bluuebunny/crossref_metadata_2025 huggingface dataset:
Symmetry-broken metamaterial for blocking, cloaking, and supertunneling of sound in a subwavelength scale
Authors: Xia Baizhan , Dai Hongqing , Yu Dejie
Published: June 2016

Metamaterials offer extraordinary possibilities for manipulating the propagation of the sound wave in a subwavelength scale. However, the design of acoustic metamaterials remains challenging with traditional strategies, employing two different types of acoustic resonators simultaneously or using specific substructures with multiple resonances. Here we design a symmetry-broken metamaterial comprising of only Helmholtz resonators whose periodical spatial arrangements are broken. The symmetry-broken metamaterials form a hollow hexagonal resonant absorber with two significant resonances. One is the monopolar resonance presenting a collective in-phase pattern motion independent of angle. The other is the dipolar resonance originating from the multiple scattering of symmetry-broken metamaterials. By concentrating the sound energy in peaks of their modes, the hollow hexagonal resonant absorber with extremely small filling ratio can be effectively used to block the propagation of the sound wave in a low-frequency range between monopolar and dipolar resonances. Numerical results also show that the symmetry-broken metamaterials with careful arrangement can be applied to the sound cloaking and the sound supertunneling.
Acoustofluidic harvesting of microalgae on a single chip
Authors: Park Jee-Woong , Kim Soo Hyeon , Ito Takuro , Fujii Teruo , Kim So Youn , Laurell Thomas , Lee Sang Wook , Goda Keisuke
Published: June 2016

We present an on-chip acoustofluidic platform for harvesting a target microalgal species from a heterogeneous population of cells and particles based on their size, density, and compressibility in a rapid, non-invasive, energy-efficient, continuously running, and automated manner. For our proof-of-principle demonstration, we use Euglena gracilis as a target species. Specifically, we show the simultaneous separation and enrichment of E. gracilis from a mixed population of E. gracilis in pond water (consisting of other microalgae and various kinds of particles as contaminants) on a single acoustofluidic chip with a recovery ratio of 92.6%, a target separation ratio of 90.1%, a concentration factor of 3.43, an enrichment factor of 12.76, and a cell viability rate of 98.3% at a high volume rate of 500 μl/min. Our results indicate that the on-chip acoustofluidic platform is an effective tool for harvesting target microalgae from mixed populations of microalgae and other contaminants.
Influences of defects evolvement on the properties of sputtering deposited ZnO:Al films upon hydrogen annealing
Authors: Yin Shiliu , Shirolkar Mandar M. , Li Jieni , Li Ming , Song Xiao , Dong Xiaolei , Wang Haiqian
Published: June 2016

Understanding how the defects interact with each other and affect the properties of ZnO:Al films is very important for improving their performance as a transparent conductive oxide (TCO). In the present work, we studied the effects of hydrogen annealing on the structural, optical and electrical properties of ZnO:Al films prepared by magnetron sputtering. High resolution transmission electron microscopy observations reveal that annealing at ∼300 oC induces the formation of partial dislocations (PD) and stacking faults (SF), which disrupt the lattice periodicity leading to decreased grain size. Annealing at temperatures above ∼500 oC can remove the PD and SF, but large number of zinc vacancies will be generated. Our results show that when films are annealed at ∼500 oC, the oxygen-related defects (interstitials Oi, etc.) in the as-grown films can be remarkably removed or converted, which lead to increments in the carrier concentration, mobility, and the transmittance in the visible range. At annealing temperatures above 550 oC, the hydrogen etching effect becomes predominant, and Al donors are deactivated by zinc vacancies. We also find an abnormal endothermic process by thermal analysis and an abnormal increase in the resistivity during heating the sample under hydrogen atmosphere, based on which the interaction of Oi with the defects (mainly Al donors and PD) is discussed. It is also demonstrated that by annealing the as-grown AZO films at ∼500 oC under hydrogen atmosphere, high performance TCO films with a low resistivity of 4.48 × 10−4 Ωcm and high transmittance of above 90% in the visible light are obtained.
Electrostriction coefficient of ferroelectric materials from ab initio computation
Authors: Jiang Z. , Zhang R. , Li F. , Jin L. , Zhang N. , Wang D. , Jia C.-L.
Published: June 2016

Electrostriction is an important material property that characterizes how strain changes with the development of polarization inside a material. We show that ab initio techniques developed in recent years can be exploited to compute and understand electrostriction of ferroelectric materials. Here, electrostriction coefficients of ferroelectric BaTiO3, PbTiO3, as well as dielectric BaZrO3, are obtained and analyzed. Possible causes of the difference between experimental and numerical results are discussed. We also identified that relative displacements between certain ions at a given polarization could be a good indicator of a material’s electrostriction property.
Airy function approach and Numerov method to study the anharmonic oscillator potentials V(x) = Ax2α + Bx2
Authors: Al Sdran N. , Maiz F.
Published: June 2016

