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Lack of behavioral flexibility has been proposed as one underlying cause of compulsions, defined as repetitive behaviors performed through rigid rituals. However, experimental evidence has proven inconsistent across human and animal models of compulsive-like behavior. In the present study, applying a similarly-designed reversal learning task in two different species, which share a common symptom of compulsivity (human OCD patients and Sapap3 KO mice), we found no consistent link between compulsive behaviors and lack of behavioral flexibility. However, we showed that a distinct subgroup of compulsive individuals of both species exhibit a behavioral flexibility deficit in reversal learning. This deficit was not due to perseverative, rigid behaviors as commonly hypothesized, but rather due to an increase in response lability. These cross-species results highlight the necessity to consider the heterogeneity of cognitive deficits in compulsive disorders and call for reconsidering the role of behavioral flexibility in the aetiology of compulsive behaviors., Nabil Benzina et al. use a reversal learning task to examine behavioral flexibility in human and mouse models of obsessive compulsive disorder (OCD). They report that only subsets of human patients or OCD-like mice show deficits in behavioral flexibility, highlighting the diverse presentation of cognitive deficits in compulsive disorders.

BACKGROUND Personality disorders (PDs) are related to poor psychosocial function, including fewer relationships with friends and romantic partners. METHODS One-hundred eighty-six psychiatric patients were included in a study cohort in 2002-2003. In 2017, data regarding living arrangements and marital status between 2003 and 2016 were collected for these participants and from a matched control group. Data on birth of first child during the study period were collected for women. The former patients were divided into two groups based on occurrence of PD or not. Groups were compared with each other and with the controls. RESULTS The proportion of participants with PD who lived together with someone did not increase at the same rate as in the other groups. PD was associated with a reduced likelihood of getting married during the study period. Women in the PD group had children to a lower extent than females in the other groups. CONCLUSION Personality disorder was associated with an increased likelihood of living alone and being unmarried. Female participants with PD had a decreased likelihood of having children compared with controls. © 2021 The Authors Personality and Mental Health Published by John Wiley & Sons Ltd.

We examine whether firms’ co-opetition (i.e., simultaneously competitive and cooperative) behaviors in standard-setting organizations (SSOs) affect their public R&D disclosure. We find that relative to matched control firms, firms that participate in SSOs increase their narrative R&D disclosure to the public after SSO participation. The effect of SSO participation on narrative R&D disclosure is more pronounced for firms with a greater ex-ante proprietary cost of disclosure and firms with higher investor information demand. Further analyses show that narrative R&D disclosure increases with the percentage of competitors in the SSO and that SSO participation raises not only the quantity but also the information content of such disclosure. Overall, the findings suggest that co-opetition inside SSOs facilitates the sharing of proprietary R&D information with competitors. This reduces firms’ proprietary cost of disclosure, incentivizing them to disclose more R&D information to the public.

Attentional biases have been overlooked as a treatment focus in CBT practice. This pilot study examined patterns of attentional bias in an OCD clinical sample with a view to understanding the key mechanisms in order to inform assessment and intervention. It was hypothesised that individuals with OCD would demonstrate vigilance, delayed disengagement, and maintenance attentional biases towards OCD-related stimuli relative to a matched control group. Participants with OCD (n = 16) were compared with healthy controls (n = 16) matched by age and gender. Vigilance, disengagement and maintenance biases were measured by recording eye-movements during a free gaze task in which pairs of neutral-OCD and neutral-aversive images were presented. The OCD group demonstrated no evidence of vigilance or delayed disengagement biases toward OCD stimuli but did exhibit a maintenance bias towards OCD and, to a lesser extent, general aversive images. Clinical implications include the assessment of patient attentional biases to aid CBT interventions.

High-flexion total knee arthroplasty (HF-TKA) prostheses were designed with hopes of improving knee function. Studies have suggested increased failure with HF-TKAs. The purpose is to compare clinical results of HF-TKA versus conventional TKA (C-TKA) from the same implant system with long-term follow-up.This review of prostheses implanted between 2004 and 2007 matched 145 of 179 possible HF-TKAs with 145 of 1347 possible C-TKAs. Mean follow-up was 121.5 ± 20.3 months. We were unable to match 12 HF-TKAs. HF-TKAs with less than 8-year follow-up were excluded. The primary outcome was failure requiring revision. Secondary outcomes included range of motion (ROM), Knee Society Scores (KSS), and radiolucent lines.In the matched cohort, there were 15 HF-TKA reoperations, 8 of which involved component revisions. There were 12 reoperations in the C-TKA cohort but no component revisions (P = .001). The analysis of the unmatched cohorts revealed a higher revision rate for HF-TKAs (P = .039) (HF-TKA: 10/179 vs C-TKA: 27/1347). At final follow-up, HF-TKAs exhibited more prosthesis radiolucent lines without evidence of loosening. Particularly, HF-TKAs demonstrated more femoral zone IV radiolucencies (38.7%) at final follow-up compared with C-TKAs (13.8%) (P.001). There were no differences found between cohorts in ROM or KSS.This study found an increased incidence of failure requiring revision with the HF-TKA in the matched and unmatched analyses. Higher incidences of radiolucent lines were found with HF-TKA. With no observed differences in ROM or KSS and a higher rate of failure with HF-TKA, there appears to be no advantage for use of the HF-TKA.

Introduction: Melody™ valve in the mitral position has been described for use in infants. Hypothesis: Melody™ valve (Medtronic) in the mitral position would improve survival compared to mechanical mitral valves for young children. Methods: Charts were retrospectively reviewed for children who had undergone a Melody™ valve insertion (MEL) between 2014 and 2020. MEL were case-matched by age and weight to those with a mechanical mitral valve (MECH). We compared transplant free survival and cumulative incidence of re-intervention. A sub-analysis was performed for children Results: Eleven children underwent Melody™ mitral valve replacement (MVR) over the study period. Age was 157 (104-402) days and weight 5.0 (4.2-7.4) kg. Indications for MVR were insufficiency in 6 (55%), stenosis in 3 (27%), and mixed disease in 2 (18%). MEL underwent a total of 13 repairs and 4 replacements (2 mechanical, 2 bioprosthetic) prior to Melody™ valve replacement. Final valve dilation size was 18 (15.5-18.5)mm. Two (18%) children salvaged from ECMO before MEL subsequently died. Three (33%) of the 9 survivors have required subsequent MVR at 9, 17, and 23 months; 1 for severe insufficiency, and 2 for severe mixed disease. The MECH cohort was not different in age, weight, valve size, bypass or cross-clamp times, indications for replacement, or number of prior repairs or replacements (p>0.10). At 1 and 3 years, transplant free survival (MEL: 80%, 80%; MECH: 82%, 64%; p=0.180) and re-intervention (MEL: 11%, 39%; MECH: 0%, 20% p=0.32) were equivalent between groups. For children Conclusions: Melody™ MVR represents a better surgical strategy for infants less than 1 year of age requiring mitral valve replacement.

