bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility of forecasting ecological performances of products in early development phases
Authors: Hein H L , Schwarte J
Published: October 2019

Sustainability, i.e. among other things climate change and resource consumption in the product development phase, have to be increasingly taken into account. The primary energy demand of products and their influence on the greenhouse effect can be scientifically analysed through life cycle assessments. For this purpose, all product, energy and material flows must be recorded in each individual product life phase. If, for some reason, no identifiable data is (yet) available, assumptions must be made whose uncertainties may later lead to deviations in the results, some of which are difficult to assess. This can pose a major problem, as many parameters have not yet been defined or will change in the early development phase such as the production scale. In order to be able to compare the products correctly with already established products, however, the possible changes must also be considered comprehensively. An extension of the established methodology by the concept of interval arithmetic makes it possible to determine the entire spectrum of all environmental impacts potentially occurring through the product, since the existing uncertainties are considered directly in the balancing. This is illustrated by the example of an aerogel-based thermal insulation composite system, the insulating material of which is evaluated.
The effect of alkali concentration on chloride penetration in geopolymer concrete
Authors: Ekaputri J J , Lie H A , Fujiyama C , Shovitri M , Alami N H , Setiamarga D H E
Published: October 2019

This paper presents the experimental study on the penetration of chloride ions in fly ash based-geopolymer concrete in the salt-water. To determine the corrosion possibility of reinforcement, lollipop-shape specimens with the size of 10x10x15 cm were prepared with the plain steel bar in the middle of concrete. The specimens were exposed to chloride ion penetration for 30-120 days. The mixtures were varied with alkali concentration of 8M-12M with the mass ratio of Na2SiO3 to NaOH was varied from 1.5 to 2.5. Specimens made with portland cement concrete was also prepared as the control. The best performance was showed by specimens made with 12M of NaOH. Due to ion exchange on the surface of geopolymer concrete, less chloride ion was found in geopolymer made with high alkali concentration. After 90 days, Portland cement concrete showed less performance while geopolymer concrete showed the strength increasing. High binding capacity due to soluble silicate content in geopolymer concrete was one of the reasons why geopolymer specimens are more resistant to chloride ion penetration.
Unit processes identification of maintenance on rigid and flexible pavement of local road
Authors: Handayani F S , Pramesti F P , Setyawan A
Published: October 2019

Maintenance and rehabilitation as parts of pavement’s life cycle become more important since it’s an effort to restore the road condition as planned. This process will produce the emission of greenhouse gases that give an impact to the environment. The Live Cycle Assessment (LCA) was used to estimate the GHG’s emissions. With LCA we could identify the unit process that will produce the GHG’s emissions during maintenance and rehabilitation of road pavement. This research aimed to identify the unit processes of the maintenance and rehabilitation of rigid and flexible pavement and to analyse the amount of GHG emitted during this process. Four local roads in Indonesia were investigated as case studies. The result indicated the amount of energy of the unit processes as well as the GHG amount. This will lead to the identification of the hotspot of flexible and rigid pavement maintenance process. In rigid pavement maintenance activities, the hotspots included the asphalt transport process to asphalt mixing plant, cement transportation to the batching plant, and cement processing. Meanwhile, in flexible pavement maintenance activities, the hotspots were the asphalt transportation to asphalt mixing plant, transportation aggregate, and transportation to site.
Effect of sodium silicate as activator on the fresh and hardened properties of cement-slag blended paste
Authors: Thymotie A , Chang T-P , Nguyen H-A
Published: October 2019

Ground granulated blast-furnace slag (GGBS) is commonly used as partial cement replacement in concrete production. Although the use of GGBS has many advantages, it possesses a lower initial hydration rate that leads to lower early strength. Therefore, an attempt to use sodium silicate to activate the GGBS was carried out to promote the early strength of cement-GGBS blended paste. Based on experimental results, incorporation of 5 and 10% of sodium silicate slightly reduced the flowability and final setting time of blended paste. For hardened properties, the addition of sodium silicate reduced the strength at early age until 28 days. The modulus of elasticity of activated paste with sodium silicate was lower at early age, however at 28 days the result was comparable with the control specimen. The addition of sodium silicate decreased the ultrasonic pulse velocity (UPV) value at early age, however, at 28 days, 5% sodium silicate specimen had a higher UPV value than the control specimen. The different trend between UPV test and compressive strength test was suggested due to the inhomogeneous structure of activated blended paste that had a different mechanism during destructive test (compressive strength test) and non-destructive test (UPV test).
Development of a tool to assess and advance the effectiveness of preceptors: The Habits of Preceptors Rubric
Authors: Larson Suzanne , Davis Lindsay E , Stevens Alison M , El-Ibiary Shareen , Grice Gloria , Pogge Elizabeth , Raney Erin , Storjohann Tara
Published: October 2019

Purpose

Present the research performed to identify and describe habits of effective pharmacy preceptors and provide a framework for targeted preceptor assessment and development.

