bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sketching for large-scale learning of mixture models
Authors: Keriven Nicolas , Bourrier Anthony , Gribonval Rémi , Pérez Patrick 
Published: November 2017

AbstractLearning parameters from voluminous data can be prohibitive in terms of memory and computational requirements. We propose a ‘compressive learning’ framework, where we estimate model parameters from a sketch of the training data. This sketch is a collection of generalized moments of the underlying probability distribution of the data. It can be computed in a single pass on the training set and is easily computable on streams or distributed datasets. The proposed framework shares similarities with compressive sensing, which aims at drastically reducing the dimension of high-dimensional signals while preserving the ability to reconstruct them. To perform the estimation task, we derive an iterative algorithm analogous to sparse reconstruction algorithms in the context of linear inverse problems. We exemplify our framework with the compressive estimation of a Gaussian mixture model (GMM), providing heuristics on the choice of the sketching procedure and theoretical guarantees of reconstruction. We experimentally show on synthetic data that the proposed algorithm yields results comparable to the classical expectation-maximization technique while requiring significantly less memory and fewer computations when the number of database elements is large. We further demonstrate the potential of the approach on real large-scale data (over $10^{8}$ training samples) for the task of model-based speaker verification. Finally, we draw some connections between the proposed framework and approximate Hilbert space embedding of probability distributions using random features. We show that the proposed sketching operator can be seen as an innovative method to design translation-invariant kernels adapted to the analysis of GMMs. We also use this theoretical framework to derive preliminary information preservation guarantees, in the spirit of infinite-dimensional compressive sensing.
NALT M cells are important for immune induction for the common mucosal immune system
Authors: Date Yasuhiro , Ebisawa Masashi , Fukuda Shinji , Shima Hideaki , Obata Yuuki , Takahashi Daisuke , Kato Tamotsu , Hanazato Misaho , Nakato Gaku , Williams Ifor R , Hase Koji , Ohno Hiroshi 
Published: November 2017

AbstractNasopharynx-associated lymphoid tissue (NALT) is one of the major constituents of the mucosa-associated lymphoid tissue (MALT), and has the ability to induce antigen-specific immune responses. However, the molecular mechanisms responsible for antigen uptake from the nasal cavity into the NALT remain largely unknown. Immunohistochemical analysis showed that CCL9 and CCL20 were co-localized with glycoprotein 2 (GP2) in the epithelium covering NALT, suggesting the existence of M cells in NALT. In analogy with the reduced number of Peyer’s patch M cells in CCR6-deficient mice, the number of NALT M cells was drastically decreased in CCR6-deficient mice compared with the wild-type mice. Translocation of nasally administered Salmonella enterica serovar Typhimurium into NALT via NALT M cells was impaired in CCR6-deficient mice, whereas S. Typhimurium demonstrated consistent co-localization with NALT M cells in wild-type mice. When wild-type mice were nasally administered with an attenuated vaccine strain of S. Typhimurium, the mice were protected from a subsequent challenge with wild-type S. Typhimurium. Antigen-specific fecal and nasal IgA was detected after nasal immunization with the attenuated vaccine strain of S. Typhimurium only in wild-type mice but not in CCR6-deficient mice. Taken together, these observations demonstrate that NALT M cells are important as a first line of defense against infection by enabling activation of the common mucosal immune system (CMIS).
The Curious Case of Chastine Cox: Murder, Race, Medicine and the Media in the Gilded Age
Authors: Thompson Courtney E 
Published: November 2017

Summary
This paper explores the intersection of race, law and medical authority in Gilded Age New York through an examination of the trial and execution of Chastine Cox. This case was a media sensation due to two controversies which played out in the courtroom and the court of public opinion. For the public, Cox’s race inflected the debate over the crime and execution. Within the courtroom, however, controversy centred on the interpretation of medical evidence, which raised the possibility that Cox was not guilty. In particular, the defence strategy centred on medical theories of suspended animation, making use of new medical evidence about the line between life and death to prompt uncertainties both about the possibility of murder and the reliability of medical professionals. This paper demonstrates the ways in which anxieties about life, death, law, race and medicine were negotiated in courts of law and public opinion.
Comparison of Pterygium Recurrence Rates Among Different Races and Ethnicities After Primary Pterygium Excision by Surgeons in Training
Authors: Campagna Giovanni , Adams Matthew , Wang Li , Khandelwal Sumitra , Al-Mohtaseb Zaina 
Published: November 2017

Purpose:
To evaluate the impact of race and ethnicity, surgical technique, and level of surgeon training on recurrence rates after primary pterygium excision.

