bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient-Reported Satisfaction and Quality of Life in Postmastectomy Radiated Patients: A Comparison between Delayed and Delayed Immediate Autologous Breast Reconstruction in a Predominantly Minority Patient Population
Authors: Kamel George N. , Nash David , Jacobson Joshua , Berk Robin , Mehta Karan , Benacquista Teresa , Draper Lawrence B. , Garfein Evan S. , Weichman Katie E.
Published: February 2019

Background Delayed immediate (DI) autologous breast reconstruction consists of immediate postmastectomy tissue expander placement, radiation therapy, and subsequent autologous reconstruction. The decision between timing of reconstructive methods is challenging and remains to be elucidated. We aim to compare patient reported outcomes and quality of life between delayed and DI reconstruction.

Methods A retrospective review of all patients, who underwent autologous breast reconstruction at Montefiore Medical Center from January 2009 to December 2016, was conducted. Patients who underwent postmastectomy radiotherapy were divided into two cohorts: delayed and DI autologous breast reconstruction. Patients were mailed a BREAST-Q survey and their responses, demographic information, complications, and need for revisionary procedures were analyzed.

Results A total of 79 patients met inclusion criteria: 34.2% (n = 27) in the delayed and 65.8% (n = 52) in the DI group. 77.2% (n = 61) of patients were a minority population. Patients in each cohort had similar baseline characteristics; however, the DI cohort was more likely to have bilateral reconstruction (46.2% [n = 24] vs. 7.4% [n = 2]; p = 0.0005) and to have major mastectomy flap necrosis (22.4% [n = 17] vs. 0.0% [n = 0]; p = 0.002). Premature tissue expander removal occurred in 17.3% (n = 9) of patients in the DI group. BREAST-Q response rates were 44.4% (n = 12) in the delayed group and 57.7% (n = 30) in the DI group. Responses showed similar satisfaction with their breasts, well-being, and overall outcome.

Conclusion Delayed and DI autologous breast reconstruction yield similar patient-reported satisfaction; however, patients undergoing DI reconstruction have higher rates of major mastectomy necrosis. Furthermore, patients in the DI group risk premature tissue expander removal.
Macrophage Migration Inhibitory Factor (MIF)-Based Therapeutic Concepts in Atherosclerosis and Inflammation
Authors: Sinitski Dzmitry , Kontos Christos , Krammer Christine , Asare Yaw , Kapurniotu Aphrodite , Bernhagen Jürgen
Published: February 2019

Chemokines orchestrate leukocyte recruitment in atherosclerosis and their blockade is a promising anti-atherosclerotic strategy, but few chemokine-based approaches have advanced into clinical trials, in part owing to the complexity and redundancy of the chemokine network. Macrophage migration inhibitory factor (MIF) is a pivotal mediator of atherosclerotic lesion formation. It has been characterized as an inflammatory cytokine and atypical chemokine that promotes atherogenic leukocyte recruitment and lesional inflammation through interactions with the chemokine receptors CXCR2 and CXCR4, but also exhibits phase-specific CD74-mediated cardioprotective activity. The unique structural properties of MIF and its homologue MIF-2/D-DT offer intriguing therapeutic opportunities including small molecule-, antibody- and peptide-based approaches that may hold promise as inhibitors of atherosclerosis, while sparing tissue-protective classical chemokine pathways. In this review, we summarize the pros and cons of anti-MIF protein strategies and discuss their molecular characteristics and receptor specificities with a focus on cardiovascular disease.
Total Articular Knee Replacement Using Polyurethane
Authors: Pritchett James W.
Published: February 2019

This study reviewed the early use of polyurethane for total knee resurfacing, the long-term results of polycarbonate urethane (PCU) for total knee replacement and conducted wear simulator testing of PCU. In 1959 and 1960, 10 patients underwent total articular polyurethane knee replacement (polyethylene was not available). The polyurethane was placed on the articular surface of the femur with metal surfaces on the tibia and patella. In 1996 and 1997, four patients received a newer PCU tibial insert in revision procedures; all had well-fixed prostheses, but no revision polyethylene implants were available. In addition, this study evaluated six new PCU tibial inserts in a 10-million cycle (Mc) wear simulator. All 10 of the early knees performed well clinically and 2 knees were functional for more than 30 years. Of the four more recent patients, all knees remain functional at more than 20 years' follow-up with no signs of wear or osteolysis. Wear simulator testing found mean material loss of 14.2 mg/Mc which equates to a volumetric wear of 11.9 mg/Mc, similar to the wear of conventional polyethylene. Polyurethane performs well as conventional polyethylene but not better than current cross-linked polyethylene tibial inserts. Its large wear particles (mean, 11 µm) and biocompatibility are less likely to cause an inflammatory response leading to pain and bone loss. Newer, superior polyurethanes can again be considered a candidate material for the tibial insert of a total knee replacement. A larger study may be able to validate polyurethane as an alternative material for joint replacement.
A Multicentered Randomized Study on Early versus Rescue Calsurf Administration for the Treatment of Respiratory Distress Syndrome in Preterm Infants
Authors: Rong Zhihui , Chang Liwen , Cheng Hongbin , Wang Huizhen , Zhu Xiaofang , Peng Fen , Fan Qihong , Lu Wei , Pan Rui , Xiong Li , Jiao Rong , Sun Jie , Xia Shiwen , Xie Jijian
Published: February 2019

Objective Surfactant and noninvasive ventilation are two major strategies for the treatment of neonates with respiratory distress syndrome (RDS). However, the optimal time for surfactant administering is yet controversial. This study compared the early and rescue Calsurf administration in preterm infants with RDS.