Methods

A 5-round Delphi consensus-building process was used to refine the initial Habits of Preceptors Rubric (HOP-R) developed by the research team. Twenty experts in pharmacy experiential education participated. During the Delphi process, feedback and agreement on all parts of the HOP-R were sought, including the premise, introductory content, framework, preceptor domains, habits, habit level descriptions, and continuous professional development (CPD) plan. After each Delphi round, the research team grouped responses into themes and modified the draft rubric accordingly. These themes were used to frame the response document sent to the expert panel for the following Delphi round; this document explained modifications made to the HOP-R. Consensus was defined as a mean score of ≥3.25 on a 4-point scale (4 = strongly agree, 1 = strongly disagree) for posed statements or ≥70% agreement for ranked items.

Results

In the final Delphi round (response rate, 95%), consensus was achieved for all HOP-R individual structural and content elements except the habit level descriptors, for which a secondary rank order analysis was performed. The final HOP-R has 3 domains encompassing 11 preceptor habits that can be displayed across 4 habit levels progressing from developing to master.

Conclusion

The HOP-R was developed to assess, quantify, and demonstrate growth across a wide variety of pharmacy preceptor habits. Potential utility includes use as a framework to articulate the knowledge, skills, and behaviors of effective preceptors, facilitate the creation of individualized CPD plans, and assess the impact of participation in teaching and learning curricula.
Analysis of antibiotic use in a large network of emergency departments
Authors: O’Neal Fredrick , Kramer Joan , Cooper Mandelin , Septimus Edward , Sharma Sanya , Burgess L Hayley
Published: October 2019

Purpose

To assess antibiotic selection, administration, and prescribing practices in emergency departments across a large hospital system using evidence-based practices and susceptibility patterns.

Methods

This retrospective data review was conducted using health system–level electronic data compiled from 145 emergency departments (EDs) across the United States. Data were examined for national generalizability, most common diagnoses of infectious origin seen in nonadmitted patients in the ED, most commonly administered antibiotics in the ED, and geographically defined areas’ unique patterns of antibiotic resistance and susceptibility.

Results

More than 627,000 unique patient encounters and 780,000 antibiotic administrations were assessed for trends in patient demographics, antibiotics administered for a diagnosis of infectious origin, and corresponding susceptibility patterns. Results indicated that practices in the EDs of this health system aligned with evidence-based practices for streptococcal pharyngitis, otitis media, cellulitis, and uncomplicated urinary tract infections.

Conclusion

These results provide a representative sample of the current state of practices within many EDs across the United States for nonadmitted patients. A similar data reconstruction can be completed by other health systems to assess their prescribing practices in the ED to improve and elevate care for patients visiting the emergency room and treated as outpatients.
Assessment of perceived workload in academic health center community pharmacies before and after implementation of a central call center
Authors: Legenza Laurel , Nickman Nancy A , Drews Frank A , Rim Matthew , Tigh Jeremy , Kelly Michael P , Tyler Linda S
Published: October 2019

Purpose

Results of a study to determine whether reducing pharmacy phone call workload through implementation of a pharmacy services call center (PSCC) led to decreased employee workload, improved efficiency, and increased pharmacist availability for patient care are reported.

Methods

A pre–post study was conducted using the NASA Task Load Index (NASA-TLX) instrument. Pharmacists, pharmacy technicians at 7 academic health center community pharmacies, and PSCC staff provided NASA-TLX data over 5 days during 3 data collection periods before and after PSCC implementation. Perceived workload was measured as an overall workload score (OWS) and mean scores for 6 NASA-TLX workload dimensions (mental demand, physical demand, temporal demand, performance, effort, and frustration).

Results

Relative to pre-PSCC values, mean postimplementation OWS scores significantly decreased in all 7 pharmacies (from 33.3 to 29.1 overall, p < 0.001) but especially in small pharmacies (from 31.7 to 27.6, p < 0.001). Scores for the physical demand and frustration dimensions were low in both the PSCC and in the 7 pharmacies, while scores for the performance dimension remained high (range, 6.8–8.3). In general, scores for all other measured NASA-TLX dimensions decreased after PSCC implementation, more so at smaller pharmacies. The PSCC staff mean OWS score increased over time (from 26.8 to 28.6, p < 0.0001) but remained near the overall pharmacy average of 29.1.

Conclusion

Use of the NASA TLX allowed for a direct subjective measurement of workload as perceived by pharmacy and PSCC employees before and after PSCC implementation. Long-term effects of the PSCC on workload should be assessed.
Posterior Vaginoplasty With Perineoplasty: A Canadian Experience With Vaginal Tightening Surgery
Authors: Austin Ryan E , Lista Frank , Vastis Peter-George , Ahmad Jamil
Published: October 2019

Following vaginal trauma, most commonly vaginal delivery, women may experience vaginal laxity as a result of local tissue stretching and separation of the pelvic floor musculature. In addition to this generalized sensation of laxity, women may complain of decreased sexual satisfaction, gaping of the perineum, and excessive vaginal secretions. Since 2014, the authors have used a posterior vaginoplasty with perineoplasty technique for the surgical management of vaginal laxity. To date, the authors have performed surgical vaginal tightening in 30 consecutive patients and found that the posterior vaginoplasty with perineoplasty technique has allowed us to achieve reproducible outcomes with no postoperative complications. This article will review the authors’ approach to patients presenting for surgical vaginal tightening and the authors’ experience to date, including our preoperative screening, perioperative management, and detailed steps of the procedure.
Changes in Infective Endocarditis Admissions in Pennsylvania During the Opioid Epidemic
Authors: Meisner Jessica A , Anesi Judith , Chen Xinwei , Grande David
Published: October 2019

Background

With the current opioid crisis in the United States, infectious complications related to injection drug use are increasingly reported. Pennsylvania is at the epicenter of the opioid crisis, with the third highest rate of drug overdose deaths in the United States.