Implementation of carbon nanofibers (CNFs) in biomedical applications have successful outcomes, however, they are still considered as a potential hazard. We herein used avian embryos at 3 days and its chorioallantoic membrane (CAM) at 6 days of incubation to evaluate the impact of synthesized CNFs on the early stage of embryogenesis and angiogenesis. Our data point out that 50 μg/embryo concentration of CNFs provoke adverse effects as 75% of CNFs-exposed embryos die within 1–5 days after exposure compared with their matched controls. Furthermore, CNFs significantly inhibit angiogenesis of the CAM after 48-hours post-treatment. Additionally, RT-PCR analysis on seven key controller genes responsible for proliferation, survival, angiogenesis, and apoptosis showed that these genes are deregulated in brain, heart, and liver tissues of CNFs-exposed embryos compared to their matched control. Our investigation suggests that CNFs could have a toxic effect on the early stages of embryogenesis as well as angiogenesis. Nevertheless, further investigations are required to evaluate the effects of CNFs and elucidate their mechanism on the early stage of the normal development and human health.

The facilitatory effect shown in native speakers processing idiomatic phrases compared to matched novel phrases may be explained by a dual route model. This postulates that all phrases are processed literally at first, and if a phrase was recognized as familiar during processing, it would then be processed by a faster retrieval-route; if the phrase was not perceived as familiar, it would continue to be processed literally by the slower computation-route. The goals of the current project were to test the dual route model and to decipher the underlying mechanism in retrieval-route activation. English idioms and translated Chinese idioms were presented to both native English speakers and Chinese-English bilinguals in a random order. Participants listened to the idiom up until the last word (e.g., "draw a snake and add"), then saw either the idiom ending (e.g., "feet") or the matched control ending (e.g., "hair"); to which they made lexical decision and reaction times were recorded. We examined the priming effect for idioms compared to controls across the two language groups. The results showed that the two groups processed idioms of different origins differently. Native English speakers' faster responses to English idioms than controls supported a dual route model; however, both native English and bilingual speakers' faster responses to Chinese idioms than controls called for a less straightforward interpretation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

BackgroundResearch on information processing of older adults with autism spectrum disorder (ASD) is scarce, which is a caveat because findings in children may not apply to (older) autistic adults. This study examines visual local-global processing approaches in older autistic adults.MethodThe Rey-Osterrieth Complex Figure Test (RCFT) is a popular measure of visual-constructional ability, organisational strategy and memory. In this matched-control study, we explore if the qualitative and quantitative performance on the RCFT can be used as an operationalisation of central coherence in autistic older adults (n = 36; ages 50−84 years), and whether RCFT performance associates with autism-symptoms. WAIS-IV scores were also obtained to test for local-global differences in performance.ResultsNo evidence was found for deviating processing approaches on the RCFT (both quantitative and qualitative) in the ASD group, although copying the RCFT was significantly slower. The WAIS-IV showed no differences between participant-groups, except for a significantly better performance on Visual Puzzles by autistic participants.ConclusionsUsing visual local-global processing tests common to clinical practice, this study provides no evidence for a weak central coherence but some support for enhanced perceptual functioning in late-diagnosed high functioning older autistic adults. There was no evidence for altered strategic approaches during the completion of a complex visual information processing task (RCFT). Combining a quantitative and a qualitative scoring system of visual information processing tasks (such as RCFT) can elucidate the preferred visual information processing style in autistic individuals.

This study examined whether, and the extent to which, the Incredible Years Teacher Classroom Management program predicted positive development of children’s emotional, behavioral, and social adjustment through changes in the child–teacher relationship. Using data from a longitudinal quasi-experimental intervention trial with a matched control condition, including 1,085 children (49.7% girls, meanage = 4.22 years; SDage = 0.88 years), the potential associations were tested by means of multilevel path modeling. The mediation model demonstrated that (1) children in the intervention condition achieved more favorable changes in the child–teacher relationship than the control condition; (2) changes in the child–teacher relationship were associated with changes in the target outcomes; and (3) the intervention effects were mediated via changes in the child–teacher relationship. © 2020 Tveit, Drugli, Fossum, Handegård, Klöckner and Stenseng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Difference-in-differences analysis with a control group that differs considerably from a treated group is vulnerable to bias from historical events that have different effects on the groups. Constructing a more closely matched control group by matching a subset of the overall control group to the treated group may result in less bias. We study this phenomenon in simulation studies. We study the effect of mountaintop removal mining (MRM) on mortality using a difference-in-differences analysis that makes use of the increase in MRM following the 1990 Clean Air Act Amendments. For a difference-in-differences analysis of the effect of MRM on mortality, we constructed a more closely matched control group and found a 95\% confidence interval that contains substantial adverse effects along with no effect and small beneficial effects., Accepted to Observational Studies

Objectives Motor difficulties are often reported in individuals with attention deficit hyperactivity disorder (ADHD). The aims of this study are to detail the motor profile of children with ADHD and to determine whether the motor impairment present in a large proportion of children with ADHD represents a phenotypic characteristic of ADHD or a co-occurring deficit. Methods Participants with ADHD (N = 51; age 8 to 15 years) and typically developing (TD) motor matched control children (N = 75; age 4 to 11 years) completed the largest battery of assessments of motor function that have been used with this population to date, as well as a measure of inhibition as a behavioural measure of ADHD characteristics. Parents/caregivers also completed questionnaires relating to ADHD symptomology and a retrospective report of their child’s motor milestone achievement. Results A motor deficit was observed in 47% of our ADHD sample. Few relationships were observed between ADHD core characteristics and motor competence. Furthermore, there was an uneven profile of motor performance across different motor tasks, relative to the TD children. Interestingly, it appears that motor milestone achievement is not delayed in ADHD. Conclusions Our findings suggest that the motor deficit observed in ADHD is not inherent to ADHD. The motor deficit observed in some children with ADHD does not represent a simple delay in development and is not observed in infancy with respect to reaching motor milestones.

Background Supermarkets are a major source of food for families, yet greater understanding of how product placement strategies influence the healthfulness of food choice is needed. We assessed the effect of improving the availability and positioning of fruit and vegetables in supermarkets, and removing confectionery from checkouts, on household-level purchases and store-level sales. Methods This study was a natural experiment with a prospective matched cluster design set in a discount supermarket chain in England. The intervention had two components: new fresh fruit and vegetable sections at store entrances (replacing smaller displays at the back), and removal of confectionery from checkouts (replacing with healthier items, such as sugar-free gum, water and non-food items) and end-of-aisle opposite checkouts. Women customers aged 18 to 45 years, with a store loyalty card, who regularly shopped at three intervention and three matched control stores in England were recruited. Data from purchases using loyalty cards and for store sales were collected for the three months before and six months after refurbishment. Individual purchasing data were analysed using a difference-in-difference method, while store sales data were analysed using controlled interrupted time series by store pair, with differences synthesised using random-effects meta-analysis. Results A total of 107 women provided household-level purchasing data. The proportion purchasing fresh fruit and vegetables per week rose in intervention stores at three months (0.2%) compared to a drop in control stores (-3.0%) (P=0.22), and at six months (1.7% vs -3.5%, P=0.05). The proportion purchasing healthier checkout items rose more in intervention stores compared to a drop in control stores at both three (1.0% vs -1.8%, P=0.04) and six (0.6% vs -1.6%, P=0.13) months. There were no differences in the purchases of frozen fruit and vegetables or confectionery. Increases in store-level sales of fresh fruit and vegetables were greater in intervention stores than predicted at three months (1.71SDs (95%CI 0.45, 2.96), P=0.01) and six months (2.42SDs (0.22, 4.62), P=0.03). Decreases in sales of confectionery were greater in intervention stores than predicted at three months (-1.05SDs (-1.98, -0.12), P=0.03) and six months (-1.37SDs (-2.95, 0.22), P=0.09). Sales of frozen fruit and vegetables and healthier checkout items showed no differences. Conclusion This study provides some evidence to suggest that healthier product placement in supermarkets improves the healthfulness of both household-level purchasing and store-level sales. Improving fruit and vegetable placement should be considered by government alongside current plans to limit prominent placement of unhealthy foods.