The numerical solutions of the time independent Schrödinger equation of different one-dimensional potentials forms are sometime achieved by the asymptotic iteration method. Its importance appears, for example, on its efficiency to describe vibrational system in quantum mechanics. In this paper, the Airy function approach and the Numerov method have been used and presented to study the oscillator anharmonic potential V(x) = Ax2α + Bx2, (A>0, B<0), with (α = 2) for quadratic, (α =3) for sextic and (α =4) for octic anharmonic oscillators. The Airy function approach is based on the replacement of the real potential V(x) by a piecewise-linear potential v(x), while, the Numerov method is based on the discretization of the wave function on the x-axis. The first energies levels have been calculated and the wave functions for the sextic system have been evaluated. These specific values are unlimited by the magnitude of A, B and α. It’s found that the obtained results are in good agreement with the previous results obtained by the asymptotic iteration method for α =3.
Bioeconomic modelling of woody regrowth carbon offset options in productive grazing systems
Authors: Gowen Rebecca , Bray Steven G.
Published: June 2016

Agricultural land has been identified as a potential source of greenhouse gas emissions offsets through biosequestration in vegetation and soil. In the extensive grazing land of Australia, landholders may participate in the Australian Government’s Emissions Reduction Fund and create offsets by reducing woody vegetation clearing and allowing native woody plant regrowth to grow. This study used bioeconomic modelling to evaluate the trade-offs between an existing central Queensland grazing operation, which has been using repeated tree clearing to maintain pasture growth, and an alternative carbon and grazing enterprise in which tree clearing is reduced and the additional carbon sequestered in trees is sold. The results showed that ceasing clearing in favour of producing offsets produces a higher net present value over 20 years than the existing cattle enterprise at carbon prices, which are close to current (2015) market levels (~$13 t–1 CO2-e). However, by modifying key variables, relative profitability did change. Sensitivity analysis evaluated key variables, which determine the relative profitability of carbon and cattle. In order of importance these were: the carbon price, the gross margin of cattle production, the severity of the tree–grass relationship, the area of regrowth retained, the age of regrowth at the start of the project, and to a lesser extent the cost of carbon project administration, compliance and monitoring. Based on the analysis, retaining regrowth to generate carbon income may be worthwhile for cattle producers in Australia, but careful consideration needs to be given to the opportunity cost of reduced cattle income.
Molecular phylogeny, divergence time estimates and historical biogeography within one of the world's largest monocot genera
Authors: Li Qin-Qin , Zhou Song-Dong , Huang De-Qing , He Xing-Jin , Wei Xian-Qin
Published: June 2016

A primary aim of historical biogeography is to identify the causal factors or processes that have shaped the composition and distribution of biotas over time. Another is to infer the evolution of geographic ranges of species and clades in a phylogenetic context. To this end, historical biogeography addresses important questions such as: Where were ancestors distributed? Where did lineages originate? Which processes cause geographic ranges to evolve through time? Allium subgenus Anguinum comprises approximately twelve taxa with a disjunct distribution in the high mountains from south-western Europe to eastern Asia and in northeastern North America. Although both the systematic position and the geographical limits of Anguinum have been identified, to date no molecular systematic study has been performed utilizing a comprehensive sampling of these species. With an emphasis on the Anguinum eastern Asian geographical group, the goals of the present study were: (i) to infer species-level phylogenetic relationships within Anguinum , (ii) to assess molecular divergence and estimated the times of the major splits in Anguinum and (iii) to trace the biogeographic history of the subgenus. Four DNA sequences (ITS, matK , trnH-psbA , rps16 ) were used to reconstruct the phylogeny of Allium subgen. Anguinum . RbcL sequences were used to estimate divergences time for Allium , and sequences of ITS were used to estimate the divergence times for Anguinum and its main lineages and to provide implications for the evolutionary history of the subgenus. Phylogenetic analyses for all Allium corroborate that Anguinum is monophyletic and indicate that Anguinum is composed of two sister groups: one with a Eurasian–American distribution, and the other restricted to eastern Asia. In the eastern Asian geographical group, incongruence between gene trees and morphology-based taxonomies was recovered as was incongruence between data from plastid and nuclear sequences. This incongruence is likely due to the combined effects of a recent radiation, incomplete lineage sorting, and hybridization/introgression. Divergence time estimates suggest that the crown group of Anguinum originated during the late Miocene (ca. 7.16 Mya) and then diverged and dispersed. Biogeographic analyses using statistical dispersal–vicariance analysis (S-DIVA) and a likelihood method support an eastern Asia origin of Anguinum . It is inferred that in the late Pliocene/Early Pleistocene, with cooling climates and the uplift of the Himalayas and Hengduan Mountains, the ancestor of the eastern Asian alliance clade underwent a very recent radiation.
The defensive role of foliar endophytic fungi for a South American tree
Authors: González-Teuber Marcia
Published: June 2016

