bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Peripapillary OCT Angiography Vessel Density and Retinal Nerve Fiber Layer Thickness Measurements for Their Ability to Detect Progression in Glaucoma
Authors: Holló Gábor 
Published: January 2018

Purpose:
The aim of this study was to investigate the applicability of peripapillary optical coherence tomography angiography angioflow vessel density measurements in the retinal nerve fiber layer for the detection of glaucomatous progression and to compare its performance with that of retinal nerve fiber layer thickness (RNFLT) measurements.

Methods:
Prospective RNFLT and vessel density measurements with the same Angiovue/RTVue-XR instrument were made immediately one after another on 1 eye of 9 normal eyes, 20 under treatment ocular hypertension eyes, and 24 under treatment open angle glaucoma eyes at 6-month intervals for 2 years (5 visits for all eyes). High image quality (signal strength index 50 to 91) was obtained for all measurements. No surgery was performed on any study eye during the study period. The normal and OHT cases were combined for comparison with the glaucoma group.

Results:
A statistically significant negative RNFLT slope was found in 16 eyes, whereas no eye had a significant negative vessel density slope (P<0.0001). The relative RNFLT and vessel density slopes were significantly different in the combined normal and OHT group, the glaucoma group, and the total population, respectively (P<0.0001). For the same groups, the relative residual SD was significantly higher for vessel density than for RNFLT measurements (P≤0.0019). The relative residual SD of RNFLT measurements was higher in the glaucoma group than in the combined normal and OHT group (P=0.0056), whereas the relative residual SD of vessel density measurements did not differ between the groups (P=0.3032).

Conclusion:
In this 2-year prospective study, peripapillary vessel density measurement did not support the detection of glaucomatous progression.
Association Between Optic Disc Hemorrhage and Renal Function in South Korea
Authors: Lee Jae Yeun , Kim Joon Mo , Shim Seong Hee , Lee Jin Young , Yoo Chungkwon , Won Yu Sam , Hyun Young Youl , Park Ki Ho 
Published: January 2018

Purpose:
The purpose of this article is to investigate the relationship between renal function and disc hemorrhage (DH).

Materials and Methods:
This retrospective cross-sectional survey was conducted at Kangbuk Samsung Hospital Health Screening Center between August 2012 and July 2013, and a total of 168,044 participants at least 20 years of age who voluntarily visited the health screening center for systemic and ophthalmologic examinations, including fundus photography, were enrolled. All subjects underwent a physical examination and provided samples for laboratory analysis. Digital fundus photographs of both eyes were taken and reviewed. Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine concentration using the Modification of Diet in Renal Disease (MDRD) formula and Cockcroft-Gault (CG) formula. Subjects were stratified by eGFR into quartiles.

Results:
Among participants, 220 (0.1%) showed DH, and 2376 (1.6%) showed glaucomatous retinal nerve fiber layer defects. The DH group showed higher creatinine and lower eGFR than the non-DH group. A significant trend was observed among higher creatinine, decreased eGFR as obtained by the MDRD and CG formulas, and the prevalence of DH (P for trend ≤0.003, logistic regression analysis). A multiple logistic regression model adjusted for age, sex, hypertension, diabetes, and hyperlipidemia showed that the lowest eGFR quartiles estimated by MDRD and CG were significantly associated with DH compared with the highest eGFR quartile (adjusted odds ratio, 1.96; 95% confidence interval, 1.22-3.14 by CG, 1.86; 95% confidence interval, 1.17-2.96 by MDRD).

Conclusion:
Renal function impairment was independently associated with a higher prevalence of DH in a South Korean population.
Functional Capacity but Not Early Uptake of Cardiac Rehabilitation Predicts Readmission in Patients With Metabolic Syndrome
Authors: Siegmund Lee Anne , Albert Nancy M. , McClelland Mark S. , Bena James F. , Morrison Shannon L. 
Published: January 2018

Background:
Phase II cardiac rehabilitation reduces hospital readmissions and cardiovascular disease risk factors and improves functional capacity. Cardiovascular disease risk factors double with patients with metabolic syndrome, a population less likely to adhere to cardiac rehabilitation.

Purpose:
The aim of this study was to determine relationships between cardiac rehabilitation uptake timing, demographic variables and functional capacity, and readmission in patients with metabolic syndrome.