Non-symbolic number changes produce transient Event Related Potentials over parietal electrodes, while numerosity effects measured with Steady-State Visual Evoked Potentials (SSVEPs) appear to originate in occipital cortex. We hypothesized that the stimulation rates used in previous SSVEP studies may be too rapid to drive parietal numerosity mechanisms. Here we recorded SSVEPs and behavioral reports over a slower range of temporal frequencies than previously used. Isoluminant dot stimuli updated at a consistent “carrier” frequency (3-6 Hz) while periodic changes in numerosity (e.g. 8→5) formed an even slower “oddball” frequency (0.5-1 Hz). Each numerosity oddball condition had a matched control condition where the number of dots did not change. Carrier frequencies induced SSVEPs with midline occipital topographies that did not differentiate the presence or absence of numerosity oddballs. By contrast, SSVEPs at oddball frequencies had parietal topographies and responded more strongly when oddballs were present. Consistent with our hypothesis, numerosity effects were stronger at slower stimulation rates. In a second study, the numerosity change was either supra-threshold (e.g. 8→5 dots) or near the threshold required for detecting numerosity changes (e.g. 8→9 dots). We found robust parietal responses for the supra-threshold case only, indicating anumerical distance effect. A third study replicated the parietal oddball SSVEP effect across four distinct suprathreshold numerosity-change conditions and showed that number change direction does not influence the effect. These findings show that SSVEP oddball paradigms can probe parietal computations of abstract numerosity, and may provide a rapid, portable approach to quantifying number sense within educational settings.

Objective: The purpose of this article was to demonstrate related characteristics of intensive care unit (ICU) admission after an unscheduled revisit by febrile children visiting the emergency department (ED). Method: We performed a retrospective study in a tertiary medical center from 2010 to 2016. Patients whose chief complaint was fever and who were admitted to the ICU following a 72-h return visit to the ED were included, and we selected patients who were discharged from the same emergency department for comparison. Results: During the study period, 54 (0.03%) patients met the inclusion criteria, and 216 patients were selected for the matched control group. Regarding clinical variables on initial ED visit, visiting during the night shift (66.7 vs. 46.8%, p = 0.010), shorter length of 1st ED stay (2.5 ± 2.63 vs. 3.5 ± 3.44 h, p = 0.017), and higher shock index (SI) (1.6 ± 0.07 vs. 1.4 ± 0.02, p = 0.008) were associated with ICU admission following a return visit. On the return ED visit, we found that clinical variables such as elevated heart rate, SI, white blood cell count, and C-reactive protein level were all associated with ICU admission. Furthermore, elevated SI and pediatric age-adjusted (SIPA) values were observed in the study group in both the initial (42.2 vs. 20.1%, OR:2.3 (1.37-4.31), p = 0.002) and return ED visits (29.7 vs. 6.9%, OR: 4.6 (2.42-8.26), p < 0.001). Conclusion: For children who visited the emergency department with a febrile complaint, elevated SIPA values on the initial ED visit were associated with ICU admission following an unscheduled ED revisit within 72 h.

PurposeTo evaluate the outcome of patients with COVID-19 triggered CRS treated with Therapeutic Plasma Exchange (TPE) as compared to propensity score matched (PSM)-controls not receiving TPE.Material and methodsUsing PS 1:1 matching, 90 patients were assigned 2 groups (45 receiving TPE and 45 controls). Forced matching and covariate matching was done to overcome bias between two groups.ResultsMedian age was 60 years (range 32-73 in TPE and 37-75 in non-TPE group), p= 0.325. Median duration of symptoms 7 days (range 3-22 days in TPE and 3-20 days in non-TPE), p=0.266. Disease severity in both groups was 6.6% moderate, 44.4% severe and 49% critical. Twenty-eight-day survival was significantly superior in TPE group (91.1%) as compared to PS-matched controls (61.5%), HR 0.21, 95% CI for HR 0.09-0.53, log rank 0.002. Median duration of hospitalization was significantly reduced in TPE treated group as compared to non-TPE controls 10 days and 15 days respectively (p< 0.01). CRS resolution time was also significantly reduced in TPE treated group (6 days vs. 12 days) (p< 0.001).ConclusionUse of TPE is associated with superior overall survival, early resolution of CRS and time to discharge as compared to standard therapy for COVID-19 triggered CRS.Highlights□Cytokine release syndrome (CRS) plays a pivotal role in pathophysiology and progression to severe and critical disease in patients with COVID-19.□Beyond supportive care, there are currently no proven effective treatment options (including Tocilizumab) for coronavirus disease (COVID-19)□Therapeutic plasma exchange (TPE) may dampen CRS of COVID-19 by removing circulating cytokines and toxins□TPE is the cheapest of all novel treatments available so far to treat severe to critical COVID-19□By intervening early with TPE, mortality and morbidity associated with COVID-19 triggered CRS can be reduced

Emotional experiences create durable memory traces in the brain, especially when these memories are consolidated in the presence of stress hormones such as cortisol. Although some research suggests cortisol elevation can increase long-term memory for emotional relative to neutral content, the impact of stress and cortisol on the consolidation of emotional and neutral aspects of memories when they are part of the same experience remains unknown. Here, after encoding complex scenes consisting of negative or neutral objects placed on neutral backgrounds, participants were exposed to a psychosocial stressor (or matched control condition) in order to examine the impact of stress and cortisol on early consolidation processes. The next day, once cortisol levels had returned to baseline, specific and gist recognition memory were tested separately for objects and backgrounds. Results indicate that while there was a numerical increase in memory for negative objects in the stress group, higher endogenous cortisol concentrations were specifically associated with decreased memory for the neutral backgrounds originally paired with negative objects. Moreover, across all participants, cortisol levels were positively correlated with the magnitude of the emotional memory trade-off effect. Specifically, while memory for negative objects was preserved, elevated cortisol during early consolidation was associated with decreased memory for neutral backgrounds that were initially paired with negative objects. These memory effects were observed in both the stricter specific measure of memory and the less conservative measure of gist memory. Together, these findings suggest that rather than influencing all aspects of an experience similarly, elevated cortisol during early consolidation selectively preserves what is most emotionally salient and adaptive to remember while allowing the loss of memory for less important neutral information over time.

