bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Increasing Malpractice Insurance Cost and Subsequent Practice of Defensive Medicine on Out-of-Hospital Birth Rates in the United States
Authors: Kim Edward Kangsuhp , Fletcher William James , Johnson Clark Timothy
Published: October 2018

Background Across the United States, the burden of malpractice litigation has influenced obstetricians and obstetric institutions to avoid high-risk patients, favor cesarean delivery, and decrease availability of trial of labor after cesarean. Recently, the United States has experienced an increase in out-of-hospital (OOH) births.

Objective The main purpose of this article is to investigate the association between malpractice insurance premium (MIP) and OOH births in the United States from 2000 to 2014.

Study Design We analyzed changes in OOH birth rates and MIP from 2000 to 2014 using birth data from the National Vital Statistics System and Medical Liability Monitor's annual survey, respectively. The change in OOH birth rates was then compared with the change in MIP.

Results Between 2000 and 2014, there has been approximately 60% increase in MIP from national average of $40,949 to $65,210 (p < 0.05). OOH births increased 57% from 39,398 births to 59,674 births (p < 0.05). There was a significant positive correlation between increase in MIP and increase in OOH births (p < 0.05, R
2 = 0.14).

Conclusion MIP and OOH birth rates have a significantly associated increase from 2000 to 2014. Given that malpractice climate affects other aspects of obstetric practice, we cautiously propose that increasing MIP may be associated with an increase in OOH births.
A microscale biomimetic platform for generation and electro-mechanical stimulation of 3D cardiac microtissues
Authors: Visone Roberta , Talò Giuseppe , Occhetta Paola , Cruz-Moreira Daniela , Lopa Silvia , Pappalardo Omar Antonio , Redaelli Alberto , Moretti Matteo , Rasponi Marco
Published: October 2018

Organs-on-chip technology has recently emerged as a promising tool to generate advanced cardiac tissue in vitro models, by recapitulating key physiological cues of the native myocardium. Biochemical, mechanical, and electrical stimuli have been investigated and demonstrated to enhance the maturation of cardiac constructs. However, the combined application of such stimulations on 3D organized constructs within a microfluidic platform was not yet achieved. For this purpose, we developed an innovative microbioreactor designed to provide a uniform electric field and cyclic uniaxial strains to 3D cardiac microtissues, recapitulating the complex electro-mechanical environment of the heart. The platform encompasses a compartment to confine and culture cell-laden hydrogels, a pressure-actuated chamber to apply a cyclic uniaxial stretch to microtissues, and stainless-steel electrodes to accurately regulate the electric field. The platform was exploited to investigate the effect of two different electrical stimulation patterns on cardiac microtissues from neonatal rat cardiomyocytes: a controlled electric field [5 V/cm, or low voltage (LV)] and a controlled current density [74.4 mA/cm2, or high voltage (HV)]. Our results demonstrated that LV stimulation enhanced the beating properties of the microtissues. By fully exploiting the platform, we combined the LV electrical stimulation with a physiologic mechanical stretch (10% strain) to recapitulate the key cues of the native cardiac microenvironment. The proposed microbioreactor represents an innovative tool to culture improved miniaturized cardiac tissue models for basic research studies on heart physiopathology and for drug screening.
Response to “Comment on ‘Water-water correlations in electrolyte solutions probed by hyper-Rayleigh scattering’” [J. Chem. Phys. 149, 167101 (2018)]
Authors: Shelton David P.
Published: October 2018

The Comment proposes that the discrepancy between two second harmonic scattering (SHS) experiments for D2O electrolyte solutions with 100 ns and 190 fs laser pulses is due to unexplained processes for 100 ns pulses that give non-quadratic power dependence for the second harmonic signal. However, the different power dependence of the second harmonic scattering signals measured with 100 ns and 190 fs laser pulses is due to changes in laser beam propagation and focal intensity caused by the combined effect of thermal defocusing and Kerr lens self-focusing. Non-quadratic power dependence does not explain the discrepancy in the second harmonic scattering results.
Perspective: High pressure transformations in nanomaterials and opportunities in material design
Authors: Machon Denis , Pischedda Vittoria , Le Floch Sylvie , San-Miguel Alfonso
Published: October 2018

Pressure and temperature phase transitions of nanomaterials often differ significantly from those of their bulk parents, offering novel approaches for the engineering of original materials. The importance or even the dominance of surface atoms in the nanoworld enhances the effects of environment, geometry, and intercalation. In the present article, we explore the current knowledge of these effects, as evidenced in the high pressure phase diagrams of nanomaterials such as nanocrystals, carbon nanotubes, fullerites, graphene, and other 2D systems, as well as nanoporous structures like clathrates or zeolites. Recent advances and future challenges in the use of extreme thermodynamic conditions to develop new functional nanomaterials, composites, or devices will be reviewed, along with the specificities of the experimental environment required for these investigations.
Flexoelectric fatigue in (K,Na,Li)(Nb,Sb)O3 ceramics
Authors: Zhu Junqiang , Chen Tingwei , Shu Longlong , Wang Zhiguo , Huang Wenbin , Fei Linfeng , Li Fei , Rao Zhenggang , Ke Shanming , Li Bo , Yao Xi , Wang Yu
Published: October 2018