Study Design Preterm infants born between 260/7 and 326/7 weeks of gestation and needed nasal continuous positive airway pressure (nCPAP) immediately after birth were randomly assigned to the early or rescue Calsurf treatment group. In the early treatment group, neonates were intubated, administered surfactant with bag–mask ventilation, and extubated to nCPAP (INSURE [intubation–surfactant–extubation]). In the rescue treatment group, InSurE was given until the clinical manifestation and chest X-ray displayed RDS. The primary outcome was to compare the reintubation rate within 72 hour age between the two groups.

Results Among 305 neonates randomized to the early (n = 154) and rescue (n = 151) groups, the reintubation rate within 72 hours of age in these two groups did not differ significantly (p > 0.05). The incidence of oxygen dependence until 36 weeks' corrected age was similar in both groups.

Conclusion No differences were observed between early and rescue Calsurf treatment groups with respect to the reintubation rate within 72 hours of age and the incidence of bronchopulmonary dysplasia.
Methemoglobinemia Associated with Late-Onset Neonatal Sepsis: A Single-Center Experience
Authors: Schierz Ingrid Anne Mandy , Pinello Giuseppa , Piro Ettore , Giuffrè Mario , Corsello Giovanni
Published: February 2019

Objective Methemoglobinemia (MetHb) is a rare congenital or acquired cause of infantile cyanosis. We examined the role of MetHb in a neonatal intensive care unit (NICU).

Study Design A retrospective observational study was conducted reviewing blood gas analyses of hospitalized newborns over a 2-year period. MetHb-positive patients (MetHb >1.8%) were matched with a control group for gestational age, weight, disease, and illness severity at admission. Maternal, neonatal, clinical, and laboratory parameters were collected and analyzed in both groups.

Results MetHb incidence was 6%. The mean MetHb in the case group was 7.2%, and the first positive samples were observed at a mean of 22 days of life, 6 days prior to clinical or culture-proven sepsis. We identified low maternal age (31 vs. 34 years; p = 0.038), sepsis (90 vs. 45%; p = 0.022), and protracted parenteral nutrition (46 vs. 23 days; p = 0.013) as risk factors for MetHb, and early minimal enteral feeding as protective factor (12th vs. 9th day; p = 0.038).

Conclusion MetHb has a high occurrence in NICU and can be a helpful prognostic indicator of an infectious process. Understanding and prompt identification of MetHb can allow pediatricians to implement a life-saving therapy.
Analytical modelling for p-i-n structured semiconductor devices
Authors: Reidt Stephanie , Pieters Bart E.
Published: February 2019

An analytical model for illuminated p-i-n structures such as Solar Cells and related devices has been developed. Starting from the semiconductor equations in their most general form, and introducing assumptions for the recombination and electrical field functions, it is aimed at modelling not only the collection of photogenerated carriers but all transport mechanisms such as carrier drift and diffusion. Using this model, the behaviour of thin film cells which is observed in operation is described in detail. This includes the dependencies of I/V curves on temperature, insolation and spectral effects, and electronic materials properties. The modeling of recombination effects results in a voltage dependent photocurrent where the carrier collection efficiency depends on the bias voltage. This model allows for relatively fast calculation of I/V curves as it is computationally less extensive than full device numerical simulations. Therefore it may be applicable for compact models i.e. in solar cell performance modelling.
Large-eddy simulation of transcritical and supercritical jets immersed in a quiescent environment
Authors: Lagarza-Cortés Christian , Ramírez-Cruz Jorge , Salinas-Vázquez Martín , Vicente-Rodríguez William , Cubos-Ramírez José M.
Published: February 2019

The study and understanding of transcritical and supercritical jet flow are critical in liquid rockets, gas turbines, and diesel engines, as high-pressure atmospheres in these devices’ mixing chambers drastically modify the morphology of their jets. In the transcritical jet, new elongated entities called finger-like structures appear and characterize the fluid flow phenomenon. This study examines these entities by simulating two classical cases based on Mayer’s experiments. The turbulence is described by the Large-eddy simulation technique with a sub-grid scale model known as the selective structures-function model. Real-gas behavior is evaluated by the Soave-Redlich-Kwong equation, and the transport properties are estimated by Chung’s methods. From the results, a longitudinal modulation which triggers an azimuthal modulation is observed. Then, bulges are formed on the jet surface. Cross-sectional views reveal pairs of streamwise vortices with inverted rotational directions, which are located on either side of the bulges (on the outer edge of the dense core). These transversal, turbulent movements seem to be engaged with the elongation of the bulges and the subsequent formation of finger-like structures. The existence of the counter-rotating vortices is related with the baroclinic vorticity. Then, since one may refer to the Rayleigh-Taylor instability when it is baroclinically generated, this instability could give an explanation of the origin of the finger-like structures. Transcritical parcels emitted at the end of the dense core are bounded by a thermal-shield. Finger-like structures are not observed in the supercritical case. The thermal-shield is absent from the supercritical parcels.
Comprehensive kinetic theory of an electron emitting electrode in a low-density isotropic plasma
Authors: Din Alif
Published: February 2019

