bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of high-resolution anorectal manometry and wireless motility capsule in the evaluation of patients with Parkinson's disease and chronic constipation
Authors: Su Andrew , Gandhy Rita , Barlow Carrolee , Triadafilopoulos George 
Published: October 2016

BackgroundThe aetiology of constipation in Parkinson's disease remains poorly understood. Defaecatory dyssynergia, anal sphincter spasticity and slow transit constipation may, individually or collectively, play a role.AimsIn this retrospective cohort analysis of patients with Parkinson's disease and chronic constipation, we determined the utility of high-resolution anorectal manometry, balloon expulsion and wireless motility capsule testing in defining the underlying aetiology for constipation.MethodsIn this retrospective cohort study, consecutive patients with Parkinson's disease and chronic constipation underwent clinical assessment, manometry with balloon expulsion and wireless motility capsule testing using standard protocols.ResultsWe studied 66 patients fulfilling Rome IV criteria for functional constipation. Most patients (89%) had abnormal manometry, exhibiting various types of defaecatory dyssynergia (mostly types II and IV), abnormal balloon expulsion, diminished rectal sensation and, in some, lacking rectoanal inhibitory reflex. 62% exhibited colonic transit delay by wireless motility capsule study, while 57% had combined manometric and transit abnormalities, suggesting of overlap constipation. Symptoms of infrequent defaecation, straining and incomplete evacuation were not discriminatory. There was a relationship between constipation scores and colonic transit times (p=0.01); Parkinson's disease scores and duration were not correlated with either the manometric or transit findings. Faecal incontinence was seen in 26% of the patients.ConclusionsChronic constipation in patients with Parkinson's disease may reflect pelvic floor dyssynergia, slow transit constipation or both, and may be associated with faecal incontinence, suggesting both motor and autonomic dysfunction. Anorectal manometry and wireless motility capsule testing are useful in the assessment of these patients.
Ophthalmologists' practice patterns and challenges in achieving optimal management for glaucoma in Nigeria: results from a nationwide survey
Authors: Kyari Fatima , Nolan Winifred , Gilbert Clare 
Published: October 2016

Purpose of the studyGlaucoma, a chronic non-communicable disease, and leading cause of irreversible blindness worldwide is a public health problem in Nigeria, with a prevalence of 5.02% in people aged ≥40 years. The purpose of this nationwide survey was to assess Nigerian ophthalmologists’ practice patterns and their constraints in managing glaucoma.Study designOphthalmologists were sent a semistructured questionnaire on how they manage glaucoma, their training in glaucoma care, where they practice, their access to equipment for diagnosis and treatment, whether they use protocols and the challenges they face in managing patients with glaucoma.Results153/250 ophthalmologists in 80 centres completed questionnaires. Although 79% felt their training was excellent or good, 46% needed more training in glaucoma diagnosis and surgery. All had ophthalmoscopes, 93% had access to applanation tonometers, 81% to visual field analysers and 29% to laser machines (in 19 centres). 3 ophthalmologists had only ophthalmoscopes and schiøtz tonometers. For 85%, a glaucomatous optic disc was the most important feature that would prompt glaucoma work-up. Only 56% routinely performed gonioscopy and 61% used slit-lamp stereoscopic biomicroscopy for disc assessment. Trabeculectomy (with/without antimetabolites) was the only glaucoma surgery performed with one mention of canaloplasty. Poor compliance with medical treatment (78%) and low acceptance of surgery (71%) were their greatest challenges.ConclusionsThis study indicates that a systems-oriented approach is required to enhance ophthalmologist's capability for glaucoma care. Strategies to improve glaucoma management include strengthening poorly equipped centres including provision of lasers and training, and improving patients’ awareness and education on glaucoma.
Treatment for paediatric chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) and comorbid depression: a systematic review
Authors: Loades Maria E , Sheils Elizabeth A , Crawley Esther 
Published: October 2016