In this letter, we report on significant flexoelectric fatigue in lead-free (K,Na,Li)(Nb,Sb)O3 (KNNLS) ceramics. In the ferroelectric phase of KNNLS, the observed effective transverse flexoelectric coefficient, which is initially as high as 1 μC/m, decreases nonlinearly with increasing cycles of strain gradient, and the fatigue regulation is well reproduced by a stretched exponential function. By comparing the time dependence of dielectric permittivity and ferroelectricity in KNNLS ceramics, we conclude that large flexoelectric and flexocoupling coefficients in the ferroelectric phase originate mainly from ferroelectricity and that the related flexoelectric fatigue is likely due to the pinning effect of ferroelectric domains.
Turbulent/non-turbulent interfaces in temporally evolving compressible planar jets
Authors: Nagata R. , Watanabe T. , Nagata K.
Published: October 2018

Turbulent/non-turbulent interfaces (TNTIs) in compressible jets are studied with direct numerical simulations of temporally evolving compressible planar jets with jet Mach numbers MJ of 0.6, 1.6, and 2.6 ejected with a jet initial pressure equal to the ambient pressure. The flow properties near the TNTI are investigated with statistics computed on the local interfacial coordinate. The layer thicknesses are about 10-13η for the TNTI layer, 3η for the viscous superlayer, and 7-10η for the turbulent sublayer (TSL), where η is the Kolmogorov scale on the jet centerline. The TSL thickness divided by η decreases from 10 to 7 as MJ increases. The turbulent fluid is characterized with lower density, higher temperature, and lower pressure than the non-turbulent fluid, where these properties sharply change within the TNTI layer. The rate of change in internal energy near the TNTI is proportional to the initial kinetic energy of the jet, where the internal energy at the outer edge of the TNTI layer changes because of the diffusive/dilatational effects. The movement of entrained fluid is similar in compressible and incompressible jets. Compressibility affects the total entrainment rate via the total surface area of the TNTI, where the surface area of the TNTI per unit area of the plane perpendicular to the cross-streamwise direction decreases from 9.5 to 7.0 as MJ increases. Strongly compressive waves appear in the non-turbulent region at a high Mach number, where the imprints of these waves are found within the TNTI layer as strong pressure/temperature correlation and large values of pressure skewness.
Collaboration and competition between Richtmyer-Meshkov instability and Rayleigh-Taylor instability
Authors: Chen Feng , Xu Aiguo , Zhang Guangcai
Published: October 2018

The two-dimensional Richtmyer-Meshkov Instability (RMI) system and the coexisting system combined with Rayleigh-Taylor Instability (RTI) are simulated with a multiple-relaxation time discrete Boltzmann model. In the RMI system, the non-equilibrium characteristics are compared with those of the RTI system, and some similarities and differences are obtained: In these two types of instability systems, heat conduction plays a major role in the degree of correlation; the correlation between thermodynamic non-equilibrium strength and nonuniformity of density in RMI is still relatively high, but the magnitude of gradual reduction over time is much greater than that of the RTI; the correlation degree curves of the RTI system are relatively smooth, but in the RMI system, there are many abrupt changes due to the existence and development of the shock wave. In the coexisting system combined with RTI, first, from the macroperspective (interface disturbance amplitude, amplitude growth rate, interface reversal mechanism, etc.), the collaboration and competition mechanisms of the two instabilities are investigated. The parameter regions in which RMI and RTI dominate are given. Second, the effects of the gravity acceleration and Mach number on non-equilibrium are carefully studied. By affecting the amplitude growth and the density gradient, the gravity acceleration has different effects on the non-equilibrium characteristics of different stages of the coexisting system. With the increase in the Mach number, the nonequilibrium degree of the system is increased exponentially, and the degree of correlation almost exponentially decreases.
Nucleation at quantized vortices and the heterogeneous phase separation in supersaturated superfluid 3He–4He liquid mixtures
Authors: Burmistrov S. N. , Dubovskii L. B.
Published: October 2018

Supersaturated superfluid 3He–4He liquid mixture, separating into the 3He-concentrated c-phase and 3He-diluted d-phase, represents a unique possibility for studying macroscopic quantum nucleation and quantum phase-separation kinetics in binary mixtures at low temperatures down to absolute zero. One of possible heterogeneous mechanisms for the phase separation of supersaturated d-phase is associated with superfluidity of this phase and with a possible existence of quantized vortices playing a role of nucleation sites for the c-phase of liquid mixture. We analyze the growth dynamics of vortex core filled with the c-phase and determine the temperature behavior of c-phase nucleation rate and the crossover temperature between the classical and quantum nucleation mechanisms.
Macroscopic vortices on the surface of superfluid He II
Authors: Levchenko A. A. , Mezhov-Deglin L. P. , Pelmenev A. A.
Published: October 2018

The visualization of phenomena on the surface of superfluid He II by means of light glass tracers located in a thin layer below the surface of the fluid has made it possible to observe, for the first time, the appearance of a vortex flow and two-dimensional macroscopic vortices that are formed on the surface of the superfluid in a vibrating cell as a result of nonlinear interaction between noncollinear Faraday waves. Standing Faraday waves are excited on the He II surface with vertical oscillations of the cell with relative variable acceleration above the threshold of the parametric instability β > βc ≈ 0.04. It was found that during intense wave-pumping at a frequency of 40 Hz with prolonged exposure for ∼270 seconds, the dependence of the kinetic energy of a vortex system on the wave vector E(k) at k ≥ 4.5 cm–1 can be described as a power law of the form E(k) ∼ k–3. In other words, with time, both an inverse turbulent cascade and a direct one may arise in a system of macroscopic vortices generated by waves on the surface of an He II layer with a depth of ∼0.4 cm.
Ideal Bose-gas in nonadditive statistics
Authors: Rovenchak Andrij
Published: October 2018