Fungal endophytes colonize living internal plant tissues without causing any visible symptoms of disease. Endophytic fungi associated with healthy leaves may play an important role in the protection of hosts against herbivores and pathogens. In this study, the diversity of foliar endophytic fungi (FEF) of the southern temperate tree Embothrium coccineum (Proteaceae), as well as their role in plant protection in nature was determined. Fungal endophytes were isolated from 40 asymptomatic leaves by the culture method for molecular identification of the 18S rRNA gene. A relationship between FEF frequency and plant protection was evaluated in juveniles of E. coccineum . Fungal endophyte frequency was estimated using real-time PCR analyses to determine endophyte DNA content per plant. A total of 178 fungal isolates were identified, with sequence data revealing 34 different operational taxonomic units (OTUs). A few common taxa dominated the fungal endophyte community, whereas most taxa qualified as rare. A significant positive correlation between plant protection (evaluated in terms of percentage of leaf damage) and FEF frequency was found. Furthermore, in vitro confrontation assays indicated that FEF were able to inhibit the growth of fungal pathogens. The data showed a relatively high diversity of fungal endophytes associated with leaves of E. coccineum , and suggest a positive relationship between fungal endophyte frequencies in leaves and host protection in nature.
Vecuum: identification and filtration of false somatic variants caused by recombinant vector contamination
Authors: Kim Junho , Maeng Ju Heon , Lim Jae Seok , Son Hyeonju , Lee Junehawk , Lee Jeong Ho , Kim Sangwoo
Published: June 2016

Motivation: Advances in sequencing technologies have remarkably lowered the detection limit of somatic variants to a low frequency. However, calling mutations at this range is still confounded by many factors including environmental contamination. Vector contamination is a continuously occurring issue and is especially problematic since vector inserts are hardly distinguishable from the sample sequences. Such inserts, which may harbor polymorphisms and engineered functional mutations, can result in calling false variants at corresponding sites. Numerous vector-screening methods have been developed, but none could handle contamination from inserts because they are focusing on vector backbone sequences alone.

Results: We developed a novel method—Vecuum—that identifies vector-originated reads and resultant false variants. Since vector inserts are generally constructed from intron-less cDNAs, Vecuum identifies vector-originated reads by inspecting the clipping patterns at exon junctions. False variant calls are further detected based on the biased distribution of mutant alleles to vector-originated reads. Tests on simulated and spike-in experimental data validated that Vecuum could detect 93% of vector contaminants and could remove up to 87% of variant-like false calls with 100% precision. Application to public sequence datasets demonstrated the utility of Vecuum in detecting false variants resulting from various types of external contamination.

Availability and Implementation: Java-based implementation of the method is available at http://vecuum.sourceforge.net/

Contact:  swkim@yuhs.ac

Supplementary information:  Supplementary data are available at Bioinformatics online.
The relationship between body angle and target strength of ribbonfish (Trichiurus japonicus) displaying a vertical swimming motion
Authors: Tomiyasu Makoto , Kao Wan-Yu , Abe Koki , Minami Kenji , Hirose Taro , Ogawa Michio , Miyashita Kazushi
Published: June 2016

During movement, the body angles of ribbonfish change, including a unique vertical swimming motion that influences their target strength (TS). In this study, we observed body angle changes in ribbonfish using an acceleration data logger and video recordings. Based on these data, variations in echo intensity in response to body angle changes were revealed using radiograph images of the swimbladder and the respective TS values. The frequency of a body angle >60° was 57.78% peak at 77°. The swimbladders were found to be slender ellipses inclined 3–4° upward from the body axis. The TS peaked (about −30 dB for the average pre-anal length of 223.9 ± 21.8 mm) when the body angle was horizontal or inclined 2–3° downward. The TS decreased substantially when the body angle was vertically inclined. From about 10° upward inclination to vertical, the TS fluctuated between −50 and −60 dB. In a comparison of the average TS values among body angle categories, the TS values for body angles grouped as ‘vertical’ (between 60° and 90°), showing static mode activity patterns in video recordings, were low (−55.7 ± 3.9 dB, Mean ± SD), whereas those for the horizontal body angle (between 0° and 30°) category, comprising the active mode, were high (−47.0 ± 8.7 dB) (P-value < 0.01). In the natural habitat, ribbonfish are known to gather at the sea floor during the daytime. In contrast, at night they disperse and move actively while foraging. Consequently, their echo intensities in natural habitats change substantially in response to their diel changes in behavioural ecology. Additional measurements or theoretical models considering the influence of ribbonfish behaviour should be undertaken as a result of this study.
Environmental correlates of Antarctic krill distribution in the Scotia Sea and southern Drake Passage
Authors: Silk Janet R.D. , Thorpe Sally E. , Fielding Sophie , Murphy Eugene J. , Trathan Philip N. , Watkins Jonathan L. , Hill Simeon L.
Published: June 2016

Antarctic krill is a key prey species for many vertebrate and invertebrate predators in the Southern Ocean; it is also an abundant fishery resource in the Scotia Sea and southern Drake Passage. Here, we identify environmental correlates of krill distribution utilizing acoustic data collected during an extensive international survey in January 2000. Separate models (at scales of 10–80 nautical miles) were derived for the full study area and for each of four subregions: northern and southern shelf waters, the seasonally ice-covered open ocean, and the generally ice-free open ocean. Krill distribution was strongly correlated with bathymetry; densities were higher over island shelves and shelf breaks and decreased with increasing distance offshore. Low krill densities occurred in areas of low chlorophyll concentration and high geostrophic velocity. Krill distribution was also related to sea level anomaly but relationships were not consistent between subregions. The models explained a maximum of 44% of the observed deviance in krill density, but did not reliably identify areas of high krill density in the open ocean, and explained a small proportion of the deviance (16%) in offshore areas covered seasonally by sea ice, probably because of the strong, residual influence of retreated ice. The commercial krill fishery is currently concentrated in shelf areas, where high densities of krill are most predictable. As krill are not predictable in the open ocean, the fishery is likely to remain principally a near-shore operation, and should be managed accordingly.
Improving the power of clinical trials of rheumatoid arthritis by using data on continuous scales when analysing response rates: an application of the augmented binary method
Authors: Wason James M. S. , Jenkins Martin
Published: June 2016

Objective. In clinical trials of RA, it is common to assess effectiveness using end points based upon dichotomized continuous measures of disease activity, which classify patients as responders or non-responders. Although dichotomization generally loses statistical power, there are good clinical reasons to use these end points; for example, to allow for patients receiving rescue therapy to be assigned as non-responders. We adopt a statistical technique called the augmented binary method to make better use of the information provided by these continuous measures and account for how close patients were to being responders.

