Neuroscience: Intracranial Recordings of Value.

The role of orbitofrontal cortex in value-based choice is well-established from animal research, but there are challenges in relating neurophysiological recordings from animals to equivalent data from humans: a new study bridges this gap.

The risk of developing cancer following metal-on-metal hip replacement compared with non metal-on-metal hip bearings: Findings from a prospective national registry "The National Joint Registry of England, Wales, Northern Ireland and the Isle of Man".

Background And Purpose: Over 1 million metal-on-metal hip replacements were implanted. Even well-functioning implants produce wear debris that can cause tissue damage, disseminate and cause DNA damage. We aimed to establish if there was an association between metal-on-metal hip replacement and the risk of subsequently developing cancer compared with alternative hip replacements.

Pain and Emergency Department Use in the Last Month of Life Among Older Adults With Dementia.

Context: Pain may be a potentially modifiable risk factor for expensive and burdensome emergency department (ED) visits near the end of life for older adults with dementia.

Objectives: The objective of this study was to assess the effect of pain and unmet need for pain management on ED visits in the last month of life in older adults with dementia.

Methods: This is a mortality follow-back study of older adults with dementia in the National Health and Aging Trends Study who died between 2012 and 2014, linked to Medicare claims.

Reconciling persistent and dynamic hypotheses of working memory coding in prefrontal cortex.

Competing accounts propose that working memory (WM) is subserved either by persistent activity in single neurons or by dynamic (time-varying) activity across a neural population. Here, we compare these hypotheses across four regions of prefrontal cortex (PFC) in an oculomotor-delayed-response task, where an intervening cue indicated the reward available for a correct saccade. WM representations were strongest in ventrolateral PFC neurons with higher intrinsic temporal stability (time-constant).

Spontaneous cortical activity transiently organises into frequency specific phase-coupling networks.

Frequency-specific oscillations and phase-coupling of neuronal populations are essential mechanisms for the coordination of activity between brain areas during cognitive tasks. Therefore, the ongoing activity ascribed to the different functional brain networks should also be able to reorganise and coordinate via similar mechanisms. We develop a novel method for identifying large-scale phase-coupled network dynamics and show that resting networks in magnetoencephalography are well characterised by visits to short-lived transient brain states, with spatially distinct patterns of oscillatory power and coherence in specific frequency bands.

Billing Practices Among US Tobacco Use Treatment Providers.

Objectives: The US Affordable Care Act (ACA) now requires almost all health insurance plans to cover tobacco use treatment (TUT), but TUT remains underutilized.

Methods: We conducted an anonymous online survey of US TUT providers in 2016 regarding their billing practices.

Results: Participants (n = 131) provided services primarily in medical and behavioral health settings and were from a variety of professions.

Differential Valuation and Learning From Social and Nonsocial Cues in Borderline Personality Disorder.

Background: Volatile interpersonal relationships are a core feature of borderline personality disorder (BPD) and lead to devastating disruption of patients' personal and professional lives. Quantitative models of social decision making and learning hold promise for defining the underlying mechanisms of this problem. In this study, we tested BPD and control subject weighting of social versus nonsocial information and their learning about choices under stable and volatile conditions.

Daily intra-abdominal pressure, Sequential Organ Failure Score and fluid balance predict duration of mechanical ventilation.

Background: Elevated intra-abdominal pressure (IAP) is a common occurrence in mechanically ventilated patients in the intensive care unit (ICU). This study was undertaken to determine the relationship between IAP, pulmonary compliance and the duration of mechanical ventilation.

Methods: A prospective study of 220 consecutively enrolled mechanically ventilated patients admitted to a mixed surgical-medical ICU in a tertiary referral hospital.

Cardiovascular toxicity of targeted therapies for cancer: a protocol for an overview of systematic reviews.

Introduction: The introduction of targeted therapies for cancer has contributed to dramatic improvements in patient survival. Nevertheless, several targeted therapies have been associated with 'off-target' adverse effects, based on varying levels of evidence. To date, this evidence has not been systematically synthesised.

Racialized Risk in Clinical Care: Clinician Vigilance and Patient Responsibility.

Racial/ethnic identity is contingent and arbitrary, yet it is commonly used to evaluate disease risk and treatment response. Drawing on open-ended interviews with patients and clinicians in two US clinics, we explore how racialized risk is conceptualized and how it impacts patient care and experience. We found that racial/ethnic risk was a common but poorly defined construct for both patients and clinicians, who intermingled concepts of genetics, biology, behavior, and culture, while disregarding historical or structural context.

An unusual diverticulum adjacent to two large colonic polyps; a case report.

Background: Adenocarcinomas can arise in a variety of circumstances in which intestinal segments have been used for urinary diversions. Whereas ureterosigmoidostomy is the oldest and simplest form of continent urinary diversion it also seems to be the most dangerous in this regard. Herein we present a case of colonic neoplasia complicating a non-functioning ureterosigmoidostomy after 55 years; the longest latent period documented to date.

The Nurr1 Ligand,1,1-bis(3'-Indolyl)-1-(-Chlorophenyl)Methane, Modulates Glial Reactivity and Is Neuroprotective in MPTP-Induced Parkinsonism.