The paper analyzes an approach to the generalization of the conventional Bose–Einstein statistics based on the nonadditive entropy of Tsallis. A detailed derivation of thermodynamic functions is presented. The calcu-lations are made for the specific heat of two model systems, namely, the ideal three-dimensional gas obeying the nonadditive modification of the Bose–Einstein statistics and the system with linear excitation spectrum at-tempted as a qualitative approximation of liquid 4He thermodynamics.
Analogues of Josephson junctions and black hole event horizons in atomic Bose-Einstein condensates
Authors: Yakimenko A. I. , Matsyshyn O. I. , Oliinyk A. O. , Biloshytskyi V. M. , Chelpanova O. G. , Vilchynskii S. I.
Published: October 2018

We study dynamical processes in coherently coupled atomic Bose-Einstein condensates. Josephson effects in ring-shaped and dumbbell geometries are theoretically investigated. Conditions for observation of the Josephson effect are revealed. We found that multicharged persistent current in toroidal condensate can be robust even for supersonic atomic flow. In numerical simulations the acoustic analogues of event horizon in quantized superflow were observed. These theoretical finding open perspectives for investigation of Bose Josephson junctions and quantum aspects of acoustic analogue of Hawking radiation in existing experimental setups.
Bubble states of atoms in liquid helium
Authors: Dyugaev A. M. , Lebedeva E. V.
Published: October 2018

The solvation of impurity atoms {Na, K, Rb, Cs, Mg, Ca, Sr, Ba} with small ionization energy in liquid helium is studied. It is shown that allowance for unmatched interaction of impurity atoms and helium atoms is important for determining the parameters of the atomic state. The size of the bubble state R0 is determined by the strong repulsion between helium atoms and valence electrons of impurity atoms. The R0 value is universal, and the expression 2R0/ν = const ≈ 11–13 depends weakly on the place of the impurity atom in the periodic table. The parameter ν is given by the impurity ionization energy J = 1/2ν2 (in atomic units); the ν value indicates the size of the impurity atom. An energy barrier that separates the bulk and surface atomic impurity states is determined.
A Highly Sensitive and Label-Free Microbead-Based ‘Turn-On’ Colorimetric Sensor for the Detection of Mercury(II) in Urine Using a Peroxidase-Like Split G-Quadruplex–Hemin DNAzyme
Authors: Fu Xin , Zhang He , Zhang Jie , Wen Shi-Tong , Deng Xing-Cheng
Published: October 2018

A highly sensitive and label-free microbead-based ‘turn-on’ assay was developed for the detection of Hg2+ in urine based on the Hg2+-mediated formation of intermolecular split G-quadruplex–hemin DNAzymes. In the presence of Hg2+, T–T mismatches between the two partial cDNA strands were stabilized by a T–Hg2+–T base pair, and can cause the G-rich sequences of the two oligonucleotides to associate to form a split G-quadruplex which is able to bind hemin to form the catalytically active G-quadruplex–hemin DNAzyme. This microbead-based ‘turn-on’ process allows the detection of Hg2+ in urine samples at concentrations as low as 0.5 pM. The relative standard deviation and recovery are 1.2–3.9 and 98.7–103.2%, respectively. The remarkable sensitivity for Hg2+ is mainly attributed to the enhanced mass transport ability that is inherent in homogeneous microbead-based assays. Compared with previous developments of intermolecular split G-quardruplex–hemin DNAzymes for the homogeneous detection of Hg2+ (the limit of detection was 19nM), a signal enhancement of ~1000 times is obtained when such an assay is performed on the surface of microbeads.
Climate change causes upslope shifts and mountaintop extirpations in a tropical bird community
Authors: Freeman Benjamin G. , Scholer Micah N. , Ruiz-Gutierrez Viviana , Fitzpatrick John W.
Published: October 2018

Significance

Global warming is predicted to constitute an “escalator to extinction” for species that live on mountains. This is because species are generally moving to higher elevations as temperatures warm, and species that live only near mountaintops may run out of room. However, there is little evidence that high-elevation populations are disappearing as predicted. Here, we show that recent warming does indeed act as an escalator to extinction for birds that live on a remote Peruvian mountain. High-elevation species have shrunk in range size and declined in abundance, and several previously common species have disappeared. We suggest that high-elevation species in the tropics are particularly vulnerable to climate change.
Role of income mobility for the measurement of inequality in life expectancy
Authors: Kreiner Claus Thustrup , Nielsen Torben Heien , Serena Benjamin Ly
Published: October 2018

Significance Statement

People in the bottom of the income distribution live shorter lives than those in the top. This is an important dimension of inequality in society. We demonstrate how forces of income mobility are important for conclusions about inequality in life expectancy. Some people escape poverty, and many people at the top of the distribution only have high incomes temporarily. Those moving out of an income class have very different mortality patterns than those staying. We provide a method that incorporates income mobility in calculations of life-expectancy inequality. The good news is that the degree of inequality in life expectancy is only half as big once accounting for income mobility. The bad news is that inequality continues to rise.
REM sleep in naps differentially relates to memory consolidation in typical preschoolers and children with Down syndrome
Authors: Spanò Goffredina , Gómez Rebecca L. , Demara Bianca I. , Alt Mary , Cowen Stephen L. , Edgin Jamie O.
Published: October 2018