Methods. We adapted the augmented binary method for use in RA clinical trials. We used a previously published randomized controlled trial (Oral SyK Inhibition in Rheumatoid Arthritis-1) to assess its performance in comparison to a standard method treating patients purely as responders or non-responders. The power and error rate were investigated by sampling from this study.

Results. The augmented binary method reached similar conclusions to standard analysis methods but was able to estimate the difference in response rates to a higher degree of precision. Results suggested that CI widths for ACR responder end points could be reduced by at least 15%, which could equate to reducing the sample size of a study by 29% to achieve the same statistical power. For other end points, the gain was even higher. Type I error rates were not inflated.

Conclusion. The augmented binary method shows considerable promise for RA trials, making more efficient use of patient data whilst still reporting outcomes in terms of recognized response end points.
The Accuracy of Web Sites and Cellular Phone Applications in Predicting the Fertile Window
Authors: Setton Robert , Tierney Christina , Tsai Tony
Published: June 2016

OBJECTIVE:

To evaluate the validity of fertility web sites and applications (apps) by comparing the predicted fertile window of these modalities to the actual fertile window of a standard 28-day cycle.

METHODS:

This was a descriptive study. The top resulting free web sites and electronic apps downloadable to a cellular phone that provide calendars for fertility and ovulation prediction were assessed. Cycles were standardized to 28 days in length, 4 days of menses, and the last menstrual period was set to January 1, 2015. The predicted date of ovulation and fertility window generated were compared with an actual estimated date of ovulation on cycle day 15, January 15, and a fertile window consisting of cycle day 10 to cycle day 15, the day of ovulation plus the preceding 5 cycle days, January 10–15.

RESULTS:

Data from 20 web sites and 33 apps were collected. Of all the web sites and apps used, one web site and three apps predicted the precise fertile window.

CONCLUSION:

Web sites and electronic apps used by the general public to predict fertile windows are generally inaccurate, although the clinical effect of this inaccuracy is unknown. Although they all include the most fertile cycle day, the range of the fertility window varies widely. Patients who are trying to conceive with the assistance of calendars generated from web sites and electronic apps should be counseled on the inaccuracy of these modalities.
Opioid Use Disorder in Pregnancy
Authors: Krans Elizabeth E. , Patrick Stephen W.
Published: June 2016

Opioid abuse among pregnant women has reached epidemic proportions and has influenced maternal and child health policy at the federal, state, and local levels. As a result, we review the current state of opioid use in pregnancy and evaluate recent legislative and health policy initiatives designed to combat opioid addiction in pregnancy. We emphasize the importance of safe and responsible opioid-prescribing practices, expanding the availability and accessibility of medication-assisted treatment and standardizing care for neonates at risk of neonatal abstinence syndrome. Efforts to penalize pregnant women and negative consequences for disclosing substance use to health care providers are harmful and may prevent women from seeking prenatal care and other beneficial health care services during pregnancy. Instead, health care providers should advocate for health policy informed by scientific research and evidence-based practice to reduce the burden of prenatal opioid abuse and optimize outcomes for mothers and their neonates.
Surgeon Experience and Complications of Transvaginal Prolapse Mesh
Authors: Kelly Erin C. , Winick-Ng Jennifer , Welk Blayne
Published: June 2016

OBJECTIVE:

To measure the proportion of women with transvaginal prolapse mesh complications and their association with surgeon volume.

METHODS:

We conducted a retrospective, population-based cohort study of all women who underwent a mesh-based prolapse procedure using administrative data (hospital procedure and physician billing records) between 2002 and 2013 in Ontario, Canada. The primary outcome was surgical revision of the mesh. Primary exposure was surgeon volume: high (greater than the 75th percentile, requiring a median of five [interquartile range 5–6] procedures per year) and very high (greater than the 90th percentile, requiring a median of 13 [interquartile range 11–14] procedures per year) volume mesh implanters were identified each year. Primary analysis was an adjusted Cox proportional hazards model.

RESULTS:

A total of 5,488 women underwent mesh implantation by 1 of 368 unique surgeons. Median follow-up time was 5.4 (interquartile range 3.0–8.0) years. We found that 218 women (4.0%) underwent mesh reoperation a median of 1.17 (interquartile range 0.58–2.90) years after implantation. The hazard of reoperation for complications was only lower for patients of very high-volume surgeons (3.0% [145/3,001] compared with 4.8% [73/2,447], adjusted hazards ratio 0.59, 95% confidence interval 0.40–0.86). In multivariable modeling, younger age, concomitant hysterectomy, blood transfusion, and increased medical comorbidity were all associated with vaginal mesh reoperation.