ObjectivesAt least 30% of young people with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) also have symptoms of depression. This systematic review aimed to establish which treatment approaches for depression are effective and whether comorbid depression mediates outcome.SettingA systematic review was undertaken. The search terms were entered into MEDLINE, EMBASE, PsycInfo and the Cochrane library.ParticipantsInclusion and exclusion criteria were applied to identify relevant papers. Inclusion criteria were children age <18, with CFS/ME, defined using CDC, NICE or Oxford criteria, and having completed a valid assessment for depression.Results9 studies were identified which met the inclusion criteria, but none specifically tested treatments for paediatric CFS/ME with depression and none stratified outcome for those who were depressed compared with those who were not depressed. There is no consistent treatment approach for children with CFS/ME and comorbid depression, although cognitive–behavioural therapy for CFS/ME and a multicomponent inpatient programme for CFS/ME have shown some promise in reducing depressive symptoms. An antiviral medication in a small scale, retrospective, uncontrolled study suggested possible benefit.ConclusionsIt is not possible to determine what treatment approaches are effective for depression in paediatric CFS/ME, nor to determine the impact of depression on the outcome of CFS/ME treatment. Young people with significant depression tend to have been excluded from previous treatment studies.
Evolution of primary care databases in UK: a scientometric analysis of research output
Authors: Vezyridis Paraskevas , Timmons Stephen 
Published: October 2016

ObjectiveTo identify publication and citation trends, most productive institutions and countries, top journals, most cited articles and authorship networks from articles that used and analysed data from primary care databases (CPRD, THIN, QResearch) of pseudonymised electronic health records (EHRs) in UK.MethodsDescriptive statistics and scientometric tools were used to analyse a SCOPUS data set of 1891 articles. Open access software was used to extract networks from the data set (Table2Net), visualise and analyse coauthorship networks of scholars and countries (Gephi) and density maps (VOSviewer) of research topics co-occurrence and journal cocitation.ResultsResearch output increased overall at a yearly rate of 18.65%. While medicine is the main field of research, studies in more specialised areas include biochemistry and pharmacology. Researchers from UK, USA and Spanish institutions have published the most papers. Most of the journals that publish this type of research and most cited papers come from UK and USA. Authorship varied between 3 and 6 authors. Keyword analyses show that smoking, diabetes, cardiovascular diseases and mental illnesses, as well as medication that can treat such medical conditions, such as non-steroid anti-inflammatory agents, insulin and antidepressants constitute the main topics of research. Coauthorship network analyses show that lead scientists, directors or founders of these databases are, to various degrees, at the centre of clusters in this scientific community.ConclusionsThere is a considerable increase of publications in primary care research from EHRs. The UK has been well placed at the centre of an expanding global scientific community, facilitating international collaborations and bringing together international expertise in medicine, biochemical and pharmaceutical research.
Occupational stress in the ED: a systematic literature review
Authors: Basu Subhashis , Qayyum Hasan , Mason Suzanne 
Published: October 2016

IntroductionOccupational stress is a major modern health and safety challenges. While the ED is known to be a high-pressure environment, the specific organisational stressors which affect ED staff have not been established.MethodsWe conducted a systematic review of literature examining the sources of organisational stress in the ED, their link to adverse health outcomes and interventions designed to address them. A narrative review of contextual factors that may contribute to occupational stress was also performed. All articles written in English, French or Spanish were eligible for conclusion. Study quality was graded using a modified version of the Newcastle-Ottawa Scale.ResultsTwenty-five full-text articles were eligible for inclusion in our systematic review. Most were of moderate quality, with two low-quality and two high-quality studies, respectively. While high demand and low job control were commonly featured, other studies demonstrated the role of insufficient support at work, effort–reward imbalance and organisational injustice in the development of adverse health and occupational outcomes. We found only one intervention in a peer-reviewed journal evaluating a stress reduction programme in ED staff.ConclusionsOur review provides a guide to developing interventions that target the origins of stress in the ED. It suggests that those which reduce demand and increase workers' control over their job, improve managerial support, establish better working relationships and make workers' feel more valued for their efforts could be beneficial. We have detailed examples of successful interventions from other fields which may be applicable to this setting.
mTOR activity and its prognostic significance in human colorectal carcinoma depending on C1 and C2 complex-related protein expression
Authors: Sticz Tamás , Molnár Anna , Márk Ágnes , Hajdu Melinda , Nagy Noémi , Végső Gyula , Micsik Tamás , Kopper László , Sebestyén Anna 
Published: October 2016

