bluuebunny/crossref_metadata_2025 huggingface dataset:
Geographic Distribution of Nontuberculous Mycobacteria Isolated from Clinical Specimens: A Systematic Review
Authors: Zweijpfenning Sanne , Hoefsloot Wouter , Ingen Jakko
Published: August 2018

Isolation frequency of nontuberculous mycobacterial (NTM) differs per region. Differences in isolation frequency as well as frequencies in clinical relevance are relevant for daily clinical practice. We conducted a systematic review, searching PubMed to assess these differences. Mycobacterium avium complex (MAC) is the most frequently isolated species and the majority of MAC isolates are causative agents of clinically relevant disease, that is, the patient ultimately meets American Thoracic Society/Infectious Disease Society of America diagnostic criteria for NTM pulmonary disease. Differences in isolation frequency between MAC species are seen in different continents. Another species that shows a remarkable difference in isolation frequency is M. abscessus complex, which is common in Asia and Oceania, in contrast to Europe, North America, and South America. Furthermore, differences in isolation frequency are seen between different continents, and also between regions or cities. These differences might drive local epidemiology of NTM pulmonary disease, and knowledge of the local situation is thus essential for daily clinical practice. To be fully able to assess this problem, larger multicenter studies with uniform microbiological methods are needed.
Indications for Thoracic EndoVascular Aortic Repair (TEVAR): A Brief Review
Authors: Newman Joshua , Mattia Allan , Manetta Frank
Published: August 2018

The utility of Thoracic EndoVascular Aortic Repair (TEVAR) continues to progress at a very rapid rate. Initially implemented for the treatment of thoracic aortic aneurysms, TEVAR has evolved to treat a variety of aortic pathologies and reduce overall morbidity and mortality rates compared with traditional open surgical repair.

Given the rapidly evolving nature of endovascular thoracic intervention, we hereby briefly review the current literature on the evolving applications of TEVAR.

TEVAR continues to rapidly evolve and is being applied to a growing number of aortic pathologies. Given the perioperative, short- and mid-term morbidity and mortality rates, TEVAR is quickly surpassing traditional open surgical intervention as the ideal procedure for patients undergoing intervention of the descending thoracic aorta and applicability to ascending and arch pathologies is being explored. However, as more data becomes available TEVAR may be associated with higher rates of reoperative requirements. Data remains limited on the long-term efficacy of the intervention and should continue to be investigated.
The variation of invariant graphs in forced systems
Authors: Fernandez Bastien , Quas Anthony
Published: August 2018

In skew-product systems with contractive factors, all orbits asymptotically approach the graph of the so-called sync function; hence, the corresponding regularity properties primarily matter. In the literature, sync function Lipschitz continuity and differentiability have been proved to hold depending on the derivative of the base reciprocal, if not on its Lyapunov exponent. However, forcing topological features can also impact the sync function regularity. Here, we estimate the total variation of sync functions generated by one-dimensional Markov maps. A sharp condition for bounded variation is obtained depending on parameters, which involves the Markov map topological entropy. The results are illustrated with examples.
Six-dimensional potential energy surfaces of the dissociative chemisorption of HCl on Ag(111) with three density functionals
Authors: Liu Tianhui , Fu Bina , Zhang Dong H.
Published: August 2018

We first constructed six-dimensional potential energy surfaces (PESs) for the dissociative chemisorption of HCl on rigid Ag(111). Three global PESs were calculated using the neural network method based on extensive density functional theory (DFT) calculations with Perdew-Burke-Ernzerhof, Perdew-Wang91, and revised Perdew-Burke-Ernzerhof functionals, respectively. The resulting three PESs are all accurately fitted and smooth, based on the small fitting errors and good agreements between the fitted PESs and the direct DFT calculations. Time-dependent wave packet calculations show that the PESs are very well converged with respect to the fitting process, as well as the number of DFT data points. Comparisons of three PESs and time-dependent quantum dynamics results on the three PESs were given and discussed. The validity of site-averaging approximation holds for the title reaction, where the 25 site-averaged four-dimensional dissociation probability can accurately reproduce the six-dimensional dissociation probability on the current three PESs. We expect that the current theoretical investigations can stimulate the experimental work for this gas-surface reaction.
Cumulative plasma effects in cavity-enhanced high-order harmonic generation in gases
Authors: Saule Tobias , Högner Maximilian , Lilienfein Nikolai , de Vries Oliver , Plötner Marco , Yakovlev Vladislav S. , Karpowicz Nicholas , Limpert Jens , Pupeza Ioachim
Published: August 2018

