bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on Engineering Construction Safety Integration based on BIM and RFID
Authors: Li Binyong , Du Zeyan , Xie Dayong , Huang Lang
Published: December 2018

According to the fact that the traditional manual management method can not solve the problem of frequent accidents in the engineering construction process, the integrated scheme of safety prevention based on BIM and RFID is put forward, and the principle and technical feasibility of the integrated scheme are analyzed. Based on the integration technology scheme, the multi-layer architecture design pattern is adopted, and the software hierarchy of the integration system is designed in detail. On this basis, the integrated application network for engineering construction safety control is analyzed and designed by using the technology based on BIM and RFID. The research results of this paper provide a feasible technical reference scheme for the automatic identification and dynamic monitoring and early warning of the hidden dangers in the construction site.
Hearing aid classification method based on improved AP algorithm
Authors: Chen Xiaomei , Ren Meina , Bo Zhong
Published: December 2018

Based on the large medical data to evaluate the performance of the hearing aid is a promising way. Achieving the classification of the hearing aid is the foundation. In this paper an improved semisupervised AP clustering algorithm based on density path is proposed. The PESQ score is taken as the substitution of subjective score for the speech segments, which is also taken as a semi-supervised basis to improve classification accuracy. The Euclidean distance similarity is improved based on the density path, making it suitable for complex shape data sets. Through experimental verification, compared with the traditional AP algorithm, the improved algorithm shows obvious advantages in terms of hearing aid classification accuracy and recognition performance.
Detectability of possible space weather effects on Mars upper atmosphere and meteor impacts in Jupiter and Saturn with small telescopes
Authors: Hueso Ricardo , del Río-Gaztelurrutia Teresa , Sánchez-Lavega Agustín , Delcroix Marc , Juaristi Jon , Fernández-González Luis Carlos
Published: December 2018

Amateur astronomers operating small telescopes accumulate a larger amount of observational time of Solar System planets than the ensemble of professional telescopes. Over the last 15 years, advancements in low-cost fast acquisition cameras and image software processing tools have pushed forward the scientific analysis of these observations thanks to a sustained increase in quality and spatial resolution. The high temporal coverage attained by amateur astronomers collaborating with scientists allows detecting rare events in the atmospheres of different planets. In particular, high-atmosphere phenomena in Mars, possibly caused by solar activity, and meteor impacts in Jupiter have been observed serendipitously in the last decade. Here we review the contribution of amateur astronomers to these two fields. Coronal Mass Ejections arriving to Mars under favorable observing conditions can be predicted after observations of the Sun, and their possible effect on Mars upper atmosphere can be monitored with small telescopes. Impacts in Jupiter of two different classes can be discovered by amateur astronomers: intermediate size impacts big enough to leave a debris field on its atmosphere (150-m size objects before the impact), and fireballs caused by objects of 5–20 m producing short-lived flashes in video observations of the planet. In this regard, we present a software tool designed to analyze video observations of Jupiter and Saturn that should help to find new impact flashes on the giant planets.
Von der Theorie in die Praxis
Authors: Johansson Kajsa , Oswald Nadine-Marie
Published: December 2018

Gesundheitsförderndes Führen bedeutet vor allem, bewusst hinzuschauen – auf die Arbeitsumstände ebenso wie auf das persönliche Miteinander. Die BGW gibt
konkrete Handlungsempfehlungen für die Umsetzung.
Meine Lebensqualität wurde deutlich besser
Authors: Starrost Klaus
Published: December 2018

Die Patientin leidet an einer Parkinson-Erkrankung und ist jetzt 74 Jahre alt.
Als die Symptome sich verschlechterten, wurde ihr angeraten, möglichst bald eine
Tiefe Hirnstimulation vornehmen zu lassen, da diese bei jüngeren Patienten
deutlich bessere Ergebnisse liefert. Vor acht Jahren hat sie sich für diese
Behandlung entschieden, lesen Sie hier ihre Geschichte.
Krankenhaus ist nicht zur Herausgabe von internen
Unterlagen verpflichtet
Authors: Häser Isabel
Published: December 2018

Immer häufiger verlangen Patienten umfangreiche Einsicht in Unterlagen eines
Krankenhauses, um Schadensersatzansprüche zu untermauern. Doch nicht jedes
Anliegen ist berechtigt. Das OLG Karlsruhe wies eine Patientin mit Urteil
vom 16.08.2017 (Aktenzeichen 7 U 202/16) in ihre Schranken. Sie forderte
Einsicht in Unterlagen über die interne Organisation der Klinik wegen
Hygienemängeln.
Koronare CT-Angiografie
Authors: Achenbach Stephan
Published: December 2018