CONCLUSION:

Approximately 5% of women who underwent mesh-based prolapse surgery required reoperation for a mesh complication within 10 years. The risk of reoperation was lowest for surgeons performing 14 or more procedures per year.
Postpartum Human Immunodeficiency Virus Care Among Women Diagnosed During Pregnancy
Authors: Swain Carol-Ann , Smith Lou C. , Nash Denis , Pulver Wendy P. , Gordon Daniel , Bian Fuqin , Miranda Wilson , Anderson Bridget J. , Chicoine Joyce , Birkhead Guthrie S. , McNutt Louise-Anne
Published: June 2016

OBJECTIVE:

To identify factors associated with continuity of care and human immunodeficiency virus (HIV) virologic suppression among postpartum women diagnosed with HIV during pregnancy in New York State.

METHODS:

This retrospective cohort study was conducted among 228 HIV-infected women diagnosed during pregnancy between 2008 and 2010. Initial receipt of HIV-related medical care (first CD4 or viral load test after diagnosis) was evaluated at 30 days after diagnosis and before delivery. Retention in care (2 or more CD4 or viral load tests, 90 days or greater apart) and virologic suppression (viral load 200 copies/mL or less) were evaluated in the 12 months after hospital discharge.

RESULTS:

Most women had their initial HIV-related care encounter within 30 days of diagnosis (74%) and before delivery (87%). Of these women, 70% were retained in the first year postpartum. Women waiting more than 30 days for their initial HIV-related care encounter were more likely diagnosed in the first (29%) compared with the third (11%) trimester and were of younger (younger than 25 years, 32%) compared with older (35 years or older, 13%) age. Loss to follow-up within the first year was significantly greater among women diagnosed in the third compared with the first trimester (adjusted relative risk 2.21, 95% confidence interval [CI] 1.41–3.45) and among women who had a cesarean compared with vaginal delivery (adjusted relative risk 1.76, 95% CI 1.07–2.91). Of the 178 women with one or more HIV viral load test in the first year postpartum, 58% had an unsuppressed viral load.

CONCLUSION:

Despite the high proportion retained in care, many women had poor postpartum virologic control. Robust strategies are needed to increase virologic suppression among newly diagnosed postpartum HIV-infected women.
Integrating Preexposure Prophylaxis for Human Immunodeficiency Virus Prevention Into Women's Health Care in the United States
Authors: Seidman Dominika , Weber Shannon
Published: June 2016

Women comprise one in five new human immunodeficiency virus (HIV) diagnoses in the United States. Trials and implementation projects demonstrate preexposure prophylaxis for HIV prevention is effective in women. Preexposure prophylaxis is a method of preventing HIV acquisition by having an HIV-negative individual take antiretroviral medication before exposure. The U.S. Food and Drug Administration approved daily oral tenofovir disoproxil fumarate coformulated with emtricitabine as preexposure prophylaxis for HIV prevention in 2012. Preexposure prophylaxis is highly dependent on adherence for effectiveness. The Centers for Disease Control and Prevention recommends offering preexposure prophylaxis to individuals at significant risk of infection and estimates 468,000 women in the United States are eligible for preexposure prophylaxis. Although variable individual and structural forces affect each woman's medication adherence, and therefore the effectiveness of preexposure prophylaxis, women's health care providers are uniquely positioned to screen, counsel about, and offer preexposure prophylaxis. Shared decision-making provides a framework for these clinical encounters, allowing patients and clinicians to make health care decisions together based on scientific evidence and patient experiences. By incorporating fertility desires and contraceptive needs, health care providers effectively integrate sexual and reproductive health care. Including preexposure prophylaxis in women's health services requires health care provider training and attention to lessons learned from family planning and HIV prevention. Nevertheless, obstetrician–gynecologists have an opportunity to play a critical role in reducing sexual transmission of HIV in the United States by integrating preexposure prophylaxis education and provision into their practices.
Abnormal Vaginal Pap Test Results After Hysterectomy in Human Immunodeficiency Virus–Infected Women
Authors: Smeltzer Stephanie , Yu Xiaoying , Schmeler Kathleen , Levison Judy
Published: June 2016

OBJECTIVE:

To evaluate the prevalence of abnormal vaginal cytology and vaginal intraepithelial neoplasia (VAIN) and vaginal cancer in human immunodeficiency virus (HIV)–infected women with no history of abnormal cytologic screening who had a hysterectomy for conditions other than cervical dysplasia and cancer and to explore the risk factors associated with VAIN and vaginal cancer.

METHODS:

A retrospective cohort study was performed identifying 238 women between January 2000 and January 2015 with a history of HIV, previous hysterectomy, and no previous abnormal Pap test results. Medical records from patients with both HIV and a history of hysterectomy were reviewed from Thomas Street Health Center and Northwest Community Health Center.