Modern ultrafast laser architectures enable high-order harmonic generation (HHG) in gases at (multi-) MHz repetition rates, where each atom interacts with multiple pulses before leaving the HHG volume. This raises the question of cumulative plasma effects on the nonlinear conversion. Utilizing a femtosecond enhancement cavity with HHG in argon and on-axis geometric extreme-ultraviolet (XUV) output coupling, we experimentally compare the single-pulse case with a double-pulse HHG regime in which each gas atom is hit by two pulses while traversing the interaction volume. By varying the pulse repetition rate (18.4 and 36.8 MHz) in an 18.4-MHz roundtrip-frequency cavity with a finesse of 187, and leaving all other pulse parameters identical (35-fs, 0.6-μJ input pulses), we observe a dramatic decrease in the overall conversion efficiency (output-coupled power divided by the input power) in the double-pulse regime. The plateau harmonics (25–50 eV) exhibit very similar flux despite the twofold difference in repetition rate and average power. We attribute this to a spatially inhomogeneous plasma distribution that reduces the HHG volume, decreasing the generated XUV flux and/or affecting the spatial XUV beam profile, which reduces the efficiency of output coupling through the pierced mirror. These findings demonstrate the importance of cumulative plasma effects for power scaling of high-repetition-rate HHG in general and for applications in XUV frequency comb spectroscopy and in attosecond metrology in particular.
Thermocapillary instabilities of liquid layers on an inclined plane
Authors: Yan Chen-Yi , Hu Kai-Xin , Chen Qi-Sheng
Published: August 2018

The thermocapillary instabilities of the liquid layers on an inclined plane with zero heat flux are examined by linear stability analysis. There is an angle between the gravity and the thermocapillary force. The basic flow depends on the ratio of the gravity effect to thermocapillary effect. When the ratio is positive, the gravity always increases the velocity and destabilizes the flow. When the ratio is negative, the influence of gravity on the flow stability depends on the Prandtl (Pr) number. At high and moderate Pr, the critical Marangoni number always decreases with the ratio. The vertical convection is the key to the instability mechanism at high Pr, while the horizontal convection is dominant at moderate Pr. By contrast, at small Pr, the critical Marangoni number has a maximum and the energy from the basic flow is important for the perturbation energy.
Observation of gyromagnetic reversal
Authors: Imai Masaki , Ogata Yudai , Chudo Hiroyuki , Ono Masao , Harii Kazuya , Matsuo Mamoru , Ohnuma Yuichi , Maekawa Sadamichi , Saitoh Eiji
Published: August 2018

We report direct observation of gyromagnetic reversal, which is the sign change of the gyromagnetic ratio in a ferrimagnet insulator Ho3Fe5O12, by using the Barnett effect measurement technique at low temperatures. The Barnett effect is a phenomenon in which magnetization is induced by mechanical rotation through the coupling between rotation and total angular momentum J of electrons. The magnetization of Ho3Fe5O12 induced by mechanical rotation disappears at 135 K and 240 K. The temperatures correspond to the magnetization compensation temperature TM and the angular momentum compensation temperature TA, respectively. Between TM and TA, the magnetization flips over to be parallel against the angular momentum due to the sign change of the gyromagnetic ratio. This study provides an unprecedented technique to explore the gyromagnetic properties.
Epitaxial integration and properties of SrRuO3 on silicon
Authors: Wang Zhe , Nair Hari P. , Correa Gabriela C. , Jeong Jaewoo , Lee Kiyoung , Kim Eun Sun , H. Ariel Seidner , Lee Chang Seung , Lim Han Jin , Muller David A. , Schlom Darrell G.
Published: August 2018