Die CT-Angiografie ist ein zunehmend robustes Verfahren zur Darstellung der
Koronararterien. Adäquate Bildqualität vorausgesetzt, gelingen Detektion und
Ausschluss von Koronararterienstenosen zuverlässig; darüber hinaus ist es
möglich, auch nicht-stenosierende koronare atherosklerotische Läsionen zu
detektieren. Allerdings sind eine ausreichend kontrollierte Herzfrequenz –
gegebenenfalls durch die Gabe von kurz wirksamen Betablockern für die
Untersuchung – sowie Compliance bezüglich der Befolgung von Atemkommandos und
das Fehlen ausgeprägten Übergewichts Voraussetzungen für eine zuverlässige
Beurteilbarkeit der koronaren CT-Angiografie. Klinisch wird die CT-Angiografie
insbesondere bei Patienten mit Verdacht auf das Vorliegen einer koronaren
Herzerkrankung aber eher geringer prä-Test-Wahrscheinlichkeit eingesetzt: Dies
ist eine durch große Studien sehr gut abgesicherte Indikation, die auch in
entsprechenden Leitlinien enthalten ist. Darüber hinaus deutet sich durch
entsprechende Studienergebnisse an, dass der Nachweis einer nicht-stenosierenden
Atherosklerose vermutlich den Einsatz von Statinen rechtfertigt, während das
Fehlen atherosklerotischer Plaques eine Statintherapie wohl in der Regel
verzichtbar macht – dies ist aber nicht Gegenstand aktueller Leitlinien.
Insgesamt bereichert die CT-Angiografie das Spektrum diagnostischer
Möglichkeiten für die Aufarbeitung von Patienten mit vermuteten Koronarstenosen
äußert sinnvoll, es ist aber nicht gerechtfertigt, ihren generellen Einsatz als
Methode der ersten Wahl zu fordern.
Meilenstein auf der Kippe?
Authors: Müller Marie-Luise
Published: December 2018

Die pflegehistorische Entscheidung zur generalistischen Ausbildung soll auf den letzten Metern mit einem Moratorium ausgebremst werden. Das darf nicht
passieren!
Pflegefachfrau und Pflegefachmann
Authors: Kutschke Thomas
Published: December 2018

Der lang ersehnte Referentenentwurf über die Neugestaltung der Berufsausbildung
Pflege liegt vor. Worauf wir uns in Zukunft, neben der neuen Berufsbezeichnung
Pflegefachfrau/Pflegefachmann, vorbereiten sollten, hat unser Experte für Sie
zusammengefasst.
Gefahr in Verzug
Authors: Weimer Tobias
Published: December 2018

Kostendruck und Fachkräftemangel gehören zum Alltag im Gesundheitsbereich. Was aber tun, wenn die Überlastung aufgrund personeller Unterbesetzung zu groß wird?
Lesen Sie hier mehr über die Rechtslage bei Whistleblowing, Überlastungs- oder Entlastungsanzeigen.
Patientenkoordination in der Notaufnahme
Authors: Steinkirchner Stefan , Straube Alexander
Published: December 2018

Gerade zu Spitzenzeiten hapert es in der Notaufnahme oft an einer zügigen Weiterverlegung der Erkrankten. Das Universitätsklinikum Regensburg hat sich
dieses Problems angenommen und einen Patientenkoordinator eingestellt.
Wenn Arbeit krank macht
Authors: Maier Julia
Published: December 2018

Stress im Job kennt jeder. Wer seine Leistungsgrenze aber ständig überschreitet, riskiert ein Burnout. Welche Anzeichen sind gefährlich? Was können Mitarbeiter
und Pflegedirektoren tun, damit ein Burnout gar nicht erst entsteht? Ein Überblick.
Neu: Entgeltordnung TVöD-VKA
Authors: Wiedmann Jörn
Published: December 2018

Nach mehr als zehn Jahren quälend langen Wartens ist sie da – die neue Entgeltordnung im TVöD-VKA. Mit ihr gelten im Bereich der Eingruppierung der
Pflegeleitungskräfte völlig neue Tätigkeitsmerkmale. Die bislang ausschließlich von Unterstellungsverhältnissen abhängigen Merkmale gibt es nicht
mehr.
‘Monstrous men’ and ‘sex scandals’: the myth of exceptional deviance in sexual harassment and violence in education
Authors: Sundaram Vanita , Jackson Carolyn
Published: December 2018

One might argue that sexism, sexual harassment and sexual violence have become hyper-visible in recent times. The #MeToo movement has focused our attention on the prevalence of sexual harassment and abuse in a range of contexts, including in Hollywood, the media industry, Westminster, science and academia. Media reporting of these high-profile cases represents the perpetrators of these crimes as ‘monsters’, ‘sex pests’, as highly unusual or deviant individuals. We argue here, that rather, such practices pervade a range of contexts, including educational ones, and are normalised and ‘hidden’ within these settings. We will draw on our recent research on ‘lad culture’ in higher education to discuss how harassment and sexual abuse are normalised in certain university contexts. Our piece will explore how such cultures silence survivors and mask, or make invisible, instances of everyday sexism and harassment and how such silencing can perpetuate the notion that individual ‘monsters’ commit such acts. Drawing on interviews with staff working in universities, this piece shows how sexual harassment is mis-perceived, justified and minimised (particularly in relation to less visible examples of degradation or abuse of women) and how the notion of the ‘problematic individual’ prevails in favour of a structural, gendered analysis of harassment and violence. University responses to sexual harassment and violence have therefore tended to be responsive and focused on individuals, rather than taking a whole-institution approach to tackling these practices.
Reconstructing the ocean floor using sea surface measurements
Authors: Larter Raima
Published: December 2018

A new technique is proposed to reconstruct the topography of the ocean bottom from free surface elevation and velocity field measurements.
Persistence of false paradigms in low-power sciences
Authors: Akerlof George A. , Michaillat Pascal
Published: December 2018

