bluuebunny/crossref_metadata_2025 huggingface dataset:
The thickness design of unintentionally doped GaN interlayer matched with background doping level for InGaN-based laser diodes
Authors: Chen P. , Zhao D. G. , Jiang D. S. , Zhu J. J. , Liu Z. S. , Yang J. , Li X. , Le L. C. , He X. G. , Liu W. , Li X. J. , Liang F. , Zhang B. S. , Yang H. , Zhang Y. T. , Du G. T.
Published: March 2016

In order to reduce the internal optical loss of InGaN laser diodes, an unintentionally doped GaN (u-GaN) interlayer is inserted between InGaN/GaN multiple quantum well active region and Al0.2Ga0.8N electron blocking layer. The thickness design of u-GaN interlayer matching up with background doping level for improving laser performance is studied. It is found that a suitably chosen u-GaN interlayer can well modulate the optical absorption loss and optical confinement factor. However, if the value of background doping concentration of u-GaN interlayer is too large, the output light power may decrease. The analysis of energy band diagram of a LD structure with 100 nm u-GaN interlayer shows that the width of n-side depletion region decreases when the background concentration increases, and may become even too small to cover whole MQW, resulting in a serious decrease of the output light power. It means that a suitable interlayer thickness design matching with the background doping level of u-GaN interlayer is significant for InGaN-based laser diodes.
Coercivity enhancement in Ce-Fe-B based magnets by core-shell grain structuring
Authors: Ito M. , Yano M. , Sakuma N. , Kishimoto H. , Manabe A. , Shoji T. , Kato A. , Dempsey N. M. , Givord D. , Zimanyi G. T.
Published: March 2016

Ce-based R2Fe14B (R= rare-earth) nano-structured permanent magnets consisting of (Ce,Nd)2Fe14B core-shell grains separated by a non-magnetic grain boundary phase, in which the relative amount of Nd to Ce is higher in the shell of the magnetic grain than in its core, were fabricated by Nd-Cu infiltration into (Ce,Nd)2Fe14B hot-deformed magnets. The coercivity values of infiltrated core-shell structured magnets are superior to those of as-hot-deformed magnets with the same overall Nd content. This is attributed to the higher value of magnetocrystalline anisotropy of the shell phase in the core-shell structured infiltrated magnets compared to the homogeneous R2Fe14B grains of the as-hot-deformed magnets, and to magnetic isolation of R2Fe14B grains by the infiltrated grain boundary phase. First order reversal curve (FORC) diagrams suggest that the higher anisotropy shell suppresses initial magnetization reversal at the edges and corners of the R2Fe14B grains.
Magnetic properties of cubic FeCo nanoparticles with anisotropic long chain structure
Authors: Liu Jinming , Wu Kai , Wang Jian-Ping
Published: March 2016

Cubic FeCo alloy nanoparticles (NPs) with body-centered cubic (bcc) phase were prepared using sputter based gas-condensation method. When the NPs formed long chain assemblies, the magnetic properties were quite different from that of well-dispersed NPs. Most of the well-dispersed NPs were superparamagnetic at room temperature while the long chain NP assemblies were ferromagnetic with coercivities around 765 Oe, which displayed quite different magnetic properties. The ferromagnetism of long chain NPs was from the exchange coupling between NPs, which eventually led to the transition from superparamagnetism (SPM) to superferromagetism (SFM). Zero-field-cooled (ZFC) and field-cooled (FC) curves were obtained and long chain NP assemblies displayed ferromagnetism at the temperature ranging from 10 K to 400 K. Time-dependent remanent magnetic moment curves also indicated that the long chain structure had better thermal stability due to the strong exchange coupling.
Can Application of Commercial Microbial Products Improve Fish Growth and Water Quality in Freshwater Polyculture?
Authors: Tang Jin-yu , Dai Yang-xin , Li You-ming , Qin Jian-guang , Wang Yan
Published: March 2016

A 31-d experiment was conducted to examine the effects of three commercial microbial products (Novozymes pond plus, Zhongshui BIO-AQUA, and Effective Microorganisms) on production performance and water quality in freshwater tanks stocked with Grass Carp Ctenopharyngodon idellus, Gibel Carp Carassius gibelio and Silver Carp Hypophthalmichthys molitrix. Four treatments were used: blank control (BL), adding Novozymes pond plus (NO), adding BIO-AQUA (PB), or adding Effective Microorganisms (EM). The fish were fed daily with a formulated feed, and each of the microbial products was added to the tanks every 10 d. No significant differences were found in survival, weight gain, and feed conversion ratio of the fishes, Secchi depth, chemical water quality, and phytoplankton between the blank control and any other treatments (NO, PB and EM). This study indicates that the addition of these three microbial products every 10 d has limited function to improve production performance and water quality in freshwater polyculture of Grass Carp, Gibel Carp, and Silver Carp within the first 31 d of application.
DUDes: a top-down taxonomic profiler for metagenomics
Authors: Piro Vitor C. , Lindner Martin S. , Renard Bernhard Y.
Published: March 2016

Motivation: Species identification and quantification are common tasks in metagenomics and pathogen detection studies. The most recent techniques are built on mapping the sequenced reads against a reference database (e.g. whole genomes, marker genes, proteins) followed by application-dependent analysis steps. Although these methods have been proven to be useful in many scenarios, there is still room for improvement in species and strain level detection, mainly for low abundant organisms.