Methods

A retrospective cohort study was performed using the Pennsylvania Health Care Cost Containment Council database of all residents hospitalized for infective endocarditis (IE) in an acute care hospital from 1 January 2013 through 31 March 2017. Patients were separated into those with and those without substance use via diagnosis codes. The primary outcome was length of stay. Secondarily, we evaluated demographics, infection history, hospital charges, and insurance status.

Results

Of the 17 224 hospitalizations, 1921 (11.1%) were in patients with drug use–associated IE (DU-IE). Total quarterly IE admissions increased 20%, with a 6.5% increase in non–drug use–associated IE (non-DU-IE) admissions and a 238% increase in DU-IE admissions. In adjusted models, DU-IE was not associated with significant changes in length of stay (incidence rate ratio, 1.02; 95% confidence interval, .975–1.072; P = .36). Patients with DU-IE were predominantly insured by Medicaid (68.3% vs 13.4% for non-DU-IE), they had higher hospital charges ($86 622 vs $66 802), and they were more likely to leave against medical advice (15.7% vs 1.1%) (all P < .001).

Conclusions

Our study demonstrates an increase in IE admissions, driven by an increase in admissions for DU-IE. The higher charges, proportion of patients on Medicaid, and rates of leaving against medical advice among the DU-IE group shows the downstream effects of the opioid crisis.
Primary care physicians’ attitudes toward research: a cross-sectional descriptive study
Authors: Adler Limor , Gabay Linoy , Yehoshua Ilan
Published: October 2019

Background

Clinical research in family medicine can improve health outcomes and increase physicians’ professionalism, yet is modest compared to other disciplines and receives little funding.

Objectives

To identify factors that promote and impede engagement of family physicians in research and to compare characteristics of family physicians who do and do not engage in research.

Methods

During September to October 2018, e-mail questionnaires were sent to 1424 primary care physicians of one health maintenance organization. Respondents were classified as researchers and non-researchers based on their research experience. Responses were analysed using univariate analysis, principal component analysis and multivariate logistic regression.

Results

Of 235 respondents, 48 (20.4%) were categorized as researchers. The respondents generally agreed that research in primary care improves medical services and provides professional prestige; and that workload, bureaucracy and lack of dedicated time hinder engagement in research. Logistic regression analysis identified several factors associated with being a researcher, including advanced research training (P = 0.001, AOR = 8.49, 95% CI [2.49–29.14]), reading more research articles (P = 0.013, AOR = 14.16, 95% CI [1.76–113.5] and self-employment (P = 0.005, AOR = 5.92, 95% CI [1.71–20.44]). In a factor analysis, only ‘importance of research’ was associated with being a researcher (P = 0.039, AOR = 1.89, 95% CI [1.03–3.48]). Compared to non-researchers, researchers were older (83.3% versus 51.3% aged >40 years, P < 0.001), more often men (60.4% versus 37.4%, P = 0.02) and worked more (41.7% versus 16.7% worked >41 hours weekly, P = 0.02).

Conclusions

Providing time dedicated to research, administrative support, research training and education about the importance of research could increase participation in research by primary care physicians.
Multifactorial Attenuation of the Murine Heat Shock Response With Age
Authors: Jurivich Donald A , Manocha Gunjan D , Trivedi Rachana , Lizakowski Mary , Rakoczy Sharlene , Brown-Borg Holly
Published: October 2019

Age-dependent perturbation of the cellular stress response affects proteostasis and other key functions relevant to cellular action and survival. Central to age-related changes in the stress response is loss of heat shock factor 1 (HSF1)–DNA binding and transactivation properties. This report elucidates how age alters different checkpoints of HSF1 activation related to posttranslational modification and protein interactions. When comparing liver extracts from middle aged (12 M) and old (24 M) mice, significant differences are found in HSF1 phosphorylation and acetylation. HSF1 protein levels and messenger RNA decline with age, but its protein levels are stress-inducible and exempt from age-dependent changes. This surprising adaptive change in the stress response has additional implications for aging and chronic physiological stress that might explain an age-dependent dichotomy of HSF1 protein levels that are low in neurodegeneration and elevated in cancer.
Is Ongoing Anticholinergic Burden Associated With Greater Cognitive Decline and Dementia Severity in Mild to Moderate Alzheimer’s Disease?
Authors: Dyer Adam H , Murphy Claire , Segurado Ricardo , Lawlor Brian , Kennelly Sean P ,   for the NILVAD Study Group
Published: October 2019

Background

Use of anticholinergic medication is associated with an increased risk of cognitive impairment and/or dementia. Despite this, the impact of continuing medication with anticholinergic properties in those diagnosed with Alzheimer’s Disease (AD) is not clear.

Methods

Analysis of data from NILVAD, an 18-month randomized controlled trial of Nilvadipine in AD. Effects of ongoing Anticholinergic Cognitive Burden (ACB) on cognition (ADAS-Cog: Alzheimer’s Disease Cog Subsection) and dementia severity (CDR-sb: Clinical Dementia Rating – Sum of Boxes/DAD: Disability Assessment for Dementia) over 18 months was evaluated adjusting for important clinical covariates.