Significance

This paper demonstrates that typical children have enhanced learning of new words across sleep periods (naps) which is linked to the amount of time in rapid eye movement (REM) sleep and shows sleep-dependent learning losses in an atypically developing group of children with REM deficits (e.g., Down syndrome). The work yields both medical and theoretical impacts by (
i
) highlighting a modifiable mechanism of intellectual disability in Down syndrome that has not been described before and (
ii
) emphasizing the important role of REM sleep in children’s learning.
Engineering yeast endosymbionts as a step toward the evolution of mitochondria
Authors: Mehta Angad P. , Supekova Lubica , Chen Jian-Hua , Pestonjamasp Kersi , Webster Paul , Ko Yeonjin , Henderson Scott C. , McDermott Gerry , Supek Frantisek , Schultz Peter G.
Published: October 2018

Significance

Endosymbiotic theory suggests that mitochondria evolved from free-living prokaryotes which entered the host cell and were retained as endosymbionts. Here, we model this earliest stage of the endosymbiotic theory of mitochondrial evolution by engineering endosymbiosis between two genetically tractable model organisms,
Escherichia coli
and
Saccharomyces cerevisiae
. In this model system, we engineered
E. coli
strains to survive in the yeast cytosol and provide ATP to a respiration-deficient yeast mutant. In a reciprocal fashion, yeast provided thiamin to an endosymbiotic
E. coli
thiamin auxotroph. This readily manipulated chimeric system was stable for more than 40 doublings and should allow us to investigate various aspects of the endosymbiotic theory of mitochondrial evolution.
Biomolecular archaeology reveals ancient origins of indigenous tobacco smoking in North American Plateau
Authors: Tushingham Shannon , Snyder Charles M. , Brownstein Korey J. , Damitio William J. , Gang David R.
Published: October 2018

Significance

While tobacco is one of the most heavily consumed (and abused) plant substances of the modern era, with profound global health consequences, its early use remains poorly understood. Here we report a substantial direct biomolecular record of ancient tobacco smoking by hunter-gatherers of interior northwestern North America. Nicotine-positive samples demonstrate deep time continuity of indigenous tobacco smoking in a place where tobacco has been depicted as being introduced by early Euro-American traders and explorers. The spread of domesticated trade tobacco seems to have overtaken and obscured ancient indigenous tobacco practices. The information—represented here by the longest continuous biomolecular record of tobacco use from a single region—informs programs designed to combat persistent commercial tobacco use rates among modern Tribal communities.
“What are you talking about?”
Authors: Northbrook Julian , Conklin Kathy
Published: October 2018

In a communicative approach to language teaching, students are presented with “authentic” language, which is thought to allow them to produce it in a nativelike way. The current study explores whether the lexical bundles in communicative Japanese junior high school textbooks are representative of conversational English. To do this, we use a corpus-based approach that compares the most frequent lexical bundles in the textbooks to those in an English reference corpus. The study finds that although lexical bundles are very frequent in the textbooks, and conform relatively well to English patterns at shorter lengths (3-word lexical bundles), they deviate considerably at longer ones (4-, 5- and 6-words). This has important implications for the communicative utility of the language in the textbooks.
A quantitative exercise on the mass–luminosity and mass–lifetime relations for main sequence stars in an introductory college astronomy course
Authors: LoPresto Michael C
Published: October 2018

What follows is a description of a simple quantitative exercise developed for students of a general education introductory astronomy course in which they discover for themselves the mass–luminosity and mass–lifetime relations for stars on the main sequence of the Hertzsprung–Russell diagram. Besides providing a demonstration of two fundamental relationships in stellar astronomy, the exercise also provides an example of the process of scientific experimentation.
Statistical inference of the rate of RNA polymerase II elongation by total RNA sequencing
Authors: Kawamura Yumi , Koyama Shinsuke , Yoshida Ryo
Published: October 2018

Motivation

Sequencing total RNA without poly-A selection enables us to obtain a transcriptomic profile of nascent RNAs undergoing transcription with co-transcriptional splicing. In general, the RNA-seq reads exhibit a sawtooth pattern in a gene, which is characterized by a monotonically decreasing gradient across introns in the 5’–3’ direction, and by substantially higher levels of RNA-seq reads present in exonic regions. Such patterns result from the process of underlying transcription elongation by RNA polymerase II, which traverses the DNA strand in a 5’–3’ direction as it performs a complex series of mRNA synthesis and processing. Therefore, data of sequenced total RNAs could be utilized to infer the rate of transcription elongation by solving the inverse problem.

Results

Though solving the inverse problem in total RNA-seq has the great potential, statistical methods have not yet been fully developed. We demonstrate what extent the newly developed method can be useful. The objective is to reconstruct the spatial distribution of transcription elongation rates in a gene from a given noisy, sawtooth-like profile. It is necessary to recover the signal source of the elongation rates separately from several types of nuisance factors, such as unobserved modes of co-transcriptionally occurring mRNA splicing, which exert significant influences on the sawtooth shape. The present method was tested using published total RNA-seq data derived from mouse embryonic stem cells. We investigated the spatial characteristics of the estimated elongation rates, focusing especially on the relation to promoter-proximal pausing of RNA polymerase II, nucleosome occupancy and histone modification patterns.

Availability and implementation

A C implementation of PolSter and sample data are available at https://github.com/yoshida-lab/PolSter.