Significance

It is believed that a lack of experimental evidence (typical in the social sciences) slows but does not prevent the adoption of true theories. We evaluate this belief using a model of scientific research and promotion in which tenured scientists are slightly biased toward tenure candidates with similar beliefs. We find that when a science lacks evidence to discriminate between theories, or when tenure decisions do not rely on available evidence, true theories may not be adopted. The nonadoption of heliocentric theory in the 16th century, the persistence of bloodletting in the 19th century, the nonadoption of underconsumption theory in the early 20th century, and the persistence of radical mastectomy in the 20th century illustrate such risk.
Food and geopolitics: when food security and hard security considerations converge - mini review.
Authors: Woertz E.
Published: December 2018

In academic research on food security, developmental and technocratic perspectives prevail. Raising agricultural productivity sustainably, guaranteeing accessibility of food to vulnerable segments of the population and nutritional impacts are at the centre of attention. Yet, food security also touches upon vital state interests and sometimes converges with hard security consideration, not only in times of war and sanctions. This mini review takes a look at some of the literature that deals with this neglected aspect of food security.
The importance of water in pig production.
Authors: Azarpajouh S. , Garcia A. , Jackson C. , Karriker L. , Ramirez A. , Johnson A.
Published: December 2018

Pigs are prandial feeders and drinkers. Focus has been directed to pig nutritional needs that include micro- and macro-nutrients, mineral and vitamin requirements and feed particle size. Water is the most important nutrient for pigs without which pigs will only survive for a short time. Additionally, detailed information on pigs' temporal drinking patterns is essential when delivering water-based health products because there is a risk that not all pigs will visit the drinker adequately and hence, may not have received sufficient vaccine or antibiotics required to protect the animal. To date there has been little focus on water function, quality and availability and how it affects pig welfare. This review paper will (a) address water functions, requirement and quality, (b) describe drinking behaviours and patterns, (c) explain factors that impact drinking behaviour and water intake and (d) discuss the water systems and pen designs that enhance drinking behaviour.
Measuring internet addiction: comparative studies based on gender using Bayesian analysis
Authors: Ifdil I , Putri Y E , Fadli R P , Erwinda L , Suranata K , Ardi Z , Fitria L , Churnia E , Zola N , Barriyah K , Rangka I B
Published: December 2018

The Internet becomes a necessity that is in a vital position for both children, teenagers and adults. Lately the use of the Internet to be a matter of concern and need to be studied, especially related to Internet addiction. As for the gender aspect, men and women have special forms of Internet addiction experienced. Based on this case, the authors designed a study related to the difference Internet addiction of male and female. The ultimate goal is the description of research results will be used for treatment. The sample for this research is 84 men and 84 women, the number of samples taken based on consideration using software G-Power 3.1 where for sample 84 people each group effect size is 0.3159282, α err prob 0.05 and power (1-β err prob) 0.65. The instrument used is Chen Internet Addiction, which amounts to 26 items. Data analysis using JASP 0.8.5.1 software uses two types of analysis of Classic Test Theory Independent Sample T-Test and Bayesian Independent Sample T-Test. A result of research from both analysis that there is significant difference of Internet addiction of man and woman.
Sewability interdependence on rigid structures
Authors: Karypidis M
Published: December 2018

Sewability is the ability of the fabric to be sewn without faults and represents the ease of fabric processing at a satisfactory level. It can be used to predict problems which may occur in the garment sewing stage and it can be accurately measured using the L&M sewability tester as a function of that needle penetration force though the fabric. Sewability is attributed to fabric properties, pretreatment, finishing, sewing conditions and mishandling. Fabric softeners affect the ease of sewing processing of garments, which is mostly reflected by the needle penetration force. The current work was driven by previous study focused on the analysis of factors affecting the sewability of cellulosic woven fabrics of a wide range of designs and constructions, where the influence of several fabric properties on the needle penetration force had been investigated, revealing the existence of a relationship between the inherent properties of mass per square metre, breaking strength and bending length. However, the in-depth statistical analysis had shown that rigid structures follow a different trend in comparison to the light ones. In the current work, thin and light structured fabrics were excluded from the investigation and focus was given exclusively to the rigid structures of higher mass per square metre fabrics which are known to be problematic in sewing stage. Although the investigation was confined to the main three inherent properties which had proven to influence needle penetration, it included fabric treatments of washing and softening on the samples. Results show an increase in the interdependency of the studied properties while treatments show a minimal effect probably to low level of application.
Virtual method of predicting the accuracy of pattern blocks
Authors: Peng X , Kuzmichev V E
Published: December 2018

Main purpose of this study is to develop the virtual method of predicting the misfit based on new obtaining relations between pattern blocks and body features. In our research, digital twin of female body in CLO3D was used. 3D-2D pattern block flattening technology was used to obtain the body prototype of avatar. The ease value of main structural parts for blouse pattern blocks and the proportions of ease value were obtained by respectively overlapping the blouse pattern blocks with the body prototype. Pattern blocks were analyzed and evaluated in terms of the proportions of ease value. New method can be used to analyze and predict the quality of blouse pattern block effectively and improve the efficiency of virtual garment design.
Investigating the role of Simpson’s paradox in the analysis of top-ranked features in high-dimensional bioinformatics datasets
Authors: Freitas Alex A
Published: December 2018