The kinetic theory of an electron emitting electrode immersed in a low-density isotropic plasma is developed for the first time to include the theory of formation of a virtual cathode in this scenario. In addition to virtual cathode solution for supercritical emission, the potential profile solution for subcritical and critical emission is also included. The plasma-electron and emitted-electron are assumed to have half Maxwellian velocity distributions at the sheath entrance and electrode surface, respectively, while the plasma ions are assumed to be cold. Poisson's equation is then solved numerically for charge densities in the assumed negative sheath structure. The resulting potential profiles in the sheath for the floating and current carrying electrode/wall are calculated numerically. These potential profiles show a smooth transition from subcritical to critical and to supercritical emissions with increasing emitted-electron temperature Te,em (decreasing parameter α = Te,pl/Te,em, plasma-electron to emitted-electron temperature ratio). The numerical solution of potential profiles for supercritical emission confirms the formation of a virtual cathode. The structure of the virtual cathode is dependent on the chosen boundary values. These results also show that the virtual cathode potential profile structure exists around α < 5 to α = 1.5 but the solution at α = 1 does not exist in this scenario. It indicates that the present model is applicable only to the situation where the sheath potential is negative relative to plasma potential.
Surface topography and water contact angle of sandblasted and thermally annealed glass surfaces
Authors: Persson B. N. J.
Published: February 2019

Surface roughness has a huge influence on most tribology properties. Sandblasting is a standard way to produce surface roughness in a controlled and reproducible way. Sometimes the sandblasted surfaces are annealed to reduce the roughness and reduce the sharpness of the roughness. We study the nature of the surface roughness of sandblasted silica glass surfaces and how it is modified by annealing at different temperatures. The surface roughness decreases with increasing annealing temperature due to viscous flow of the glass driven by the surface tension. However, the skewness and kurtosis remain nearly unchanged. Optical pictures of the annealed glass surfaces exhibit cell-like structures (cell diameter ≈20–40 μm), which we interpret as micro-cracks. The concentration of micro-cracks increases with increasing annealing temperature. The micro-cracks result in a (advancing) water contact angle which decreases with increasing annealing temperature, which is opposite to what is expected from the theory if no micro-cracks would occur.
Fractional operators with generalized Mittag-Leffler kernels and their iterated differintegrals
Authors: Abdeljawad Thabet
Published: February 2019

Depending on a previous work about fractional operators of Riemann type (ABR) and Caputo type (ABC) with kernels of Mittag-Leffler in three parameters [Eα,μγ(λ,t−s)], we derive the corresponding fractional integrals with arbitrary order by using the infinite binomial theorem, and study their semi-group properties and their action on the ABC type fractional derivatives to prove the existence and uniqueness theorem for the ABC-fractional initial value problems. In fact, as advantages to the obtained extension, we find that for μ≠1, we obtain a nontrivial solution for the linear ABC-type initial value problem with constant coefficient and prove a certain semigroup property in the parameters μ and γ simultaneously. Iterated type fractional differ-integrals are constructed by iterating fractional integrals of order (α,μ,1) to add a fourth parameter, and a semigroup property is derived under the existence of the fourth parameter. The Laplace transforms for the Atangana-Baleanu (AB) fractional integrals and the AB iterated fractional differ-integrals are calculated. An alternative representation of the ABR-derivatives is given and is compared, in the case γ=1, with the iterated AB differ-integrals with negative order (α,μ,1),−1. An example and several remarks are given to illustrate part of the proven results and to point out some particular cases. The obtained results generalized and improved some recent results.
Nanocement Produced from Borosilicate Bioactive Glass Nanoparticles Composited with Alginate
Authors: Xie Xin , Pang Libin , Yao Aihua , Ye Song , Wang Deping
Published: February 2019

A novel injectable bone cement was prepared using sol–gel derived borosilicate bioactive glass nanoparticles as a solid phase and sodium alginate solution as a liquid phase. The gelation reaction of the alginate was modulated by Ca2+ ions released from the borosilicate glass phase, which in turn greatly depended on the boron content of the borosilicate glass phase. Such a gelation reaction not only significantly enhanced the anti-washout property of the bone cements, but also allowed control of the setting, handling properties, and compressive strength of the composite bone cements. Consequently, bone cements with controllable performances can be developed by simply adjusting the B2O3/SiO2 ratio of the borosilicate glass phase. Borosilicate bioactive glass with 20–30 mol-% borate contents exhibit a short setting time, good compressive strength, injectability, and anti-washout properties. With controllable performances and excellent bioactivity, the borosilicate bioactive glass/sodium alginate (BSBG/SA) composite bone cements are highly attractive for bone filling and regeneration applications.
Association between social determinants and the presence of essential hypertension in type 2 diabetes mellitus patients
Authors: Fan Hong , Wang Jianming , Gu Xiaoxu
Published: February 2019