Methods:
A retrospective review of patients who underwent primary pterygium excision at our academic institution was performed. The surgical technique—conjunctival autografting (CAG) or amniotic membrane grafting (AMG)—was chosen at the attending surgeon's discretion, and all surgeries were performed by surgeons in training. The primary outcome measure was pterygium recurrence, defined as regrowth of fibrovascular tissue onto a clear cornea in the region of previous pterygium removal.

Results:
There was a significant difference in age at presentation between white (64.3 ± 11.4), Hispanic (50.0 ± 13.5), black (64.8 ± 14.5), and Asian (59.3 ± 9.2) patients (P < 0.001). Average time to recurrence was 4.4 ± 3.0 months and was similar between races (P = 0.98). There was a significant difference in recurrence rates between the white (13%), Hispanic (28%), black (33%), and Asian (0%) patients (P = 0.049). Over 12 months, a significant difference in cumulative proportion with recurrence after AMG versus CAG was observed in Hispanic (75% vs. 30%; P = 0.002) and black (100% vs. 42%; P = 0.001) patients. Sex, method of graft fixation (glue, suture, or both), and level of surgeon training showed no difference in pterygium recurrence (P > 0.05).

Conclusions:
Hispanic and black patients are more likely to experience pterygium recurrence after AMG than CAG. White patients are less likely than Hispanic or black patients to experience recurrence regardless of the surgical technique. To reduce the likelihood of recurrence, surgeons may consider race and ethnicity when selecting their operative technique.
Collagen-Based Fillers as Alternatives to Cyanoacrylate Glue for the Sealing of Large Corneal Perforations
Authors: Samarawickrama Chameen , Samanta Ayan , Liszka Aneta , Fagerholm Per , Buznyk Oleksiy , Griffith May , Allan Bruce 
Published: November 2017

Purpose:
To describe the use of collagen-based alternatives to cyanoacrylate glue for the sealing of acute corneal perforations.

Methods:
A collagen analog comprising a collagen-like peptide conjugated to polyethylene glycol (CLP-PEG) and its chemical crosslinker were tested for biocompatibility. These CLP-PEG hydrogels, which are designed to act as a framework for corneal tissue regeneration, were then tested as potential fillers in ex vivo human corneas with surgically created full-thickness perforations. Bursting pressures were measured in each of 3 methods (n = 10 for each condition) of applying a seal: 1) cyanoacrylate glue with a polyethylene patch applied ab externo (gold standard); 2) a 100-μm thick collagen hydrogel patch applied ab interno, and 3) the same collagen hydrogel patch applied ab interno supplemented with CLP-PEG hydrogel molded in situ to fill the remaining corneal stromal defect.

Results:
Cyanoacrylate gluing achieved a mean bursting pressure of 325.9 mm Hg, significantly higher than the ab interno patch alone (46.3 mm Hg) and the ab interno patch with the CLP-PEG filler (86.6 mm Hg). All experimental perforations were sealed effectively using 100 μm hydrogel sheets as an ab interno patch, whereas conventional ab externo patching with cyanoacrylate glue failed to provide a seal in 30% (3/10) cases.

Conclusions:
An ab interno patch system using CLP-PEG hydrogels designed to promote corneal tissue regeneration may be a viable alternative to conventional cyanoacrylate glue patching for the treatment of corneal perforation. Further experimentation and material refinement is required in advance of clinical trials.
Role of Confocal Microscopy in the Diagnosis of Pythium insidiosum Keratitis
Authors: Anutarapongpan Orapin , Thanathanee Onsiri , Worrawitchawong Jittraporn , Suwan-apichon Olan 
Published: November 2017

Purpose:
To investigate the role of in vivo confocal microscopy for detection of Pythium insidiosum keratitis.

Methods:
Medical records and confocal microscopy findings of 20 patients (21 eyes) with culture- or polymerase chain reaction–proven P. insidiosum keratitis diagnosed at the Khon Kaen University Eye Center from January 2009 to December 2015 were retrospectively reviewed. Confocal microscopy was performed using Nidek ConfoScan 4. The images from 21 eyes with P. insidiosum keratitis and 4 other fungal keratitides were analyzed visually for morphology of the hyphae and special characteristics that would enable physicians to distinguish P. insidiosum keratitis from other fungal keratitides.