Results: We propose a new method: DUDes, a reference-based taxonomic profiler that introduces a novel top-down approach to analyze metagenomic Next-generation sequencing (NGS) samples. Rather than predicting an organism presence in the sample based only on relative abundances, DUDes first identifies possible candidates by comparing the strength of the read mapping in each node of the taxonomic tree in an iterative manner. Instead of using the lowest common ancestor we propose a new approach: the deepest uncommon descendent. We showed in experiments that DUDes works for single and multiple organisms and can identify low abundant taxonomic groups with high precision.

Availability and Implementation: DUDes is open source and it is available at http://sf.net/p/dudes

Supplementary information:  Supplementary data are available at Bioinformatics online.

Contact:  renardB@rki.de
Measles Outbreak Associated With Low Vaccine Effectiveness Among Adults in Pohnpei State, Federated States of Micronesia, 2014
Authors: Hales Craig M. , Johnson Eliaser , Helgenberger Louisa , Papania Mark J. , Larzelere Maribeth , Gopalani Sameer V. , Lebo Emmaculate , Wallace Greg , Moturi Edna , Hickman Carole J. , Rota Paul A. , Alexander Hinden S. , Marin Mona
Published: March 2016

Background.  A measles outbreak in Pohnpei State, Federated States of Micronesia in 2014 affected many persons who had received ≥1 dose of measles-containing vaccine (MCV). A mass vaccination campaign targeted persons aged 6 months to 49 years, regardless of prior vaccination.

Methods.  We evaluated vaccine effectiveness (VE) of MCV by comparing secondary attack rates among vaccinated and unvaccinated contacts after household exposure to measles.

Results.  Among 318 contacts, VE for precampaign MCV was 23.1% (95% confidence interval [CI], −425 to 87.3) for 1 dose, 63.4% (95% CI, −103 to 90.6) for 2 doses, and 95.9% (95% CI, 45.0 to 100) for 3 doses. Vaccine effectiveness was 78.7% (95% CI, 10.1 to 97.7) for campaign doses received ≥5 days before rash onset in the primary case and 50.4% (95% CI, −52.1 to 87.9) for doses received 4 days before to 3 days after rash onset in the primary case. Vaccine effectiveness for most recent doses received before 2010 ranged from 51% to 57%, but it increased to 84% for second doses received in 2010 or later.

Conclusions.  Low VE was a major source of measles susceptibility in this outbreak; potential reasons include historical cold chain inadequacies or waning of immunity. Vaccine effectiveness of campaign doses supports rapid implementation of vaccination campaigns in outbreak settings.
Anchors Away: A New Approach for Estimating Ideal Points Comparable across Time and Chambers
Authors: Asmussen Nicole , Jo Jinhee
Published: March 2016

Existing methods for estimating ideal points of legislators that are comparable across time and chambers make restrictive assumptions regarding how legislators' ideal points can move over time, either by fixing some legislators' ideal points or by constraining their movement over time. These assumptions are clearly contradictory to some theories of congressional responsiveness to election dynamics and changes in constituency. Instead of using legislators as anchors, our approach relies on matching roll calls in one chamber and session with roll calls or cosponsorship decisions on identical bills introduced in a different chamber or session. By using these “bridge decisions” to achieve comparability, we can remove any assumptions about the movement of legislators' ideal points. We produce these estimates for both chambers from the 102nd (1991–92) to 111th (2009–11) Congresses, and we show that our estimates provide interesting insights into the nature of legislative behavior change.
Decision Making Under the Gambler’s Fallacy: Evidence from Asylum Judges, Loan Officers, and Baseball Umpires
*
Authors: Chen Daniel L. , Moskowitz Tobias J. , Shue Kelly
Published: March 2016

We find consistent evidence of negative autocorrelation in decision making that is unrelated to the merits of the cases considered in three separate high-stakes field settings: refugee asylum court decisions, loan application reviews, and Major League Baseball umpire pitch calls. The evidence is most consistent with the law of small numbers and the gambler’s fallacy—people underestimating the likelihood of sequential streaks occurring by chance—leading to negatively autocorrelated decisions that result in errors. The negative autocorrelation is stronger among more moderate and less experienced decision makers, following longer streaks of decisions in one direction, when the current and previous cases share similar characteristics or occur close in time, and when decision makers face weaker incentives for accuracy. Other explanations for negatively autocorrelated decisions such as quotas, learning, or preferences to treat all parties fairly are less consistent with the evidence, though we cannot completely rule out sequential contrast effects as an alternative explanation.
A Novel Algorithm to Derive Spread of Excitation Based on Deconvolution
Authors: Biesheuvel Jan Dirk , Briaire Jeroen J. , Frijns Johan H. M.
Published: March 2016

Objective:

The width of the spread of excitation (SOE) curve has been widely thought to represent an estimate of SOE. Therefore, correlates between psychophysical parameters, such as pitch discrimination and speech perception, and the width of SOE curves, have long been investigated. However, to date, no relationships between these objective and subjective measurements have yet been determined. In a departure from the current thinking, the authors now propose that the SOE curve, recorded with forward masking, is the equivalent of a convolution operation. As such, deconvolution would be expected to retrieve the excitation areas attributable to either masker or probe, potentially more closely revealing the actual neural SOE. This study aimed to develop a new analytical tool with which to derive SOE using this principle.

