bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Observations About the Potential Benefits and Pitfalls of Between-Session Contacts with Borderline Patients
Authors: Jacob Karen L. 
Published: September 2016

Abstract
Borderline Personality Disorder (BPD) has a reputation for being a challenging disorder to treat due to the nature of the illness. With the development of evidence-based treatments, therapists are becoming more skilled at successfully helping this cohort of patients. A common factor associated with all validated treatments for BPD is the active involvement of therapists. For example, DBT is one treatment where therapists are expected to be available to patients for coaching outside of sessions. However, understanding the benefits and pitfalls associated with therapists’ accessibility in between sessions is relevant to any treatment with intersession contact. In this article, three benefits of intersession contact are described: to generalize the use of skills, to improve understanding of the patient’s needs, and to facilitate an alliance. This article also addresses the pitfalls of therapists being so accessible to patients. Both the benefits and pitfalls of intersession contact are illustrated using case vignettes. Assessing the function served by a patient’s contact in between sessions is an important way to determine whether such contact is a productive part of treatment. Recommendations are provided to avoid detrimental outcomes for both the therapist (therapist burnout) and the patient.
Paroxysmal Sympathetic Hyperactivity in Pediatric Rehabilitation: Pathological Features and Scheduled Pharmacological Therapies
Authors: Pozzi Marco , Conti Valentino , Locatelli Federica , Galbiati Sara , Radice Sonia , Clementi Emilio , Strazzer Sandra 
Published: September 2016

Objective:
Information on course and treatment of paroxysmal sympathetic hyperactivity (PSH) during rehabilitation and in pediatric patients is lacking. To increase knowledge on the course and treatment of PSH in pediatric patients during rehabilitation, we retrospectively analyzed 23 pediatric patients with PSH, describing the course of PSH and administered drugs, and explored the association of PSH remission with drug doses.

Setting:
Neurorehabilitation unit of IRCCS Eugenio Medea, Bosisio Parini (LC), Italy.

Participants:
Twenty-three pediatric patients with postacute acquired brain injury, who remitted from PSH.

Design:
Retrospective cohort study.

Main Measures:
Description of features and course of PSH, description of drug therapies, and analysis of covariance of their doses. Correlations between remission and drug doses/clinical variables. Estimation of the odds ratios of remission.

Results:
At admittance patients displayed at least 3 features of PSH with an overall score of 9, which diminished progressively during remission. Therapies with propranolol, baclofen, niaprazine, and diazepam were progressively uptitrated, indicating potential usefulness. When testing possible predictors of remission, we found positive effects of propranolol and diazepam and of traumatic etiology and a negative effect of maximum PSH severity.

Conclusions:
Results should be interpreted carefully regarding causal relationships and drug doses and combinations, but they encourage further studies on the use of propranolol and diazepam to favor PSH remission.
A Single- Versus Double-Layered Closure Technique in Anophthalmic Surgery
Authors: Verhoekx Jennifer S. N. , Rengifo Coolman Anina , Tse Win Hou Willy , Paridaens Dion 
Published: September 2016

Purpose:
To compare the frequency of orbital implant exposure and extrusion following eye removal with a simplified closure technique, closing Tenon’s capsule and conjunctiva in 1 layer versus the classic technique of closure in 2 separate layers.

Methods:
The authors conducted a retrospective case note review of patients who underwent evisceration or enucleation treated by 1 surgeon between 2001 and 2013. Between 2001 and 2004, Tenon’s capsule and conjunctiva were closed in separate layers; after 2004, a simplified 1-layer closure following eye removal was used. The primary outcome parameters were presence or absence of implant exposure or extrusion.

Results:
One hundred fifty-seven patients who underwent evisceration and 172 patients who underwent enucleation were included. Following evisceration, 2.5% developed exposure or extrusion of the implant, this was 2.5% in the 1-layer closure technique and 2.7% in the 2-layer closure technique (p = 0.95). Following enucleation, 1.7% developed exposure or extrusion of the implant, this was 1.8% in the 1-layer closure technique and 1.7% in the 2-layer closure technique (p = 0.96). Overall implant exposure and extrusion was 2.1%, this was 2.2% in the 1-layer closure technique and 2.1% in the 2-layer closure technique (p = 0.96).