We present our novel software, nanomonsv, for detecting somatic structural variations (SVs) using tumor and matched control long-read sequencing data with a single-base resolution. The current version of nanomonsv includes two detection modules, Canonical SV module, and Single breakend SV module. Using paired long-read sequencing data from three cancer and their matched lymphoblastoid lines, we demonstrate that Canonical SV module can identify somatic SVs that can be captured by short-read technologies with higher precision and recall than existing methods. In addition, we have developed a workflow to classify mobile element insertions while elucidating their in-depth properties, such as 5’ truncations, internal inversions, as well as source sites for 3’ transductions. Furthermore, Single breakend SV module enables the detection of complex SVs that can only be identified by long-reads, such as SVs involving highly-repetitive centromeric sequences, and LINE1- and virus-mediated rearrangements. In summary, our approaches applied to cancer long-read sequencing data can reveal various features of somatic SVs and will lead to a better understanding of mutational processes and functional consequences of somatic SVs.

IntroductionRecent studies have shown a high frequency of abnormal electrocardiograms in patients with schizophrenia. The objective of this study was to associate schizophrenia diagnoses with early repolarization patterns in a sample of hospitalized patients from a single hospital in Japan.MethodsWe conducted a retrospective age, sex and coronary risk factors matched case-control study on 85 patients with schizophrenia and 89 controls from medical checkups. First, we compared the presence of early repolarization patterns in both groups. Secondly, we elucidated an association between the presence of an early repolarization pattern and clinical findings in the patients’ groups. We also evaluated J-point elevation patterns.ResultsAs a result, we found that both early repolarization patterns and J-point elevation patterns observed were significantly higher in the schizophrenic group than in the matched control group (early repolarization pattern 23;6 P < 0.001; J-point elevation pattern 34:12; P = 0.001). After multivariable logistic regression among the patients and controls, schizophrenia was the independent predictor for early repolarization pattern (P = 0.001) and J-point elevation (P < 0.001). Among the patients, the independent predictor for early repolarization pattern was psychiatric family history (P = 0.006), while older age (P = 0.038) and psychiatric family history (P = 0.014) were predictors for J-point elevation patterns.ConclusionThese findings suggest that an association between early repolarization pattern or J-point elevation pattern and schizophrenia in a single Japanese center.

Despite the high incidence of sarcopenia in the orthopaedic community, studies evaluating the influence of sarcopenia following primary total knee arthroplasty (TKA) are limited. Therefore, the purpose of this study is to determine if sarcopenic patients undergoing primary TKA have higher rates of (1) in-hospital lengths of stay (LOS); (2) medical complications; (3) implant-related complications; (4) fall risk; (5) lower extremity fracture risk; and (6) costs of care. Sarcopenia patients were matched to controls in a 1:5 ratio according to age, sex, and medical comorbidities. The query yielded 90,438 patients with (n = 15,073) and without (n = 75,365) sarcopenia undergoing primary TKA. Primary outcomes analyzed included: in-hospital LOS, 90-day medical complications, 2-year implant-related complications, fall risk, lower extremity fracture risk, and costs of care. A p-value of less than 0.05 was considered statistically significant. Patients with sarcopenia undergoing primary TKA had greater in-hospital LOS (4 vs. 3 days, p

Detection of (1,3)-beta-d-glucan (BDG), a component of the cell wall of many fungi, was studied in bronchoalveolar lavage fluid (BALF) as a possible aid for the diagnosis of proven/probable invasive pulmonary aspergillosis (IPA). BDG was measured on stored BALF from 13 patients with EORTC/MSGERC defined proven/probable IPA and 26 matched control patients without IPA. The median BALF BDG was 80 pg/mL (range

International audience; Objectives: Severe childhood traumatic brain injury (TBI) leads to long-standing executive function and attention deficits, with negative consequences for participation, academic outcome and independence. This study aimed to assess executive function and attention 7 years after severe childhood TBI in comparison with a matched control group and to investigate associated factors. Methods: Children (< 15 years) with severe accidental TBI consecutively admitted in a single trauma center over 3 years were included in the Traumatisme Grave de l'Enfant (TGE) prospective longitudinal study. Of the 81 children initially included, 65 survived. At 7 years post-TBI, executive functions and attention were assessed in 27 participants (42 % of the 65 survivors) by using a combination of computerized tasks from the Test of Attentional Performance (TAP) and the Behavioral Rating of Executive Functions (BRIEF) questionnaire. Patients were compared to a group of 27 typically developing controls who were matched for sex, age and parental education level. Results: Among the 27 participants, mean (SD) age at injury was 7.7 (4.6) years, and mean length of coma 5.6 (4.6) days. Regarding the TAP, the number of errors was significantly higher (P = 0.003) and reaction time marginally slower (P = 0.08) in the TBI than control group. The BRIEF questionnaire completed by parents indicated significantly more executive difficulties in the TBI than control group (Behavior Regulation Index, P = 0.005; Metacognitive index, P = 0.02; Global Executive Composite, P = 0.012). Correlations between BRIEF and TAP scores did not reach statistical significance. BRIEF total score was correlated moderately with length of coma (r = 0.40, P = 0.037), and TAP scores were correlated with the Full-Scale Intellectual Quotient (total number of errors: r = -0.48; P = 0.01; mean reaction time: r = −0.51; P = 0.009). Conclusions: Executive and attention deficits were evident 7 years after severe childhood TBI. Computerized tasks and questionnaires provide complementary and non-redundant information. Systematic long-term follow-up should be provided until the transition to adulthood, to assess ongoing development and to implement timely tailored interventions.

Parkinson’s disease (PD) is the second most common neurodegenerative disorder for which identification of robust biomarkers to complement clinical PD diagnosis would accelerate treatment options and help to stratify disease progression. Here we demonstrate the use of paper spray ionisation coupled with ion mobility mass spectrometry (PSI IM-MS) to determine diagnostic molecular features of PD in sebum. PSI IM-MS was performed directly from skin swabs, collected from 34 people with PD and 30 matched control subjects as a training set and a further 91 samples from 5 different collection sites as a validation set. PSI IM-MS elucidates ~ 4200 features from each individual and we report two classes of lipids (namely phosphatidylcholine and cardiolipin) that differ significantly in the sebum of people with PD. Putative metabolite annotations are obtained using tandem mass spectrometry experiments combined with accurate mass measurements. Sample preparation and PSI IM-MS analysis and diagnosis can be performed ~5 minutes per sample offering a new route to for rapid and inexpensive confirmatory diagnosis of this disease.