An important problem in bioinformatics consists of identifying the most important features (or predictors), among a large number of features in a given classification dataset. This problem is often addressed by using a machine learning–based feature ranking method to identify a small set of top-ranked predictors (i.e. the most relevant features for classification). The large number of studies in this area has, however, an important limitation: they ignore the possibility that the top-ranked predictors occur in an instance of Simpson’s paradox, where the positive or negative association between a predictor and a class variable reverses sign upon conditional on each of the values of a third (confounder) variable. In this work, we review and investigate the role of Simpson’s paradox in the analysis of top-ranked predictors in high-dimensional bioinformatics datasets, in order to avoid the potential danger of misinterpreting an association between a predictor and the class variable. We perform computational experiments using four well-known feature ranking methods from the machine learning field and five high-dimensional datasets of ageing-related genes, where the predictors are Gene Ontology terms. The results show that occurrences of Simpson’s paradox involving top-ranked predictors are much more common for one of the feature ranking methods.
Regional Specialization of Pyramidal Neuron Morphology and Physiology in the Tree Shrew Neocortex
Authors: Parra Andres , Baker Christopher A , Bolton M McLean
Published: December 2018

The mammalian cerebral cortex is divided into different areas according to their function and pattern of connections. Studies comparing primary visual (V1) and prefrontal cortex (PFC) of primates have demonstrated striking pyramidal neuron (PN) specialization not present in comparable areas of the mouse neocortex. To better understand PFC evolution and regional PN specialization, we studied the tree shrew, a species with a close phylogenetic relationship to primates. We defined the tree shrew PFC based on cytoarchitectonic borders, thalamic connectivity and characterized the morphology and electrophysiology of layer II/III PNs in V1 and PFC. Similar to primates, the PFC PNs in the tree shrew fire with a regular spiking pattern and have larger dendritic tree and spines than those in V1. However, V1 PNs showed strikingly large basal dendritic arbors with high spine density, firing at higher rates and in a more varied pattern than PFC PNs. Yet, unlike in the mouse and unreported in the primate, medial prefrontal PN are more easily recruited than either the dorsolateral or V1 neurons. This specialization of PN morphology and physiology is likely to be a significant factor in the evolution of cortex, contributing to differences in the computational capacities of individual cortical areas.
Usefulness of mycophenolate mofetil in Indian patients with C3 glomerulopathy
Authors: Bharati Joyita , Tiewsoh Karalanglin , Kumar Ashwani , Nada Ritambhra , Rathi Manish , Gupta Krishan Lal , Kohli Harbir Singh , Jha Vivekananda , Ramachandran Raja
Published: December 2018

Background

C3 glomerulopathy (C3G) is a heterogeneous disease caused by alternative complement pathway abnormalities without any standardized treatment. An immunosuppressive agent, mycophenolate mofetil (MMF), has been recently shown to be useful in treating C3G, mainly in studies from the west. We report the clinical outcome of 17 Indian C3G patients treated with MMF with or without steroids.

Methods

The clinical and histology details of the C3G patients treated with MMF for at least 6 months with a follow-up of at least 12 months were retrieved from the medical records of our center.

Results

The median serum creatinine and proteinuria at presentation were 0.8 mg/dL and 3.7 g/day, respectively, with the majority (88.2%) presenting as nephrotic syndrome. The mean dose of MMF was 1.65 (±0.56) g/day, and the median duration of MMF therapy was 18 months. Two-thirds (64%) of the patients responded to the treatment, with complete remission in 4 (23%) and partial remission in 7 (41%) (median time: 9 months). Three patients progressed to end-stage renal disease (ESRD) on follow-up. Of the three patients, one (33%) had an initial response in proteinuria to MMF but did not respond after a relapse and subsequently progressed to ESRD and two (67%) other patients were nonresponsive to MMF from the start of the therapy.

Conclusion

Despite a small sample size and lack of a control arm, this study describes the effectiveness of MMF in treating C3G patients from Asia and forms a basis for future randomized trials.
A micro X-ray computed tomography dataset of fossil echinoderms in an ancient obrution bed: a robust method for taphonomic and palaeoecologic analyses
Authors: Reid Mhairi , Bordy Emese M , Taylor Wendy L , le Roux Stephan G , du Plessis Anton
Published: December 2018

Background

Taphonomic and palaeoecologic studies of obrution beds often employ conventional methods of investigation such as physical removal and extraction of fossils from their host rock (matrix) by mechanical preparation. This often-destructive method is not suitable for studying mold fossils, which are voids left in host rocks due to dissolution of the original organism in post-depositional processes.

Findings

Microcomputed tomography (μCT) scan data of 24 fossiliferous rock samples revealed thousands of Paleozoic echinoderms. Digitally "stitching" together individually μCT scanned rock samples within three-dimensional (3D) space allows for quantifiable taphonomic data on a fossil echinoderm-rich obrution deposit from the Devonian (Emsian) of South Africa. Here, we provide a brief step-by-step guide on creating, segmenting, and ultimately combining sections of richly fossiliferous beds to create virtual models suited for the quantitative and qualitative taphonomic analyses of fossil invertebrate assemblages.