Supplementary information

Supplementary data are available at Bioinformatics online.
Occurrence and species diversity of human-pathogenic Mucorales in commercial food-stuffs purchased in Paris area
Authors: Mousavi Bita , Botterel Françoise , Costa Jean-Marc , Arné Pascal , Guillot Jacques , Dannaoui Eric
Published: October 2018

Mucormycoses are life-threatening fungal diseases that affect a variety of patients including those with diabetes mellitus or hematological malignancies. The responsible agents, the Mucorales, are opportunistic pathogens originating from the environment such as soil or decaying organic matter. The aim of the present study was to assess the prevalence and diversity of human-pathogenic species of Mucorales in commercially available foodstuffs in France. All food samples were purchased from January 2014 to May 2015 in France. A total of 159 dried food samples including spices and herbs (n = 68), herbal tea (n = 19), cereals (n = 19), vegetables (n = 14), and other foodstuffs (n = 39) were analyzed. Each strain of Mucorales was identified phenotypically, and molecular identification was performed by ITS sequencing. From the 28 (17.6%) samples that were culture-positive for Mucorales, 30 isolates were recovered. Among the isolates, 13 were identified as Rhizopus arrhizus var. arrhizus, 10 R. arrhizus var. delemar, two Rhizopus microsporus, one Lichtheimia corymbifera, three Lichtheimia ramosa, and one Syncephalastrum racemosum. Culture-positive samples originated from different countries (Europe, Asia) and brands. The samples most frequently contaminated by Mucorales were spices and herbs (19/68, 27.9%), followed by herbal tea (2/19, 10.5%), cereals (2/19, 10.5%), other food products (5/39, 12.8%). The present study showed that human-pathogenic Mucorales were frequently recovered from commercially available foodstuffs in France with a large diversity of species. The potential danger represented by Mucorales present in food for immunocompromised patients should be further analyzed.
Imaging [CI] around HD 131835: reinterpreting young debris discs with protoplanetary disc levels of CO gas as shielded secondary discs
Authors: Kral Quentin , Marino Sebastian , Wyatt Mark C , Kama Mihkel , Matrá Luca
Published: October 2018

Despite being >10Myr, there are ∼10 debris discs with as much CO gas as in protoplanetary discs. Such discs have been assumed to be “hybrid”, i.e., with secondary dust but primordial gas. Here we show that both the dust and gas in such systems could instead be secondary, with the high CO content caused by accumulation of neutral carbon (C0) that shields CO from photodissociating; i.e., these could be “shielded secondary discs”. New ALMA observations are presented of HD131835 that detect ∼3 × 10−3 M⊕ of C0, the majority 40-200au from the star, in sufficient quantity to shield the previously detected CO. A simple semi-analytic model for the evolution of CO, C and O originating in a volatile-rich planetesimal belt shows how CO shielding becomes important when the viscous evolution is slow (low α parameter) and/or the CO production rate is high. Shielding by C0 may also cause the CO content to reach levels at which CO self-shields, and the gas disc may become massive enough to affect the dust evolution. Application to the HD 131835 observations shows these can be explained if α ∼ 10−3; an inner cavity in C0 and CO may also mean the system has yet to reach steady state. Application to other debris discs with high CO content finds general agreement for α = 10−3 to 0.1. The shielded secondary nature of these gas discs can be tested by searching for C0, as well as CN, N2 and CH+, which are also expected to be shielded by C0.
Revised wavelength and spectral response calibrations for AKARI near-infrared grism spectroscopy: Post-cryogenic phase
Authors: Baba Shunsuke , Nakagawa Takao , Usui Fumihiko , Yamagishi Mitsuyoshi , Onaka Takashi
Published: October 2018

We present a new calibration for the second-order light contamination in the near-infrared grism spectroscopy with the Infrared Camera aboard AKARI, specifically for the post-cryogenic phase of the satellite (Phase 3). Following our previous work on the cryogenic phase (Phases 1 and 2), the wavelength and spectral response calibrations were revised. Unlike Phases 1 and 2, during Phase 3 the temperature of the instrument was not stable and gradually increased from 40 to 47 K. To assess the effect of the temperature increase, we divided Phase 3 into three sub-phases and performed the calibrations separately. As in Phases 1 and 2, we confirmed that there was contamination due to the wavelength dependence of the refractive index of the grism material in every sub-phase. The wavelength calibration curves for the three sub-phases coincided with each other and did not show any significant temperature dependence. The response decreased with temperature by ∼10% from the beginning to the end of Phase 3. We approximated the temperature dependence of the response at a linear relation and derived a correction factor as a function of temperature. The relative fraction of the second-order light contamination to the first-order light was found to be 25% smaller than that in Phases 1 and 2.
Advertising in Young Children's Apps: A Content Analysis
Authors: Meyer Marisa , Adkins Victoria , Yuan Nalingna , Weeks Heidi M. , Chang Yung-Ju , Radesky Jenny
Published: October 2018

Objective:

Young children use mobile devices on average 1 hour/day, but no studies have examined the prevalence of advertising in children's apps. The objective of this study was to describe the advertising content of popular children's apps.

Methods:

To create a coding scheme, we downloaded and played 39 apps played by children aged 12 months to 5 years in a pilot study of a mobile sensing app; 2 researchers played each app, took detailed notes on the design of advertisements, and iteratively refined the codebook (interrater reliability 0.96). Codes were then applied to the 96 most downloaded free and paid apps in the 5 And Under category on the Google Play app store.

Results:

Of the 135 apps reviewed, 129 (95%) contained at least 1 type of advertising. These included use of commercial characters (42%); full-app teasers (46%); advertising videos interrupting play (e.g., pop-ups [35%] or to unlock play items [16%]); in-app purchases (30%); prompts to rate the app (28%) or share on social media (14%); distracting ads such as banners across the screen (17%) or hidden ads with misleading symbols such as “$” or camouflaged as gameplay items (7%). Advertising was significantly more prevalent in free apps (100% vs 88% of paid apps), but occurred at similar rates in apps labeled as “educational” versus other categories.