Design:

Intraoperative SOE curve measurements of 16 subjects, implanted with an Advanced Bionics implant, were analyzed. Evoked compound action potential (ECAP)-based SOE curves were recorded on electrodes 3 to 16, using the forward masker paradigm, with variable masker. The measured SOE curves were then compared with predicted SOE curves, built by the convolution of basic excitation density profiles (EDPs). Predicted SOE curves were fitted to the measured SOEs by iterative adjustment of the EDPs for the masker and the probe.

Results:

It was possible to generate a good fit between the predicted and measured SOE curves, inclusive of their asymmetry. The rectangular EDP was of least value in terms of its ability to generate a good fit; smoother SOE curves were modeled using the exponential or Gaussian EDPs. In most subjects, the EDP width (i.e., the size of the excitation area) gradually changed from wide at the apex of the electrode array, to narrow at the base. A comparison of EDP widths to SOE curve widths, as calculated in the literature, revealed that the EDPs now provide a measure of the SOE that is qualitatively distinct from that provided using conventional methods.

Conclusions:

This study shows that an eCAP-based SOE curve, measured with forward masking, can be treated as a convolution of EDPs for masker and probe. The poor fit achieved for the measured and modeled data using the rectangular EDP, emphasizes the requirement for a sloping excitation area to mimic actual SOE recordings. Our deconvolution method provides an explanation for the frequently observed asymmetry of SOE curves measured along the electrode array, as this is a consequence of a wider excitation area in the apical part of the cochlea, in the absence of any asymmetry in the actual EDP. In addition, broader apical EDPs underlie the higher eCAP amplitudes found for apical stimulation.
Do articulating spacers or static spacers have more effect on the mental health status of patients undergoing two-stage revision total knee arthroplasty for periprosthetic joint infection?
Authors: Lee Su Chan , Gondalia Viral , Ahn Hye Sun , Kim Jong Won , Park Ha Young , Ong Alvin , Jung Kwang Am
Published: March 2016

Background:

There are several studies that have focused on functional outcome and rate of recurrent infection for patients undergoing two-stage revision total knee arthroplasty (TKA) for the treatment of periprosthetic joint infection (PJI). However, there are very few studies assessing the mental health status of these patients, which is why we conducted a study to assess and compare the mental health status between patients who underwent first-stage revision with a static spacer and those who had an articulating spacer. Our hypothesis was that the patients with articulating spacers have a lesser degree of mental stress than those with static spacers.

Methods:

From 2011 to 2013, a total of 40 knees with a diagnosis of PJI were treated with a standard two-stage revision TKA. Hospital anxiety and depression scale (HADS)-A and D, Visual Analogue Scale (VAS), Short-form-36 mental health (SF-36) scores were compared between groups preoperatively and 4 weeks postoperatively.

Results:

There were no significant differences between the two groups. Similarly, P value did not show any significant differences between the groups for both VAS and SF-36 score even though it was significant within the groups for VAS score preoperatively and postoperatively (P<0.0001).

Conclusions:

Both articulating and static spacers significantly reduced the psychological stress on the patients undergoing two-stage revision for PJI. Based on our results, we concluded that improvement in mental health status of both articulating and static spacer groups were comparable with no statistically significant differences.
Rotator cuff repair in the elderly: is it worthwhile?
Authors: Tahal Dimitri S. , Katthagen J. Christoph , Millett Peter J.
Published: March 2016

Rotator cuff pathology is a major contributor to shoulder dysfunction, particularly in the elderly population. Elderly individuals have shown an increasing desire to remain physically active and have high expectations of treatment. The ideal method to provide pain relief and restore function is controversial, with some surgeons advocating conservative measures and others preferring surgical management. The purpose of this article was to highlight the factors that influence decision-making when treating elderly individuals with rotator cuff pathology. Current treatment recommendations with their reported clinical outcomes and possible future developments are discussed.
What is the evidence to support a psychological component to rehabilitation programs after anterior cruciate ligament reconstruction?
Authors: Ardern Clare L. , Kvist Joanna
Published: March 2016

One of the main indications for anterior cruciate ligament reconstruction is the athlete’s desire to return to his or her preinjury level of sports. Postoperative rehabilitation has a strong focus on recovery of the physical capabilities necessary to manage a return to sports. On average, athletes achieve good physical function after surgery, based on standard impairment-based and activity-based measures. Yet the return to sports rate is disappointingly low; only two in every three return to their preinjury level sport and only half of the athletes return to competitive sports after surgery. There are a range of factors, many of them nonmodifiable (e.g. age, sex, and preinjury level of competition), that affect returning to a specific sport. However, recent research has identified psychological factors as key influences on returning to sports after anterior cruciate ligament reconstruction. This is particularly important for clinicians given that these factors may be modifiable with appropriate intervention. However, they are not systematically discussed during standard postoperative rehabilitation. In this review, we examine the evidence for the effect of psychological factors on return to sport outcomes after anterior cruciate ligament reconstruction and provide a rationale for the inclusion of interventions that specifically and systematically affect these factors during postoperative rehabilitation.
Lateral wedge osteotomy for pediatric post-traumatic cubitus varus: Kirschner-wires or locking angular plate?
Authors: Persiani Pietro , Noia Giovanni , de Cristo Claudia , Graci Jole , Gurzì Michele D. , Villani Ciro
Published: March 2016