Conclusions

Visualizing the internal features of fossiliferous beds in 3D is an invaluable taphonomic tool for analyzing delicate fossils, accounting for all specimens irrespective of their preservation stages and with minimal damage. This technique is particularly useful for analyzing fossiliferous deposits with mold fossils that prove to be difficult to study with traditional methods, because the method relies on the large density contrast between the mold and host rock.
Double Infection With Leishmania tropica and L. major in an HIV Patient Controlled With High Doses of Amphotericin B
Authors: Al Balushi Asma , Khamis Faryal , Klaassen Corné H W , Gangneux Jean-Pierre , Van Hellemond Jaap J , Petersen Eskild
Published: December 2018

We present a unique case of disseminated Leishmaniasis in an HIV patient. Two different Leishmania species were identified by genomic sequencing in both bone marrow and skin. The Leishmania infection could be suppressed but not cured, despite a high dose of amphotericin B of nearly 65 g over more than 6 years.
Reaching Parents Through an Online Community
Authors: Boat Anne , Monteleone Matthew , Lee Jennifer J. , Sun Lena S.
Published: December 2018

Scientific studies in animal models have demonstrated the neurotoxic effects of anesthetic and sedative drugs on the developing brain. Human studies, however, have been limited and less conclusive. The implications for clinical care remain unclear, and there is a critical need for further research on anesthetic toxicity to ensure safe anesthesia practices for infants and children. The sixth PANDA Symposium organized a session on “Engaging Stakeholders to Support Research” to facilitate dialog around improving communication and collaboration among stakeholders and to promote coordinated research efforts. Key stakeholders include patients, families, clinicians, researchers, community organizations, and federal agencies. This article provides an overview of an online platform called the Family Talkboard, a novel method which is destined to enhance patient outreach, engagement, and quality improvement, as well as outcomes research.
Minimally Displaced Humeral Lateral Condyle Fractures: Immobilize or Operate When Stability Is Unclear?
Authors: Greenhill Dustin A. , Funk Shawn , Elliott Marilyn , Jo Chan-Hee , Ramo Brandon A.
Published: December 2018

Background:

Either casting or in situ fixation (to prevent displacement) are recommended for minimally displaced pediatric lateral condyle fractures of indeterminate stability with ≤2 mm lateral displacement and narrowed fracture extension to the epiphyseal articular cartilage. This study compares casting only, acute prophylactic in situ pinning, and surgery if casting fails due to displacement.

Methods:

In total, 738 fractures at a level 1 trauma center between 2008 and 2014 were reviewed. All fractures were assigned a Song classification and Song 2 fractures followed to union were analyzed. Worsening displacement was defined as an increase in Song stage. Patients were grouped per treatment: (1) cast only; (2) in situ pinning; or (3) closed or open reduction percutaneous pinning after displacement during attempted cast treatment.

Results:

In total, 139 fractures were included and 45 (32%) underwent surgery. Among 114 fractures intended for casting, only 20 (18%) displaced and needed surgery. This implies 82% of fractures prophylactically pinned in situ may have remained stable in a cast. On average, displaced fractures were noted 6.5 (2 to 13) days after presentation and required 1 extra clinic visit and week of immobilization without increased complications. Surgeons chose open reduction percutaneous pinning more often for displaced fractures.

Conclusions:

Our data estimate 82% of Song 2 fractures never meaningfully displace in a cast. Meaningful displacements occur in <2 weeks. Benefits of prophylactic pinning include 1 less x-ray and clinic visit in exchange for a clinically insignificant lateral cortex reduction and inherent surgical risks. Compliance, surgical scheduling, and a higher rate of open reduction after displacement should influence early treatment decisions.

Level of Evidence:

Level III.
Efficacy and Safety of Bronchial Artery Embolization on Hemoptysis in Chronic Thromboembolic Pulmonary Hypertension: A Pilot Prospective Cohort Study
Authors: Yang Suqiao , Wang Jianfeng , Kuang Tuguang , Gong Juanni , Ma Zhanhong , Shen Ying H. , Liang Lirong , Yang Yuanhua , Huang Kewu
Published: December 2018

Objectives:

Managing hemoptysis in chronic thromboembolic pulmonary hypertension can be challenging due to the difficulties in maintaining coagulation homeostasis in affected patients. In this study, we evaluated the efficacy and safety of bronchial artery embolization in treating hemoptysis in chronic thromboembolic pulmonary hypertension patients.

Design:

Pilot, prospective cohort study.

Setting:

A large respiratory medical institute.

Patients:

From January 1, 2012, to December 31, 2017, hospitalized chronic thromboembolic pulmonary hypertension patients were eligible for inclusion. Patients with pulmonary hypertension caused by other conditions, or who failed to participate in the follow-up were excluded.

Interventions:

Hemoptysis in chronic thromboembolic pulmonary hypertension patients was treated with or without bronchial artery embolization based on whether the bleeding could be stopped with medication alone and patient willingness for bronchial artery embolization treatment.

Measurements and Main Results:

A total of 328 patients diagnosed with chronic thromboembolic pulmonary hypertension were consecutively collected, 317 patients were completed the follow-up. There were 15 chronic thromboembolic pulmonary hypertension patients with hemoptysis in total, and the occurrence rate of hemoptysis in chronic thromboembolic pulmonary hypertension patients was 4.7%. Among the hemoptysis chronic thromboembolic pulmonary hypertension patients, 10 (67%) underwent bronchial artery embolization, and five (33%) were treated with medication only. The median follow-up period for hemoptysis patients was 7.6 months. In patients underwent bronchial artery embolization treatment, oxygenation index and right heart function showed no significant difference between pre bronchial artery embolization and post bronchial artery embolization. Hemoptysis relapse (20% vs 80%; p = 0.025) and hemoptysis-related mortality (0% vs 40%; p = 0.032) were significantly lower, whereas the overall survival (90% vs 40%; p = 0.040) was higher in patients treated with bronchial artery embolization than in patients treated without bronchial artery embolization.