We report the integration of SrRuO3, one of the most widely used oxide electrode materials in functional oxide heterostructures, with silicon using molecular-beam epitaxy and an SrTiO3 buffer layer. The resulting SrRuO3 film has a rocking curve full width at half maximum of 0.01°, a resistivity at room temperature of 250 μΩ cm, a residual resistivity ratio (ρ300 Kρ4 K) of 11, and a paramagnetic-to-ferromagnetic transition temperature of ∼160 K. These structural, electrical, and magnetic properties compare favorably to the best reported values for SrRuO3 films on silicon and rival those of epitaxial SrRuO3 films produced directly on SrTiO3 single crystals by thin film growth techniques other than molecular-beam epitaxy. These high quality SrRuO3 films with metallic conductivity on silicon are relevant to integrating multi-functional oxides with the workhorse of semiconductor technology, silicon.
Time provides a new window into plasmonic signal analysis
Authors: Majors J. H.
Published: August 2018

To address the unique complexities of simulating surface plasmon polariton signals, where frequency domain analysis is suboptimal, an FDTD approach reveals pulse dynamics in the time domain.
Nur77 serves as a molecular brake of the metabolic switch during T cell activation to restrict autoimmunity
Authors: Liebmann Marie , Hucke Stephanie , Koch Kathrin , Eschborn Melanie , Ghelman Julia , Chasan Achmet I. , Glander Shirin , Schädlich Martin , Kuhlencord Meike , Daber Niklas M. , Eveslage Maria , Beyer Marc , Dietrich Michael , Albrecht Philipp , Stoll Monika , Busch Karin B. , Wiendl Heinz , Roth Johannes , Kuhlmann Tanja , Klotz Luisa
Published: August 2018

Significance

The role of metabolic processes during T cell activation has been increasingly acknowledged, and recent data suggest an impact of T cell immunometabolism on T cell function and T cell-mediated autoimmunity. The factors regulating metabolic function in T cells are not clear, however. We identify the nuclear receptor Nur77 as central regulator of T cell immunometabolism, controlling oxidative phosphorylation and aerobic glycolysis during T cell activation. Functionally, Nur77 restricts murine and human T cell activation and proliferation and limits inflammation in autoimmune conditions in animal models of CNS autoimmunity, contact dermatitis, and arthritis. These findings identify Nur77 as a central regulator of T cell immunometabolism that restricts T cell-mediated autoimmunity, which might open up new avenues for a more tailored therapeutic approach.
Kinase-dependent structural role of DNA-PKcs during immunoglobulin class switch recombination
Authors: Crowe Jennifer L. , Shao Zhengping , Wang Xiaobin S. , Wei Pei-Chi , Jiang Wenxia , Lee Brian J. , Estes Verna M. , Alt Frederick W. , Zha Shan
Published: August 2018

Significance

To combat pathogens, B lymphocytes switch the types of antibody they express through a DNA break and repair event termed class switch recombination (CSR). To do so, DNA breaks introduced in specific genomic regions within the antibody gene locus are joined together by the nonhomologous end-joining (NHEJ) DNA repair pathway. Here, we show that mutation and deletion in one NHEJ factor, the catalytic subunit of the DNA-dependent protein kinase (DNA-PKcs), leave different molecular signatures at the CSR junctions, uncovering activation-dependent structural function of DNA-PKcs in DNA repair and antibody maturation.
Residual stress in a restrained specimen processed by post-weld ultrasonic impact treatment
Authors: Liu Chuan , Yan Yi , Cheng Xiaohua , Wang ChunJing , Zhao Yong
Published: August 2018