The purpose of this study was to analyse the association between social determinants and the presence of essential hypertension in type 2 diabetes mellitus patients in one rural county (Jintan) of China. A health survey of Jintan residents was conducted in 2013, applying a cluster sampling method. Three hundred and fifty-seven type 2 diabetes mellitus patients were selected as research subjects. Among the patients selected, essential hypertension prevalence was 45.4% (n=162). After univariate analyses and logistic regression analyses, an association was observed between the presence of essential hypertension in type 2 diabetes mellitus patients and marital status, described as ‘others (unmarried, divorce, widower, etc.)’, and participating in active physical activity. Both of these two significant variables were positively associated with the higher prevalence of essential hypertension in type 2 diabetes mellitus patients. In conclusion, the patients suffering from type 2 diabetes mellitus combined with essential hypertension often reported an association with more negative social determinants (with the exception of participation in physical activity). Further strengthening the comprehensive multi-disease management to control and reduce the prevalence of essential hypertension in type 2 diabetes mellitus patients is required.
A web-based wildfire simulator for operational applications
Authors: Arca Bachisio , Ghisu Tiziano , Casula Marcello , Salis Michele , Duce Pierpaolo
Published: February 2019

Wildfire simulators and decision support systems can assist the incident command teams in charge of tactical wildfire suppression. This paper presents a web-based wildfire simulator developed to provide real-time support for wildfire management. The paper describes the overall software architecture, the modelling chain characteristics and the results produced by the simulator considering a set of actual wildfires that occurred in the island of Sardinia, Italy. The simulator consists of a graphical user interface that deals with data input–output management, a mass-consistent model devoted to the downscaling of wind fields, and a module that provides a spatially explicit representation of wildfire propagation. The simulator is a client‐server application that is operated through a web-based graphical user interface that leaves the computational work to a dedicated server; most of the code is parallelised in order to minimise computational run-time. The validation phase demonstrated the capabilities of the simulator in providing wildfire predictions with a substantial agreement with actual wildfires, and a computational cost suitable for faster than real-time applications. The simulator is proposed as a tool to provide assistance to civil protection and fire management agencies during the incident response phase. The simulator is also appropriate for the training of personnel.
Public administration in transition
Authors: Karlsson Tom
Published: February 2019

This article focuses on how common-sense knowledge is enacted by middle managers in order to make sense of contemporary public administration. Specifically, the article demonstrates how managerialization and market logics is embedded in actors’ perceptions of public administration and becomes manifested through understandings and legitimations. The article presents an analysis of conversational data from middle management positions within a Swedish government agency. The analysis demonstrates how actors categorize a traditional hierarchy together with contemporary ideas of consumerism. It is also demonstrated how actors draw on legitimations of authority and mythopoesis in order to make sense of and to understand their managerial role within the agency. As such, the article contributes to contemporary public administration literature and its discussion regarding the effects of embedding marketization logics on actor and organizational levels as well as to ethnomethodologically informed literature within the social science and humanities.
Context and text in scientific disciplines of English
Authors: Butt David G.
Published: February 2019

As major world languages – Chinese, Spanish and Portuguese, for instance – become the medium of university
networks, it may be the right time to take stock of the influence that English has had over the way the disciplines of humanities
and sciences have been shaped, directed and evaluated, in particular in the second half of the 20th century. This paper is an
attempt to understand some of the textual, linguistic and historical determinants of Disciplinary English (DE) specifically in the
spectrum of technical subjects. DE is now a way of meaning which has become associated with objective authority. From this
association, DE has shaped our disciplinary knowledge and spread across to registers of bureaucratic and political subject matter.
The discussion also considers innovative potential in disciplinary discourses, in particular what Halliday regarded as the
“knight’s move” in text: this is the related, analogical effect of Hasan’s “symbolic
articulation” in verbal art and grammatical metaphor in the language of technical disciplines.
An exploratory account of the register of nursing textbooks
Authors: García Alexandra I.
Published: February 2019

Given the pressing issues that affect nursing education (e.g. higher attrition and plagiarism rates), this study aims to obtain
initial insight on whether nursing textbooks meet the demands of their context of situation. These demands could be listed as:
construing biomedical knowledge, establishing a pattern of evidence-based nursing practice and promoting the values of
person-centred care. For this analysis, I draw on aspects of parameters of context developed by Hasan (2004), Butt (2004) and Matthiessen (2015), and relate them to their semantic and lexicogrammatical realisation across different
metafunctions using corpus-based techniques and detailed manual analysis of short extracts. The results may suggest that nursing
textbooks may be meeting the demands of nursing as a research-based discipline but failing to model empathetic communication.
Reference tracking in Tima and its interplay with split ergative marking
Authors: Schneider-Blum Gertrud , Hellwig Birgit
Published: February 2019

Tima, a Niger-Congo language of the Sudan, shows signs of split ergativity. If its constituent order deviates from the basic AVO order to OVA order, the postverbal agent is formally marked, unlike preverbal agents. A direct object, regardless of its position relative to the verb, is never marked. Research so far has shown that ergative constructions are triggered by certain participant constellations in discourse. In particular, when the speaker keeps a non-agentive participant, more specifically a direct object, as the centre of attention in sentence-initial position, a newly introduced agent occurs postverbally and receives ergative marking. In addition, AOV and OAV constructions are attested, both involving focus marking.
Intelligent modes of imperfect governance
Authors: Bannink Duco , Trommel Willem
Published: February 2019