The orphan nuclear receptor Nurr1 (also called nuclear receptor-4A2) regulates inflammatory gene expression in glial cells, as well as genes associated with homeostatic and trophic function in dopaminergic neurons. Despite these known functions of Nurr1, an endogenous ligand has not been discovered. We postulated that the activation of Nurr1 would suppress the activation of glia and thereby protect against loss of dopamine (DA) neurons after subacute lesioning with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP).

Space-Based Sentinels for Measurement of Infrared Cooling in the Thermosphere for Space Weather Nowcasting and Forecasting.

Infrared radiative cooling by nitric oxide (NO) and carbon dioxide (CO) modulates the thermosphere's density and thermal response to geomagnetic storms. Satellite tracking and collision avoidance planning require accurate density forecasts during these events. Over the past several years, failed density forecasts have been tied to the onset of rapid and significant cooling due to production of NO and its associated radiative cooling via emission of infrared radiation at 5.

Comorbidities in Anti-Cyclic Citrullinated Peptide Positive At-Risk Individuals Do Not Differ from Those Patients with Early Inflammatory Arthritis.

Objectives: To compare comorbidities in a cohort of cyclic citrullinated peptide (CCP) antibody positive patients without or prior to onset of inflammatory arthritis (IA) to those in patients with early IA.

Methods: Baseline data from two established cohorts were used. The first recruited people at risk of IA: CCP antibody positive cases without IA (CCP Cohort,  = 296).

Detection of colistin heteroresistance in Acinetobacter baumannii from blood and respiratory isolates.

Polymyxins are one of the last-line antibiotics for multidrug-resistant Acinetobacter baumannii. Reports have demonstrated the emergence of colistin heteroresistance in A. baumannii, which can complicate assessment of minimum inhibitory concentrations and promote resistance to colistin.

Rituximab: a novel treatment for refractory Riedel's thyroiditis.

Unlabelled: This case report reviews the rare condition of Riedel's thyroiditis via a patient case. The report highlights the difficulties that one may encounter when managing such a case in regards to patient symptoms, side effects of medications and the relapsing nature of the condition. The case report also highlights novel treatment in the treatment of Riedel's thyroiditis, rituximab, how this works and the resolution of symptoms that we have achieved with our patient on this treatment.

Ullazine Donor-π bridge-Acceptor Organic Dyes for Dye-Sensitized Solar Cells.

A series of four ullazine-donor based donor-π bridge-acceptor (D-π-A) dyes have been synthesized and compared to a prior ullazine donor-acceptor (D-A) dye as well as a triphenylamine donor with an identical π-bridge and acceptor. The D-π-A ullazine series demonstrates an unusually uniform-in-intensity panchromatic UV/Vis absorption spectrum throughout the visible region. This is in part due to the introduction of strong high-energy bands through incorporation of the ullazine building block as shown by computational analysis.

Teaching a Person with Memory Impairment Smartphone Use for Emergencies during Outdoors Walking: Case Report.

Safety issues arise during the performance of activities as dementia advances. Occupational therapists collaborate with dementia clients and their caregivers to find solutions and strategies to prolong safe activity participation. Additionally, occupational therapists teach through demonstration showing engagement in specific activities may no longer be safe.

Implications of Introducing New Technology: Comparative Survivorship Modeling of Metal-on-Metal Hip Replacements and Contemporary Alternatives in the National Joint Registry.

Background: New medical technologies are often used widely without adequate supporting data, a practice that can lead to widespread catastrophic failure such as occurred with metal-on-metal (MoM) hip replacements. We determined both how revision rates would have differed if, instead of receiving MoM hip replacements, patients had received existing alternatives and the subsequent cumulative re-revision rates of the patients who did receive MoM hip replacements compared with alternatives.

Methods: This study is a population-based longitudinal cohort study of patient data recorded in the National Joint Registry (NJR) for England, Wales and Northern Ireland between April 2003 and December 2014.

Emergency Department Use by Community-Dwelling Individuals With Dementia in the United States: An Integrative Review.

As part of the National Plan to Address Alzheimer's Disease, reducing potentially avoidable emergency department (ED) use by individuals with dementia has been identified as a component of enhancing the quality and efficiency of care for this population. To help inform the development of interventions to achieve this goal, an integrative review was conducted to: (a) compare rates and reasons for ED visits by community-dwelling individuals with and without dementia, considering also the effect of dementia subtype and severity; and (b) identify other risk factors for increased ED use among community-dwelling individuals with dementia. Nineteen articles met inclusion criteria.

Is the rate of revision of 36 mm metal-on-metal total hip arthroplasties with Pinnacle acetabular components related to the year of the initial operation? an interrupted time-series analysis using data from the National Joint Registry for England and Wales.

Aims: The aim of this study was to determine whether the rates of revision for metal-on-metal (MoM) total hip arthroplasties (THAs) with Pinnacle components varied according to the year of the initial operation, and compare these with the rates of revision for other designs of MoM THA.

Patients And Methods: Data from the National Joint Registry for England and Wales included 36 mm MoM THAs with Pinnacle acetabular components which were undertaken between 2003 and 2012 with follow-up for at least five years (n = 10 776) and a control group of other MoM THAs (n = 13 817). The effect of the year of the primary operation on all-cause rates of revision was assessed using Cox regression and interrupted time-series analysis.