A multipass thick welded specimen restrained by three saddle-shape plates welded to the bottom surface was prepared and treated using the post-weld ultrasonic impact treatment (UIT). The stresses in the specimen were measured and analysed. Results show that the as-welded stresses on the top surface of the restrained specimen do not drop quickly beyond the weld zone as compared with the typical welding stress distributions in thick unrestrained specimens. The UIT induces compressive stresses with a depth up to 2–4 mm and it has little effect on the as-welded stresses outside of the UIT-treated region. The welding of restraining plates causes a significant increase of the longitudinal stress within the local welding region.
A small wins framework to overcome the evaluation paradox of governing wicked problems
Authors: Termeer Catrien J A M , Dewulf Art
Published: August 2018

The evaluation of policy strategies to tackle wicked policy problems inevitably involves a paradox of trying to judge solutions for problems that have no solutions and for which additional efforts might increase the chances of finding better responses. This paper analyzes how the concept of small wins can contribute to evaluating progress in wicked problem areas in a way that energizes a variety of stakeholders instead of paralyzing them and embraces complexity instead of reverting to taming and overestimation. It presents a small wins evaluation framework that is rooted in the underlying policy perspective of making progress through accumulating small wins. It comprises three steps: 1) identifying and valuing small wins; 2) analyzing whether the right propelling mechanisms are activated so as to accumulate into transformative change; 3) organizing that results feed back into the policy process to activate new small wins. This framework will inevitably clash with unrealistic expectations of addressing wicked problems rapidly, radically and comprehensively.
Ward Climate in a High-Secure Forensic Psychiatric Setting: Comparing Two Instruments
Authors: de Vries Meike Godelieve , Brazil Inti Angelo , van der Helm Peer , Verkes Robbert-Jan , Bulten Berend Hendrik
Published: August 2018

The psychometric properties and associations between the Essen Climate Evaluation Schema (EssenCES) and the Group Climate Instrument-revised (GCI-r) were examined. These self-report questionnaires assessing ward climate were filled out by 123 male patients, residing in 3 high-secure forensic psychiatric facilities. Good internal consistency was found for all subscales of both instruments. The original factor structure was confirmed for the EssenCES, but not for the GCI-r. Bivariate correlation analyses indicated that the instruments measure related concepts. The results of this study call for further development and validation and for finding common grounds in the definition and operationalization of ward climate.
Augmenting the Left
Authors: Kingsmith A. T. , von Bargen Julian , Murray Karen Bridget , Latham Robert
Published: August 2018

Nine papers with respective replies, grounded in Marxist traditions, analyse the potential for social transformation through a reinvigorated radical Left, all within the context of the ascendance of the far Right worldwide. Papers variously take up new lines of analysis, while also identifying and theorizing strategies and possibilities for increasing and deepening popular participation and support on the far Left. Authors are drawn variously from Australia, Britain, Canada, Cyprus, France, Greece, Ireland, Japan, Slovenia, and the United States. They comprise new scholars as well as established and leading theorists and activists. Collectively, the papers address three predominant themes: the changing and expanding conceptualization on the Left of contemporary capitalism; what it means to speak of ‘the people’ in relation to political action today; and approaches to mobilizing and organizing that people. The wide-ranging but focused and rigorous insights produced across the pieces are aimed at speaking to scholars, students, observers, and activists who seek knowledge about the challenges and opportunities the Left faces today.
A boundary layer approach to the whispering gallery phenomenon
Authors: Matkowsky B.
Published: August 2018

We consider the eigenvalue problem for the Laplace operator in a two dimensional domain, bounded by a smooth, closed convex curve

C
C

, on which the eigenfunctions vanish. Waves whose wavelengths

λ
\lambda

are very small may be viewed as particles traveling along specific paths termed rays, along which the waves propagate. Small wavelengths