Conclusion:

In this exploratory study, we found high rates of mobile advertising through manipulative and disruptive methods. These results have implications for advertising regulation, parent media choices, and apps' educational value.
Ketorolac Use and Anastomotic Leak in Elective Colorectal Surgery: A Detailed Analysis
Authors: Hawkins Alexander T. , McEvoy Matthew D. , Wanderer Jonathan P. , Ford Molly M. , Hopkins M. Benjamin , Muldoon Roberta L. , Martin Barbara J. , King Adam B. , Geiger Timothy M.
Published: October 2018

BACKGROUND:

Recent population-level analyses have linked ketorolac use to adverse outcomes. However, its use is also associated with decreased opioids and faster return of bowel function.

OBJECTIVE:

This study aims to assess the association between ketorolac and anastomotic leak. We hypothesize that receiving at least 1 dose of ketorolac will not be associated with anastomotic leak in elective colorectal surgery.

DESIGN:

This is a retrospective, observational cohort study of a prospectively collected data base. Anastomotic leak rates and other patient outcomes were adjusted for patient-level factors and then compared via a multivariable logistic regression. A secondary analysis assessed a dose-response association with anastomotic leak.

SETTING:

This study was conducted at a tertiary care colorectal surgery service.

PATIENTS:

Consecutive patients undergoing elective colorectal surgery with a nondiverted anastomosis were identified from 2012 to 2016.

INTERVENTION:

Exposure was defined as any administration of ketorolac during the perioperative time period.

MAIN OUTCOME MEASURES:

The primary outcome measured was anastomotic leak.

RESULTS:

A total of 877 patients met inclusion criteria. Of these, 479 (54.6%) were women, and the median age was 55 years. Overall, 566 (64.5%) patients were exposed to ketorolac. In the cohort, 27 (3.1%) patients experienced an anastomotic leak. In an unadjusted analysis, there was no association between ketorolac exposure and anastomotic leak (ketorolac: 3.1% vs no ketorolac: 3.3%; p = 0.84). This persisted in a multivariable model (OR, 0.98; 95% CI, 0.38–2.57; p = 0.98). Neither AKI (OR, 3.24; 95% CI, 0.51–20.6; p = 0.21), return to the operating room (OR, 1.07; 95% CI, 0.40–2.85; p = 0.88), nor readmission (OR, 1.03; 95% CI, 0.59–1.80; p = 0.93) was associated with ketorolac use. In a secondary analysis of patients receiving ketorolac, there was no association between total ketorolac dosing and anastomotic leak (OR, 0.99; 95% CI, 0.99–1.00; p = 0.20).

LIMITATIONS:

This study was a retrospective review, and there was a low incidence of anastomotic leak.

CONCLUSION:

Ketorolac exposure was associated with neither anastomotic leak nor other important postoperative outcomes. See Video Abstract at http://links.lww.com/DCR/A784.
Vault Changes Caused by Light-Induced Pupil Constriction and Accommodation in Eyes With an Implantable Collamer Lens
Authors: Kato Sayaka , Shimizu Kimiya , Igarashi Akihito
Published: October 2018

Purpose:

An appropriate vault after implantation of a posterior chamber phakic intraocular lens with a central hole (ICL KS-AP) is important for successful long-term outcomes. In the present study, we used anterior segment optical coherence tomography (AS-OCT) to examine dynamic pupil and vault changes under photopic and scotopic conditions and during accommodation in eyes with ICL KS-AP.

Methods:

This retrospective study included patients at an outpatient ophthalmology clinic who underwent ICL KS-AP implantation >1 month before enrollment. All patients underwent dynamic AS-OCT imaging under photopic and scotopic conditions. Patients aged <40 years also underwent imaging in the accommodative and nonaccommodative states. Primary outcome measures were the pupil size and vault at the maximum and minimum pupil sizes.

Results:

This study included 91 eyes of 47 patients (35.5 ± 8.6 years, 21 men). Accommodation was examined in 51 eyes of 26 patients (28.9 ± 5.0 years, 10 men) younger than 40 years. The pupil size was significantly smaller under photopic conditions (3.64 ± 0.77 mm) than under scotopic conditions (4.91 ± 0.75 mm, P < 0.001) and during accommodation (3.88 ± 0.64 vs. 4.10 ± 0.61 mm, P < 0.001). Vault was also significantly lower under photopic conditions (476.1 ± 219.6 μm) than under scotopic conditions (521.1 ± 220.4 μm, P < 0.001) and during accommodation (454.8 ± 224.9 vs. 481.6 ± 219.1 μm, P < 0.001).

Conclusions:

Vault can be significantly lowered by light-induced pupil constriction and accommodation in eyes with ICL KS-AP.
Predicting Unsuccessful Clozapine Treatment After First Use in Adult Patients With Psychotic Disorders
Authors: Beex-Oosterhuis Marieke M. , Heerdink E.R. (Rob) , Van Gool Arthur R. , van Marum Rob J.
Published: October 2018

Purpose/Background

Cessation of clozapine therapy and insufficient response may result in relapse of psychotic symptoms and in clinical admissions. However, discontinuation rates are high. Identifying patients at risk for unsuccessful clozapine use might enable clinicians to direct specific attention to them.

Methods/Procedures

Routinely collected data from a large insurance company were used to develop a simple prediction model for unsuccessful clozapine treatment in psychiatric patients 1 year after clozapine was first dispensed by a community pharmacy in the Netherlands. Multivariate logistic regression analyses were performed with the Nagelkerke R
2 statistic as a measure of the predictive value of the model.