Conclusions:

Bronchial artery embolization procedure demonstrated effectiveness and safety to treat hemoptysis in chronic thromboembolic pulmonary hypertension patients at our center, but further controlled studies are needed before it can be considered as an effective therapy for these patients.
Response to Pazopanib in Patients With Relapsed Osteosarcoma
Authors: Elete Kunal R. , Albritton Karen H. , Akers Lauren J. , Basha Riyaz , Ray Anish
Published: December 2018

Axial skeleton primary tumor, metastatic disease at presentation, incomplete surgical resection, and <90% tumor necrosis have all been known to influence prognosis adversely in osteosarcoma. Relapse of osteosarcoma, typically occurring within the first 18 months of therapy, with an incidence rate of 50% is treated with surgery, chemotherapy, and targeted therapy. Here, we discuss 2 patients treated with pazopanib, a multi–tyrosine kinase inhibitor presently approved to treat renal cell carcinoma and soft tissue sarcomas. Case 1 achieved positive response and remains on pazopanib. Case 2 sustained gastrointestinal toxicity requiring suspension of drug, despite achieving stable disease.
Building and Sustaining a Culture of Clinical Inquiry in a Pediatric Quaternary Hospital
Authors: DeGrazia Michele , Difazio Rachel L. , Connor Jean A. , Hickey Patricia A.
Published: December 2018

The Nurse Executive Committee for Research and Inquiry (NECRI) was established to align clinical inquiry with nursing clinical operations to advance nursing science and improve patient care and outcomes for patients and their families. The authors describe the development, structure, and function of NECRI, outcomes to date, and infrastructure necessary to support a sustainable model.
An Exploratory, Descriptive Study of Nurse Leaders’ Personal and Work Experiences During Union Negotiations and Strike Events
Authors: Stichler Jaynelle F. , Pelletier Luc R. , Thomason Tanna
Published: December 2018

OBJECTIVE

This study explored the experiences, perceptions and emotional state of nurse leaders during union activities to understand the impact on their personal and professional lives.

BACKGROUND

Other than anecdotal stories shared during union negotiations and strike preparations, very little evidence exists in nursing and healthcare literature about nursing unions and their impact on nurse leaders and their organizational priorities.

METHODS

This study used an exploratory, descriptive design with a convenience and snowball sample of Association of California Nurse Leaders members.

RESULTS

The findings indicate nurse leaders experience a range of emotional states in response to union activities with perceptions of increased workload, job stress, and constrained and deliberate communications with their staff.

CONCLUSION

This study adds to the body of knowledge about nurse leader experiences and feelings during union activities.
Linking to Improve Nursing Care and Knowledge
Authors: Cato Kenrick D. , Sun Carolyn , Carter Eileen J. , Liu Jianfang , Rivera Reynaldo , Larson Elaine
Published: December 2018

OBJECTIVES

The aim of this study is to describe and evaluate the impact of the Linking to Improve Nursing Care and Knowledge (LINK) project on increasing nurse-led clinical research.

BACKGROUND

Nurse-generated research is the cornerstone of evidence-based practice and continues to be a marker of nursing excellence. However, the dearth of PhD-prepared nurses creates a challenge for creating an environment to promote clinical nursing research. We evaluated the LINK project, an academic-clinical partnership, to assess its impact and feasibility, for fostering nurse-led clinical research.

METHODS

The LINK project created a formal command and control structure bringing together existing academic resources, including a PhD-prepared nurse researcher, a biostatistician, and a development of a formal research consultation request process. Measures tracked over a 12-month period included average response time, request volume, client satisfaction, institutional review board (IRB)–submitted protocols, and work products.

RESULTS

All measures exceeded expectations with an average 1-day request response time, 35 requests, 98% client satisfaction, a 367% increase in nurse-led IRB approved protocols from the previous 12-month period, and 2 publications in peer-reviewed journals.

CONCLUSIONS

The process and outcome measures indicate that the LINK project is feasible, sustainable, and reproducible. We were able to meet and, in many cases, exceed measurement goals. In addition, implementation science literature indicates that the most valid measure of a successful project rollout is user satisfaction and usefulness. The LINK project received consistently positive feedback.
Histopathologic False-positive Diagnoses of Prostate Cancer in the Age of Immunohistochemistry
Authors: Beltran Luis , Ahmad Amar S. , Sandu Holly , Kudahetti Sakunthala , Soosay Geraldine , Møller Henrik , Cuzick Jack , Berney Daniel M.
Published: December 2018

There are few studies into the rate and causes of histopathologic false-positive diagnosis of prostate cancer. Only 2 of these, including a previous one from our group, incorporate survival data. In addition, in none of the previous studies had immunohistochemistry (IHC) been originally requested on any of the misdiagnosed cases. Diagnostic biopsies (n=1080) and transurethral resection of prostate specimens (n=314) from 1394 men with clinically localized prostate cancer diagnosed in the United Kingdom but treated conservatively between 1990 and 2003 were reviewed by a panel of 3 genitourinary pathologists. Thirty-five cases were excluded for being potentially incomplete. Of the remaining 1359, 30 (2.2%) were reassigned to a nonmalignant category (26 benign and 4 suspicious for malignancy). IHC had been originally performed on 7 of these. The reasons for the errors were recorded on each case: adenosis (19), partial atrophy (3), prostatic intraepithelial neoplasia (2), seminal vesicle epithelium (1), and hyperplasia (1). Follow-up of these men revealed only one prostate cancer–related death, possibly due to unsampled tumor. In conclusion, a relatively small number of prostate cancer mimics were responsible for a large proportion of the false-positive prostate cancer diagnoses and the use of IHC did not prevent the overcall of benign entities as cancer in approximately a quarter of these cases. Targeting these mimics at educational events and raising awareness of the pitfalls in the interpretation of IHC in prostate cancer diagnosis, emphasizing that glands within a suspicious focus should be treated as a whole rather than individually, may be beneficial in lowering the rate of false-positive diagnosis.
The Effect of Increasing Age on Outcomes of Digital Revascularization or Replantation
Authors: Retrouvey Helene , Solaja Ogi , Baltzer Heather L.
Published: December 2018