λ
\lambda

correspond to large wave numbers

k
=

2
π

λ

k=\frac {2 \pi }{\lambda }

, which are the eigenvalues. Therefore, we restrict attention to the consideration of large eigenvalues. Keller and Rubinow considered the problem from the point of view of geometrical optics. They constructed eigenvalues and eigenfunctions by means of rays for special geometries, and qualitatively discussed general geometries. They noted the existence of caustics, i.e., envelopes of rays in the domain, with the property that the amplitude of the eigenfunctions is appreciable only in the region between the boundary and the caustic. Inside the caustic the solution is negligibly small. The caustic is the locus of the turning points on the rays, at which the behavior changes from oscillatory (wavelike) to exponentially decaying. We are interested in those eigenfunctions for which the caustic is “near” the boundary. They correspond, in acoustics, to the whispering gallery modes, by means of which a person speaking near the wall of a convex room can be heard across the room, but not in the interior of the room. We consider domains bounded by a general smooth convex curve

C
C

, and employ a boundary layer approach to the problem, to determine these eigenvalues and eigenfunctions. Our results provide improvements to those of Keller and Rubinow.
PredMP: a web server for de novo prediction and visualization of membrane proteins
Authors: Wang Sheng , Fei Shiyang , Wang Zongan , Li Yu , Xu Jinbo , Zhao Feng , Gao Xin
Published: August 2018

Motivation

PredMP is the first web service, to our knowledge, that aims at de novo prediction of the membrane protein (MP) 3D structure followed by the embedding of the MP into the lipid bilayer for visualization. Our approach is based on a high-throughput Deep Transfer Learning (DTL) method that first predicts MP contacts by learning from non-MPs and then predicts the 3D model of the MP using the predicted contacts as distance restraints. This algorithm is derived from our previous Deep Learning (DL) method originally developed for soluble protein contact prediction, which has been officially ranked No. 1 in CASP12. The DTL framework in our approach overcomes the challenge that there are only a limited number of solved MP structures for training the deep learning model. There are three modules in the PredMP server: (i) The DTL framework followed by the contact-assisted folding protocol has already been implemented in RaptorX-Contact, which serves as the key module for 3D model generation; (ii) The 1D annotation module, implemented in RaptorX-Property, is used to predict the secondary structure and disordered regions; and (iii) the visualization module to display the predicted MPs embedded in the lipid bilayer guided by the predicted transmembrane topology.

Results

Tested on 510 non-redundant MPs, our server predicts correct folds for ∼290 MPs, which significantly outperforms existing methods. Tested on a blind and live benchmark CAMEO from September 2016 to January 2018, PredMP can successfully model all 10 MPs belonging to the hard category.

Availability and implementation

PredMP is freely accessed on the web at http://www.predmp.com.

Supplementary information

Supplementary data are available at Bioinformatics online.
Associations between cardiovascular disease, cancer, and very low high-density lipoprotein cholesterol in the REasons for Geographical and Racial Differences in Stroke (REGARDS) study
Authors: Penson Peter , Long D Leann , Howard George , Howard Virginia J , Jones Steven R , Martin Seth S , Mikhailidis Dimitri P , Muntner Paul , Rizzo Manfredi , Rader Daniel J , Safford Monika M , Sahebkar Amirhossein , Toth Peter P , Banach Maciej
Published: August 2018

Aims

Relatively little is known about the health outcomes associated with very low plasma concentrations of high-density lipoprotein cholesterol (HDL-C) mainly because of the small numbers of individuals with such extreme values included in clinical trials. We, therefore, investigated the association between low and very low HDL-C concentration at baseline and incident all-cause-mortality, death from malignant disease (i.e. cancer), and with fatal or non-fatal incident coronary heart disease (CHD) in individuals from the Reasons for Geographical And Racial Differences in Stroke (REGARDS) study.