Findings/Results

A total of 937 patients were dispensed clozapine for the first time by their community pharmacy between January 1, 2011, and December 31, 2015 (index date). Of these, 741 patients had started their clozapine treatment in hospital before the index date (inpatient starters); the remaining 196 patients started clozapine as outpatients on the index date (outpatient starters). In 191 patients (20.4%), clozapine treatment was unsuccessful 1 year after the index date. Unsuccessful treatment was more common among outpatient starters than among inpatient starters (32.1% vs 17.3%). Using backward selection of the variables, a model consisting of 61 variables had the best predictive value overall (Nagelkerke R
2 = 0.301), whereas a model consisting of 52 variables had the best predictive value in outpatient starters (Nagelkerke R
2 = 0.676).

Implications/Conclusions

The likelihood of unsuccessful clozapine treatment after 1 year was higher among patients who started clozapine as outpatients. Despite the use of a diversity of variables and different statistical approaches, it was not possible to make a simple prediction model for unsuccessful clozapine treatment using relatively easily accessible data.
Incidentally Detected Focal Fundal Gallbladder Wall Thickening at Contrast-Enhanced Computed Tomography: Prevalence and Computed Tomography Features of Malignancy
Authors: Corwin Michael T. , Khera Satinderpal S. , Loehfelm Thomas W. , Yang Nuen Tsang , Fananapazir Ghaneh
Published: October 2018

Objective

The aim of this study was to determine the prevalence and computed tomography (CT) features of malignancy in incidental focal fundal gallbladder wall thickening.

Methods

Patients with incidental focal fundal gallbladder wall thickening on CT were included if they had an ultrasound or magnetic resonance imaging diagnostic of the etiology (n = 19), stability on CT for 1 year (n = 84), or pathological correlation (n = 13). Morphologies were classified as type 1 (nodular/pinched intramural low attenuation), type 2 (intramural low attenuation), type 3 (homogeneous enhancement), type 4 (nodular/pinched homogeneous enhancement), type 5 (intramural cystic spaces), or type 6 (hyperenhancing/heterogeneous enhancement).

Results

One hundred sixteen patients had the following morphologies: type 1 (n = 57), type 2 (n = 10), type 3 (n = 6), type 4 (n = 19), type 5 (n = 14), and type 6 (n = 10). Four cases (3.4%; 95% confidence interval, 0.9%–8.6%) of malignancy were identified (type 6 in 3 and type 3 in 1).

Conclusions

Incidental focal fundal gallbladder wall thickening is usually benign. Computed tomography features help distinguish benign from malignant etiologies.
The Liver Fat Fraction and Abdominal Subcutaneous and Visceral Fat Volume Distribution in Normal-Weight, Overweight, and Obese Children Using a New Magnetic Resonance Imaging Technique
Authors: Pirimoglu Berhan , Sade Recep , Islek Ali , Kantarci Mecit
Published: October 2018

Objectives

The purpose of this study was to evaluate liver fat fraction and subcutaneous and visceral fat volumes using new magnetic resonance imaging in normal-weight, overweight, and obese children.

Methods

Patients at below the 85th percentile of body mass index (BMI) z score (5/25 patients) were assigned to the normal-weight group; patients between 85th and 95th percentile of BMI z score (9/25 patients) were assigned to the overweight group, and patients above the 95th percentile of BMI z score (11/25 patients) were assigned to the obese group. Liver fat fraction and subcutaneous and visceral fat volumes were measured on 3-dimensional volume measurement workstation.

Results

Liver fat fraction and subcutaneous fat volume had weak correlation (r = 0.18, P = 0.411). Liver fat fraction and visceral fat volume revealed weak correlation (r = 0.25, P = 0.672); visceral and subcutaneous fat volume demonstrated strong correlation (r = 0.67, P = 0.047).

Conclusions

There is strong correlation between subcutaneous fat volume and visceral fat volume in overweight and obese children.
Conventional Magnetic Resonance Features for Predicting 1p19q Codeletion Status of World Health Organization Grade II and III Diffuse Gliomas
Authors: Peng Xiaorong , Yishuang Chen , Kaizhou Zhan , Xiao Liqun , Ma Chunnong
Published: October 2018

Purpose

The conventional magnetic resonance features of World Health Organization (WHO) grade II and III diffuse gliomas in relation to chromosome 1p and 19q deletions (1p19q codeletion) were analyzed.

Methods

We identified 147 cases of WHO grade II and III diffuse gliomas (1p/19q codeletion, 36 cases; no 1p/19q codeletion, 111 cases). χ2 Test and univariate and multivariate binary logistic regression analyses were conducted to evaluate the association between the imaging features and 1p19q codeletion status of WHO grade II and III diffuse gliomas in the discovery group, including the WHO grade II and III subgroups.

Results

(1) In the entire population, multivariate regression demonstrated that proportion contrast-enhanced tumor (>5% vs ≤5%; odds ratio [OR], 0.169; P = 0.009), enhancing margin (poorly vs well defined; OR, 12.435; P = 0.002), and hemorrhage (yes vs no; OR, 21.082; P < 0.001) were associated with a higher incidence of 1p19q codeletion status. The nomogram showed good discrimination (area under the curve [AUC], 0.803) and calibration. (2) For grade II tumors, subgroup analysis found that enhancing margin (poorly vs well defined; OR, 0.308; P = 0.007) and subventricular zone (presence vs absence−; OR, 0.137; P < 0.001) were associated with a higher incidence of 1p19q codeletion status (AUC, 0.779). (3) For grade III tumors, subgroup analysis found that age (≥40 years vs <40 years; OR, 5.977; P = 0.03) and hemorrhage (yes vs no; OR, 18.051; P < 0.001) were associated with a higher incidence of 1p19q codeletion status (AUC, 0.816).