This study aimed to evaluate and compare two types of internal fixation, locking angular plate (group 1) and Kirschner-wires (group 2), for post-traumatic cubitus varus. The parameters used were Laupattarakasem’s criteria (for range of motion in extension/flexion, correction of carrying angle, and the ‘lazy S’ deformity) and the Barrett’s questionnaire (for patient satisfaction). In group I (plate+screws), we had three excellent results and five good. In group II (Kirschner-wires), we had two good results, three fair, and two poor. Statistical analysis showed a better outcome for group I (plate+screws) considering the correction of the humeral-elbow-wrist angle (P<0.003), the postoperative lateral prominence index (P<0.048), and the patient satisfaction (P<0.011). We recommend the locking angular plate, because it can rigidly stabilize the osteotomy, ensuring an excellent functional and cosmetic outcome.
Is there a role for a child life specialist during orthopedic cast room procedures? A prospective-randomized assessment
Authors: Schlechter John A. , Avik Anna L. , DeMello Stephanie
Published: March 2016

Pediatric anxiety during cast room procedures is common and various methods to manage distress may be used. Certified Child Life Specialists (CCLS) are formally trained professionals with proficiency in helping children during taxing events. The utilization of a CCLS has not been well documented in a pediatric orthopedic cast room. The aim of this study was to assess the impact of a CCLS in this setting through a prospective randomized trial. 86 children, age range 2–10 years, who underwent cast room procedures were randomized: group I (42 children) had a CCLS present during their procedure. Group II (44 children) did not have a CCLS present during their procedure. Procedures included cast removal/placement, fracture manipulation, and pin removal. We calculated change in heart rate as beats per min (bpm) during various stages of the visit and a subjective behavior score evaluating behaviors, score range −3 to 3. There was no significant difference in the demographics and age between groups. The mean behavior score for group I was 1.78 versus 1.04 in group II (P<0.001). The change in heart rate recorded showed an increase by 7.5 and 9.3 bpm in groups I and II, respectively (P=0.829). CCLS Therapy significantly affects the observed behavior score of children undergoing a procedure in a pediatric orthopedic cast room. A greater increase in heart rate was observed as a trend in those children treated in the absence of a CCLS. The presence of a CCLS appears to positively affect the cast-room experience for children and their caregivers. Level of Evidence: Level II – Therapeutic Randomized-Controlled Trial.
Efficacy, Safety, and Potential Biomarkers of Sunitinib and Transarterial Chemoembolization (TACE) Combination in Advanced Hepatocellular Carcinoma (HCC)
Authors: Pokuri Venkata K. , Tomaszewski Garin M. , Ait-Oudhia Sihem , Groman Adrienne , Khushalani Nikhil I. , Lugade Amit A. , Thanavala Yasmin , Ashton Edward A. , Grande Catherine , Fetterly Gerald J. , Iyer Renuka
Published: March 2016

Objectives:

To evaluate the safety/efficacy and explore biomarkers for a rationally designed combination of sunitinib and transarterial chemoembolization (TACE) in a prospective phase 2 study of advanced hepatocellular carcinoma (HCC).

Methods:

Inoperable HCC patients with Child-Pugh A disease received 37.5 mg sunitinib from days 1 to 7 followed by TACE on day 8. Sunitinib was resumed from days 15 to 36 followed by 2 weeks off. Patients received subsequent sunitinib cycles of 4 weeks on and 2 weeks off. Dynamic contrast-enhanced magnetic resonance imaging and circulating soluble biomarkers were assessed at baseline, day 8, day 10, and day 36.

Results:

Sixteen patients with liver only (n=10) and extrahepatic disease (n=6) were enrolled. After a median follow-up of 12.8 months, 2 partial responses, 11 stable disease, and 3 clinical deteriorations were seen for a clinical benefit rate of 81%. Median progression-free survival (PFS) was 8 months (95% CI, 4.3-9.3) and overall survival was 14.9 months (95% CI, 6.3-27.1). Eleven of 16 patients (69%) had grade 3/4 toxicities attributable to sunitinib, the most frequent being thrombocytopenia, amylase/lipase elevations, lymphopenia, and fatigue. Mean Ktrans(volume transfer constant) and viable tumor percent in consented patients decreased by 27% and 14.8%, respectively, with combination therapy. Soluble vascular endothelial growth factor receptor-2 (sVEGFR2) levels, cytokines (interleukin-8, interleukin-21), and monocytes decreased with combination therapy. Estimated sunitinib IC50 values of 15 and 10 ng/mL modulated Ktransand AUC90. sVEGFR2 levels decreased with Ktransand AUC90.

Conclusions:

Encouraging progression-free survival and overall survival were seen with acceptable toxicity in our study of sunitinib and TACE combination in advanced HCC. Potential imaging and serum biomarkers showed increased benefit with combination therapy.
The Posterior Approach Tarsal Switch Procedure for Myopathic Ptosis: A Modified Technique
Authors: Lenake Mpopi N. , McNab Alan A.
Published: March 2016

Purpose:

The surgical management of myopathic ptosis remains a challenge. The authors report the results of a modified posterior approach tarsal switch technique, which raises both the upper and lower eyelids and reduces the risk of corneal exposure in these patients.

Methods:

A modified tarsal switch technique is described. A tarsoconjunctival and Muller’s muscle graft is harvested via a posterior approach from the upper eyelid, the defect closed, and the graft transferred to the lower eyelid.