Methods and results

Analysis was based on 21 751 participants from the REGARDS study who were free of CHD, other cardiovascular disease, and cancer at baseline and were categorized by baseline HDL-C into <30 mg/dL (very low), 30–<40 mg/dL (low), and ≥40 mg/dL (reference). A series of incremental Cox proportional hazards models were employed to assess the association between the HDL-C categories and outcomes. Statistical analysis was performed using both complete case methods and multiple imputations with chained equations. After adjustment for age, race, and sex, the hazard ratios (HRs) comparing the lowest and highest HDL-C categories were 1.48 [95% confidence interval (CI) 1.28–1.73] for all-cause mortality, 1.35 (95% CI 1.03–1.77) for cancer-specific mortality and 1.39 (95% CI 0.99–1.96) for incident CHD. These associations became non-significant in models adjusting for demographics, cardiovascular risk factors, and treatment for dyslipidaemia. We found evidence for an HDL paradox, whereby low HDL (30–<40 mg/dL) was associated with reduced risk of incident CHD in black participants in a fully adjusted complete case model (HR 0.63; 95% CI 0.46–0.88) and after multiple imputation analyses (HR 0.76; 95% CI 0.58–0.98). HDL-C (<30 mg/dL) was significantly associated with poorer outcomes in women for all outcomes, especially with respect to cancer mortality (HR 2.31; 95% CI 1.28–4.16) in a fully adjusted complete case model, replicated using multiple imputation (HR 1.81; 95% CI 1.03–3.20).

Conclusion

Low HDL-C was associated with reduced risk of incident CHD in black participants suggesting a potential HDL paradox for incident CHD. Very low HDL-C in women was significantly associated with cancer mortality in a fully adjusted complete case model.
Family planning and fertility in South Africa under apartheid
Authors: Norling Johannes
Published: August 2018

During the apartheid era, all South Africans were formally classified as white, African, colored, or Asian. Starting in 1970, the government directly provided free family planning services to residents of townships and white-owned farms. Relative to African residents of other regions of the country, the share of African women that gave birth in these townships and white-owned farms declined by nearly one-third during the 1970s. Deferral of childbearing into the 1980s partially explains the decline, but lifetime fertility fell by one child per woman.
Reliable noise measure in time-gated NMR data
Authors: Irons Trevor P , McPherson Brian JOL , Kass M Andrew
Published: August 2018

Time gating is a commonly used approach in the pre-processing of nuclear magnetic resonance data before inversion. Gating suppresses spurious signals that can degrade recovered decay time distributions and therefore often stabilizes inversion. However, care must be taken in applying this technique when assumptions of uncorrelated Gaussianity break down and reduce stacking efficiency. If not properly accounted for, unreliable noise estimates introduce inversion artefacts through over- or underfitting of the data. Block-bootstrap resampling of noise realization proxies obtained through data phasing can be used to generate reliable noise estimates for the windows. Benefits of the approach are demonstrated through inversion of synthetic and borehole data. Analysis confirms that bootstrapped noise metrics are more reliable under variable noise conditions and result in more stable inversion results.
Enlarged GMRES for solving linear systems with one or multiple right-hand sides
Authors: Al Daas Hussam , Grigori Laura , Hénon Pascal , Ricoux Philippe
Published: August 2018

We propose a variant of the generalized minimal residual (GMRES) method for solving linear systems of equations with one or multiple right-hand sides. Our method is based on the idea of the enlarged Krylov subspace to reduce communication. It can be interpreted as a block GMRES method. Hence, we are interested in detecting inexact breakdowns. We introduce a strategy to perform the test of detection. Furthermore, we propose a technique for deflating eigenvalues that has two benefits. The first advantage is to avoid the plateau of convergence after the end of a cycle in the restarted version. The second is to have very fast convergence when solving the same system with different right-hand sides, each given at a different time (useful in the context of a constrained pressure residual preconditioner). We test our method with these deflation techniques on academic test matrices arising from solving linear elasticity and convection–diffusion problems as well as matrices arising from two real-life applications, seismic imaging and simulations of reservoirs. With the same memory cost we obtain a saving of up to $50 \%$ in the number of iterations required to reach convergence with respect to the original method.
On the Sobolev–Poincaré Inequality of CR-manifolds
Authors: Wang Yi , Yang Paul
Published: August 2018