AimsTumour heterogeneity and altered activation of signalling pathways play important roles in therapy resistance. The PI3K/Akt/mTOR signalling network is a well-known regulator of several functions that contribute to tumour growth. mTOR exists in two functionally different multiprotein complexes. We aimed to determine mTOR activity-related proteins in clinically followed, conventionally treated colon carcinomas and to analyse the correlation between clinical data and mTORC1 and mTORC2 activity.MethodsImmunohistochemistry was performed with different antibodies on tissue microarray blocks from 103 patients with human colorectal adenocarcinoma. mTORC1- and mTORC2-related activity were scored on different stainings including analysis of the expression of Raptor and Rictor—specific elements of mTORC1 and C2 complexes. The staining scores and clinical/survival data were compared and analysed.ResultsDetailed characterisation showed stage and grade independent high mTOR activity in 74% of cases. High mTOR activity was present in mTORC1 and/or mTORC2 complexes; >60% of cases had mTORC2-related high mTOR activity. Based on our analysis, high mTOR activity and Rictor overexpression could be markers of a bad prognosis. Combined phosphoprotein and Rictor/Raptor expression evaluation revealed even stronger statistical correlation with prognosis.ConclusionsThe presented staining panel could be appropriate and highly recommended for the accurate specification of mTORC1 and C2 activity of tumour tissues. This could help in the selection of mTOR inhibitors and can provide information about prognosis, which may guide decisions about the intensity of therapy.
Association and interaction analysis of diabetes mellitus andSCN10Afor cardiovascular autonomic neuropathy in a Chinese population
Authors: Lv Yubao , Zhou Linuo , Tang Zihui , Dong Jingcheng 
Published: October 2016

ABSTRACTBackgroundThis study assessed the extent to which diabetes mellitus (DM) and SCN10A (rs7375036) and their interaction impact on cardiovascular autonomic neuropathy (CAN) susceptibility in a Chinese Han sample.MethodWe performed a study in a cross-sectional dataset that included 419 patients with DM and 1557 controls who were genotyped for the presence of the SCN10A rs7375036 polymorphisms. Genotyping was performed by iPLEX technology. The associations of rs7375036 and DM with CAN was assessed by using univariate and multivariate logistic regression controlling for confounders. The interaction between rs7375036 and DM for CAN susceptibility on an additive scale was calculated by using the relative excess risk due to interaction (RERI), the proportion attributable to interaction (AP), and the synergy index (S).ResultsThe univariate logistic analyses failed to show an association between the SCN10A rs7375036 polymorphisms and CAN. Interestingly, a novel interaction effect of SCN10A rs7375036 and DM on CAN was assessed (p=0.055; RERI=3.515, 95% CI 1.829 to 5.805; AP=0.632, 95% CI −0.368 to 1.632; S=4.361, 95% CI 2.071 to 9.184).ConclusionsOur findings suggest that there are interaction effects of DM and SCN10A (rs7375036) that influence the development of CAN.Trial registration numberNCT02461342
Clinical features and disease progression of L‐2‐hydroxyglutaric aciduria in 27 Staffordshire bull terriers
Authors: Shea A. , De Risio L. , Carruthers H. , Ekiri A. , Beltran E. 
Published: October 2016