In this article, we aim to show that the treatment of wicked problems in the literature on public administration approaches is inadequate. We briefly discuss the literature on wicked problems and propose a conceptualization of wicked problems that, we think, shows the core of the problem of wicked problems. Wicked problems, we argue, are wicked because the factual and normative aspects of the issues are intertwined at actor-level. As a result, the phenomena that Rittel and Webber observed at problem level emerge. This has strong implications for public administration. Since actors are deciding on responses, a wicked problem evokes, what we call, a double governance challenge. The governance mechanisms provided in the literature on public administration approaches, also the new ones, do not provide responses to such double challenge. They either assume that actors do not build upon their own, actor-level factual and normative evaluations or that some compiled actor or supra-actor might overcome the limitations of the actors that together constitute the collective level of wicked problem response. Making such assumptions, they apparently conceptualize the wicked problem as non-wicked. Therefore, re-iterating, wicked problems are indeed wicked: solutions that implicitly conceptualize the wicked problem as non-wicked might be perfect, but seem unintelligent. A wicked problem, we argue, does not allow perfect, but instead requires imperfect, but intelligent responses. In this paper, we then discuss four such intelligently imperfect responses. They are necessarily imperfect in the sense that they cannot be considered to completely cover the problem, but intelligent in the sense that they truly acknowledge its wickedness.
Eigenstate Distribution Fluctuation of a Quenched Disordered Bose–Hubbard System in Thermal-to-Localized Transitions*
Authors: Xu 许 Junjun 军军 , Li 李 Yanxing 彦星
Published: February 2019

We study the thermalization of a quenched disordered Bose–Hubbard system. By considering the eigenstate distribution fluctuation, we show that the thermal to many-body localized transition is always connected to a minimum of this distribution fluctuation. We also observe a Mott-localized regime, where the system fails to thermalize due to the strong on-site repulsion. Lastly, we show how to detect this eigenstate distribution fluctuation in a cold atom system, which is equivalent to measure the Loschmidt echo of the system. Our work suggests a way to measure the thermal-to-localized transitions in experiments, especially for a large system.
A note on an effective Polish topology and Silver’s dichotomy theorem
Authors: Sami Ramez
Published: February 2019

⋅
\boldsymbol {\cdot }

We define a Polish topology inspired from the Gandy-Harrington topology and show how it can be used to prove Silver’s dichotomy theorem while remaining in the Polish realm.

⋅
\boldsymbol {\cdot }

In this topology, a

Π

1

1

\Pi _{1}^{1}

equivalence decomposes into a “sum” of a clopen relation and a meager one.

⋅
\boldsymbol {\cdot }

We characterize it as the largest regular topology with a basis included in 

Σ

1

1

\Sigma _{1}^{1}

.
Nondegeneracy of standard double bubbles
Authors: Di Matteo Gianmichele
Published: February 2019

In this paper we prove that all Jacobi fields of a standard double bubble in

R

m
+
1

\mathbb {R}^{m+1}

are generated by infinitesimal translations and rotations. This implies that the degeneracy of the area functional on double bubbles is only generated by global isometries, with dimension

2
m
+
1

2m+1

. The proof relies on a Fourier expansion of the normal components of the Jacobi fields and on an accurate analysis of some ordinary differential equations.
Bôcher-type theorem on n-dimensional manifolds with conical metric
Authors: Li Jiayu , Wan Fangshu
Published: February 2019

We generalize the Bôcher-type theorem and give a sharp characterization of the behavior at the isolated singularities of a solution bounded on one side for the equation

Δ
g

u
=
0

\Delta _g u =0

on singular manifolds with conical metrics. Furthermore, we also obtain a Liouville-type result which demonstrates that the fundamental solution is the unique nontrivial solution of

div
⁡
(

|

x

|

θ

∇
u
)
=
0

\operatorname {div}(|x|^\theta \nabla u)=0

in

R

n

∖
{
0
}

\mathbb {R}^n\setminus \{0\}

that is bounded on one side in both a neighborhood of the origin as well as at infinity.
Using pharmacists’ documentation of clinical activities to reclaim employees and reposition the department
Authors: McDaniel Michael R. , DeJong Douglas J.
Published: February 2019

The use of documentation on pharmacist clinical activities to encourage greater hospital investment in a department is described.

From 1983 through 1988, the number of full-time-equivalent (FTE) positions in the pharmacy department at a 468-bed medical center was reduced from 63 to 39.4. To cope with the challenge of a sharply reduced staff, the department established a permanent pharmacy-nursing task force, developed a pharmacy strategic plan, used total quality management, recruited the best staff possible when openings appeared, and held staff retreats. In addition, measures were taken to begin documenting all pharmacist clinical activities online. As data were accumulated, it became clear that more pharmacist involvement in patient care areas was needed and that more resources would be necessary to achieve that. Presentations were made to hospital administration to demonstrate the existing and potential contributions of the department; the presentations drew heavily on the clinical documentation. Formal reports were also submitted. As a result, the department received approval for a pharmacist career ladder, an increase of 1.6 pharmacist FTEs for the evening shift, a large salary-range adjustment for staff pharmacists, and an increase of 1 pharmacist FTE to focus on antimicrobial use.