Methods:
This retrospective, medical records study involved 353 patients with metabolic syndrome who subsequently received cardiac rehabilitation. Logistic regression was used to examine relationships between time from discharge to cardiac rehabilitation uptake and readmission. Unordered categorical factors were compared between readmission groups using Pearson χ2 tests. Multivariable logistic regression was used to identify predictors of readmission.

Results:
Patients readmitted within 30 and 90 days of hospitalization were more often women (P ≤ .018) and nonwhite (P ≤ .002) and had lower functional capacity (P < .001). In multivariable analysis, white race (odds ratio [OR], 0.50 [95% confidence interval (CI), 0.25–0.99]; P = .045) and higher functional capacity (OR, 0.80 [95% CI, 0.68–0.93]; P = .005) were protective against hospital readmission within the first 90 days. Race, sex, and functional capacity remained significant predictors of readmission at 1 year. In multivariable analysis, only race (OR, 0.41 [95% CI, 0.22–0.79]; P = .007) and functional capacity (OR, 0.83 [95% CI, 0.73–0.95]; P = .007) were significant. Early cardiac rehabilitation was not associated with readmission at any time point (P > .05).

Conclusions:
Sex, race, and functional capacity were important predictors of readmission for metabolic syndrome, even when cardiac rehabilitation intake was delayed. Results raise questions about the unique traits of patients with metabolic syndrome and need for novel approaches to improve cardiac rehabilitation utilization and functional capacity in metabolic syndrome.
Integrating Quantitative Pupillometry Into Regular Care in a Neurotrauma Intensive Care Unit
Authors: Anderson Maighdlin , Elmer Jonathan , Shutter Lori , Puccio Ava , Alexander Sheila 
Published: January 2018

ABSTRACT
In the setting of acute traumatic brain injury (TBI), an abnormal pupil assessment may suggest a worsening intracranial lesion. Early detection of pupillary changes may expedite emergent care to improve outcomes. Automated, handheld pupillometers have been commercially available for 20 years, and several studies suggest that their use may facilitate early recognition of worsening injury and intracranial hypertension. The use of pupillometry as a bedside tool in the routine care of patients with severe TBI (Glasgow Coma Scale score ≤ 8) has not been described. We performed a quality improvement project to implement routine use of quantitative pupillometry in our neurotrauma intensive care unit. Nursing staff were trained on device use and the project’s aims in a 30-minute in-service session. Nurses caring for severe TBI patients completed standard pupil assessments using (a) a flashlight and (b) a pupillometer to quantify pupil size and reactivity (Neurological Pupil index) every hour. Abnormal results were reported to on-call providers. We administered surveys to evaluate knowledge, practical use of the pupillometer data, and satisfaction with the device every 3 months. Data were available for 22 nurses at 4 separate time points. Staff were positive about their ability to use and understand the device (µ = 8.7 and 9.1, respectively, on a 10-point scale) and reported that it added value to patient care and critical decision-making. Use of automated pupillometry is acceptable to nursing staff in a neurotrauma intensive care unit, and staff believed that pupillometry results enhanced clinical decision-making.
Experiences Related to Urinary Incontinence of Stroke Patients: A Qualitative Descriptive Study
Authors: Arkan Gulcihan , Beser Ayse , Ozturk Vesile 
Published: January 2018

ABSTRACT

Introduction: Poststroke urinary incontinence is a common problem, with a prevalence ranging from 32% to 79%. Urinary incontinence after stroke has negative physiological, psychological, and economic effects, which lead to lifestyle changes for both patients and caregivers. Nurses play an important role in preventing and improving incontinence, understanding the experiences of individuals experiencing incontinence, providing healthcare for them, and implementing behavioral therapy methods. The aim of this study was to determine the experience related to urinary incontinence of stroke patients. Methods: In this qualitative descriptive study, using semistructured interviews, 15 participants with urinary incontinence after stroke selected through purposeful sampling were interviewed. Data were collected with a semistructured interview form prepared within the framework of the Health Belief Model. All data were analyzed using content analysis. Results: Three main themes were identified: “perception of urinary incontinence,” “effects of urinary incontinence,” and “management of urinary incontinence.” The respondents explained that urinary incontinence also adversely affected their caregivers. They experienced many daily life and psychological problems because of urinary incontinence. In addition, they made several changes to management urinary incontinence such as limiting fluid intake, changing underwear frequently, using waterproof mattress protectors, applying traditional practice, and taking medicine. Conclusions: This study revealed that stroke patients needed help and support for urinary incontinence management. Nurses should provide information about management and urinary incontinence after stroke.
Alzheimer Disease and Related Disorders and Out-of-Pocket Health Care Spending and Burden Among Elderly Medicare Beneficiaries
Authors: Dwibedi Nilanjana , Findley Patricia A. , Wiener R Constance , Shen Chan , Sambamoorthi Usha 
Published: January 2018