RESULTS:

Among 238 women, 164 (69%) had normal Pap test results, 12 (5%) had results showing atypical cells of undermined significance and human papillomavirus-positive, 55 (23.1%) had results showing low-grade squamous intraepithelial lesion, and seven (2.9%) had results showing high-grade squamous intraepithelial lesion. No demographic risk factor was associated with abnormal Pap test results after hysterectomy. Median follow-up time for the Pap test was 16 years. Of those who underwent vaginal biopsies for abnormal Pap test results, 15 (28%) had normal results, 23 (43%) had VAIN 1, nine (16%) had VAIN 2, and seven (13%) had VAIN 3. No patients had invasive vaginal cancer.

CONCLUSION:

More than 30% of HIV-infected women who had no prehysterectomy history of abnormal Pap test results had abnormal vaginal Pap test results. Among those who had vaginal biopsies, 29% had VAIN 2 or 3, suggesting that Pap testing posthysterectomy in the HIV population may be indicated.
Obstetric and Neonatal Risks Among Obese Women Without Chronic Disease
Authors: Kim Sung Soo , Zhu Yeyi , Grantz Katherine L. , Hinkle Stefanie N. , Chen Zhen , Wallace Maeve E. , Smarr Melissa M. , Epps Nikira M. , Mendola Pauline
Published: June 2016

OBJECTIVE:

To investigate whether prepregnancy obesity is associated with adverse pregnancy outcomes among women without chronic disease.

METHODS:

Singleton deliveries (N=112,309) among mothers without chronic diseases in the Consortium on Safe Labor, a retrospective U.S. cohort, were analyzed using Poisson regression with robust variance estimation. Relative risks and 95% confidence intervals (CIs) estimated perinatal risks in relation to prepregnancy obesity status adjusted for age, race–ethnicity, parity, insurance, smoking and alcohol use during pregnancy, and study site.

RESULTS:

Obstetric risks were variably (and mostly marginally) increased as body mass index (BMI) category and obesity class increased. In particular, the risk of gestational hypertensive disorders, gestational diabetes, cesarean delivery, and induction increased in a dose–response fashion. For example, the percentage of gestational diabetes among obese class III women was 14.6% in contrast to 2.8% among women with normal BMIs (corresponding relative risks [95% CI] 1.99 [1.86–2.13], 2.94 [2.73–3.18], 3.97 [3.61–4.36], and 5.47 [4.96–6.04] for overweight, obese class I, obese class II, and obese class III women, respectively) compared with women with normal BMIs. Similarly, neonatal risks increased in a dose–response fashion with maternal BMI status including preterm birth at less than 32 weeks of gestation, large for gestational age (LGA), transient tachypnea, sepsis, and intensive care unit admission. The percentage of LGA neonates increased from 7.9% among women with normal BMIs to 17.3% among obese class III women and relative risks increased to 1.52 (1.45–1.58), 1.74 (1.65–1.83), 1.93 (1.79–2.07), and 2.32 (2.14–2.52) as BMI category increased.

CONCLUSION:

Prepregnancy obesity is associated with increased risks of a wide range of adverse pregnancy and neonatal outcomes among women without chronic diseases.
Variation in Postpartum Glycemic Screening in Women With a History of Gestational Diabetes Mellitus
Authors: Eggleston Emma Morton , LeCates Robert Franklin , Zhang Fang , Wharam James Franklin , Ross-Degnan Dennis , Oken Emily
Published: June 2016

OBJECTIVE:

To assess patterns and predictors of postpartum diabetes screening in a commercially insured, geographically and sociodemographically diverse sample of women with gestational diabetes mellitus.

METHODS:

Using commercial insurance claims (2000–2012) from all 50 states, we conducted a retrospective cohort study in 447,556 women with at least one delivery and continuous enrollment 1 year before and after delivery. We identified women with a gestational diabetes mellitus pregnancy and examined postpartum diabetes screening type and timing and performed logistic regression to identify screening predictors.

RESULTS:

Gestational diabetes mellitus was diagnosed in 32,253 (7.2%) women during the study timeframe. Three fourths received no screening within 1 year postpartum. Rates of recommended 75-g oral glucose tolerance testing within 6–12 weeks were low but increased over time (27 [2%] in 2001 compared with 249 [7%] in 2011, adjusted odds ratio [OR] 3.1, 95% confidence interval [CI] 2.0–47). Among women screened, those in the Northeast (19%) and South (18%) were least likely to receive a 75-g oral glucose tolerance test within 0–12 weeks (adjusted OR 0.4 for each, CI 0.4–0.5) compared with the West (36%). Asian women were most likely to receive any screening (18%; adjusted OR 1.5, CI 1.3–1.6) compared with white women (12%). Black women were most likely to receive hemoglobin A1c (21%; adjusted OR 2.0, CI 1.3–3.2) compared with white women (11%). Antepartum antiglycemic medication (21%; adjusted OR 2.1, CI 2.0–2.3) or visit to a nutritionist–diabetes educator (19%; adjusted OR 1.6, CI 1.4–1.7) or endocrinologist (23%; adjusted OR 1.7, CI 1.6–1.9) predicted screening within 12 weeks postpartum.

CONCLUSION:

Postpartum diabetes screening remains widely underused among commercially insured women with gestational diabetes mellitus. Differences in screening by geography, race, and antepartum care can inform health system and public health interventions to increase diabetes detection in this high-risk population.
Control of Postpartum Hemorrhage Using Vacuum-Induced Uterine Tamponade
Authors: Purwosunu Yuditiya , Sarkoen Widyastuti , Arulkumaran Sabaratnam , Segnitz Jan
Published: June 2016

BACKGROUND:

Postpartum hemorrhage is the leading cause of maternal mortality worldwide. Vacuum-induced uterine tamponade is a possible alternative approach to balloon tamponade systems for the treatment of postpartum hemorrhage resulting from atony.