Results:
A total of 21 eyes of 20 patients were included in the study. Fourteen (70%) were men, and 6 (30%) were women. In vivo confocal microscopy was able to identify hyphae in 20 of 21 eyes (95%). Beaded string-like hyperreflective branching structures with mean branching angles at 78.6 degrees or thin hyperreflective long lines were found in confocal microscopy findings of P. insidiosum keratitis. The diameter of the hyphae varied from 1.5 to 7.5 μm.

Conclusions:

P.
insidiosum keratitis is a severe progressive infectious corneal disease that causes vision loss in most patients. Confocal microscopy may provide rapid in vivo visualization of P. insidiosum hyphae in corneal tissues, but it cannot distinguish P. insidiosum from other fungal keratitides. Culture identification with zoospore induction or polymerase chain reaction remains the most reliable means to confirm the diagnosis of P. insidiosum keratitis.
Can Appropriate Systemic Treatment Help Protect the Cornea in Patients With Rheumatoid Arthritis? A Multidisciplinary Approach to Autoimmune Ocular Involvement
Authors: Amador-Patarroyo Manuel J. , Jalil-Florencia Emilio , Otero-Marquez Oscar , Molano-Gonzalez Nicolás , Mantilla Ruben D. , Rojas-Villarraga Adriana , Anaya Juan-Manuel , Barraquer-Coll Carmen 
Published: November 2017

Purpose:
To correlate rheumatologic with ophthalmic and laboratory findings in patients with rheumatoid arthritis (RA) to identify what effect these have on development of ocular disease.

Methods:
This is a cross-sectional study of 172 eyes of 86 patients with RA. Patients were examined by a group of rheumatologists. Sociodemographic, clinical, and laboratory data were collected. All patients underwent complete ophthalmologic examination including corneal topography and endothelial cell count.

Results:
There was no significant correlation between RA-negative prognostic indicators (NPIs) and pathologic corneal findings. Patients using disease-modifying antirheumatic drugs (DMARDs) and antimalarial drugs had greater corneal volumes (mean difference 8.51 mm3, 90% confidence interval [CI], 3.98–13.04, P = 0.004; and 2.24, 90% CI, 0.32–4.54, P = 0.048, respectively). Patients using azathioprine had lower endothelial cell counts compared with those using other drugs (mean difference 180 cells/mm2, 90% CI, 69–291, P = 0.008). Patients using biologic DMARDs had better tear osmolarity values (between 280 and 300 mOsm/L) than patients not using them (mean difference 14.3 mOsm/L, P = 0.022). There was no correlation between NPIs of RA and positive keratoconus screening indices (Spearman correlation OD −0.013, P = 0.91; OS −0.033, P = 0.76).

Conclusions:
There was no clear correlation between RA-NPIs and pathologic corneal findings in our study. DMARDs treatment may help maintain corneal integrity in our patients and prevented collagenolytic manifestations of RA. Other medications such as azathioprine should be used carefully, as endothelial damage may potentially occur.
A Pilot Study of a Topical Intervention for Treatment of Female Sexual Dysfunction
Authors: Gomaa Adel Abdel-Wadood , Abdel Aziz Nermeen M. , Thabet Romany H. , Fouly Howieda A. , Altellawy Sara H. , Gomaa Ghada A. 
Published: November 2017

Abstract

Purpose/Background
Many investigators reported that pharmacological treatment of female sexual dysfunction (FSD) has been a promising field yet to be explored. The purpose of this pilot study was to investigate the efficacy and safety of a topical cream containing small concentrations of three vasodilators with different mechanisms of action in treating FSD.

Methods
In this randomized, controlled pilot trial, premenopausal (n = 30) and postmenopausal (n = 30) cases of 21- to 62-year age range with FSD were allocated randomly into 15 given placebo or 15 given active cream in each group. The women included had FSD for more than a 6-month duration and a total score of Female Sexual Distress Scale-Revised of at least 15. Assessing sexual function by measuring female sexual function index (FSFI) during five clinic visits, one at the end of baseline week and at the end of each week of the 4-week treatment period. The primary end point was changed from baseline FSFI total scores to week 4 treatment. Secondary end point included the changes from baseline arousal, desire, orgasm, and satisfaction scores to week 4 treatment.