To describe the development of clinical signs (CS) and outcome of L‐2‐hydroxyglutaric aciduria (L‐2‐HGA), owners of 119 Staffordshire bull terriers positive for the known L‐2‐hydroxyglutarate dehydrogenase autosomal‐recessive mutations were requested to complete a questionnaire regarding their pet's CS. Questionnaires were returned for 27 dogs, all with neurological abnormalities—not all questions were answered in all cases. The mean age of CS onset was 12 months (range 2.5–60). Gait dysfunction was reported in 26/26 dogs, with stiffness of all four limbs the most common (24/26) and earliest recognised abnormality. Kyphosis (19/26), body and/or head tremors (19/26) and hypermetria (15/26) were frequent. Behavioural changes were present in 24/27 dogs; most commonly staring into space (21/24), signs of dementia (17/24) and loss of training (15/24). Eighteen dogs demonstrated paroxysmal seizure‐like/dyskinetic episodes. Nineteen (70 per cent) dogs were alive at a mean survival time of 76.6 months (12–170) after onset of CS. L‐2‐HGA was the cause of euthanasia in six dogs. Euthanasia occurred at a mean survival time of 44 months (8.5–93) after onset of CS, with 2/8 dogs euthanased within 12 months. L‐2‐HGA is considered a progressive neurological disease; however, CS can be successfully managed with affected dogs potentially living a normal lifespan.
Dispersion engineering of a As2Se3-based strip/slot hybrid waveguide for mid-infrared broadband wavelength conversion
Authors: Hui Zhanqiang , Zhang Lingxuan , Wang Leiran , Zhang Wenfu 
Published: October 2016

An arsenic tri-selenide-based strip/slot hybrid waveguide with a single horizontal silica slot is proposed to achieve an extremely low and flat dispersion with three zero dispersion wavelengths. By adjusting the geometrical structural parameters of the hybrid waveguide, dispersion tailoring is fully obtained. The flat group velocity dispersion varying between ±[Formula: see text]0.08 ps2/(m) is obtained over a 1253 nm bandwidth. The parameters of effective area, nonlinear coefficient, and third-order dispersion are all investigated. Moreover, a compact on-chip all-optical wavelength converter is designed based on degenerate four-wave mixing in this waveguide. The dependencies of conversion efficiency and conversion bandwidth on the pump wavelength are discussed. The impact of pump power and signal power on the conversion efficiency is also investigated. The results show that a maximal conversion efficiency of −0.46 dB, and a 3-dB conversion bandwidth of 830 nm in the mid-infrared is achieved.
On Selecting the Right Optimizations for Virtual Machine Migration
Authors: Nathan Senthil , Bellur Umesh , Kulkarni Purushottam 
Published: October 2016

To reduce the migration time of a virtual machine and network traffic generated during migration, existing works have proposed a number of optimizations to pre-copy live migration. These optimizations are delta compression, page skip, deduplication, and data compression. The cost-benefit analysis of these optimizations may preclude the use of certain optimizations in specific scenarios. However, no study has compared the performance & cost of these optimizations, and identified the impact of application behaviour on performance gain. Hence, it is not clear for a given migration scenario and an application, what is the best optimization that one must employ?
In this paper, we present a comprehensive empirical study using a large number of workloads to provide recommendations on selection of optimizations for pre-copy live migration. The empirical study reveals that page skip is an important optimization as it reduces network traffic by 20% with negligible additional CPU cost. Data compression yields impressive gains in reducing network traffic (37%) but at the cost of a significant increase in CPU consumption (5×). De-duplication needs to be applied with utmost care as the increase in CPU utilization might outweigh the benefits considerably. The combination of page skip and data compression works the best across workloads and results in a significant reduction in network traffic (40%).
Passive stimulation and behavioral training differentially transform temporal processing in the inferior colliculus and primary auditory cortex
Authors: Vollmer Maike , Beitel Ralph E. , Schreiner Christoph E. , Leake Patricia A. 
Published: October 2016