Results:

The procedure was performed on 16 eyelids of 9 patients. No adjunctive procedures were performed. The patients ranged in age from 36 years to 79 years. All patients had bilateral myopathic ptosis, reduced levator function, and a poor Bell’s response. The margin reflex distance-1 increased by 1.5 to 4.5 mm (mean 2.3 mm) and the margin reflex distance-2 decreased by 0.5 to 2.5 mm (mean 1.6 mm). There were no intraoperative complications, no significant corneal exposure problems, and no patients required revision surgery over a follow-up period of 6 to 52 months (mean 16 months).

Conclusions:

This technique of harvesting the tarsoconjunctival-Muller’s muscle graft posteriorly, closing that defect and transferring the graft into the lower eyelid to elevate it, is an effective surgical procedure for the management of ptosis in patients with poor ocular protective mechanisms.
Nodular Lymphocyte Predominant Hodgkin Lymphoma Presenting With Unilateral Orbital Involvement
Authors: Mettu Pradeep , Griffith Megan , Yohe Sophia , Harrison Andrew R.
Published: March 2016

A 40-year-old white woman presented to her general ophthalmologist for swelling of the left upper eyelid that began approximately 6 months before. CT scan of the orbits with and without contrast demonstrated homogenous enhancement of the left lacrimal gland. Examination was notable for left hypoglobus and proptosis. The patient underwent left lateral orbitotomy with biopsy of the mass and frozen section analysis showed lymphoid infiltrates. Subsequent histopathologic diagnosis was consistent with nodular lymphocyte predominant Hodgkin lymphoma, a rare subtype of Hodgkin lymphoma that has only once been previously reported in the orbit. The authors review the case and the relevant literature.
Factors Associated With the Efficacy of Probing for Adult Patients With Lacrimal Duct Obstruction
Authors: Ohtomo Kazuyoshi , Ueta Takashi
Published: March 2016

Purpose:

To investigate the factors associated with the effectiveness of probing for epiphora in adults with lacrimal duct obstruction.

Methods:

This was a cross-sectional retrospective study involving 116 eyes of 82 patients (26 males and 56 females) with a primary acquired lacrimal duct obstruction who received a probing from June 2007 to October 2013. The influences of age, gender, the duration of the symptom before probing, the number of probing treatments during the follow-up period, locations of the obstructions, and the presence of mucopurulent discharge upon irrigation of the lacrimal sac on the efficacy of probing were evaluated.

Results:

Obstructions were observed in the nasolacrimal duct, common canaliculus, canaliculus, and punctum for 76% (88/116), 22% (26/116), 4% (5/116), and 3% (3/116), respectively. The overall efficacy of probing was 52% (60/116). Between the effective group and the noneffective group, 77% (20/26) of the common canaliculus obstructions were found in the effective group (p = 0.0039), whereas 67% (29/43) of the cases with discharge from the lacrimal sac were found in the noneffective group (p = 0.0020). On logistic regression analysis, the efficacy of probing was increased by the presence of common canaliculus obstruction (odds ratio = 6.0408; 95% confidence interval = 1.1255–48.9179, p = 0.0353), but was decreased by the presence of discharge from the lacrimal sac (odds ratio = 0.3508; 95% confidence interval = 0.1425–0.8345, p = 0.0176).

Conclusion:

Probing can be a therapeutic choice for lacrimal duct obstructions, particularly when there is a common canaliculus obstruction and no discharge from the lacrimal sac.
The Bleph and the Brain: The Effect of Upper Eyelid Surgery on Chronic Headaches
Authors: Mokhtarzadeh Ali , McClelland Collin , Lee Michael S. , Smith Scott , Harrison Andrew R.
Published: March 2016

Purpose:

To determine effect of upper eyelid surgery on headache symptoms.

Methods:

Consecutive adults undergoing upper eyelid surgery for obscuration of superior visual field, who also reported headache symptoms for greater than 1 year completed a pre- and postoperative Headache Impact Test-6 quality of life questionnaire (study group). A cohort of patients undergoing other oculoplastic procedures with headaches also completed the questionnaire pre- and postoperatively (control group). The study was conducted over a 2-year period. Neither the patients nor the study investigators were masked.

Results:

Twenty-eight patients met criteria for the study group, and 19 patients in the control group. Mean age was 58.7 and 60.7 years, respectively. There was no statistically significant difference in preoperative location of headaches. There was no significant difference in mean Headache Impact Test-6 scores preoperatively, 57.7 study group, 58.1 control group, p = 0.86. Mean postoperative scores were lower (improved) in the study arm, 45.3, as compared with the control arm, 58.6, p < 0.05. There was no statistically significant difference between individual preoperative survey questions between the study arm and control group, while every Headache Impact Test-6 question significantly improved in the study arm compared with the control arm. Mean Headache Impact Test-6 score improved 12.4 points in the study arm after surgery (p < 0.05), while the mean postoperative score worsened by 5 points in the control arm, but this was not significant (p = 0.48). Subjectively, 25 of 28 study patients, and 4 of 19 control patients noticed at least some improvement in headache symptoms after surgery.

Conclusions:

Correction of visually significant upper eyelid position may improve chronic headache symptoms.
Changes in and Determinants of Quality of Life in Patients With Advanced Non-Small-Cell Lung Cancer Undergoing Initial Chemotherapy
Authors: Dai Yu-Lee , Yang Cheng-Ta , Chen Kang-Hua , Tang Siew-Tzuh
Published: March 2016

Background:

Few studies have evaluated completely the changes in quality of life (QOL) that occur from pretreatment through the first four consecutive cycles of chemotherapy or determined its determinants in patients with advanced non-small-cell lung cancer (NSCLC).