Results

Just over one-quarter (27.90%, n = 142/510) of patients with mild to moderate AD were prescribed a potential/definite anticholinergic. While ACB score was not associated with greater progression on the ADAS-Cog/CDR-sb over time, a higher total ACB predicted greater dementia severity on the DAD, which persisted after robust covariate adjustment (β Coef: −1.53, 95% CI: −2.83 to −0.23, p = .021). There was a significant interaction between APOE ε4 status and ACB score, with carriers experiencing greater progression on both the CDR-Sb (β Coef: 0.36, 95% CI: 0.05–0.67, p = .021) and DAD (β Coef: −3.84, 95% CI: −7.65 to 0.03, p = .049).

Conclusions

Ongoing use of anticholinergic medication was associated with greater dementia progression on the DAD, but not the CDR-sb. APOE ε 4 carriers may be particularly vulnerable to the effect of ongoing anticholinergic medication on dementia severity, with significant APOE ε 4 x ACB score interactions demonstrated on both the DAD and CDR-sb.
The Institutional “Hinge”: How the End of the Cold War Conditioned Canadian, Russian, and Swiss IR Scholarship
Authors: Grenier Félix , Hagmann Jonas , Biersteker Thomas , Lebedeva Marina , Nikitina Yulia , Koldunova Ekaterina
Published: October 2019

Major international events contribute to guiding IR scholarship's interests, yet it remains surprisingly unexplored how transformative political events affect international relations as an academic field. This article focuses on the linkage between key global moments and the institutional factors that condition IR scholarship, focusing on the important yet under-explored intervening elements in the interrelation between political events and academic practice. The article defines the utility of such focus and illustrates it with case studies of three central parties to the Cold War conflict: Russia as representative of the Eastern bloc, Canada of the Western alliance, and Switzerland as a neutral polity. This article shows how institutional factors such as funding schemes, the marketization of education, and the creation of new IR departments operate as effective “hinges” exerting significant influence over the ways scholars develop ideas about international relations.
Increased Prediction Ability in Norway Spruce Trials Using a Marker X Environment Interaction and Non-Additive Genomic Selection Model
Authors: Chen Zhi-Qiang , Baison John , Pan Jin , Westin Johan , Gil Maria Rosario García , Wu Harry X
Published: October 2019

A genomic selection study of growth and wood quality traits is reported based on control-pollinated Norway spruce families established in 2 Northern Swedish trials at 2 locations using exome capture as a genotyping platform. Nonadditive effects including dominance and first-order epistatic interactions (including additive-by-additive, dominance-by-dominance, and additive-by-dominance) and marker-by-environment interaction (M×E) effects were dissected in genomic and phenotypic selection models. Genomic selection models partitioned additive and nonadditive genetic variances more precisely than pedigree-based models. In addition, predictive ability in GS was substantially increased by including dominance and slightly increased by including M×E effects when these effects are significant. For velocity, response to genomic selection per year increased up to 78.9/80.8%, 86.9/82.9%, and 91.3/88.2% compared with response to phenotypic selection per year when genomic selection was based on 1) main marker effects (M), 2) M + M×E effects (A), and 3) A + dominance effects (AD) for sites 1 and 2, respectively. This indicates that including M×E and dominance effects not only improves genetic parameter estimates but also when they are significant may improve the genetic gain. For tree height, Pilodyn, and modulus of elasticity (MOE), response to genomic selection per year improved up to 68.9%, 91.3%, and 92.6% compared with response to phenotypic selection per year, respectively.Subject Area: Quantitative genetics and Mendelian inheritance
Diabetes and Clinical Outcome in Patients With Metastatic Colorectal Cancer: CALGB 80405 (Alliance)
Authors: Brown Justin C , Zhang Sui , Ou Fang-Shu , Venook Alan P , Niedzwiecki Donna , Lenz Heinz-Josef , Innocenti Federico , O’Neil Bert H , Shaw James E , Polite Blase N , Denlinger Crystal S , Atkins James N , Goldberg Richard M , Ng Kimmie , Mayer Robert J , Blanke Charles D , O’Reilly Eileen M , Fuchs Charles S , Meyerhardt Jeffrey A
Published: October 2019

Background

Diabetes is a prognostic factor for some malignancies, but its association with outcome in patients with advanced or metastatic colorectal cancer (CRC) is less clear.

Methods

This cohort study was nested within a randomized trial of first-line chemotherapy and bevacizumab and/or cetuximab for advanced or metastatic CRC. Patients were enrolled at 508 community and academic centers throughout the National Clinical Trials Network. The primary exposure was physician-documented diabetes at the time of enrollment. The primary endpoint was overall survival (OS); secondary endpoints were progression-free survival (PFS) and adverse events. Tests of statistical significance were two-sided.