Objective:
To estimate the excess burden of out-of-pocket health care spending associated with Alzheimer disease and related disorders (ADRD) among older individuals (age 65 y and older).

Methods:
We adopted a retrospective, cross-sectional study design with data from 2012 Medicare Current Beneficiary Survey. The study sample comprised of elderly community-dwelling individuals who had positive total health care expenditures, and enrolled in Medicare throughout the calendar year (462 with ADRD, and 7160 without ADRD). We estimated the per-capita total annual out-of-pocket spending on health care and out-of-pocket spending by service type: inpatient, outpatient, home health, prescription drugs, and other services. We measured out-of-pocket spending burden by calculating the percentage of income spent on health care and defined high out-of-pocket spending burden as having this percentage above 10%. Multivariable analyses included ordinary least squares regressions and logistic regressions and these analyses adjusted for predisposing, enabling, need, personal health care practices and external environment characteristics.

Results:
The average annual per-capita out-of-pocket health care spending was greater among individuals with ADRD compared with those without ADRD ($3285 vs. $1895); home health and prescription drugs accounted for 52% of total out-of-pocket spending among individuals with ADRD and 34% among individuals without ADRD. Elderly individuals with ADRD were more likely to have high out-of-pocket spending burden (adjusted odds ratio, 1.49; 95% confidence interval, 1.13–1.97) compared with those without ADRD.

Conclusion:
ADRD is associated with excess out-of-pocket health care spending, primarily driven by prescription drugs and home health care use.
Impact of Medication Adherence on Health Services Utilization in Medicaid
Authors: Roebuck Mark C. , Kaestner Robert J. , Dougherty Julia S. 
Published: January 2018

Objective:
To examine the impact of adherence to chronic disease medications on health services utilization among Medicaid enrollees.

Subjects:
Eligibility, claims, and encounter data from the Medicaid Analytic Extract files from 10 states (Alabama, California, Florida, Illinois, Indiana, Louisiana, New Hampshire, New Mexico, New York, and Virginia) were used to construct a 3-year (2008–2010), longitudinal dataset of Medicaid recipients 18–64 years of age, including 656,646 blind/disabled individuals and 704,368 other adults. Patients were classified as having ≥1 of 7 chronic conditions: (1) congestive heart failure; (2) hypertension; (3) dyslipidemia; (4) diabetes; (5) asthma/chronic obstructive pulmonary disease; (6) depression; and (7) schizophrenia/bipolar.

Methods:
Poisson regression was used to estimate associations between medication adherence [continuous and categorical proportion of days covered (PDC)] and 3 dependent variables: number of inpatient hospitalizations, emergency department visits, and outpatient physician/clinic visits.

Results:
Full adherence was associated with 8%–26% fewer hospitalizations and 3%–12% fewer emergency department visits among those with congestive heart failure, hypertension, diabetes, and schizophrenia/bipolar. In all analyses, full adherence was associated with up to 15% fewer outpatient physician/clinic visits. Moreover, low and moderate levels of adherence were also related to less health care use.

Conclusions:
Substantial reductions in health services utilization and costs may be realized with improved medication adherence in Medicaid. These benefits begin to accrue at adherence levels below the common 0.80 PDC threshold. Therefore, interventions should focus not just on perfecting moderate adherers, but also on encouraging Medicaid patients with chronic conditions to initiate pharmacotherapy.
Higher Recurrence Rate After Endoscopic Totally Extraperitoneal (TEP) Inguinal Hernia Repair With Ultrapro Lightweight Mesh
Authors: Roos Marleen , Bakker Wouter J. , Schouten Nelleke , Voorbrood Charlotte , Clevers Geert Jan , Verleisdonk Egbert Jan , Davids Paul , Burgmans Josephina 
Published: January 2018

Objective:
The aim of this study was to determine inguinal hernia recurrence rates 5 years after endoscopic totally extraperitoneal (TEP) inguinal hernia repair when either lightweight or heavyweight mesh was used.