Absolute pitch (AP) refers to the ability of identifying the pitch of a given tone without reliance on any reference pitch. The downside of possessing AP may be the experience of disturbance when exposed to out-of-tune tones. Here, we investigated this so-far unexplored phenomenon in AP, which we refer to as auditory aversion. Electroencephalography (EEG) was recorded in a sample of AP possessors and matched control musicians without AP while letting them perform a task underlying a so-called affective priming paradigm: Participants judged valenced pictures preceded by musical primes as quickly and accurately as possible. The primes were bimodal, presented as tones in combination with visual notations that either matched or mismatched the actually presented tone. Regardless of the prime condition, AP possessors performed more poorly in judging pleasant pictures and their EEG revealed later peaks at around 200 ms (P200) after prime onset. Their performance dropped when responding to pleasant pictures preceded by incongruent primes, especially when mistuned by one semitone. This interference was also reflected in an EEG deflection at around 400 ms (N400) after picture onset, preceding the behavior responses. These findings suggest that AP possessors process mistuned musical stimuli and pleasant pictures as affectively unrelated with each other, supporting an aversion towards out-of-tune tones in AP possessors. The longer prime-related P200 latencies exhibited by AP possessors suggest a delay in integrating musical stimuli, underlying an altered affinity towards pitch-label associations.

OBJECTIVE. Exercise-induced laryngeal obstruction (EILO) occurs with paradoxical vocal fold motion or supraglottic collapse during moderate to vigorous exercise. Previously, Gallena et al. (2015) reported lower-than-normal inspiratory (R(i)) and expiratory (R(e)) resistances during resting tidal breathing (RTB) in female teenage athletes with EILO. This study aimed to replicate that unexpected result. METHOD. The Airflow Perturbation Device (APD) measured R(i) and R(e) during three 1-minute trials of RTB in 16 teenage female athletes with EILO and 16 sex-, age- and height-matched controls. Multiple linear regression examined group, age, height, and weight as predictors of R(i) and R(e). RESULTS. R(i) and R(e) tended to be lower in the EILO group than the control group [R(i): F(1,30) = 3.58, p = .068, d = .686; R(e): F(1,30) = 3.28, p = .080, d = .640], but there was no statistically significant difference in the overall effect [F(2,29) = 1.75, p = .192]. After one outlier for R(e) from the EILO group and her matched control were removed, the overall difference was statistically significant, F(2,27) = 3.38, p = .049, with R(e) primarily contributing to the difference [R(i): F(1,28) = 3.66, p = .066, d = .719; R(e): F(1,28) = 5.69, p = .024, d = .899]. CONCLUSION. These results did not replicate the robust differences found previously between R(i) and R(e) during resting tidal breathing in teenage girls with and without EILO, but the results trended in the same direction and met criterion for statistical significance once an outlier was removed from analysis. Overall, the observation that resting respiratory resistances were lower in most teenage girls with EILO suggests that reduced tone of the laryngeal and/or lower airways may predispose young athletes to EILO.

We investigate the effects of private equity on product markets using price and sales data for an extensive number of consumer products. Following a buyout, target firms increase sales 50% more than matched control firms. Price increases—roughly 1% on existing products—do not drive this growth. The launch of new products and geographic expansion do. Competitors lose shelf space and marginally raise prices. Results for public vs. private targets, during and after the financial crisis, and in industries that vary in structure suggest private equity tailors strategies to the environment, eases financial constraints, and provides expertise to manage growth. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

Objectives To evaluate design, methods, and reporting of impact studies of cardiovascular clinical prediction rules (CPRs). Study Design and Setting We conducted a systematic review. Impact studies of cardiovascular CPRs were identified by forward citation and electronic database searches. We categorized the design of impact studies as appropriate for randomized and nonrandomized experiments, excluding uncontrolled before-after study. For impact studies with appropriate study design, we assessed the quality of methods and reporting. We compared the quality of methods and reporting between impact and matched control studies. Results We found 110 impact studies of cardiovascular CPRs. Of these, 65 (59.1%) used inappropriate designs. Of 45 impact studies with appropriate design, 31 (68.9%) had substantial risk of bias. Mean number of reporting domains that impact studies with appropriate study design adhered to was 10.2 of 21 domains (95% confidence interval, 9.3 and 11.1). The quality of methods and reporting was not clearly different between impact and matched control studies. Conclusion We found most impact studies either used inappropriate study design, had substantial risk of bias, or poorly complied with reporting guidelines. This appears to be a common feature of complex interventions. Users of CPRs should critically evaluate evidence showing the effectiveness of CPRs.

INTRODUCTION Several studies have found the negative impact of alcohol use disorder (AUD), most notably coagulation derangements. We sought to investigate the effects of AUD after primary total knee arthroplasty (TKA) for (1) postoperative complications, (2) lengths of stay, and (3) costs of care. METHODS This was a retrospective database analysis of Medicare patients with AUD undergoing primary TKA performed between 2005 and 2014. Patients with AUD were matched to controls in a 1:5 ratio by age, sex, and medical comorbidities. The query yielded 354,690 TKA patients: 59,126 with AUD and 295,564 without AUD. RESULTS Patients with AUD had significantly greater odds ratio (OR) of medical complications, including venous thromboembolism (VTE) within 90 days (OR: 1.41, P < 0.0001) and at 1 year (OR: 1.51, P < 0.0001) and greater 2-year implant-related complications after primary TKA. Furthermore, patients with AUD had significantly longer lengths of stay (4 versus 3 days, P < 0.0001) and incurred a significantly higher episode of care costs ($15,569.76 versus $13,763.06, P < 0.0001). DISCUSSION The present study demonstrated a significant association between AUD and the development of VTE. We hope this research will aid in risk stratification and tailoring of VTE chemoprophylaxis and postoperative management in this at-risk group after TKA. LEVEL OF EVIDENCE Level III.

Background Intraoperative femoral fractures are well-known but often overlooked complications in total hip arthroplasty (THA). We examined outcomes of cerclage cabling for intraoperative calcar cracks in THA with cementless tapered wedge stems. Methods In total, 4928 primary THAs were performed using broach-only, tapered wedge stems between January 2007 and November 2017 in a single institution. Of these, we identified 71 intraoperative calcar cracks (69 patients) managed by 2-mm cerclage cables. Clinical outcomes, amount of stem subsidence, and implant survivorship of the calcar crack group (68 THAs) were compared with those of the matched control group (68 THAs) without intraoperative fractures. Multivariate analysis was performed to identify potential risk factors for stem subsidence >3 mm. Results The mean stem subsidence was greater in the calcar crack group (2.0 vs 1.2 mm, P = .021), whereas revision-free survivorships of THA were similar between groups at 6 years (98.5% vs 98.4%; log-rank, P = .987). In the calcar crack group, a Dorr type C femur and the absence of cabling proximal to the lesser trochanter (LT) were identified as independent risk factors for stem subsidence >3 mm. For the subgroup with 42 calcar cracks managed by a single cable applied proximal to the LT, revision-free survivorship of THA was 100% at 6 years. There was no complete radiolucency to indicate aseptic stem loosening in either group. Conclusion The application of a single cable proximal to the LT of the femur for intraoperative calcar cracks demonstrated 100% revision-free survivorship with lower stem subsidence in THA with tapered wedge stems.