A pharmacy department successfully used documentation of its clinical activities to make a case to administration for reclaiming some of the pharmacist FTEs lost through downsizing.
Power-Assisted Liposuction and Lipofilling: Techniques and Experience in Large-Volume Fat Grafting
Authors: Abboud Marwan H , Dibo Saad A , Abboud Nicolas M
Published: February 2019

Background

Power-assisted liposuction and lipofilling (PALL) is a simple and reproducible surgical technique for large volume fat grafting.

Objectives

The authors share their 7-year experience with their large-volume fat transfer technique, PALL.

Methods

A total of 417 patients who underwent PALL-related surgeries involving the breast and buttock were evaluated in a retrospective study. Liposculpting and fat harvesting were performed with power-assisted liposuction. Fat was transferred with simultaneous power-assisted vibration and tunnelization to provoke expansion of the recipient site. Following lipofilling, additional external vibration of the recipient site was performed to enhance diffusion of the injected fat.

Results

Liposuction volumes up to 5000 mL were recorded, and injection volumes ranged from 300 to 900 mL per side for each session. Operating times ranged from 45 to 120 minutes. Patients were followed-up for 1 to 4 years. No major complications were recorded.

Conclusions

PALL is an efficient, safe, and reproducible procedure with myriad applications in aesthetic and reconstructive surgery.

Level of Evidence: 4
Multispectral tracing in densely labeled mouse brain with nTracer
Authors: Roossien Douglas H , Sadis Benjamin V , Yan Yan , Webb John M , Min Lia Y , Dizaji Aslan S , Bogart Luke J , Mazuski Cristina , Huth Robert S , Stecher Johanna S , Akula Sriakhila , Shen Fred , Li Ye , Xiao Tingxin , Vandenbrink Madeleine , Lichtman Jeff W , Hensch Takao K , Herzog Erik D , Cai Dawen
Published: February 2019

This note describes nTracer, an ImageJ plug-in for user-guided, semi-automated tracing of multispectral fluorescent tissue samples. This approach allows for rapid and accurate reconstruction of whole cell morphology of large neuronal populations in densely labeled brains.

Availability and implementation

nTracer was written as a plug-in for the open source image processing software ImageJ. The software, instructional documentation, tutorial videos, sample image and sample tracing results are available at https://www.cai-lab.org/ntracer-tutorial.

Supplementary information

Supplementary data are available at Bioinformatics online.
Beyond the Deficit Model: The Ambassador Approach to Public Engagement
Authors: Nadkarni Nalini M , Weber Caitlin Q , Goldman Shelley V , Schatz Dennis L , Allen Sue , Menlove Rebecca
Published: February 2019

Scientists are increasingly motivated to engage the public, particularly those who do not or cannot access traditional science education opportunities. Communication researchers have identified shortcomings of the deficit model approach, which assumes that skepticism toward science is based on a lack of information or scientific literacy, and encourage scientists to facilitate open-minded exchange with the public. We describe an ambassador approach, to develop a scientist's impact identity, which integrates his or her research, personal interests and experiences to achieve societal impacts. The scientist identifies a community or focal group to engage, on the basis of his or her impact identity, learns about that group, and promotes inclusion of all group members by engaging in venues in which that group naturally gathers, rather than in traditional education settings. Focal group members stated that scientists communicated effectively and were responsive to participant questions and ideas. Scientists reported professional and personal benefits from this approach.
Control of blood pressure and risk of mortality in a cohort of older adults: the Berlin Initiative Study
Authors: Douros Antonios , Tölle Markus , Ebert Natalie , Gaedeke Jens , Huscher Dörte , Kreutz Reinhold , Kuhlmann Martin K , Martus Peter , Mielke Nina , Schneider Alice , Schuchardt Mirjam , van der Giet Markus , Schaeffner Elke
Published: February 2019

Aims

To assess whether blood pressure (BP) values below 140/90 mmHg during antihypertensive treatment are associated with a decreased risk of all-cause mortality in community-dwelling older adults.

Methods and results

Within the Berlin Initiative Study, we assembled a cohort of patients ≥70 years treated with antihypertensive drugs at baseline (November 2009–June 2011). End of prospective follow-up was December 2016. Cox proportional hazards models yielded adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality associated with normalized BP [systolic BP (SBP) <140 mmHg and diastolic BP (DBP) <90 mmHg] compared with non-normalized BP (SBP ≥140 mmHg or DBP ≥90 mmHg) overall and after stratification by age or previous cardiovascular events. Among 1628 patients (mean age 81 years) on antihypertensive drugs, 636 exhibited normalized BP. During 8853 person-years of follow-up, 469 patients died. Compared with non-normalized BP, normalized BP was associated with an increased risk of all-cause mortality (incidence rates: 60.3 vs. 48.5 per 1000/year; HR 1.26; 95% CI 1.04–1.54). Increased risks were observed in patients ≥80 years (102.2 vs. 77.5 per 1000/year; HR 1.40; 95% CI 1.12–1.74) and with previous cardiovascular events (98.3 vs. 63.6 per 1000/year; HR 1.61; 95% CI 1.14–2.27) but not in patients aged 70–79 years (22.6 vs. 22.7 per 1000/year; HR 0.83; 95% CI 0.54–1.27) or without previous cardiovascular events (45.2 vs. 44.4 per 1000/year; HR 1.16, 95% CI 0.90–1.48).