Background:
Recurrence is an important complication of inguinal hernia surgery. Higher recurrence rates of Ultrapro lightweight meshes after TEP repair have been demonstrated, yet data regarding long-term follow-up are limited.

Methods:
From 2010 to 2012, 950 male adult patients with primary unilateral hernias were randomized to TEP hernia repair with heavyweight (Prolene) or lightweight (Ultrapro) mesh. Five years postoperatively, the validated PINQ-PHONE telephone questionnaire was carried out. Participants with a positive questionnaire reply were scheduled for a clinical visit. A recurrence was defined as a clinically detectable bulge in the operated groin on physical examination.

Results:
Data on development of recurrence could be obtained from 790 patients (83.2% 5-year follow–up rate). Four patients presented with a recurrence at the outpatient clinic between 2 and 5 years postoperatively. Thirty-five patients (4.6%) with a positive PINQ-PHONE reply (60.0% lightweight vs 40.0% heavyweight) were physically examined at the outpatient clinic. In 2 patients (lightweight) a recurrence was detected. The total 5-year recurrence rate after TEP hernia repair was 2.4% (3.8% lightweight, 1.1% heavyweight, P = 0.01). A significantly higher recurrence rate for lightweight mesh in primary direct hernias was found (P = 0.003).

Conclusions:
The overall recurrence rate 5 years after TEP repair was low. Ultrapro lightweight meshes showed higher recurrence rates than heavyweight meshes and are not recommended for endoscopic TEP inguinal hernia repair.
Mucus Microbiome of Anastomotic Tissue During Surgery Has Predictive Value for Colorectal Anastomotic Leakage
Authors: van Praagh Jasper B. , de Goffau Marcus C. , Bakker Ilsalien S. , van Goor Harry , Harmsen Hermie J. M. , Olinga Peter , Havenga Klaas 
Published: January 2018

Objective:
The aim of the present study is to investigate the association of gut microbiota, depending on treatment method, with the development of colorectal anastomotic leakage (AL).

Background:
AL is a major cause for morbidity and mortality after colorectal surgery, but the mechanism behind this complication still is not fully understood.

Methods:
Bacterial DNA was isolated from 123 “donuts” of patients where a stapled colorectal anastomosis was made and was analyzed using 16S MiSeq sequencing. In 63 patients, this anastomosis was covered with a C-seal, a bioresorbable sheath stapled to the anastomosis.

Results:
In non-C-seal patients, AL development was associated with low microbial diversity (P = 0.002) and correspondingly with a high abundance of the dominant Bacteroidaceae and Lachnospiraceae families (P = 0.008 and 0.010, respectively). In C-seal samples, where AL rates were slightly higher (25% vs 17%), an association with the gut microbiota composition was almost undetectable. Only a few opportunistic pathogenic groups of low abundance were associated with AL in C-seal patients, in particular Prevotella oralis (P = 0.007).

Conclusions:
AL in patients without a C-seal can be linked to the intestinal microbiota, in particular with a low microbial diversity and a higher abundance of especially mucin-degrading members of the Bacteroidaceae and Lachnospiraceae families. In C-seal patients, however, it seems that any potential protective benefits or harmful consequences of the gut microbiota composition in regard to wound healing are negated, as progression to AL is independent of the initially dominant bacterial composition.
Olfactory and Vomeronasal Receptor Feedback Employ Divergent Mechanisms of PERK Activation
Authors: Dalton Ryan P , Karagöz G Elif , Kahiapo Jerome , Sharma Ruchira , Bashkirova Lisa E , Lyons David B. , Matsunami Hiroaki , Walter Peter 
Published: January 2018