Purpose:

The aim of this study was to explore the changes to and determinants of QOL in patients with advanced NSCLC under initial chemotherapy from pretreatment through Cycle 4 of chemotherapy.

Methods:

The QOL of 139 patients with advanced NSCLC was assessed from prechemotherapy through Cycle 4 of chemotherapy. Changes to and determinants of QOL were evaluated using multivariate linear regression, which used generalized estimation equation models.

Results:

No significant changes were observed in the global QOL or the physical, role, emotional, or cognitive functional domains of QOL during the course of chemotherapy. However, the social functional domain of QOL improved significantly at Cycle 3 in comparison with the prechemotherapy values. Better global QOL was determined as better performance status, less frequent physical symptoms, and less severe anxiety and depressive symptoms. Important determinants of better QOL in the five functional domains included younger age, better performance status, less frequent physical symptoms, less severe anxiety and depressive symptoms, and weaker perceived social support. Furthermore, patients who achieved a partial response after chemotherapy enjoyed stronger improvements in global QOL and the QOL emotional functional domain than those who did not.

Conclusions:

To help patients with advanced NSCLC optimize their QOL, healthcare professionals should enhance their ability to identify patients who are at elevated risk of poor QOL throughout the course of chemotherapy and to appropriately detect and manage the related physical symptoms and side effects, strengthen patients’ social support, and lessen the anxiety and depressive symptoms of patients.
Living With Chronic Obstructive Pulmonary Disease
Authors: Chen Kang-Hua , Liu Chien-Ying , Shyu Yea-Ing Lotus , Yeh Shu-Ling
Published: March 2016

Background:

Disease self-management for patients with chronic obstructive pulmonary disease (COPD) is less well characterized than that for patients with other chronic diseases. A patient-centered perspective calls for qualitative research to investigate the process of self-management as a means of enhancing quality of life in patients with COPD.

Purpose:

This study explores the process of self-management for patients with COPD and the factors that impact the efficacy of this process.

Methods:

A qualitative inquiry approach was used to collect data in the thoracic ward, outpatient department, and respiratory therapy room of a medical center in Taiwan. A convenience sample of 19 patients was collected. Qualitative content analysis was used to analyze data.

Results:

Living with COPD is a process that involves self-regulation and selecting suitable healthcare behaviors. The related healthcare behaviors identified in this study include symptom management, exercise implementation, environmental control, emotional adjustment, maintenance of a healthy life style, and utilization of community and healthcare resources. The factors that were found to influence this process include the physical and psychological conditions of the patient, his or her disease-related cognition, and the social support that he or she receives. In this study, once participants became dissatisfied with the consequences of their healthcare behaviors, they chose a new set of healthcare behaviors and continued to engage in the process of self-regulation.

Conclusions/Implications for Practice:

Patients naturally become experts with regard to their lives through a process of trial and error. Even so, healthcare professionals play a key role in the process of self-management and help patients with COPD cope with various problems in their daily lives. The findingsof this study contribute to the development of evidence-based self-management interventions that promote quality of life in patients with COPD.
Should Patients with Hepatic Fibrosis Undergo LVAD Implantation: A Comparative Analysis
Authors: Xuereb Linnea , Go Pauline H. , Kaur Babbaljeet , Akrawe Silvy , Borgi Jamil , Paone Gaetano , Morgan Jeffrey A.
Published: March 2016

The purpose of our study was to evaluate outcomes in patients with hepatic fibrosis at the time of LVAD implantation. There were five (2.1%) patients with preoperative hepatic fibrosis with a mean age of 51.2 ± 16.8 years. Survival at 180 days was significantly reduced in patients with hepatic fibrosis, 40.0% vs. 88.0%; p = 0.001. Hepatic fibrosis was a significant independent predictor of mortality in multivariate analysis (hazard ratio [HR] 2.27, p = 0.036).
Role of Survival Scores Before Left Ventricular Assist Device Implantation: The New CHRiSS Compared to the HeartMate II Score
Authors: Scandroglio Anna Mara , Pieri Marina , Zangrillo Alberto , Kaufmann Friedrich , Falk Volkmar , Potapov Evgenij , Krabatsch Thomas
Published: March 2016

Risk stratification of patients are claimed to be useful before left ventricular assist device (LVAD) implantation and different scoring systems are available. The aim of the study was to validate the Cardiac Health Risk Stratification System (CHRiSS), based on Bayesian network analysis, and the HeartMate II score in our patient population. We retrospectively calculated the CHRiSS using a web-based application and the HeartMate II score of 105 adult patients who underwent consecutive HVAD (HeartWare International, Inc.) implantation as primary LVAD at our institution in a 12-month period (May 2014–April 2015). Survival was 83.8 % (3.6%) at 30 days, 77.8% (4.0%) at 90 days, and 72.8% (4.8%) at 6 months and 1 year. The area under the curve (AUC) of the receiver operating characteristics (ROC) curve for CHRiSS was 0.75 at 30 days, 0.66 at 90 days, and 0.65 at 6 months. The HeartMate II score had an AUC of 0.73 at 90 days. Comparison between the ROC curves of the two models calculated at 90 days showed no statistically significant difference (p = 0.48): CHRiSS presents a high positive predictive value (85 [80–91]), the opposite to the HeartMate II score, which has a high negative predictive value (91 [83.4–96.6]). In our population, application of the CHRiSS was valuable at 30 days, but the overall predictive value of both scores is not satisfactory. The CHRiSS model proved to be a promising tool, suggesting that, with greater sample size and a longer data collection period, it might potentially outperform the HeartMate II scoring system.
Increased prevalence of heparin-induced thrombocytopenia in patients with Budd–Chiari syndrome: a retrospective analysis
Authors: Zaman Sameer , Wiebe Stefan , Bernal William , Wendon Julia , Czuprynska Julia , Auzinger Georg
Published: March 2016