Conclusion

Blood pressure values below 140/90 mmHg during antihypertensive treatment may be associated with an increased risk of mortality in octogenarians or elderly patients with previous cardiovascular events.
Pesticide use and risk of non-Hodgkin lymphoid malignancies in agricultural cohorts from France, Norway and the USA: a pooled analysis from the AGRICOH consortium
Authors: Leon Maria E , Schinasi Leah H , Lebailly Pierre , Beane Freeman Laura E , Nordby Karl-Christian , Ferro Gilles , Monnereau Alain , Brouwer Maartje , Tual Séverine , Baldi Isabelle , Kjaerheim Kristina , Hofmann Jonathan N , Kristensen Petter , Koutros Stella , Straif Kurt , Kromhout Hans , Schüz Joachim
Published: February 2019

Background

Pesticides are commonly used in agriculture, and previous studies endorsed the need to further investigate the possible association between their use and risk of lymphoid malignancies in agricultural workers.

Methods

We investigated the relationship of ever use of 14 selected pesticide chemical groups and 33 individual active chemical ingredients with non-Hodgkin lymphoid malignancies (NHL) overall or major subtypes, in a pooled analysis of three large agricultural worker cohorts. Pesticide use was derived from self-reported history of crops cultivated combined with crop-exposure matrices (France and Norway) or self-reported lifetime use of active ingredients (USA). Cox regression models were used to estimate cohort-specific hazard ratios (HRs) and 95% confidence intervals (CIs), which were combined using random effects meta-analysis to calculate meta-HRs.

Results

During follow-up, 2430 NHL cases were diagnosed in 316 270 farmers accruing 3 574 815 person-years under risk. Most meta-HRs suggested no association. Moderately elevated meta-HRs were seen for: NHL and ever use of terbufos (meta-HR = 1.18, 95% CI: 1.00–1.39); chronic lymphocytic leukaemia/small lymphocytic lymphoma and deltamethrin (1.48, 1.06–2.07); and diffuse large B-cell lymphoma and glyphosate (1.36, 1.00–1.85); as well as inverse associations of NHL with the broader groups of organochlorine insecticides (0.86, 0.74–0.99) and phenoxy herbicides (0.81, 0.67–0.98), but not with active ingredients within these groups, after adjusting for exposure to other pesticides.

Conclusions

Associations of pesticides with NHL appear to be subtype- and chemical-specific. Non-differential exposure misclassification was an important limitation, showing the need for refinement of exposure estimates and exposure–response analyses.
Observations of photospheric magnetic structure below a dark filament using the Hinode Spectro-Polarimeter
Authors: Yokoyama Takaaki , Katsukawa Yukio , Shimojo Masumi
Published: February 2019

The structure of the photospheric vector magnetic field below a dark filament on the Sun is studied using the observations of the Spectro-Polarimeter attached to the Solar Optical Telescope onboard Hinode. Special attention is paid to discriminating between two suggested models, a flux rope or a bent arcade. “Inverse polarity” orientation is possible below the filament in a flux rope, whereas “normal polarity” can appear in both models. We study a filament in the active region NOAA 10930, which appeared on the solar disk during 2006 December. The transverse field perpendicular to the line of sight has a direction almost parallel to the filament spine with a shear angle of 30°, the orientation of which includes the 180° ambiguity. To know whether it is in the normal orientation or in the inverse one, the center-to-limb variation is used for the solution under the assumption that the filament does not drastically change its magnetic structure during the passage. When the filament is near the east limb, we found that the line-of-site magnetic component below the filament is positive, while it is negative near the west limb.This change of sign indicates that the horizontal photospheric field perpendicular to the polarity inversion line beneath the filament has an “inverse-polarity”, which indicates a flux-rope structure of the filament supporting field.
CO Multi-line Imaging of Nearby Galaxies (COMING). VI. Radial variations in star formation efficiency
Authors: Muraoka Kazuyuki , Sorai Kazuo , Miyamoto Yusuke , Yoda Moe , Morokuma-Matsui Kana , Kobayashi Masato I N , Kuroda Mayu , Kaneko Hiroyuki , Kuno Nario , Takeuchi Tsutomu T , Nakanishi Hiroyuki , Watanabe Yoshimasa , Tanaka Takahiro , Yasuda Atsushi , Yajima Yoshiyuki , Shibata Shugo , Salak Dragan , Espada Daniel , Matsumoto Naoko , Noma Yuto , Kita Shoichiro , Komatsuzaki Ryusei , Kajikawa Ayumi , Yashima Yu , Pan Hsi-An , Oi Nagisa , Seta Masumichi , Nakai Naomasa
Published: February 2019