Conclusions:
No difference was found in the frequency of spheric acrylic implant exposure or extrusion in patients who underwent eye removal with single-layer closure of Tenon’s capsule and conjunctiva compared with patients treated with separate closure of these layers.
Self-Management Behaviors of Children With Spina Bifida
Authors: Yun Hyun Jung , Kim Hee Soon 
Published: September 2016

ABSTRACT

Purpose: The aim of this study was to identify factors associated with self-management behaviors in children with spina bifida (SB). The Individual and Family Self-Management Theory was used as a framework. Methods: This was a cross-sectional survey study of 112 elementary school children (7–12 years old) with SB who regularly attended scheduled follow-up appointments at the SB clinic of a children’s hospital in Seoul, Korea, and their parents. Demographics, condition severity, school adjustment, and family function were the contextual self-management factors, whereas self-management knowledge, self-efficacy, and social support were the process factors. Results: Age and condition severity were the contextual factors influencing self-management behaviors in children with SB; among the process factors, self-management knowledge and self-efficacy were statistically significant predictors. Conclusion: To improve self-management behaviors in children with SB, it is necessary to develop intervention programs that reflect their age and condition severity as contextual factors and aim to enhance self-management knowledge and self-efficacy as process factors.
A Depression Screening Protocol for Patients With Acute Stroke: A Quality Improvement Project
Authors: McIntosh Celia 
Published: September 2016

ABSTRACT

Background: Depression after stroke is common and is associated with poor functional recovery, suicidal ideation, decreased quality of life, and increased mortality. Despite this knowledge, poststroke depression (PSD) is often underdetected and thus undertreated. PSD is clinically important for the caregiver, the family, and the stroke survivor. Inconsistencies in screening and treatment practices may further contribute to these negative outcomes. Purpose: The purposes of this evidence-based clinical scholarship project were to (1) determine the efficacy of an evidence-based depression screening protocol in improving early detection and treatment of PSD and (2) identify if there were any relationships between the protocol interventions, depression scores, and diagnosis. Methods: A retrospective chart review was conducted in a convenience sample of 79 hospitalized patients with acute stroke. Depression was assessed using the Patient Health Questionnaire-9. Demographic data and medical and protocol variables were also collected. Descriptive statistics, chi-square test, and Pearson correlation test were used for data analysis. Results: Of the 79 participants, 56% were men, 65% were White, 77% were admitted with ischemic stroke, and 48% were identified as being depressed (Patient Health Questionnaire-9 depression scale > 4). Individuals with a history of depression (χ2 = 17.09, p = .002) were also more likely to have higher levels of depression severity as compared with patients who did not have a history of depression. After the intervention, patients screening positive were more likely to receive an educational booklet on stroke and depression (χ2 = 30.0, p = .000) and be medically treated for PSD before discharge (χ2 = 5.57, p = .018). Nurses’ documentation of screening results also improved (χ2 = 9.19, p = .002). Conclusion: Implementation of the Evidence Based Depression Screening and Treatment (EBDST) protocol improved early detection and treatment of PSD in the hospitalized patients with acute stroke before discharge. The EBDST protocol promoted systematic evidence-based depression screening in the hospitalized patients with acute stroke. Use of the EBDST protocol may further improve long-term health outcomes, decrease mortality, and improve functional recovery and quality of life.
Perforated Appendicitis: Nurse Practitioner Follow-Up Telephone Calls Reducing Unplanned Return to Care With/Without Readmission
Authors: O’Donnell Ellen Ann , Micalizzi Rosella , Phinney Caitlin , Lemire Lindsay , Dawson Michelle 
Published: September 2016

TOPIC
This is about the impact of nurse practitioner (NP) telephone follow-up in the prevention of unplanned return to care for patients with perforated appendicitis.