Background:

The aim of this study was to evaluate the impact of increasing age on rates of digital failure.

Method:

A retrospective cohort study of digital replantation or revascularization patients was undertaken from 2005 to 2016. Data collected consisted of patient demographics, smoking status, injury mechanisms, procedure types, and postoperative morbidity and mortality. Descriptive statistics and logistic regression were performed to assess outcomes. All comparisons were made between patients older than and younger than 60 years.

Results:

Two hundred eighty-three patients underwent replantation or revascularization; 11 percent were older than 60 years. The majority of patients had multiple devascularized digits (70 percent), most commonly inflicted by a blade mechanism (77 percent). Approximately half of the patients underwent revascularization alone (54.4 percent). American Society of Anesthesiologists score and number of comorbidities were significantly greater in the older adult group. Overall, 88 patients (31 percent) experienced digital replantation or revascularization failure, with 12 failures in patients aged 60 years or older. Multivariate logistic regression demonstrated that age did not have an impact on failure rate. Older patients did not experience more major complications, but had significantly higher rates of minor complications (p = 0.0485).

Conclusions:

Older patients presented with significantly higher American Society of Anesthesiologists physical status and number of comorbidities, but did not experience higher rates of digital failure, major perioperative complications, or 30-day mortality. Adults aged 60 years or older should be offered digital replantation or revascularization if medically or surgically indicated.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Risk, II.
Determinants of Restoration of CD4 and CD8 Cell Counts and Their Ratio in HIV-1–Positive Individuals With Sustained Virological Suppression on Antiretroviral Therapy
Authors: Gras Luuk , May Margaret , Ryder Lars Peter , Trickey Adam , Helleberg Marie , Obel Niels , Thiebaut Rodolphe , Guest Jodie , Gill John , Crane Heidi , Dias Lima Viviane , d'Arminio Monforte Antonella , Sterling Timothy R. , Miro Jose , Moreno Santiago , Stephan Christoph , Smith Colette , Tate Janet , Shepherd Leah , Saag Mike , Rieger Armin , Gillor Daniel , Cavassini Matthias , Montero Marta , Ingle Suzanne M. , Reiss Peter , Costagliola Dominique , Wit Ferdinand W.N.M. , Sterne Jonathan , de Wolf Frank , Geskus Ronald ,   for the Antiretroviral Therapy Cohort Collaboration (ART-CC)
Published: December 2018

Background:

An increasing number of HIV-positive individuals now start antiretroviral therapy (ART) with high CD4 cell counts. We investigated whether this makes restoration of CD4 and CD8 cell counts and the CD4:CD8 ratio during virologically suppressive ART to median levels seen in HIV-uninfected individuals more likely and whether restoration depends on gender, age, and other individual characteristics.

Methods:

We determined median and quartile reference values for CD4 and CD8 cell counts and their ratio using cross-sectional data from 2309 HIV-negative individuals. We used longitudinal measurements of 60,997 HIV-positive individuals from the Antiretroviral Therapy Cohort Collaboration in linear mixed-effects models.

Results:

When baseline CD4 cell counts were higher, higher long-term CD4 cell counts and CD4:CD8 ratios were reached. Highest long-term CD4 cell counts were observed in middle-aged individuals. During the first 2 years, median CD8 cell counts converged toward median reference values. However, changes were small thereafter and long-term CD8 cell count levels were higher than median reference values. Median 8-year CD8 cell counts were higher when ART was started with <250 CD4 cells/mm3. Median CD4:CD8 trajectories did not reach median reference values, even when ART was started at 500 cells/mm3.

Discussion:

Starting ART with a CD4 cell count of ≥500 cells/mm3 makes reaching median reference CD4 cell counts more likely. However, median CD4:CD8 ratio trajectories remained below the median levels of HIV-negative individuals because of persisting high CD8 cell counts. To what extent these subnormal immunological responses affect specific clinical endpoints requires further investigation.
Recent insights into HSV infection and disease: results of wider genome analysis
Authors: Patel Anjali , Patel Rajul
Published: December 2018

Purpose of review

Technology to rapidly determine the partial or full genomic sequences of large viruses has developed rapidly in the last few years. Required sample sizes have diminished and sequencing of directly collected patient samples is now possible. Using banked samples from a number of clinical studies researchers have investigated how genomic variation may determine pathogenicity and answering important questions around the limits of vaccine therapy.

Recent findings

The natural variation in HSV-1 and HSV-2 geographically has been determined. Variation in the genes responsible for surface glycoproteins may explain the current limitations of therapy. Studies looking at genomic sequences for HSV-2 in subjects with recurrent disease and in those who took part in failed vaccine studies show that multiple HSV-2 strain infection is rare outside Africa and in those with immunodeficiency, whereas there is no evidence that vaccination drives viral evolution. Genome wide association studies have investigated rates of HSV shedding have failed to identify the link between subject genomic sequence and the severity.