Background

Budd–Chiari syndrome (BCS) is a rare, potentially fatal disease characterized by hepatic venous outflow tract obstruction. Heparin-induced thrombocytopenia (HIT) is an immune-mediated complication of heparin therapy, with mortality approaching 10%. The reported prevalence of HIT in adults is 0.2–5.2%. Expert consensus through case reports is the only existing evidence of HIT in BCS. To our knowledge, this is the first study to formalize this anecdotal evidence.

Methods

A retrospective analysis was carried out of patients presenting at a tertiary liver centre with acute liver failure because of BCS or BCS as the primary indication for liver transplantation between 2000 and 2013. The prevalence of HIT in the study group was compared with the highest reported prevalence in adult medical patients receiving heparin (5.2%). Mortality, length of stay and liver transplantation rates were also studied.

Results

Of 32 BCS patients, 9 (28.1%) developed HIT, significantly higher than the previously reported prevalence of HIT in medical patients (5.2%) (P<0.0001). There was no difference in mortality (P=0.66), length of stay (P=0.58) and liver transplantation rate (P=0.39) between HIT-positive and HIT-negative patients.

Conclusion

The prevalence of HIT (28.1%) in our cohort of BCS patients is significantly higher than that in the general population (0.2–5.2%). Although this study was not powered to detect outcome differences, as heparin is the mainstay of acute BCS treatment, this represents a significant risk. We recommend a high index of suspicion for HIT in patients with BCS and thrombocytopenia, an appropriate HIT-testing strategy and consideration of direct thrombin inhibitors.
Two Subtypes of Atypical Leiomyoma
Authors: Ubago Julianne M. , Zhang Qing , Kim Julie J. , Kong Beihua , Wei Jian-Jun
Published: March 2016

Atypical leiomyoma (ALM) is a rare variant of uterine smooth muscle tumors. Several recent studies have suggested that ALM has distinct, but also heterogenous, histologic and molecular features, yet little is known about the biology and histogenesis of ALM. Some have even postulated whether the atypical histologic features represent true atypia or simply degenerative changes. In this study, we analyzed the cytologic features of 60 ALM cases and found that ALM could be further divided into 2 subtypes, type I and type II, based primarily on nuclear features. Type I ALM showed round or oval nuclei, distinct and smooth nuclear membranes, prominent nucleoli with perinucleolar halos, and open coarse chromatin. Type II ALM showed elongated or spindled nuclei, irregular nuclear membranes, pinpoint or no nucleoli, and dark smudgy chromatin. There were also architectural differences between type I and type II ALM. Type I ALM often showed diffuse atypia within the tumor, whereas the atypia in type II ALM was patchy, surrounded by usual-type leiomyoma. The 2 subtypes also differed when we compared the immunohistochemical and molecular patterns. Type II tumors showed significantly higher rates of immunoreactivity for p16, p53, and HMGA2 and showed MED12 mutations more frequently than the type I counterparts. Our findings suggest that the type I and type II subtypes of ALM may arise from 2 different pathways. Type I tumors may be related to fumarate hydratase mutations, whereas type II ALM appear to arise in a existing usual-type leiomyomas.
Combination of Vascular Intervention Surgery and Free Tissue Transfer for Critical Diabetic Limb Salvage
Authors: Chou Chieh , Kuo Pao-Jen , Chen Yen-Chou , Huang Shu-Hung , Chang Chih-Hau , Wu Yi-Chia , Lee Su-Shin , Lai Cheng-Sheng , Lin Sin-Daw , Chang Kao-Ping , Kuo Yur-Ren
Published: March 2016

Background

Complex, nontraumatic diabetic foot ulcers with peripheral vascular compromise often lead to extensive lower-limb amputation. The aim of this study is to determine the outcome of combined vascular intervention and free tissue transfer for critical diabetic limb salvage.

Materials and Methods

A total of 26 consecutive diabetic patients with 28 legs with diabetic foot ulcers who underwent limb salvage with a combination of revascularization (bypass surgery or endovascular angioplasty) and free flap transfers were reviewed. There were 14 male and 12 female patients. The average age was 58.8 years (range, 35–85 years). Amputation-free survival and complete wound healing were defined as the primary endpoints. All preoperative and postoperative data were retrospectively analyzed.