Background
Perforated appendicitis is a high-volume diagnosis managed by NPs in the ambulatory surgical clinic at the Boston Children’s Hospital. Patients’ symptoms and well-being are routinely assessed with serial follow-up telephone calls while on home antibiotic therapy to coordinate extension or discontinuation of antibiotic therapy. Patients received a telephone call by an NP within 2 business days. The intent of the call is to assess the patient’s current clinical status through an in-depth symptom analysis, clarify antibiotic therapy, reinforce discharge education, and answer questions. It also allows the NP to determine if an interim NP appointment is needed.

Method and Design
Population: This shows a retrospective chart review of pediatric patients with a diagnosis of perforated appendicitis undergoing home antibiotic therapy.

Inclusion Criteria
The following are the inclusion criteria: patients diagnosed with perforated appendicitis and discharged home on intravenous and oral antibiotic therapy.

Data Analysis
Data regarding patient receipt of telephone call—collection of symptom analysis, antibiotic regimen, and patient well-being—were collected. Data will be used to assess if preventative telephone follow-up by NPs and the provision of anticipatory patient/family education may lead to the earlier detection and management of potential complications.

Conclusion
An NP follow-up telephone call may help reduce the total number of unplanned emergency department visits and, potentially, hospital readmission.
Allogeneic hematopoietic stem cell transplantation for dyskeratosis congenita
Authors: Elmahadi Shaimaa , Muramatsu Hideki , Kojima Seiji 
Published: September 2016

Purpose of reviewDyskeratosis congenita is an inherited bone marrow failure syndrome caused by defects in telomere maintenance. Hematopoietic stem cell transplantation (HSCT) is the only curative treatment for bone marrow failure because of dyskeratosis congenita. The present review summarizes the literature with respect to the diagnosis and treatment of patients with dyskeratosis congenita who received HSCT, and discusses the recent progress in the management of dyskeratosis congenita.Recent findingsThe recent systematic review of the literature showed poor long-term outcome, with 10-year survival estimates of only 23% in 109 patients with dyskeratosis congenita who received HSCT. Multivariate analysis identified age greater than 20 years at HSCT, HSCT before 2000, and alternative donor source to be poor prognostic markers. HSCT for dyskeratosis congenita is characterized by a marked decline in long-term survival because of late deaths from pulmonary complications. However, a prospective study using danazol showed promising results in gain in telomere length and hematologic responses.SummaryA recent prospective study may support the recommendation that HSCT is not indicated for patients with dyskeratosis congenita; instead, they should receive androgen, particularly danazol, as a first-line therapy. Another option may be routine use of androgen after HSCT for the prophylaxis of pulmonary fibrosis.
Recent progress in understanding skills and impairments in social cognition
Authors: Happé Francesca , Conway Jane R. 
Published: September 2016

Purpose of review
Social interaction is affected in many different developmental disorders; indeed, the new Diagnostic and Statistical Manual of Mental Disorders has introduced social cognition as one of six core components of neurocognitive functioning. Social cognition is not one thing, but a wide range of putative processes, which may be differentially affected in different clinical groups. This review focuses on recent advances in one aspect of social cognition, ‘theory of mind’ (ToM, representing what people think), and one core clinical group, autism spectrum disorder (ASD).

Recent findings
It is 30 years since impaired ToM was proposed as an explanation for ASD social difficulties, and recently there has been a widening of interest to other clinical groups. ToM has been found to be distinct from emotion recognition and empathy. Recent research on ASD has focused increasingly on atypical sensory responses and commonly comorbid conditions. Interventions for social deficits, including ToM training and oxytocin, have shown mixed results to date.

Summary
Heterogeneity poses a major obstacle to current research. Theoretical and empirical refinements are needed to elucidate neurocognitive and aetiological underpinnings of sociocognitive processes and inform clinical advances.
The microbiome in asthma
Authors: Noval Rivas Magali , Crother Timothy R. , Arditi Moshe 
Published: September 2016

Purpose of review
Asthma is a complex and heterogeneous disease with strong genetic and environmental components that manifests within a variety of clinical features and diverse patterns of immune responses. Asthma prevalence has dramatically increased over the last decade in Westernized societies, thereby suggesting a key function of environmental factors in disease promotion and development.