Results

Among 2326 patients, 378 (16.3%) had diabetes. The median follow-up time was 6.0 years. We observed 1973 OS events and 2173 PFS events. The median time to an OS event was 22.7 months among those with diabetes and 27.1 months among those without diabetes (HR = 1.27, 95% CI = 1.13 to 1.44; P < .001). The median time to a PFS event was 9.7 months among those with diabetes and 10.8 months among those without diabetes (HR = 1.16, 95% CI = 1.03 to 1.30; P = .02). Patients with diabetes were more likely to experience no less than grade 3 hypertension (8.1% vs 4.4%; P = .054) but were not more likely to experience other adverse events, including neuropathy.

Conclusions

Diabetes is associated with an increased risk of mortality and tumor progression in patients with advanced or metastatic CRC. Patients with diabetes tolerate first-line treatment with chemotherapy and monoclonal antibodies similarly to patients without diabetes.
Tailoring treatment of hyperkalemia
Authors: Coutrot Maxime , Dépret Francois , Legrand Matthieu
Published: October 2019

Hyperkalemia is a common electrolyte disorder that may be rapidly life-threatening because of its cardiac toxicity. Hyperkalemia risk factors are numerous and often combined in the same patient. Most of the strategies to control serum potassium level in the short term have been used for decades. However, evidence for their efficacy and safety remains low. Treatment of hyperkalemia remains challenging, poorly codified, with a risk of overtreatment, including short-term side effects, and with the priority of avoiding unnecessary hospital stays or chronic medication changes. Recently, new oral treatments have been proposed for non-life-threatening hyperkalemia, with encouraging results. Their role in the therapeutic arsenal remains uncertain. Finally, a growing body of evidence suggests that hyperkalemia might negatively impact outcomes in the long term in patients with chronic heart failure or kidney failure through underdosing or withholding of cardiovascular medication (e.g. renin–angiotensin–aldosterone system inhibitors). Recognition of efficacy and potential side effects of treatment may help in tailoring treatments to the patient’s status and conditions. In this review we discuss how treatment of hyperkalemia could be tailored to the patient’s conditions and status, both on the short and mid term.
A Baker’s Dozen of Top Antimicrobial Stewardship Intervention Publications in 2018
Authors: Chahine Elias B , Durham Spencer H , Mediwala Krutika N , Chastain Daniel B , Gauthier Timothy P , Hill Brandon K , Jones Bruce M , Kisgen Jamie J , Marx Ashley H , Stover Kayla R , Worley Marylee V , Bland Christopher M , Bookstaver P Brandon
Published: October 2019

With an increasing number of antimicrobial stewardship–related articles published each year, attempting to stay current is challenging. The Southeastern Research Group Endeavor (SERGE-45) identified antimicrobial stewardship–related peer-reviewed literature that detailed an actionable intervention for 2018. The top 13 publications were selected using a modified Delphi technique. These manuscripts were reviewed to highlight the actionable intervention used by antimicrobial stewardship programs to provide key stewardship literature for teaching and training as well as to identify potential intervention opportunities within one’s institution.
A case of fatal disseminated strongyloidiasis accompanied with intestinal obstruction
Authors: Heydarian Peyman , Mobedi Iraj , Mohaghegh Mohamad Ali , Hosseini Abozar , Chegini Fatemeh Goudarzvand , Esboei Bahman Rahimi
Published: October 2019

Strongyloides stercoralis is an endemic parasite in some regions including the tropical and subtropical areas with high humidity. Most infections are asymptomatic with nonspecific signs and symptoms, making the final diagnosis complicated. Here, we report a patient referred to our hospital with signs consistent with sepsis, intestine obstruction, which finally died with the diagnosis of strongyloidiasis. The patient was from northern parts of Iran which are considered as endemic areas for S. stercoralis. In conclusion, there is an important message in this history, i.e. physicians should be aware of specific and non-specific signs of strongyloidiasis especially in people living in endemic areas to make an accurate final diagnosis by proper clinical and paraclinical examinations.
Borromean Feshbach resonance in $^{11}$Li studied via $^{11}$Li($p$,$p'$)
Authors: Matsumoto Takuma , Tanaka Junki , Ogata Kazuyuki
Published: October 2019

A dipole resonance of $^{11}$Li is found by a $^9$Li + $n$ + $n$ three-body model analysis with the complex-scaling method. The resonance can be interpreted as a bound state in the $^{10}$Li + $n$ system, i.e., a Feshbach resonance in the $^9$Li + $n$ + $n$ system. As a characteristic feature of the Feshbach resonance of $^{11}$Li, the $^{10}$Li + $n$ threshold is open above the $^{9}$Li + $n$ + $n$ one, which reflects a distinctive property of the Borromean system. A microscopic four-body reaction calculation for the $^{11}$Li($p$,$p'$) reaction at 6 MeV/nucleon is performed by taking into account the resonant and nonresonant continuum states of the three-body system. The calculation of angular distributions of the elastic and inelastic scattering as well as the energy spectrum reproduced a recent experimental result. Furthermore, the $E1$ strength distribution from a Coulomb dissociation experiment was also reproduced in this framework. This means that the existence of the Borromean Feshbach resonance may consistently answer a long-standing open question of an excited state of $^{11}$Li.
Auditory Training Supports Auditory Rehabilitation: A State-of-the-Art Review
Authors: Stropahl Maren , Besser Jana , Launer Stefan
Published: October 2019

Objectives:

Auditory training (AT), which is active listening to various auditory stimuli, aims to improve auditory skills. There is evidence that AT can be used as a tool in auditory rehabilitation to improve speech perception and other auditory cognitive skills in individuals with hearing impairment. The present state-of-the-art review examines the effect of AT on communication abilities in individuals with hearing impairment. In particular, transfer of AT effects on performance in untrained speech perception tasks was evaluated.

