc ratio of 0.9. Ultrasound biomicroscopy revealed a shallow anterior chamber, posterior synechiae, and closed angle in the right eye, as well as a narrow angle in the left eye, despite an axial length of 28.9 mm in the right eye and 30.0 mm in the left eye, measured by A-scan ultrasound biometry. The crystalline lens thickness measured by ultrasound biomicroscopy was 4.18 mm in the right eye and 4.12 mm in the left eye.Conclusions and Importance:Despite long axial lengths, shallow anterior chambers with occluded angles are possible in Crouzon syndrome and are most likely caused byFGFR2-related anterior segment dysgenesis. To the best of our knowledge, this is the first report that describes closed angles and anterior segment dysgenesis as a secondary cause of congenital glaucoma in Crouzon syndrome.
Shame and Defectiveness Beliefs in Treatment Seeking Patients With Body Dysmorphic Disorder
Authors: Weingarden Hilary , Shaw Ashley M. , Phillips Katharine A. , Wilhelm Sabine 
Published: March 2018

Abstract
Shame is a distressing emotion experienced when individuals judge themselves in a broadly negative and critical manner. Clinical descriptions of body dysmorphic disorder (BDD) emphasize the centrality of shame, yet research on shame in BDD remains scarce. This study is the largest investigation of shame in clinically diagnosed individuals with BDD, and it is the first to examine whether shame changes with treatment. Eighty-three adults with BDD were treated with 14 weeks of open-label escitalopram. Shame was measured using the Young Schema Questionnaire–Short Form. Shame was significantly higher in individuals with BDD than in previously reported healthy control and psychiatric outpatient samples. Shame was significantly, moderately correlated with greater suicidal thoughts and hopelessness and marginally significantly correlated with greater BDD severity. Shame decreased significantly with treatment. Reductions in shame with escitalopram were significantly associated with reductions in suicidal thoughts and hopelessness, even when accounting for reductions in BDD and depression severity.
Perspectives on Patient Safety and Medical Malpractice: A Comparison of Medical and Legal Systems in Italy and the United States
Authors: di Luca Alessandro , Vetrugno Giuseppe , Pascali Vincenzo Lorenzo , Oliva Antonio , Ozonoff Al 
Published: March 2018

Objectives
Italy is experiencing a crisis of malpractice litigation with important repercussions on the insurance industry (e.g., lower profits), physicians (e.g., defensive medicine), and the courts (e.g., work backlog, lengthy proceedings). We searched for common ground between legal systems in Italy and the United States and considered the implications for international collaborations in patient safety.

Methods
We examined the judicial frameworks of medical malpractice litigation in two countries with different legal foundations: the United States (a public-private system governed by common law) and Italy (a publicly financed healthcare system governed by civil law).

Results
We found important differences and similarities across the two systems that suggest a high compatibility for future comparisons and collaborations. Although many Italian hospitals maintain risk management programs, the U.S. emphasis on patient safety and quality has not yet been integrated into Italian healthcare systems.

Conclusions
Based on our findings, we propose that the Italian system might benefit from assertively adopting some concepts from the U.S. system. In particular, we consider the role of the law and Italian medicolegal experts as key facilitators for the integration of patient safety and risk management units within Italian healthcare facilities.