Recent findings
‘Early-life’ microbial exposure and bacterial colonization are crucial for the maturation and the education of the immune system. The commensal flora is also critical in order to maintain immune homeostasis at the mucosal surfaces and may consequently play an important function in allergic disease development. Recent evidence demonstrates that asthma influences and is also impacted by the composition and function of the human intestinal and respiratory microbiome.

Summary
In this review, we summarize the most recent findings on how asthma development is connected with respiratory and intestinal microbial dysbiosis. We highlight and discuss recent research that reveals the existence of a ‘gut–lung’ microbial axis and its impact on asthma development. We also analyze how ‘early-life’ microbial exposure affects the immune response and the consequences for asthma development.
Text Messaging Effect on Adherence in Children With Inflammatory Bowel Disease
Authors: Miloh Tamir , Shub Mitchell , Montes Ramon , Ingebo Kristy , Silber Gary , Pasternak Brad 
Published: September 2016

ABSTRACTBackground:Successful treatment of patients with inflammatory bowel disease (IBD) requires regular intake of medication. Nonadherence to treatment is associated with increased frequency of relapses, morbidity, and cost.Methods:Pediatric patients with IBD taking oral medication and with access to text messaging (TM) services were included. Children were randomized by age, sex, medication administration responsibility (self vs parent), and disease activity (Pediatric Crohn Disease Activity Index or Pediatric Ulcerative Colitis Activity Index) into TM intervention and standard of care. Prospectively, the interventional group received 2‐way TM reminders about medication administration. Failure to confirm intake by the patient resulted in a TM alert to the caregiver and weekly compliance reports were sent to patients, caregivers, and healthcare providers. Patients’ medical records were reviewed and an adherence Morisky questionnaire completed at recruitment, 6 and 12 months.Results:A total of 51 children were randomized (21 TM and 30 control). The age, sex, diagnosis (ulcerative colitis/Crohn), activity index, ethnicity, insurance, and Morisky score at baseline were similar in both groups. Morisky score improved by 1 and 0.8 points, respectively in the TM group at 6 and 12 months, whereas it did not change in the control group (P = 0.0131 and P = 0.1687, prospectively).Conclusions:TM may be effective in promoting adherence in children with IBD. Larger and longer multicenter studies are required to confirm this finding.
Dissection of the contribution of regulation mode to the properties of feedforward and feedback gene regulatory motifs
Authors: Iyengar Bharat Ravi , Pillai Beena , Venkatesh K.V. , Gadgil Chetan J. 
Published: September 2016

AbstractWe present a framework enabling dissection of the effects of motif structure (feedback or feedforward), nature of the controller (mRNA or protein), and regulation mode (transcriptional, post-transcriptional or translational) on the response to a step change in the input. We have used a common model framework for gene expression where both motif structures have an activating input and repressing regulator, with the same set of parameters to enable comparison of the responses. We studied the global sensitivity of the system properties such as steady-state gain, overshoot, peak time, and peak duration, to parameters. We find that, in all motifs, overshoot correlated negatively whereas peak duration varied concavely, with peak time. Differences in other system properties were found to be mainly dependent on the the nature of the regulator, than the motif structure. Protein mediated motifs showed a higher degree of adaptation; feedforward motifs exhibited perfect adaptation. RNA mediated motifs had a mild regulatory effect; they also exhibited lower peaking tendency and mean overshoot. Protein mediated feedforward motifs showed higher overshoot and lower peak time compared to corresponding feedback motifs.
Molecular adaptation in Rubisco: discriminating between convergent evolution and positive selection using mechanistic and classical codon models
Authors: Parto Sahar , Lartillot Nicolas 
Published: September 2016