These studies will help develop better diagnostics and vaccines that are likely to be more widely effective. The findings will help counsel patients. The factors determining HSV disease severity in individuals remain elusive.
Analysis of the 4q35 chromatin organization reveals distinct long-range interactions in patients affected with Facio-Scapulo-Humeral Dystrophy.
Authors: Gaillard Marie-Cecile , Broucqsault Natacha , Morere Julia , Laberthonniere Camille , Dion Camille , Badja Cherif , Roche Stephane , Nguyen Karine , Magdinier Frederique , Robin Jerome
Published: December 2018

Facio-Scapulo Humeral dystrophy (FSHD) is the third most common myopathy, affecting 1 amongst 10,000 individuals (FSHD1, OMIM #158900). This autosomal dominant pathology is associated in 95% of cases with genetic and epigenetic alterations in the subtelomeric region at the extremity of the long arm of chromosome 4 (q arm). A large proportion of the remaining 5% of cases carry a mutation in the SMCHD1 gene (FSHD2, OMIM #158901). Here, we explored the 3D organization of the 4q35 locus by three-dimensions DNA in situ fluorescent hybridization (3D-FISH) in primary cells isolated from patients. We found that D4Z4 contractions and/or SMCHD1 mutations impact the spatial organization of the 4q35 region and trigger changes in the expression of different genes. Changes in gene expression was corroborated in muscle biopsies suggesting that long distance interaction modulate expression of a number of genes at the 4q35 locus in FSHD. Using induced pluripotent stem cells (hIPSC), we examined if chromatin organization is inherited or acquired during differentiation. Our data suggest that folding of the 4q35 region is modified upon differentiation. These results together with previous findings highlight the role of the D4Z4 repeat in the organization of chromatin and further indicate that the D4Z4-dependent 3D structure induces transcriptional changes of 4q35 genes expression.
Introduction to Genomic Analysis Workshop: A catalyst for engaging life-science researchers in high throughput analysis
Authors: Richmond Phillip Andrew , Wasserman Wyeth W
Published: December 2018

Researchers in the life sciences are increasingly faced with the task of obtaining compute resources and training to analyze large, high-throughput technology generated datasets. As demand for compute resources has grown, high performance computing (HPC) systems have been implemented by research organizations and international consortiums to support academic researchers. However, life science researchers lack effective time-of-need training resources for utilization of these systems. Current training options have drawbacks that inhibit the effective training of researchers without experience in computational analysis. We identified the need for flexible, centrally-organized, easily accessible, interactive, and compute resource specific training for academic HPC use. In our delivery of a modular workshop series, we provided foundational training to a group of researchers in a coordinated manner, allowing them to further pursue additional training and analysis on compute resources available to them. Efficacy measures indicate that the material was effectively delivered to a broad audience in a short time period, including both virtual and on-site students. The practical approach to catalyze academic HPC use is amenable to diverse systems worldwide.
The effect of dietary intervention on inflammatory markers in patients with type 2 diabetes. An analysis of the Lifestyle Over and Above Drugs in Diabetes (LOADD) study
Authors: Booker Chris S , Coppell Kirsten J , Duncan Ashley , Kataoka Minako , Williams Sheila M , Mann Jim I
Published: December 2018

Ninety-three participants with poorly controlled type 2 diabetes despite optimized drug therapy were randomised to receive intensive dietary advice or usual care for six months. Following dietary intervention a significant reduction in interleukin-18 levels was observed, with a ratio of change (95% CI) of 0.90 (0.82-0.99); p = 0.033. Changes in IL-18 correlated with changes in neopterin, r = 0.299 (p = 0.009). Clinical Trial registration ID #NCT00124553.
Brain volumes of very low birth weight infants measured by two dimensional cranial ultrasonography, a prospective cohort study
Authors: Kadioglu Gulsum , Canpolat Fuat Emre , Buyuktiryaki Mehmet , Kanmaz Kutman H. Gozde , Tayman Cuneyt
Published: December 2018

Background: Cranial ultrasonography is the main neuroimaging technique for very low birth weight infants. Brain volume is a very important information about central nervous system of preterm babies. This study aimed to evaluate brain volumes of preterm infants with two dimensional measurements of cranial ultrasonography.
Methods: Intracranial height, anteroposterior diameter, bi-parietal diamater, ventricular height, thalamo-occipital distance and ventricular index measured with routine cranial ultrasonographic scanning. Brain considered a spheric, ellipsoid model and estimated absolute brain volume (EABV) calculated by substracting two lateral ventricular volumes from the total brain volume.
Results: One hundred and twenty one preterm infants under a birthweight of 1500 g and 32 weeks of gestational age included in this study. Mean gestational age of study population was 27,7 weeks, and mean birthweight was 1057 grams. Twenty two of 121 infants had dilated ventricle, in this group EABV was lower than normal group (202 ± 58 cm3 vs 250 ± 53 cm3, respectively, p<0.01). Advanced resuscitation, bronchopulmonary dysplasia and late onset sepsis found to be independent risk factors for low brain volume in our data.
Conclusions: Estimated absolute brain volume could be calculated and estimated by two dimensional measurements with transfontanel ultrasonography.
Clinical Trial Registration ID #NCT02848755.