Design:

PubMed, Medline, and Web of Science databases were searched using combinations of key words with restriction to the publication date from December 2012 until December 2018. The participant, intervention, control, outcome, and study design criteria were used for the inclusion of articles. Only studies comparing effects in an intervention group to a control group were considered. The target group included individuals with a mild to moderately severe hearing impairment, with and without hearing-aid experience. Out of 265 article abstracts reviewed, 16 met the predefined criteria and were taken for review.

Results:

The majority of studies that were included in this state of- the-art review report at least one outcome measure that shows an improvement in non-trained tasks after a period of intense AT. However, observed shortcomings are that a comparison between studies remains difficult as training benefits were assessed with various outcome measures. Also, the sustainability of training benefits was not investigated sufficiently.

Conclusions:

Recent evidence suggests that intensive auditory (-cognitive) training protocols are a valid tool to improve auditory communication skills. Individuals with hearing impairment seem to benefit the most using a combination of sensory rehabilitation with hearing aids and AT to enhance auditory rehabilitation. Long term benefits of AT are still not consistently observed and should be in the focus of future research.
Maximum Output and Low-Frequency Limitations of B71 and B81 Clinical Bone Vibrators: Implications for Vestibular Evoked Potentials
Authors: Clinard Christopher G. , Piker Erin G. , Thorne Andrew P. , Surface Elizabeth N. , Anderson Allison E. , Beacham Valerie A. , Crouse Megan C. , Whitney Victoria H. , Depaolis Rory A.
Published: October 2019

Objectives:

Bone-conducted vestibular evoked myogenic potentials (VEMPs) are tuned to have their maximum amplitude in response to tone bursts at or below 250 Hz. The low-frequency limitations of clinical bone vibrators have not been established for transient, tone burst stimuli at frequencies that are optimal for eliciting VEMPs.

Design:

Tone bursts with frequencies of 250 to 2000 Hz were delivered to B71 and B81 bone vibrators and their output was examined using an artificial mastoid. The lower-frequency limit of the transducers was evaluated by examining the spectral output of the bone vibrators. Maximum output levels were evaluated by measuring input–output functions across a range of stimulus levels.

Results:

Both the B71 and B81 could produce transient tone bursts with frequency as low as 400 Hz. However, tone bursts with frequencies of 250 and 315 Hz resulted in output with peak spectral energy at approximately 400 Hz. From 500 to 2000 Hz, maximum output levels within the linear range were between 120 and 128 dB peak force level. The newer B81 bone vibrator had a maximum output approximately 5 dB higher than the B71 at several frequencies.

Conclusions:

These findings demonstrate that both transducers can reach levels appropriate to elicit bone-conducted VEMPs, but the low-frequency limitations of these clinical bone vibrators limit tone burst frequency to approximately 400 Hz when attempting to stimulate the otolith organs via tone bursts.
A Comparative Study Between the Stryker EZout Powered Acetabular Revision System and the Zimmer Explant Acetabular Cup Removal Systems
Authors: Kwong Louis , Billi Fabrizio , Keller Scott , Kavanaugh Aaron , Luu Andrew , Paprosky Wayne
Published: October 2019

The conservation of bone stock and the decrease of intraoperative acetabular fracture risk associated with revision surgery is a primary goal to improve the outcome of the procedure. The objective of this study was to evaluate and compare the performance of the Explant Acetabular Cup Removal System and the EZout Powered Acetabular Revision System in an in vitro model. Acetabular components were implanted into instrumented composite hemipelvises and divided into 2 groups, EZout System and Explant System. One experienced orthopedic surgeon and 1 orthopedic resident physician performed the removal procedures. The strains at various points in the periacetabular bone, the temperature at the implant-bone interface, the total time to removal, the torque applied to the implant and the amount of acetabular foam on each cup after extraction, as a surrogate for cavitary acetabular bone stock loss, were calculated for each test. Statistical analysis was conducted using 2-way multivariate analysis of variance followed by Tukey honestly significant difference multiple comparisons. The EZout System required an overall lower force and torque (P<0.0001, both) during removal, producing lower strains in the surrounding composite bone. The procedure was faster (P<0.0001) and less energy demanding with the EZout compared with the Explant. The amount of foam on the cup was on average less for the EZout than for the Explant (P<0.05). We found that the EZout System is effective in achieving safe removal of a well-fixed acetabular component in an in vitro model of cementless fixation. This system should be considered as a reasonable alternative to manual removal techniques.
Breastfeeding Behaviors and Maternal Interaction Quality in a Low-Income, Ethnic Minority Population
Authors: Whipps Mackenzie D. M. , Miller Elizabeth B. , Bogen Debra L. , Mendelsohn Alan L. , Morris Pamela A. , Shaw Daniel , Gross Rachel S.
Published: October 2019

Objective:

To examine the associations between breastfeeding intensity and underexplored features of maternal-child interaction quality over and above the influence of breastfeeding initiation.