Conclusions

Conventional magnetic resonance features can be conveniently used to facilitate the preoperative prediction of 1p19q codeletion status of WHO grade II and III diffuse gliomas. Decision curve analysis demonstrated that the nomogram was clinically useful.
Pancreatic Lymphangioma: A Case Report and Literature Review
Authors: Karajgikar Jay , Deshmukh Sandeep
Published: October 2018

We report a case of a 29-year-old woman with a pancreatic lymphangioma who presented clinically as a case of acute pancreatitis. Lymphangiomas are benign tumors of vascular origin with lymphatic differentiation, most commonly found in the head and neck. Pancreatic lymphangiomas are extremely rare, accounting for only 1% of abdominal lymphangiomas, with approximately 60 cases reported in the literature. Although imaging findings are characteristic and can point to the diagnosis, confirmation with fine needle aspiration and histopathologic correlation is necessary. Although these lesions are benign, they can often present a diagnostic dilemma and can be mistaken for other cystic pancreatic lesions, namely, pseudocysts, cysts, cystadenomas, and cystadenocarcinomas.
Differentiated Thyroid Cancer Outcomes After Surgery and Activity-Adjusted 131I Theragnostics
Authors: Avram Anca M. , Rosculet Natalja , Esfandiari Nazanene H. , Gauger Paul G. , Miller Barbra S. , Cohen Mark , Hughes David T.
Published: October 2018

Purpose

The aim of this study was to determine clinical outcomes in patients with differentiated thyroid cancer after surgery and activity-adjusted 131I therapy informed by diagnostic 131I scans with SPECT/CT (Dx scan).

Methods

Single-institution retrospective cohort study analysis of clinical outcomes after 1 to 5 years (mean, 39.6 ± 23.4 months) of follow-up in 350 patients with differentiated thyroid cancer associated with histopathologic risk factors, nodal metastases, and/or distant metastases. Postoperatively, all patients underwent Dx scans for completion of staging and risk stratification, and 131I therapy was based on integration of information from histopathology, stimulated thyroglobulin and scintigraphy.

Results

Twenty-three patients (6.6%) underwent reoperative neck dissection for removal of unsuspected residual nodal metastases identified on Dx scans. Clinical outcomes were as follows: 84.3% complete response, 1.4% biochemical incomplete response, 2.3% indeterminate response, and 12% structural incomplete response. Of the entire cohort, only 8 patients (2.3%) had persistent iodine-avid metastatic disease, which required repeated 131I therapy. Of 31 patients with iodine-avid distant metastases identified on Dx scans, 13 patients (42%) achieved complete response with a single 131I treatment.

Conclusions

Detection of regional and distant metastases on postoperative Dx scans permits adjustment of prescribed 131I activity for targeted treatment, as compared with fixed-activity ablation. This approach resulted in complete response after a single 131I treatment in 88% patients with histopathologic risk factors and regional metastases and 42% patients with distant metastases. Most patients with structural incomplete response (81%) had elevated thyroglobulin levels with negative follow-up 131I scans and positive PET/CT and/or CT scans consistent with altered tumor biology (non–iodine-avid disease).
Primary and Secondary Breast Angiosarcoma
Authors: Cassou-Mounat Thibaut , Champion Laurence , Bozec Laurence , Laurence Valerie , Huchet Virginie , Luporsi Marie , Jehanno Nina
Published: October 2018

Breast angiosarcoma is a rare and aggressive tumor. The role of 18F-FDG PET/CT in breast angiosarcoma is poorly known. We report a series of 13 lesions in 11 patients with histologically proven primary or secondary breast angiosarcoma who underwent FDG PET/CT at the initial assessment in our institution. All breast lesions showed FDG avidity. Visually and statistically, we observed a significant difference of SUVmax uptake foci between primary and secondary breast angiosarcoma (Wilcoxon test P < 0.0046) and a significantly poorer prognosis for high SUVmax than those with low SUVmax (P = 0.049) regardless of primary or secondary origins.
Hemosiderotic Fibrolipomatous Tumor on FDG PET/CT
Authors: Yang Fanhui , Chen Fei , Cao Lingzhi , Lin Shiyu , Li Suping
Published: October 2018

A 74-year-old woman with a history of melanoma 10 years ago presented worsening swelling pain associated with a lump in her inner left thigh. Metastatic disease was suspected and for this reason, FDG PET/CT was performed. The images demonstrated peripherally increased FDG activity in the lump with a centrally photopenic region. Postsurgical pathological examination showed a hemosiderotic fibrolipomatous tumor.
Brain Metastases of a Neuroendocrine Tumor Visualized by 68Ga-DOTATATE PET/CT
Authors: Hoberück Sebastian , Michler Enrico , Zöphel Klaus , Platzek Ivan , Kotzerke Jörg , Brogsitter Claudia
Published: October 2018

A 65-year-old woman with a long history of metastasized, highly differentiated (G1) neuroendocrine tumor of pancreatic origin presented for follow-up 68Ga-DOTATATE PET/CT after 7 peptide receptor radiotherapies. In the previous scan, she already had discrete intracranial tracer accumulations, which were massively progressive in the recent 68Ga-DOTATATE PET/CT 8 months later. This case illustrates that cerebral metastases in neuroendocrine tumors may occur many years after initial diagnosis, and their somatostatin receptor expression may rise within a few months to a level that reasonably justifies further peptide receptor radiotherapy.