AbstractMutually-exclusive chemoreceptor expression in olfactory and vomeronasal sensory neurons (OSNs and VSNs) enables odorant discrimination. This configuration involves chemoreceptor mediated activation of the endoplasmic reticulum (ER)-resident kinase PERK. PERK drives translation of the transcription factor ATF5 to preclude additional chemoreceptor expression. ATF5 translation is transient in OSNs but persistent in VSNs, suggesting chemoreceptor-specific modes of PERK activation. Herein, we showed that the ER-lumenal domain (LD) of PERK recognized vomeronasal receptor (VR)-derived peptides, suggesting direct PERK activation drives persistent ATF5 translation in VSNs. In contrast, PERK LD did not recognize olfactory receptor (OR)-derived peptides in vitro, and facilitating OR maturation in vivo prevented PERK activation, suggesting that ORs activate PERK indirectly through a failure to exit the ER. Importantly, impairing or prolonging ATF5 expression drove specific chemoreceptor repertoire biases. Together, these results demonstrate mechanistic divergence in chemoreceptor feedback and establish that differences in PERK activation promote qualitatively different gene regulatory results.
The Trithorax group protein dMLL3/4 instructs the assembly of the zygotic genome at fertilization
Authors: Prudêncio Pedro , Guilgur Leonardo G. , Sobral João , Becker Jörg D. , Martinho Rui Gonçalo , Navarro-Costa Paulo 
Published: January 2018

ABSTRACTThe transition from fertilized oocyte to totipotent embryo relies on maternally-provided factors that are synthetized and accumulated in developing oocytes. Yet, it is still unclear how oocytes regulate the expression of these embryo fate-promoting genes within the general transcriptional program of oogenesis. Here we report that theDrosophilaTrithorax group protein MLL3/4 (dMLL3/4, also known as Trr) is essential for the transition to embryo fate at fertilization. In the absence of dMLL3/4, oocytes develop normally but fail to initiate the embryo mitotic divisions after fertilization. This incapability results from defects in both paternal genome reprogramming and maternal meiotic completion. We show that, during oogenesis, dMLL3/4 promotes the expression of a functionally coherent gene subset that is later required for the correct assembly of the zygotic genome. Accordingly, we identify the evolutionarily-conserved IDGF4 glycoprotein (known as oviductin in mammals) as a new oocyte-to-embryo transition gene under dMLL3/4 transcriptional control. Based on these observations, we propose that dMLL3/4 plays an instructive role in the oocyte-to-embryo transition that is functionally uncoupled from the requirements of normal oocyte differentiation.
UBE3A–mediated p18/LAMTOR1 ubiquitination and degradation regulate mTORC1 activity and synaptic plasticity
Authors: Sun Jiandong , Liu Yan , Jia Yousheng , Tran Jennifer , Hao Xiaoning , Lin Weiju , Lynch Gary , Baudry Michel , Bi Xiaoning 
Published: January 2018

AbstractAccumulating evidence indicates that the lysosomal Ragulator complex is essential for full activation of the mechanistic target of rapamycin complex 1 (mTORC1). Abnormal mTORC1 activation has been implicated in several developmental neurological disorders, including Angelman syndrome (AS), which is caused by maternal deficiency of the ubiquitin E3 ligase UBE3A. Here we report that Ube3a regulates mTORC1 signaling by targeting p18, a subunit of the Ragulator. Ube3a ubiquinates p18, resulting in its proteasomal degradation, and Ube3a deficiency in hippocampus of AS mice results in increased lysosomal localization of p18 and other members of the Ragulator-Rag complex, such as RagA, and increased mTORC1 activity. P18 down-regulation by siRNA or shRNA in hippocampal CA1 neurons of AS mice reduces elevated mTORC1 activity and improves long-term potentiation (LTP) and dendritic spine maturation. Our results indicate that Ube3a-mediated regulation of p18 and subsequent mTORC1 signaling is critical for typical synaptic plasticity and dendritic spine development.
The method of modeling the human EEG by calculating radial traveling waves on the folded surface of the human cerebral cortex
Authors: Verkhlyutov Vitaly M. , Balaev Vladislav V. 
Published: January 2018

AbstractThere are many data about traveling waves in the cortex of animals such as rats, ferrets, monkey, and even birds. Waves registered invasively using electrical and optical imaging techniques. Such registration is not possible in healthy man.Non-invasive EEG recordings show scalp waves propagation at rates two orders greater than the data obtained invasively in animal experiments. At the same time, it has recently been argued that the traveling waves of both local and global nature do exist in the human cortex. We have developed a novel methodology for simulation of EEG as produced by depolarization waves with parameters taken from animal models. We simulate radially propagating waves, taking into account the complex geometry of the surface of the gyri and sulci in the areas of the visual, motor, somatosensory and auditory cortex. The dynamics of the distribution of electrical fields on the scalp in our simulations is consistent with the EEG data recorded in humans.