Methods:

The current study leveraged an on-going, multisite randomized controlled trial of a tiered parenting program for 462 Medicaid-eligible mothers and their infants in the United States. We examined whether breastfeeding intensity and exclusivity was associated with observed maternal sensitivity, intrusiveness, and detachment, as well as self-reported maternal verbal responsiveness, 6 months infant age. Analyses controlled for breastfeeding initiation, demographics, and early parenting experiences.

Results:

Higher intensity breastfeeding at 6 months was significantly related to higher maternal sensitivity (β = 0.12, p = 0.004) and lower maternal intrusiveness (β = −0.10, p = 0.045). There was no significant association between breastfeeding intensity at 6 months and detachment (β = −0.02, no significant [ns]) or self-reported verbal responsiveness (β = 0.11, ns). Results were the same when intensity was measured as a dichotomous indicator for exclusive breastfeeding. Effect sizes were small-to-moderate, ranging from Cohen's d = 0.26 to 0.31. Associations did not vary by site, race/ethnicity, infant difficultness, or household poverty.

Conclusion:

The finding that breastfeeding intensity was significantly and independently associated with maternal sensitivity and intrusiveness is novel in the literature on low-income families from the United States. These findings have implications for breastfeeding promotion strategies and indicate that future research should explore synergistic or spillover effects of interventions aimed at maternal-child interaction quality into the infant feeding domain, particularly in the primary care setting.
Potential of the Cardiovascular Drug Levosimendan in the Management of Amyotrophic Lateral Sclerosis: An Overview of a Working Hypothesis
Authors: Al-Chalabi Ammar , Heunks Leo M. A. , Papp Zoltán , Pollesello Piero
Published: October 2019

Levosimendan is a calcium sensitizer that promotes myocyte contractility through its calcium-dependent interaction with cardiac troponin C. Administered intravenously, it has been used for nearly 2 decades to treat acute and advanced heart failure and to support the heart function in various therapy settings characterized by low cardiac output. Effects of levosimendan on noncardiac muscle suggest a possible new application in the treatment of people with amyotrophic lateral sclerosis (ALS), a neuromuscular disorder characterized by progressive weakness, and eventual paralysis. Previous attempts to improve the muscle response in ALS patients and thereby maintain respiratory function and delay progression of disability have produced some mixed results. Continuing this line of investigation, levosimendan has been shown to enhance in vitro the contractility of the diaphragm muscle fibers of non-ALS patients and to improve in vivo diaphragm neuromuscular efficiency in healthy subjects. Possible positive effects on respiratory function in people with ALS were seen in an exploratory phase 2 study, and a phase 3 clinical trial is now underway to evaluate the potential benefit of an oral form of levosimendan on both respiratory and overall functions in patients with ALS. Here, we will review the various known pharmacologic effects of levosimendan, considering their relevance to people living with ALS.
Biocompatibility and zinc release testing of a zinc-containing vaginal gel
Authors: Fenyvesi Ferenc , Váradi Judit , Fehér Pálma , Bácskay Ildikó , Vecsernyés Miklós , Sipos Attila , Takacs Peter
Published: October 2019

Objective:

To test the biocompatibility of a zinc-containing vaginal gel, evaluate its ability to release zinc, and to assess the transepithelial permeability of zinc on human vaginal epithelium.

Methods:

The release and membrane diffusion of zinc from the vaginal gel was tested by a vertical Franz-diffusion cell system. The biocompatibility of the gel was tested on HaCaT cells and reconstructed human vaginal epithelium. MTT assay was used to detect cell viability. Lactate dehydrogenase (LDH) assay was used to access cytotoxicity. The permeability of zinc was tested on the reconstructed human vaginal epithelium. The integrity of the reconstructed human vaginal epithelium after the permeability experiments was measured by transepithelial electric resistance. Zinc levels were determined by inductively coupled plasma optical emission spectrometry.

Results:

20 μM zinc sulfate did not decrease cell viability during the 24 and 72-hour treatment. Similarly, cell viability did not decrease significantly after 60 minutes of incubation with the gel and no toxic compound released from the vaginal gel during the 120 minutes diffusion experiment. A total of 72-hour exposure to the zinc-containing vaginal gel showed no cytotoxicity using LDH assay. Using cellulose-acetate membranes, 24.6% of the zinc content of the gel was released and appeared in the acceptor phase after 15 minutes. Zinc had high permeability (2.2 ± 0.8 × 10−5 cm/s) from the vaginal gel on reconstructed human vaginal epithelium.

Conclusions:

The zinc-containing (20 μM) vaginal gel was not toxic. The release of zinc is rapid from the vaginal gel. Zinc permeated rapidly through the vaginal epithelial cell layers.
SEROUS MACULAR DETACHMENT IN BEST DISEASE
Authors: Zatreanu Luca , Freund K. Bailey , Leong Belinda C. S. , Yu Hyeong G. , Teke Mehmet Y. , Yzer Suzanne , Sadda SriniVas R. , Sarraf David
Published: October 2019

Purpose:

To describe the clinical and multimodal imaging findings of a series of cases of serous macular detachment (SMD) caused by Best disease (BD) masquerading as neovascular age-related macular degeneration or central serous chorioretinopathy that were inappropriately treated with intravitreal anti–vascular endothelial growth factor or laser therapy. This study will also present data to support age-related progressive choroidal thickening in BD patients, which may play a role in the development of SMD in this population.