Findings/Results
The sexual problem reported by patients was orgasmic or/and arousal disorders. In premenopausal cases, active cream led to a high significant increase in mean change FSFI total score from the baseline to week 4 compared with placebo (1.7 ± 1.886 vs 13.35 ± 4.646, respectively; P < 0.0001). Greater improvement of mean change of orgasm and arousal domain score was also observed (0.3 ± 0.45 and 0.35 ± 0.39 vs. 2.66 ± 0.63 and 1.87 ± 0.168, respectively; P < 0.0001). In postmenopausal cases, there were significantly greater improvements with active cream in all sexual functions compared with placebo cream (P < 0.0001). In triple cream, mean change of FSFI total score, orgasm domain score, and arousal score domain were 14.85 ± 6.33, 1.87 ± 0.168 and 2.66 ± 1.182, whereas in the placebo cream, they were 1.54 ± 2.1,0.7 ± 0.76 and 0.22 ± 0.44, respectively. Meanwhile, orgasm scores increased significantly after the use of placebo cream. No serious adverse effects were reported during treatment.

Implications/Conclusions
The results of the pilot trial suggest that topical cream containing small concentrations of three vasodilators may act synergistically, and was effective in improving arousal, orgasmic, and satisfaction disorder with a safer profile for premenopausal and postmenopausal women with FSD. Further studies are recommended to be conducted using a large number of nondepressive and depressive patients.
Utilization of Research Findings and Barriers in Pediatric Surgical Nurses in Turkey
Authors: Esenay Figen Isik , Calik Ceren , Doru Ozlem , Gedik Gamze 
Published: November 2017

Background
The aim of this study was to investigate the utilization of research and perceived barriers to research utilization in nurses employed in pediatric surgery departments.

Method
The study population included all nurses employed in pediatric surgery departments in Turkey, whereas the study sample consisted of 102 pediatric surgical nurses selected by stratified random sampling method by region. A questionnaire on demographic features and research activities of the nurses and the Barriers to Research Utilization Scale were used as data collection tools. The data were collected online and analyzed by using the SPSS program.

Results
In this study, the “greatest barrier” for the nurses working in pediatric surgery departments was detected as “The nurse feels results are not generalizable to own setting” (37.3%). In the subgroups of Barriers to Research Utilization Scale, the items in the characteristics of workplace subscale were perceived as the greatest barriers.

Conclusion
Utilization of research in pediatric surgical nursing practice was found to be mostly affected by the features of workplace (settings). We think that research utilization might be increased by making necessary institutional arrangements, developing strategies for the use of clinical research, and providing nurses with educational and research opportunities.
Appropriate use of laboratory test requests in the emergency department: a multilevel intervention
Authors: Nazerian Peiman , Vanni Simone , Fanelli Alessandra , Fallai Linda , Duranti Cesare , Ognibene Agostino , Rapi Stefano , Betti Laura , Tomaiuolo Matteo , Calamai Monica , Grifoni Stefano 
Published: November 2017

Objective
Laboratory test requests in the emergency department (ED) are increasing worldwide. We evaluated whether a multilevel intervention on the basis of the optimization of test profiles and educational meetings with physicians could reduce the number of tests ordered.

Patients and methods
In a single-center before and after study design, the 8-month intervention period was compared with the 8-month preintervention period. Laboratory test profiles were reduced from 6 to 2 and the number of tests in each profile was reduced by 50%. All physicians received education about the costs and appropriate use of the tests. Primary outcomes were the number of laboratory blood tests and their costs, with a focus on high-cost tests. Secondary outcomes were ED and laboratory performances (patients’ waiting time, number of deaths in ED, re-entry, laboratory turn-around time, and add-on tests).

Results
Overall, 61 976 and 61 154 patients were evaluated, respectively, during the intervention and the preintervention period. Laboratory blood test requests were decreased by 207 637 (−36.3%) in the intervention period (P < 0.05), which corresponds to a reduction of 337.3 tests/100 patients. Costs were decreased by 608 079€ ( − 29.6%, P < 0.05), leading to a cost reduction of 981.2€/100 patients. High-cost test requests decreased by 11 457 ( − 27.3%) and contributed toward the overall reduction in costs with 197 206€ ( − 30.5%). No significant differences were found in ED and laboratory performances between intervention and preintervention periods.