METHOD:

In a prospective proof-of-concept investigation of 10 women with vaginal deliveries in a hospital setting who failed first-line therapies for postpartum hemorrhage, tamponade was used. Vacuum-induced uterine tamponade was created through a device inserted transvaginally into the uterine cavity. An occlusion balloon built into the device shaft was inflated at the level of the external cervical os to create a uterine seal. Negative pressure was created by attaching a self-contained, mobile, electrically powered, pressure-regulated vacuum pump with a sterile graduated canister.

EXPERIENCE:

In all 10 cases, the suction created an immediate seal at the cervical os, 50–250 mL of residual blood was evacuated from the uterine cavity, the uterus collapsed and regained tone within minutes, and hemorrhaging was controlled. The device remained in place for a minimum of 1 hour and up to 6.5 hours in one case while vaginal and perineal lacerations were easily repaired.

CONCLUSION:

This preliminary investigation suggests that a device designed to create vacuum-induced uterine tamponade may be a reasonable alternative to other devices used to treat atonic postpartum hemorrhage.
Association of Low-Dose Aspirin and Survival of Women With Endometrial Cancer
Authors: Matsuo Koji , Cahoon Sigita S. , Yoshihara Kosuke , Shida Masako , Kakuda Mamoru , Adachi Sosuke , Moeini Aida , Machida Hiroko , Garcia-Sayre Jocelyn , Ueda Yutaka , Enomoto Takayuki , Mikami Mikio , Roman Lynda D. , Sood Anil K.
Published: June 2016

OBJECTIVE:

To examine the survival outcomes in women with endometrial cancer who were taking low-dose aspirin (81–100 mg/d).

METHODS:

A multicenter retrospective study was conducted examining patients with stage I–IV endometrial cancer who underwent hysterectomy-based surgical staging between January 2000 and December 2013 (N=1,687). Patient demographics, medical comorbidities, medication types, tumor characteristics, and treatment patterns were correlated to survival outcomes. A Cox proportional hazard regression model was used to estimate adjusted hazard ratio for disease-free and disease-specific overall survival.

RESULTS:

One hundred fifty-eight patients (9.4%, 95% confidence interval [CI] 8.8–11.9) were taking low-dose aspirin. Median follow-up time for the study cohort was 31.5 months. One hundred twenty-seven patients (7.5%) died of endometrial cancer. Low-dose aspirin use was significantly correlated with concurrent obesity, hypertension, diabetes mellitus, and hypercholesterolemia (all P<.001). Low-dose aspirin users were more likely to take other antihypertensive, antiglycemic, and anticholesterol agents (all P<.05). Low-dose aspirin use was not associated with histologic subtype, tumor grade, nodal metastasis, or cancer stage (all P>.05). On multivariable analysis, low-dose aspirin use remained an independent prognostic factor associated with an improved 5-year disease-free survival rate (90.6% compared with 80.9%, adjusted hazard ratio 0.46, 95% CI 0.25–0.86, P=.014) and disease-specific overall survival rate (96.4% compared with 87.3%, adjusted hazard ratio 0.23, 95% CI 0.08–0.64, P=.005). The increased survival effect noted with low-dose aspirin use was greatest in patients whose age was younger than 60 years (5-year disease-free survival rates, 93.9% compared with 84.0%, P=.013), body mass index was 30 or greater (92.2% compared with 81.4%, P=.027), who had type I cancer (96.5% compared with 88.6%, P=.029), and who received postoperative whole pelvic radiotherapy (88.2% compared with 61.5%, P=.014). These four factors remained significant for disease-specific overall survival (all P<.05).

CONCLUSION:

Our results suggest that low-dose aspirin use is associated with improved survival outcomes in women with endometrial cancer, especially in those who are young, obese, with low-grade disease, and who receive postoperative radiotherapy.
Making Room at the Table for Obstetrics, Midwifery, and a Culture of Normalcy Within Maternity Care
Authors: Akileswaran Chitra P. , Hutchison Margaret S.
Published: June 2016

The principle of avoiding the worst possible outcomes guided the enormous successes of modern obstetrics in reducing the morbidity and mortality of childbirth. The challenges of improving the quality of childbirth today has prompted health care providers, policymakers, and patients to ask whether this principle is in fact preventing us from supporting the normal processes of childbirth, resulting in undue intervention and potentially causing harm. In this commentary, we suggest that recognizing the strengths of the medical model of childbirth does not preclude looking outside of it to meet the maternity care needs of the majority of healthy, low-risk women. Obstetricians have the good fortune to have a partner in their work among midwives, who hail from a long tradition of incorporating a perspective of “normalcy” in the care of childbearing women. Given the many evidence-based practices demonstrating the strengths of midwifery to actualize patient-centered, low-intervention birth, we advocate for the explicit establishment of professional standards for team-based physician–midwife care. More than merely introducing midwives into a physician-dominated setting, this means elevating the contributions of midwives and meaningfully incorporating a culture of normalcy to standardize practices such as intermittent auscultation, continuous birth support, nonpharmacologic pain management, and positional flexibility in labor. The literature suggests that a woman's health care provider is the most powerful determinant of her birth outcomes; striking the balance between averting poor outcomes and normalcy compels us to make room at the table for both obstetricians and midwives.
Update on the pathogenesis and treatment of childhood-onset systemic lupus erythematosus
Authors: Couture Julie , Silverman Earl D.
Published: June 2016

Purpose of review

This article will provide an update of studies published in the last year regarding epidemiology, pathogenesis, major disease manifestations and outcomes, and therapies in childhood-onset systemic lupus erythematosus (cSLE).