The purpose is to study the CR-manifold with a contact structure conformal to the Heisenberg group. In our previous work [22], we have proved that if the $Q^{\prime }$-curvature is nonnegative and the integral of $Q^{\prime }$-curvature is below the dimensional bound $c_1^{\prime }$, then we have the isoperimetric inequality. In this paper, we manage to deal with general contact structure conformal to the Heisenberg group, removing the condition that $Q^{\prime }$-curvature is nonnegative. We prove that the volume form $e^{4u}$ is a strong $A_{\infty }$ weight. As a corollary, we prove the Sobolev–Poincaré inequality on a class of CR-manifolds with integrable $Q^{\prime }$-curvature.
Detection of a cyclotron line in SXP 15.3 during its 2017 outburst
Authors: Maitra C , Paul B , Haberl F , Vasilopoulos G
Published: August 2018

We report the results of AstroSat and NuSTAR observations of the Be/X-ray binary pulsar SXP 15.3 in the Small Magellanic Cloud during its outburst in late 2017, when the source reached a luminosity level of ∼1038 erg s−1, close to the Eddington limit. The unprecedented broad-band coverage of the source allowed us to perform timing and spectral analysis between 3 and 80 keV. The pulse profile exhibits a significant energy dependence, and morphs from a double-peaked profile to a single broad pulse at energies >15 keV. This can be explained by a spectral hardening during an intensity dip seen between the two peaks of the pulse profile. We detect a Cyclotron Resonance Scattering Feature at ∼5 keV in the X-ray spectrum, independent of the choice of the continuum model. This indicates a magnetic field strength of 6 × 1011 G for the neutron star.
Surgical Treatment of Posterior Malleolus Fractures and Posterior Fixation
Authors: Herring Matthew , Yoon Patrick
Published: August 2018

Posterior malleolar fractures (PMFs) have been demonstrated to result in poorer outcomes than other types of ankle fractures with a higher incidence of posttraumatic arthritis. Accordingly, there has been a recent surge in interest in reduction and fixation of PMFs. Operative criteria for PMFs have been based on size, step-off, ankle joint instability, and syndesmotic injury, though universally accepted criteria have yet to be defined. Anatomically, the posterior malleolus is important as an insertion point of the posterior inferior tibiofibular ligament and thereby may play a role in syndesmotic stability. However, the important lateral ankle ligament complex is also important in governing stability of the talus within the ankle mortise. PMFs have been classified by the Haraguchi system based on morphology and extent. Radiographs, although always appropriate to perform as the initial diagnostic imaging study, are likely insufficient to evaluate the size and displacement; computed tomography scan is recommended for optimal evaluation for preoperative planning. When treating the posterior malleolus by a posterolateral approach, prone and lateral positioning of the patient facilitates exposure, although it can also be performed in the supine position with a large bump and with a leg that can be safely passively internally rotated sufficiently, or externally rotated if a posteromedial approach is used. Fixation can be performed with lag screw fixation alone versus buttress or standard plating techniques. Wound complications and posttraumatic arthritis are relatively common complications encountered in the treatment of PMFs.

Level of Evidence: Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.
Factors Affecting Consumer Acceptance of an Online Health Information Portal Among Young Internet Users
Authors: Tao Da , Yuan Juan , Shao Fenglian , Li Debiao , Zhou Qi , Qu Xingda
Published: August 2018