Conclusions
Optimization of test profiles and education on the costs and appropriate use of the tests significantly reduced laboratory test ordering and costs without affecting ED and laboratory performances.
Changes in Case-Mix and Health Outcomes of Medicare Fee-for-Service Beneficiaries and Managed Care Enrollees During the Years 1992–2011
Authors: Koroukian Siran M. , Basu Jayasree , Schiltz Nicholas K. , Navale Suparna , Bakaki Paul M. , Warner David F. , Dor Avi , Given Charles W. , Stange Kurt C. 
Published: November 2017

Background:
Recent studies suggest that managed care enrollees (MCEs) and fee-for-service beneficiaries (FFSBs) have become similar in case-mix over time; but comparisons of health outcomes have yielded mixed results.

Objective:
To examine changes in differentials between MCEs and FFSBs both in case-mix and health outcomes over time.

Design:
Temporal study of the linked Health and Retirement Study (HRS) and Medicare data, comparing case-mix and health outcomes between MCEs and FFSBs across 3 time periods: 1992–1998, 1999–2004, and 2005–2011. We used multivariable analysis, stratified by, and pooled across the study periods. The unit of analysis was the person-wave (n=167,204).

Subjects:
HRS participants who were also enrolled in Medicare.

Measures:
Outcome measures included self-reported fair/poor health, 2-year self-rated worse health, and 2-year mortality. Our main covariate was a composite measure of multimorbidity (MM), MM0–MM3, defined as the co-occurrence of chronic conditions, functional limitations, and/or geriatric syndromes.

Results:
The case-mix differential between MCEs and FFSBs persisted over time. Results from multivariable models on the pooled data and incorporating interaction terms between managed care status and study period indicated that MCEs and FFSBs were as likely to die within 2 years from the HRS interview (P=0.073). This likelihood remained unchanged across the study periods. However, MCEs were more likely than FFSBs to report fair/poor health in the third study period (change in probability for the interaction term: 0.024, P=0.008), but less likely to rate their health worse in the last 2 years, albeit at borderline significance (change in probability: −0.021, P=0.059).

Conclusions:
Despite the persistence of selection bias, the differential in self-reported fair/poor status between MCEs and FFSBs seems to be closing over time.
New thinking on gonorrhoea control in MSM: are antiseptic mouthwashes the answer?
Authors: Fairley Christopher K. , Zhang Lei , Chow Eric P.F. 
Published: November 2017

Purpose of review
The rate of gonorrhoea is rising and is much higher in men who have sex with men (MSM) than heterosexuals. The purpose of this review was to describe research supporting a new paradigm of transmission of gonorrhoea in MSM and interventions that may result from this.

Recent findings
Evidence is accumulating that gonorrhoea in MSM is transmitted differently than previously thought and that asymptomatic sites of infection may play a major role in the persistent of gonorrhoea at a population level. Saliva commonly contains gonorrhoea, and saliva is commonly used during sexual acts. Both in-vitro, in-vivo studies have suggested that antibacterial mouthwash may reduce gonorrhoea at the oropharynx. A recently published mathematical model also suggests that if mouthwash were effective, it would result in considerable declines in the community prevalence in MSM.

Summary
A newly suggested paradigm for the transmission of gonorrhoea in MSM could potentially offer a simple condom-free control strategy. But considerable more research is required before it could be recommended even if it were shown to be effective in a clinical trial.
Transition to survivorship: can there be improvement?
Authors: Fitch Margaret I. 
Published: November 2017

Purpose of review
The transition from primary cancer treatment to posttreatment follow-up care is seen as critical to the long-term health of survivors. However, relatively little attention has been paid to understanding this pivotal period. This review will offer a brief outline of the significant work surrounding this pivotal time published in the past year.

Recent findings
The growing number of cancer survivors has stimulated an emphasis on finding new models of care, whereby responsibility for survivorship follow-up is transitioned to primary care providers. A variety of models and tools have emerged for follow-up care. Survivorship care plans are heralded as a key component of survivorship care and a vehicle for supporting transition. Uptake of survivorship care plans and implementation of evidence-based models of survivorship care has been slow, hindered by a range of barriers.

Summary
Evaluation is needed regarding survivorship models in terms of feasibility, survivor friendliness, cost effectiveness, and achievement of sustainable outcomes. How, and when, to introduce plans for transition to the patient and determine transition readiness are important considerations but need to be informed by evidence. Additional study is needed to identify best practice for the introduction and application of survivorship care plans.