Inflammation is considered as a key pathogenesis factor of dementia and epilepsy. However, epilepsy's association with dementia, particularly its role in the development of dementia, remains unclear. To evaluate the association between epilepsy and the risk of dementia, in Taiwan, we have now conducted a retrospective cohort study comprising 675 individuals (age, ≥50 years) with epilepsy and 2,025 matched control subjects without epilepsy. In order to match individuals diagnosed with epilepsy with those with no diagnosis of epilepsy (comparison cohort), we utilized exact matching at a ratio of 1:3. Compared with those in the comparison cohort, individuals in the epilepsy cohort had a significantly increased risk of developing dementia (adjusted hazard ratio = 2.87, p < 0.001). A similar result has been observed after stratifying for sex (adjusted hazard ratio in males = 2.95, p < 0.001; adjusted hazard ratio in females = 2.66, p < 0.001). To conclude, based on these data, epileptic individuals ≥50 years were at a greater risk of developing dementia than people who do not have epilepsy, which indicates that a diagnosis of epilepsy presents a greater risk for the development of dementia.

Primary Objective: Symptoms following concussion commonly include deficits in attentional processing and elevated anxiety. Prioritized allocation of attentional resources to threat-related information is referred to as attentional bias to threat, which is a cardinal symptom - and in some cases a causal factor in the development - of anxiety. Here, we aimed to assess two possibilities regarding the relationship between attentional bias and anxiety in the post-concussive phase of sport-related concussion: (1) attentional bias mediates the relationship between concussion and anxiety or (2) attentional bias and concussion are uniquely associated with anxiety.Research Design: A cross-sectional between-groups design was used to assess differences in anxiety and attentional bias to threat between collegiate athletes with a recent sport-related concussion and a matched control group.Methods and Procedures: Forty-two collegiate athletes, 21 with a sport-related concussion and 21 matched controls, completed the dot-probe task of attentional bias and an anxiety questionnaire.Main Outcomes and Results: Anxiety, but not attentional bias, is elevated in concussion. Additionally, concussion and attentional bias to threat appear to be uniquely associated with anxiety symptoms.Conclusions: Unique treatment/rehabilitation strategies should be considered for individuals with elevated anxiety following concussion.

Transcatheter atrial septal defect closure (TAC) is a well-established therapy for most patients with secundum atrial septal defects (ASD) based on short-term data ([1][1]). In previous surgical studies, mortality was not significantly different from age-and-sex matched control subjects ([2][2]).

Purpose: To compare the characteristics and outcomes of severely injured trauma patients with or without preinjury stroke. Methods: A retrospective matched cohort study was conducted using data from the Japan Trauma Databank (JTDB), a Japan-nationwide hospital-based trauma registry from the year of 2003 to 2017. Adult (>15 years old) trauma patients were selected from the database and subjected to the within-cluster propensity-score matching. Patients with or without preinjury stroke were matched on 1:1 basis with the balancing of preinjury confounders consisted of fixed effect confounders (age and preinjury comorbidities except for stroke) and random effect confounders (sex, year of injury and hospital). The mechanism, anatomical distribution and severity of injury under the definition of the Abbreviated Injury Scale and hospital mortality was compared across the patients with or without preinjury stroke. Association between prior stroke and hospital mortality was also assessed by the quasi Poisson regression model doubly-adjusted for confounders included in the propensity score estimation and the trauma severity. Results: Of 294,274 patients registered in JTDB, 13,532 and 254,670 trauma patients did and did not complicate with preinjury stroke were selected as the study participants, respectively. Within-cluster propensity score matching extracted 13,212 patients each with or without preinjury stroke whose preinjury characteristics were adequately balanced across the groups. Fall on the ground was the most popular mechanism of injury and significantly higher in the group with preinjury stroke (75.9% versus 64.4%, risk ratio [RR] 1.18 95%CI [1.14, 1.21]). The severe injuries in head (34.1% versus 31.4%, RR 1.09 96%CI [1.04, 1.14]) pelvis and lower extremities (42.9% versus 39.8%, RR 1.08 95%CI [1.04, 1.12]) were relatively frequent in the stroke survivors, in contrast, those in chest, abdomen, and spine were relatively infrequent in the stroke survivors. Adjusted hospital mortality was similar in patients with or without prior stroke (RR 1.00 95%CI [0.91, 1.09]). Conclusion: Severely injured trauma patients with preinjury stroke were associated with frequent fall and possibly fall-related injuries on the head, hip and lower extremities.

Private religiosity can lead to perceived growth after bereavement, but little is known about the role of mindfulness and the time since loss in widowed adults. Using data from the second panel of the Midlife in the United States study (MIDUS), this study examined adults (n = 250) who were married one time and became widowed. Results showed that spiritual mindfulness moderated the effect of private religious practices on personal growth, and that the association between spiritual mindfulness and positive reinterpretation was moderated by time since loss. A high level of spiritual mindfulness seems to benefit widowed adults’ personal growth and positive reinterpretation. Additionally, the greater time since loss the more positive is the association between mindfulness and positive reinterpretation. No difference was found in means between widowed adults and a matched control group of non-widowed adults (n = 250) on personal growth and positive reinterpretation.

To examine the effect of untreated obstructive sleep apnea (OSA) on health care utilization (HCU) and costs among a nationally representative sample of Medicare beneficiaries.Our data source was a random 5% sample of Medicare administrative claims data for years 2006-2013. OSA was operationalized as (1) receipt of one or more International Classification of Disease, Version 9, Clinical Modification diagnostic codes for OSA in combination with (2) initiation of OSA treatment with either continuous positive airway pressure or oral appliance (OA) therapy. First, HCU and costs were assessed during the 12 months prior to treatment initiation. Next, these HCU and costs were compared between beneficiaries with OSA and matched control patients without sleep-disordered breathing using generalized linear models.The final sample (n = 287,191) included 10,317 beneficiaries with OSA and 276,874 control patients. In fully adjusted models, during the year prior to OSA diagnosis and relative to matched control patients, beneficiaries with OSA demonstrated increased HCU and higher mean total annual costs ($19,566, 95% confidence interval [CI] $13,239, $25,894) as well as higher mean annual costs across all individual points of service. Inpatient care was associated with the highest incremental costs (ie, greater than control patients; $15,482, 95% CI $8,521, $22,443) and prescriptions were associated with the lowest incremental costs (ie, greater than control patients; $431, 95% CI $339, $522).In this randomly selected and nationally representative sample of Medicare beneficiaries and relative to matched control patients, individuals with untreated OSA demonstrated increased HCU and costs across all points of service.