In profoundly deaf cats, behavioral training with intracochlear electric stimulation (ICES) can improve temporal processing in the primary auditory cortex (AI). To investigate whether similar effects are manifest in the auditory midbrain, ICES was initiated in neonatally deafened cats either during development after short durations of deafness (8 wk of age) or in adulthood after long durations of deafness (≥3.5 yr). All of these animals received behaviorally meaningless, “passive” ICES. Some animals also received behavioral training with ICES. Two long-deaf cats received no ICES prior to acute electrophysiological recording. After several months of passive ICES and behavioral training, animals were anesthetized, and neuronal responses to pulse trains of increasing rates were recorded in the central (ICC) and external (ICX) nuclei of the inferior colliculus. Neuronal temporal response patterns (repetition rate coding, minimum latencies, response precision) were compared with results from recordings made in the AI of the same animals (Beitel RE, Vollmer M, Raggio MW, Schreiner CE. J Neurophysiol 106: 944–959, 2011; Vollmer M, Beitel RE. J Neurophysiol 106: 2423–2436, 2011). Passive ICES in long-deaf cats remediated severely degraded temporal processing in the ICC and had no effects in the ICX. In contrast to observations in the AI, behaviorally relevant ICES had no effects on temporal processing in the ICC or ICX, with the single exception of shorter latencies in the ICC in short-deaf cats. The results suggest that independent of deafness duration passive stimulation and behavioral training differentially transform temporal processing in auditory midbrain and cortex, and primary auditory cortex emerges as a pivotal site for behaviorally driven neuronal temporal plasticity in the deaf cat. NEW & NOTEWORTHY Behaviorally relevant vs. passive electric stimulation of the auditory nerve differentially affects neuronal temporal processing in the central nucleus of the inferior colliculus (ICC) and the primary auditory cortex (AI) in profoundly short-deaf and long-deaf cats. Temporal plasticity in the ICC depends on a critical amount of electric stimulation, independent of its behavioral relevance. In contrast, the AI emerges as a pivotal site for behaviorally driven neuronal temporal plasticity in the deaf auditory system.
A novel computational model to probe visual search deficits during motor performance
Authors: Singh Tarkeshwar , Fridriksson Julius , Perry Christopher M. , Tryon Sarah C. , Ross Angela , Fritz Stacy , Herter Troy M. 
Published: October 2016

Successful execution of many motor skills relies on well-organized visual search (voluntary eye movements that actively scan the environment for task-relevant information). Although impairments of visual search that result from brain injuries are linked to diminished motor performance, the neural processes that guide visual search within this context remain largely unknown. The first objective of this study was to examine how visual search in healthy adults and stroke survivors is used to guide hand movements during the Trail Making Test (TMT), a neuropsychological task that is a strong predictor of visuomotor and cognitive deficits. Our second objective was to develop a novel computational model to investigate combinatorial interactions between three underlying processes of visual search (spatial planning, working memory, and peripheral visual processing). We predicted that stroke survivors would exhibit deficits in integrating the three underlying processes, resulting in deteriorated overall task performance. We found that normal TMT performance is associated with patterns of visual search that primarily rely on spatial planning and/or working memory (but not peripheral visual processing). Our computational model suggested that abnormal TMT performance following stroke is associated with impairments of visual search that are characterized by deficits integrating spatial planning and working memory. This innovative methodology provides a novel framework for studying how the neural processes underlying visual search interact combinatorially to guide motor performance. NEW & NOTEWORTHY Visual search has traditionally been studied in cognitive and perceptual paradigms, but little is known about how it contributes to visuomotor performance. We have developed a novel computational model to examine how three underlying processes of visual search (spatial planning, working memory, and peripheral visual processing) contribute to visual search during a visuomotor task. We show that deficits integrating spatial planning and working memory underlie abnormal performance in stroke survivors with frontoparietal damage.