We examined radial variations in molecular-gas based star formation efficiency (SFE), which is defined as star formation rate per unit molecular gas mass, for 80 galaxies selected from the CO Multi-line Imaging of Nearby Galaxies project (Sorai et al. 2019, PASJ, 71, S14). The radial variations in SFE for individual galaxies are typically a factor of 2–3, which suggests that SFE is nearly constant along the galactocentric radius. We found an averaged SFE in 80 galaxies of (1.69 ± 1.1) × 10−9 yr−1, which is consistent with Leroy et al. (2008, AJ, 136, 2782) if we consider the contribution of helium to the molecular gas mass evaluation and the difference in the assumed initial mass function between the two studies. We compared SFE among different morphological (i.e., SA, SAB, and SB) types, and found that SFE within the inner radii (r/r25 < 0.3, where r25 is the B-band isophotal radius at 25 mag arcsec−2) of SB galaxies is slightly higher than that of SA and SAB galaxies. This trend can be partly explained by the dependence of SFE on global stellar mass, which probably relates to the CO-to-H2 conversion factor through the metallicity. For two representative SB galaxies in our sample, NGC 3367 and NGC 7479, the ellipse of r/r25 = 0.3 seems to cover not only the central region but also the inner part of the disk, mainly the bar. These two galaxies show higher SFE in the bar than in the spiral arms. However, we found an opposite trend in NGC 4303; SFE is lower in the bar than in the spiral arms, which is consistent with earlier studies (e.g., Momose et al. 2010, ApJ, 721, 383). These results suggest a diversity of star formation activities in the bar.
Resistance to Phytophthora cinnamomi in American Chestnut (Castanea dentata) Backcross Populations that Descended from Two Chinese Chestnut (Castanea mollissima) Sources of Resistance
Authors: Westbrook Jared W. , James Joseph B. , Sisco Paul H. , Frampton John , Lucas Sunny , Jeffers Steven N.
Published: February 2019

Restoration of American chestnut (Castanea dentata) depends on combining resistance to both the chestnut blight fungus (Cryphonectria parasitica) and Phytophthora cinnamomi, which causes Phytophthora root rot, in a diverse population of C. dentata. Over a 14-year period (2004 to 2017), survival and root health of American chestnut backcross seedlings after inoculation with P. cinnamomi were compared among 28 BC3, 66 BC4, and 389 BC3F3 families that descended from two BC1 trees (Clapper and Graves) with different Chinese chestnut grandparents. The 5% most resistant Graves BC3F3 families survived P. cinnamomi infection at rates of 75 to 100% but had mean root health scores that were intermediate between resistant Chinese chestnut and susceptible American chestnut families. Within Graves BC3F3 families, seedling survival was greater than survival of Graves BC3 and BC4 families and was not genetically correlated with chestnut blight canker severity. Only low to intermediate resistance to P. cinnamomi was detected among backcross descendants from the Clapper tree. Results suggest that major-effect resistance alleles were inherited by descendants from the Graves tree, that intercrossing backcross trees enhances progeny resistance to P. cinnamomi, and that alleles for resistance to P. cinnamomi and C. parasitica are not linked. To combine resistance to both C. parasitica and P. cinnamomi, a diverse Graves backcross population will be screened for resistance to P. cinnamomi, survivors bred with trees selected for resistance to C. parasitica, and progeny selected for resistance to both pathogens will be intercrossed.
Clinical Reasoning Assessment Methods: A Scoping Review and Practical Guidance
Authors: Daniel Michelle , Rencic Joseph , Durning Steven J. , Holmboe Eric , Santen Sally A. , Lang Valerie , Ratcliffe Temple , Gordon David , Heist Brian , Lubarsky Stuart , Estrada Carlos A. , Ballard Tiffany , Artino Anthony R. , Sergio Da Silva Ana , Cleary Timothy , Stojan Jennifer , Gruppen Larry D.
Published: February 2019

Purpose

An evidence-based approach to assessment is critical for ensuring the development of clinical reasoning (CR) competence. The wide array of CR assessment methods creates challenges for selecting assessments fit for the purpose; thus, a synthesis of the current evidence is needed to guide practice. A scoping review was performed to explore the existing menu of CR assessments.

Method

Multiple databases were searched from their inception to 2016 following PRISMA guidelines. Articles of all study design types were included if they studied a CR assessment method. The articles were sorted by assessment methods and reviewed by pairs of authors. Extracted data were used to construct descriptive appendixes, summarizing each method, including common stimuli, response formats, scoring, typical uses, validity considerations, feasibility issues, advantages, and disadvantages.

Results

A total of 377 articles were included in the final synthesis. The articles broadly fell into three categories: non-workplace-based assessments (e.g., multiple-choice questions, extended matching questions, key feature examinations, script concordance tests); assessments in simulated clinical environments (objective structured clinical examinations and technology-enhanced simulation); and workplace-based assessments (e.g., direct observations, global assessments, oral case presentations, written notes). Validity considerations, feasibility issues, advantages, and disadvantages differed by method.

Conclusions

There are numerous assessment methods that align with different components of the complex construct of CR. Ensuring competency requires the development of programs of assessment that address all components of CR. Such programs are ideally constructed of complementary assessment methods to account for each method’s validity and feasibility issues, advantages, and disadvantages.