This study aimed to compare screw placement accuracy and clinical aspects between Augmented Reality Surgical Navigation (ARSN) and free-hand (FH) technique. Twenty patients underwent spine surgery with screw placement using ARSN and were matched retrospectively to a cohort of 20 FH technique cases for comparison. All ARSN and FH cases were performed by the same surgeon. Matching was based on clinical diagnosis and similar proportions of screws placed in the thoracic and lumbosacral vertebrae in both groups. Accuracy of screw placement was assessed on postoperative scans according to the Gertzbein scale and grades 0 and 1 were considered accurate. Procedure time, blood loss and length of hospital stay, were collected as secondary endpoints. A total of 262 and 288 screws were assessed in the ARSN and FH groups, respectively. The share of clinically accurate screws was significantly higher in the ARSN vs FH group (93.9% vs 89.6%, p

For families with a child with chronic pain, the home environment is the context in which adaptive or maladaptive illness behaviors are developed. Supporting families to effectively cope with their child’s chronic pain is a critical need. This work analyzes intervention approaches from emerging treatment programs to support families coping with pediatric pain that diverge from traditional treatment models by specifically targeting parents. Two novel parent intervention programs are presented that consider caregiver needs in both outpatient and inpatient pain treatment settings: Parents as Coping Coaches and Putting Parents FIRST. These programs are evaluated through comparing parental training components across different stages of treatment. Additionally, the efficacy of Putting Parents FIRST in promoting maintenance of children’s functional gains achieved in intensive interdisciplinary pain treatment is presented, and compared to previous results of the efficacy of Putting Parents FIRST. Specifically, outcomes of 36 children whose parents received the intervention in Putting Parents FIRST were compared to a matched control sample of children whose parents did not receive the parent intervention. Similar to the findings from Parents as Coping Coaches, results indicated that patients whose parents received the intervention maintained/improved program gains in disability, coping, and pain significantly more than patients whose parents did not receive the intervention. Implications for parent-focused intervention development efforts targeting parent and youth functioning in the context of pediatric chronic pain are considered.

Background To evaluate the presence of oral lesions in a group of patients with primary Sjögren’s syndrome (pSS) and compare these results with a matched control group (CG). Material and Methods An observational cross-sectional study was conducted. 61 pSS patients (60 women, 1 man, mean age 57.64±13.52) diagnosed according to the American European Criteria (2002), and 122 matched control patients (120 women, 2 men, mean age 60.02±13.13) were included. Demographic and medical data, oral lesions and salivary flow rate were collected. Results Compared with the controls, pSS patients were 3.95 more likely to have oral lesions (OR 3.95; 95% CI 2.06-7.58; p=0.0001). 57.4% pSS patients presented oral lesions compared to 25.4% in CG. The most common were candidiasis (13.1% vs 2.5%), traumatic lesions (13.1% vs 4.1%), apthae (8.2% vs 0), and fissuration of the tongue (8.2% vs 0.8%). pSS patients with oral lesions had lower salivary flow levels (stimulated and unstimulated), although these differences were not significant. Significant associations were found between the presence of oral lesions and systemic manifestations and history of parotid gland enlargement in pSS patients. Conclusions pSS patients suffer more oral lesions than general population and these lesions may aggravate the pSS disease. Key words:Sjögren’s syndrome, oral lesions, oral diseases, oral manifestations, oral disorders.

Background home advice and modification interventions aim to promote independent living for those living in the community, but quantitative evidence of their effectiveness is limited. Aim assess the risk of care home admissions for people with different frailty levels receiving home advice and modification interventions against a control group who do not. Study design and setting matched control evaluation using linked longitudinal data from the Secure Anonymised Information Linkage (SAIL) Databank, comprising people aged 60–95, registered with a SAIL contributing general practice. The intervention group received the Care & Repair Cymru (C & RC) service, a home advice and modification service available to residents in Wales. Methods frailty, age and gender were used in propensity score matching to assess the Hazard Ratio (HR) of care home admissions within a 1-, 3- and 5-year period for the intervention group (N = 93,863) compared to a matched control group (N = 93,863). Kaplan–Meier curves were used to investigate time to a care home admission. Results the intervention group had an increased risk of a care home admission at 1-, 3- and 5-years [HR (95%CI)] for those classified as fit [1-year: 2.02 (1.73, 2.36), 3-years: 1.87 (1.72, 2.04), 5-years: 1.99 (1.86, 2.13)] and mildly frail [1-year: 1.25 (1.09, 1.42), 3-years: 1.25 (1.17, 1.34), 5-years: 1.30 (1.23, 1.38)], but a reduced risk of care home admission for moderately [1-year: 0.66 (0.58, 0.75), 3-years: 0.75 (0.70, 0.80), 5-years: 0.83 (0.78, 0.88)] and severely frail individuals [1-year: 0.44 (0.37, 0.54), 3-years: 0.54 (0.49, 0.60), 5-years: 0.60(0.55, 0.66)]. Conclusions HRs indicated that the C & RC service helped to prevent care home admissions for moderately and severely frail individuals. The HRs generally increased with follow-up duration.

Absolute pitch (AP) refers to the ability of identifying the pitch of a given tone without reliance on any reference pitch. The downside of possessing AP may be the experience of disturbance when exposed to out-of-tune tones. Here, we investigated this so-far unexplored phenomenon in AP, which we refer to as auditory aversion. Electroencephalography (EEG) was recorded in a sample of AP possessors and matched control musicians without AP while letting them perform a task underlying a so-called affective priming paradigm: Participants judged valenced pictures preceded by musical primes as quickly and accurately as possible. The primes were bimodal, presented as tones in combination with visual notations that either matched or mismatched the actually presented tone. Both samples performed better in judging unpleasant pictures over pleasant ones. In comparison with the control musicians, the AP possessors revealed a more profound discrepancy between the two valence conditions, and their EEG revealed later peaks at around 200 ms (P200) after prime onset. Their performance dropped when responding to pleasant pictures preceded by incongruent primes, especially when mistuned by one semitone. This interference was also reflected in an EEG deflection at around 400 ms (N400) after picture onset, preceding the behavior responses. These findings suggest that AP possessors process mistuned musical stimuli and pleasant pictures as affectively unrelated with each other, supporting an aversion towards out-of-tune tones in AP possessors. The longer prime-related P200 latencies exhibited by AP possessors suggest a delay in integrating musical stimuli, underlying an altered affinity towards pitch-label associations.