AbstractRubisco (Ribulose-1, 5-biphosphate carboxylase/oxygenase) is the most important enzyme on earth, catalyzing the first step of CO2 fixation in photosynthesis. Its molecular adaptation to C4 photosynthetic pathway has attracted a lot of attention. C4 plants, which comprise less than 5% of land plants, have evolved more efficient photosynthesis compared to C3 plants. Interestingly, a large number of independent transitions from C3 to C4 phenotype have occurred. Each time, the Rubisco enzyme has been subject to similar changes in selective pressure, thus providing an excellent model for convergent evolution at the molecular level. Molecular adaptation is often identified with positive selection and is typically characterized by an elevated ratio of non-synonymous over synonymous substitution rates (dN/dS). However, convergent adaptation is expected to leave a different molecular signature, taking the form of repeated transitions toward identical or similar amino acids.Here, we use a previously introduced codon-based differential selection model to detect and quantify consistent patterns of convergent adaptation in Rubisco in Amaranthaceae. We further contrast the results thus obtained with those obtained under classical codon models based on the estimation of dN/dS. We find that the two classes of models tend to select distinct, although overlapping, sets of positions. This discrepancy in the results illustrates the conceptual difference between these models, while emphasizing the need to better discriminate between qualitatively different selective regimes, by using a broader class of codon models than those currently considered in molecular evolutionary studies.
Transcriptome analysis revealed the possible contribution of chromosome introgression fragments from Sea Island cotton (Gossypium barbadense) to fiber strength in Upland cotton (Gossypium hirsutum)
Authors: Lu Quanwei , Shi Yuzhen , Xiao Xianghui , Li Pengtao , Gong Juwu , Liu Aiying , Shang Haihong , Gong Wankui , Chen Tingting , Ge Qun , Li Junwen , Su Wei , Li Shaoqi , Zhang Zhen , Yuan Youlu , Huang Jinling 
Published: September 2016

AbstractCotton fiber strength is a critical property determining fiber qualities, and determined by the secondary cell wall development. Understanding the mechanism of fiber development will provide a way to improvement of fiber strength. In this study, the introgression lines of upland and sea island cotton, and have experience of four generations of backcross with upland parent, and have significant higher fiber strength than their upland parent, and the transcriptome were analyzed and compared between the introgression lines and their upland parent. There were 2201 differentially expressed genes (DEG) identified by comparing two introgression lines with their recurrent parent CCRI45, in different development stages from 15 days post-anthesis (DPA) to 28 DPA. The up-regulated genes regulated the polysaccharide metabolic process, single-organism localization, cell wall organization or biogenesis and so on. The down-regulated genes involved in the microtubule-based process, cellular response to stress, cell cycle process and so on. Further functional analysis revealed three significant functional genes, XLOC_036333 (mannosyl-oligosaccharide-alpha-mannosidase mns1), XLOC_029945 (FLA8) and XLOC_075372 (snakin-1), playing important roles in the regulation of cotton fiber strength. Our results provide important candidates genes and inspirations for the future investigation of the molecular mechanism of fiber quality formation, and improvement of cotton fiber quality in breeding.
A living vector field reveals constraints on galactose network induction in yeast
Authors: Stockwell Sarah R. , Rifkin Scott A. 
Published: September 2016

AbstractWhen a cell encounters a new environment, its transcriptional response can be constrained by its history. For example, yeast cells in galactose induce GAL genes with a speed and unanimity that depends on previous nutrient conditions. To investigate how cell-level gene expression dynamics produce population-level phenotypes, we built living vector fields from thousands of single-cell timecourses of the inducers Gal3p and Gal1p as cells switched to galactose from various nutrient histories. We show that, after sustained glucose exposure, the lack of GAL inducers leads to induction delays that are long but also variable; that cellular resources constrain induction; and that bimodally distributed expression levels arise from lineage selection -a subpopulation of cells induces more quickly and outcompetes the rest. Our results illuminate cellular memory in this important model system and illustrate how resources and randomness interact to shape the response of a population to a new environment.One Sentence SummarySingle-cell galactose induction timecourses reveal that cellular resources and stochastic events determine which yeast cells outcompete their peers.