Recent findings

Recent studies on cSLE epidemiology supported previous findings that cSLE patients have more severe disease and tend to accumulate damage rapidly. Lupus nephritis remains frequent and is still a significant cause of morbidity and mortality. In the past year unfortunately there were no new reproducible, biomarker studies to help direct therapy of renal disease. However, some progress was made in neuropsychiatric disease assessment, with a new and promising automated test to screen for cognitive dysfunction reported. There were no prospective interventional treatment trials designed for patients with cSLE published in the last year, but some studies involving children are currently active and might improve the therapeutic options for patients with cSLE.

There is a need to get a better understanding of pathogenesis and identify new biomarkers in cSLE to more accurately predict outcomes. New insights into characterization of different clinical manifestations may enable to optimize individual interventions and influence the prognosis.
Short-Term Adaptation of Accommodative Responses in Myopes Fitted With Multifocal Contact Lenses
Authors: Ozkan Jerome , Fedtke Cathleen , Chung Jiyoon , Thomas Varghese , Bakaraju Ravi Chandra
Published: June 2016

Objectives:

To investigate whether adaptation of accommodative responses occurred in non-presbyopic myopes fitted with four multifocal contact lens (MFCL) designs.

Methods:

Prospective, subject-masked clinical investigation comprising 40 experienced myopic lens wearers (18–25 years) fitted bilaterally with single-vision (SV) control lens (Air Optix Aqua [Alcon, Fort Worth, TX]) and randomized to two of four test MFCL (Proclear MFCL [Distance and Near] [CooperVision, Pleasanton, CA], Air Optix Aqua MFCL, Purevision MFCL [Bausch & Lomb, Rochester, NY]). Lenses were dispensed on a daily wear basis and worn for a minimum of 8 (maximum 14) days over three assessment visits, with a 1-week wash out between stages. Paraxial curvature matched spherical equivalent (M) was measured with lenses on eye using the BHVI-EyeMapper with an internal movable fixation target positioned at target vergences of +1.00 diopter (D) (fogging) and −2.00 to −5.00 in 1.00 D steps (accommodative stimuli). Accommodative facility was assessed by several flips of ±2.00 D/min (cycles/min) at 33 cm and horizontal phoria with a Howell phoria card at distance (3 m) and near (33 cm).

Results:

For center-distance MFCL (Proclear D), the spherical equivalent (M) at all near vergences became significantly more negative at the follow-up visits compared with the dispensing visit (P<0.029). For all center-near MFCLs and SV lens, M remained invariant during the adaptation period, however (P≥0.267). At distance, M became significantly less minus with Air Optix Aqua MFCL over time (P=0.049). Accommodative facility increased over the three assessment visits for participants wearing Air Optix Aqua SV, Air Optix Aqua MFCL, and PureVision MFCL (P=0.003). Distance and near horizontal phoria remained stable over the three assessment visits for all lens types (P≥0.181).

Conclusions:

Adaptation differences were not consistently found for static accommodative measures gauged by M, as measured with lenses on eye, and phoria but were found in dynamic measures (facility), perhaps indicating some learning effects. Accommodative adaptation seems unlikely to occur with long-term MFCL in non-presbyopes.
Facile usage of a MYTHEN 1K with a Huber 5021 diffractometer and angular calibration inoperandoexperiments
Authors: Gao Mei , Gu Yueliang , Li Li , Gong Zhengliang , Gao Xingyu , Wen Wen
Published: June 2016

A facile usage of a MYTHEN 1K detector with a Huber 5021 six-circle diffractometer is described in detail. A mechanical support has been custom designed for the first time to combine the MYTHEN 1K detector with a point detector, which can be used as a reference point for each individual pixel of the MYTHEN 1K during measurements. The MYTHEN 1K is mounted on the arm of the 2θ circle of the Huber diffractometer with an intrinsic angular resolution of ∼0.0038°, and its pitch angle can be automatically adjusted with an accuracy of 0.0072°. Standard procedures are discussed for its calibration. Programs have been written in theSPECenvironment for simultaneous data conversion, integration and acquisition. The X-ray powder diffraction patterns of standard samples were measured in the Debye–Scherrer geometry and matched well with those of references. The angular shift due to sample-to-center displacement in the `flat-plate transmission' geometry, which is frequently employed inoperandoexperiments, has been successfully investigated and can be efficiently corrected. Oneoperandoexperiment using the MYTHEN 1K is presented. This work provides a straightforward procedure to use the MYTHEN 1K detector properly in Debye–Scherrer geometry, and could facilitate its application at other synchrotron facilities.