Purpose. To evaluate the diagnostic performance of a novel noninvasive automated workup employed for the diagnosis of dry eye disease (DED). Methods. One hundred patients with mild to moderate DED and 100 matched control subjects were enrolled in this cross-sectional study. Ocular surface examinations were carried out by means of IDRA Plus (SBM Sistemi, Turin, Italy), which allows the automated evaluation of noninvasive breakup time (NIBUT), lipid layer thickness (LLT), tear meniscus height (TMH), infrared meibography for the measurement of meibomian gland loss (MGL), and blinking analysis. Continuous variables were compared between patients with DED and controls by using the Mann–Whitney U test. The area under the curve (AUC) of receiver operating characteristic curves was calculated. The correlations between ocular surface parameters were evaluated with Pearson correlation analysis. Results. Patients with DED showed significantly lower values of NIBUT, LLT, and TMH compared to controls (6.9 ± 2.5 vs 10.4 ± 2.4 s, P P = 0.003; 0.231 ± 0.115 vs 0.289 ± 0.164, P = 0.012, respectively). Conversely, no significant differences were observed for MGL and blinking analysis (both P > 0.05). NIBUT had the highest diagnostic power (AUC = 0.841, sensitivity = 0.89, and specificity = 0.69), followed by LLT (AUC = 0.621, sensitivity = 0.89, and specificity = 0.55), TMH (AUC = 0.606, sensitivity = 0.57, and specificity = 0.63), blink analysis (AUC = 0.533, sensitivity = 0.48, and specificity = 0.59), and MGL (AUC = 0.531, sensitivity = 0.54, and specificity = 0.48). In patients with DED, NIBUT showed a significant correlation with TMH (R = 0.347, P = 0.002) and blinking analysis (R = 0.356, P P = 0.008). Conclusions. The automated noninvasive workup validated in this study may be a useful tool for reaching a noninvasive diagnosis of DED with a good performance, especially for NIBUT.

Having constructed a matched control group, one must check that it is satisfactory, in the sense of balancing the observed covariates. If some covariates are not balanced, then adjustments are made to bring them into balance. Three adjustments are almost exact matching, exact matching, and the use of small penalties. Exact matching has a special role in extremely large problems, where it can be used to accelerate computation. Matching when some covariates have missing values is discussed.

Background A recent systematic review found that language deficits are not very common in individuals with multiple sclerosis (MS). However, there are significant gaps in our knowledge about language abilities in MS. For instance, morphosyntactic production has not been explored adequately thus far. This study investigated verb-related morphosyntactic production in MS focusing on Greek, a morphologically rich language. Methods A sentence completion task tapping into the production of subject-verb agreement, time reference/tense, and grammatical aspect was administered to 39 Greek-speaking individuals with MS [25 individuals with relapsing-remitting MS (RRMS group) and 14 individuals with secondary progressive MS (SPMS group)]. The task included only regular verbs. Generalized linear mixed-effects models were used to investigate the ability of individuals with MS to produce the above-mentioned morphosyntactic categories. Results Overall, the RRMS and SPMS groups performed significantly worse than their matched control groups. Moreover, all four groups performed significantly worse on grammatical aspect than on subject-verb agreement and time reference. The difference between subject-verb agreement and time reference was not significant in any of the four groups. The overall performances of the RRMS and SPMS groups did not differ significantly. Conclusion Individuals with MS are impaired in verb-related morphosyntactic production. Moreover, the pattern of performance of individuals with MS is identical to that exhibited by neurologically healthy individuals. Thus, the production performance of individuals with MS on verb inflection differs from that of healthy controls quantitatively but not qualitatively.

We investigate the long-run stock return performance of European cross-border merger and acquisition (M&A) bidders for the period 2002–2012. Our analysis shows that, though acquirers underperform their matched control firms over the thirty-six months following deal completion, this underperformance is not ascribed to the acquisition event, but rather explained by differences between acquirers and control firms in seven firm characteristics. Results are obtained by applying the augmented buy-and-hold abnormal return (BHAR) method. We enhance the robustness of our results by introducing the propensity score methodology to the analysis in addition to matching based on size and book-to-market equity.

Left-turn lanes are commonly introduced to provide space to accommodate comfortable deceleration and adequate storage of turning vehicles. Operational shortcomings may arise due to inadequate length, including overflow and blockage of left-turn entrance by queues on an adjacent through lane. This study investigates the potential safety and operational benefits of treating left-turn lanes by extending the length further upstream a signalized intersection. Video data was collected at three treated left-turn lanes as well as three matched control lanes; all in both before and after treatment conditions. Safety parameters consisted of the counts and severities of traffic conflicts occurring on the left-turn lanes and inside the intersection. There was a marked reduction in traffic conflict counts in all treated sites. The overall treatment effect, which accounts for the simultaneous change in control sites, was 63.2% (p 0.05). There was a marked reduction in frequency of traffic conflicts at different severity levels. The mobility benefit of the treatment was demonstrated in terms of the reduction in average travel time for left-turn as well as through vehicles. The count of traffic signal cycles with blocked left-turn entrance was considerably reduced after the treatment. The use of collision data gathered from more sites is suggested as potential future work to further evaluate this treatment.

There are differences concerning reported mortality rates and prognostic factors of bullous pemphigoid (BP) patients in different studies. Our objectives were to evaluate the mortality rates and prognostic factors among Israeli BP patients compared to matched control subjects. Three age- and sex-matched patients without BP (n = 261) who were treated in our clinic were selected and compared to BP patients (n = 87). Mean survival period of the BP group was 4.1 years (95% CI: 3.3-4.8 years) and 5.9 years among the non-BP group (95% CI: 5.6-6.3 years). The 1-year mortality rate was 24.1% for the BP group and 6.5% for the control group. In multivariate analysis, age above 80 was a significant risk factor for mortality [HR 3.22 (95% CI, 1.15-8.96), p = 0.03], while statins intake had a protective role [HR 0.36 (95% CI, 0.15-0.88), p = 0.03]. In univariant analysis, dementia [HR 2.44 (95% CI, 1.02-5.99), p = 0.04] was a risk factor. In conclusion, BP patients' mortality is correlated to increasing age at diagnosis, dementia, and statins use. Statins' protective role is newly discussed in the literature.

Objectives: To evaluate serum vitamin D3, Blood Eosinophils, AbsoluteEosinophils Counts and IgE in the upper respiratory tract allergies (URTA) in Rural PopulationSindh. Study Design: Case control study. Place and Duration: Department of Medicine andBiochemistry, Isra University from January 2014 to October 2015. Subjects & Methods: Asample of 50 diagnosed cases of URTA and 50 age and gender matched control subjects wereselected through non-probability sampling. Blood samples were centrifuged to separate sera.Serum vitamin D3, Blood Eosinophils, Absolute Eosinophils and serum IgE were estimated.Data was analyzed on the SPSS 22.0 software at 95% confidence interval (P≤0.05). Results:Vitamin D3 showed significant decrease in allergic subjects; noted as 26.96±9.75 ng/dlcompared to 32.62±11.75 ng/dl in controls. Blood Eosinophils (%) were raised in the allergicsubjects compared to controls 3.42±1.91 and 1.93±0.65 respectively (p=0.0001). AbsoluteEosinophils counts (AEC) were significantly raised in the allergic cases as shown in Table-I(p=0.0001). Serum IgE in controls and cases was noted as 86.7±17.39 and 400.26±232.8IU/ml respectively (p=0.0001). Conclusion: The present study reports vitamin D3 deficiencyassociated with raised Eosinophils, Absolute Eosinophils counts and serum IgE in upperrespiratory tract allergy.

Aim of the work: To assess the neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) in rheumatoid arthritis (RA) patients and compare between active cases and those in remission. Patients and methods: The study included 50 RA patients and 20 matched control. Patients were enrolled into 2 equally divided groups; group A (active) with a disease activity score (DAS-28) ≥2.6 and group B (remission)