Results

Thirty flaps were used for reconstruction in 28 legs, including 21 free anterolateral thigh (ALT) perforator flaps, 3 ALT myocutaneous flaps, 5 gracilis muscle flaps, and 1 latissimus dorsi muscle flap. All flaps used end-to-side anastomoses for the recipient artery and end-to-end anastomoses for the recipient vein. The overall flap success rate was 90% (27/30). Two flaps failed completely because of severe arteriosclerosis, which resulted in anastomosed vessel thrombosis. New flaps were applied in both cases after debridement and trimming of necrotic tissue. One flap failed because of restenosis and inadequate perfusion combined with severe infection, resulting in pedicle thrombosis. A below-knee amputation was subsequently performed. Seven flaps exhibited a partial loss, including 6 ALT perforator flaps and 1 latissimus dorsi flap, because of inadequate margin perfusion. After debridement, the flap revision and wound care, 5 flaps healed uneventfully without additional intervention. The remaining 2 ALT perforator flaps required debridement with a skin graft. The limb-salvage rates were 92.8% after 1 year and 89.2% after 5 years.

Conclusions

The combination of peripheral arterial intervention and free tissue transfer resulted in successful wound healing and limb salvage instead of amputation in select diabetic patients with difficult-to-heal wounds.
testCryopreservation of human mucosal leukocytes
Authors: Hughes Sean M. , Shu Zhiquan , Levy Claire N. , Ferre April L. , Hartig Heather , Fang Cifeng , Lentz Gretchen , Fialkow Michael , Kirby Anna C. , Adams Waldorf Kristina M. , Veazey Ronald S , Germann Anja , Briesen Hagen von , McElrath M. Juliana , Dezzutti Charlene S. , Sinclair Elizabeth , Baker Chris A. R. , Shacklett Barbara L , Gao Dayong , Hladik Florian
Published: March 2016

Background

Understanding how leukocytes in the cervicovaginal and colorectal mucosae respond to pathogens, and how medical interventions affect these responses, is important for developing better tools to prevent HIV and other sexually transmitted infections. An effective cryopreservation protocol for these cells following their isolation will make studying them more feasible.

Methods and findings

To find an optimal cryopreservation protocol for mucosal mononuclear leukocytes, we compared cryopreservation media and procedures using human vaginal leukocytes and confirmed our results with endocervical and colorectal leukocytes. Specifically, we measured the recovery of viable vaginal T cells and macrophages after cryopreservation with different cryopreservation media and handling procedures. We found several cryopreservation media that led to recoveries above 75%. Limiting the number and volume of washes increased the fraction of cells recovered by 10-15%, possibly due to the small cell numbers in mucosal samples. We confirmed that our cryopreservation protocol also works well for both endocervical and colorectal leukocytes.

Cryopreserved leukocytes had slightly increased cytokine responses to antigenic stimulation relative to the same cells tested fresh. Additionally, we tested whether it is better to cryopreserve endocervical cells on the cytobrush or in suspension.

Conclusions

Leukocytes from cervicovaginal and colorectal tissues can be cryopreserved with good recovery of functional, viable cells using several different cryopreservation media. The number and volume of washes has an experimentally meaningful effect on the percentage of cells recovered. We provide a detailed, step-by-step protocol with best practices for cryopreservation of mucosal leukocytes.
Complete mitochondrial genome ofMuricea crassaandMuricea purpurea(Anthozoa: Octocorallia) from the eastern tropical Pacific
Authors: Poliseno Angelo , Breedy Odalisca , Eitel Michael , Wöerheide Gert , Guzman Hector M. , Krebs Stefan , Blum Helmuth , Vargas Sergio
Published: March 2016

We sequenced the complete mitogenomes of two eastern tropical Pacific gorgonians,Muricea crassaandMuricea purpurea,using NGS technologies. The assembled mitogenomes ofM. crassaandM. purpureawere 19,586 bp and 19,358 bp in length, with a GC-content ranging from 36.0% to 36.1%, respectively. The two mitogenomes had the same gene arrangement consisting of 14 protein-coding genes, two rRNAs and one tRNA. Mitogenome identity was 98.5%. The intergenic regions betweenCOBandNAD6and betweenNAD5andNAD4were polymorphic in length with a high level of nucleotide diversity. Based on a concatenated dataset of 14 mitochondrial protein-coding genes we inferred the phylogeny of 26 octocoral species.
Testing pseudo-linear models of responses to natural scenes in primate retina
Authors: Heitman Alexander , Brackbill Nora , Greschner Martin , Sher Alexander , Litke Alan M. , Chichilnisky E.J.
Published: March 2016

A central goal of systems neuroscience is to develop accurate quantitative models of how neural circuits process information. Prevalent models of light response in retinal ganglion cells (RGCs) usually begin with linear filtering over space and time, which reduces the high-dimensional visual stimulus to a simpler and more tractable scalar function of time that in turn determines the model output. Although these pseudo-linear models can accurately replicate RGC responses to stochastic stimuli, it is unclear whether the strong linearity assumption captures the function of the retina in the natural environment. This paper tests how accurately one pseudo-linear model, the generalized linear model (GLM), explains the responses of primate RGCs to naturalistic visual stimuli. Light responses from macaque RGCs were obtained using large-scale multi-electrode recordings, and two major cell types, ON and OFF parasol, were examined. Visual stimuli consisted of images of natural environments with simulated saccadic and fixational eye movements. The GLM accurately reproduced RGC responses to white noise stimuli, as observed previously, but did not generalize to predict RGC responses to naturalistic stimuli. It also failed to capture RGC responses when fitted and tested with naturalistic stimuli alone. Fitted scalar nonlinearities before and after the linear filtering stage were insufficient to correct the failures. These findings suggest that retinal signaling under natural conditions cannot be captured by models that begin with linear filtering, and emphasize the importance of additional spatial nonlinearities, gain control, and/or peripheral effects in the first stage of visual processing.