Methods:

Clinical examination and multimodal imaging findings, including color fundus photography, spectral-domain optical coherence tomography, fundus autofluorescence, fluorescein angiography, and optical coherence tomography-angiography, were reviewed and analyzed. Subfoveal choroidal thickness was also formally measured, and an age-related choroidal thickness analysis was performed and compared with a normal population.

Results:

Twenty-six eyes of 13 patients (5 women) were included. Median age was 44 years. Nine patients presented with a history of SMD and subretinal fluid recalcitrant to various therapies, including intravitreal anti–vascular endothelial growth factor injections and photodynamic therapy. Best disease was subsequently diagnosed genetically in six patients and by detailed family history in seven. Mean logarithm of the minimum angle of resolution best-corrected visual acuity for all 26 eyes at last follow-up was +0.36 (Snellen equivalent of 20/46). Subfoveal choroidal thickness positively correlated with age for our cohort, increasing linearly at a rate of 25.6 µm per decade (R2 = 0.64; P < 0.001). Choroidal neovascularization was identified in four eyes on optical coherence tomography angiography, but these eyes did not respond to anti–vascular endothelial growth factor treatment.

Conclusion:

The diagnosis of BD should be considered in patients presenting with SMD and recalcitrant subretinal fluid masquerading as neovascular age-related macular degeneration or chronic central serous chorioretinopathy to avoid unnecessary treatment procedures. The positive correlation of subfoveal choroidal thickness with age in BD patients may be a factor in the pathogenesis and development of SMD in this population. Recognizing the multimodal imaging features of SMD associated with BD, described in detail in this study, will guide practitioners to the accurate diagnosis of BD and reduce the risk of unnecessary intraocular procedures with potential complications.
DISTINGUISHING INTRARETINAL MICROVASCULAR ABNORMALITIES FROM RETINAL NEOVASCULARIZATION USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY
Authors: Arya Malvika , Sorour Osama , Chaudhri Juhi , Alibhai Yasin , Waheed Nadia K. , Duker Jay S. , Baumal Caroline R.
Published: October 2019

Purpose:

With the increasing prevalence of diabetes, fast, noninvasive identification of proliferative diabetic retinopathy (PDR) becomes essential. This study evaluated the utility of optical coherence tomography angiography (OCTA) to characterize intraretinal microvascular abnormalities (IRMA) and retinal neovascularization (NV).

Methods:

Patients with severe non-PDR or PDR were imaged with fluorescein angiography and widefield swept-source OCTA (Zeiss Plex Elite 9000; Carl Zeiss Meditec, Dublin, CA). Regions suspicious for IRMA or retinal NV were identified and the OCTA, including flow overlay on the co-registered structural optical coherence tomography, and fluorescein angiography images were graded by two masked readers.

Results:

Ninety-six foci of irregular vasculature were analyzed, comprised of 70 IRMA and 26 retinal NV lesions from 14 eyes. Compared with fluorescein angiography, OCTA with flow overlay demonstrated specificity of 99% and sensitivity of 92% in identifying IRMA and NV. Neovascularization differed from IRMA on OCTA by demonstrating supraretinal flow breaching the internal limiting membrane and posterior hyaloid (P < 0.001). Intraretinal microvascular abnormalities were distinguished from NV by outpouching of the internal limiting membrane (P = 0.035). Vascular flow was reduced in the presence of fibrosis.

Conclusion:

Optical coherence tomography angiography, through flow overlay, has utility to image and differentiate IRMA and NV, which are key features distinguishing severe non-PDR and PDR, respectively. Noninvasive widefield OCTA may be a useful tool to diagnose high-risk diabetic retinopathy eyes.
HISTOLOGIC FINDINGS IN VITREORETINAL LYMPHOMA
Authors: Albadri Sam T. , Pulido Jose S. , Macon William R. , Garcia Joaquin J. , Salomao Diva R.
Published: October 2019

Purpose:

We aimed to describe the clinical and histologic findings in a few enucleation cases with intraocular lymphoma.

Methods:

Retrospective review of pathology files from a 22-year period identified cases with intraocular lymphoma among all enucleation specimens. Patient demographics, clinical findings, laboratory results, radiographic studies, and indication for enucleation were abstracted from electronic health records; slides were reviewed.

Results:

Four patients (three women and one man; age range, sixth through eighth decades of life) underwent enucleation with a final diagnosis of intraocular lymphoma. Two patients with primary vitreoretinal large B-cell lymphomas had been treated for refractory uveitis. Specimens showed retinal and subretinal infiltrates by atypical large B-lymphocytes and rare neoplastic cells in the vitreous. The remaining two patients had systemic lymphoproliferative disorders. One patient had chronic lymphocytic leukemia and floaters in his eye; vitreoretinal lymphoma developed, consistent with intraocular Richter transformation. The other had diffuse large B-cell lymphoma in remission; however, blurred vision developed, she was treated for panuveitis without improvement, and was later found to have ocular involvement by diffuse large B-cell lymphoma.

Conclusion:

Our series details the unusual circumstances when an eye is removed for intraocular lymphoma. Different patterns of ocular tissue involvement were observed when we compared primary and secondary lymphomas.