Despite the proliferation of health and nursing informatics applications in the past decade, factors influencing consumer acceptance of the applications are not well understood. This study was conducted to investigate factors affecting acceptance of a consumer-used nursing informatics application (ie, online health information portal) within the framework of the Technology Acceptance Model. A cross-sectional study was conducted in which 201 Chinese young adults were invited to participate in usability testing with a typical health information portal and to complete a self-report questionnaire measuring the model's constructs and five hypothesized variables drawn from consumer and portal characteristics. Hierarchical regression analyses were used to test research hypotheses. Fifteen of the 22 research hypotheses were supported. Perceived ease of use and perceived usefulness predicted satisfaction and behavioral intention, respectively, over and above the portal and consumer characteristics examined in the study. All portal and consumer characteristics had significant, although varied, impacts on the original model constructs. This study demonstrated that an adapted Technology Acceptance Model, extended with portal and consumer characteristics, provides an effective means to understand consumer acceptance of health portals. The findings hold important implications for design and implementation strategies to increase the likelihood of acceptance of consumer-used nursing informatics applications.
VISUALIZATION OF CHOROIDAL NEOVASCULARIZATION USING TWO COMMERCIALLY AVAILABLE SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY DEVICES
Authors: Arya Malvika , Rebhun Carl B. , Cole Emily D. , Sabrosa Almyr S. , Arcos-Villegas Gabriel , Louzada Ricardo N. , Novais Eduardo A. , Lane Mark , Dang Sabin , Ávila Marcos , Witkin André J. , Baumal Caroline R. , Duker Jay S. , Waheed Nadia K.
Published: August 2018

Purpose:

To compare the sensitivity of detection and the measured size of choroidal neovascularization (CNV) on two commercially available spectral domain optical coherence tomography angiography (OCTA) devices, the Optovue RTVue XR Avanti with AngioVue and the Zeiss Cirrus HD-OCT with AngioPlex.

Methods:

Patients with CNV lesions were imaged consecutively on both OCTA devices on the same day of their visit. 3 × 3 mm and 6 × 6 mm scans centered at the fovea were obtained. Two independent masked readers evaluated the OCTA images for CNV identification and its area measurements.

Results:

No significant differences were observed between the 2 OCTA devices in CNV area measurements on their 3 × 3 mm and 6 × 6 mm scans. However, there was suboptimal performance of their automated segmentation algorithms as compared to manually adjusted segmentation for visualizing CNV lesions.

Conclusion:

There was no significant difference in the size of the CNV lesion as measured on either commercially available spectral domain OCTA device. Both devices were comparable in their detection of CNV lesions on manual adjustment of segmentation lines. However, their automated segmentation algorithms need improvement to allow for accurate measurement of CNV lesions for routine clinical application.
Moment-to-moment changes in perceived social support and pain for men living with HIV: an experience sampling study
Authors: Crockett Kaylee B. , Turan Bulent
Published: August 2018

Research suggests that people living with HIV experience levels of pain disproportionate to the general population. Pain is a stressor that can negatively impact health-related quality of life. As the number of people aging with HIV increases, we must understand the dynamics of pain experiences among people living with HIV and how to effectively harness evidence-based treatments and supportive resources to enhance adaptive coping. We used an experience sampling method (also called Ecological Momentary Assessment) to assess moment-to-moment experiences of pain and social support 3 times a day for 7 days in a sample of 109 men living with HIV. Participants also responded to questionnaires assessing attachment-related insecurity and social support. In hierarchical linear modeling analyses controlling for age, race, sexual orientation, and socioeconomic status, we found that experiences of social support were associated with lower subsequent pain within-persons. On the other hand, experiences of pain were not associated with later experiences of social support. Men with higher levels of attachment-related avoidance reported more pain on average. Attachment-related avoidance also moderated the association between moment-to-moment experiences of felt social support on pain. Results suggest that within-persons, experiences of daily social support reduce experiences of pain. Between-persons, attachment style may influence how individuals make use of social support in coping with experiences of pain. These findings imply a need to assess social well-being at the clinic level and also support tailored biopsychosocial approaches to pain management in HIV care settings.
Young females with long-standing patellofemoral pain display impaired conditioned pain modulation, increased temporal summation of pain, and widespread hyperalgesia
Authors: Holden Sinéad , Straszek Christian Lund , Rathleff Michael Skovdal , Petersen Kristian Kjær , Roos Ewa M. , Graven-Nielsen Thomas
Published: August 2018

Patellofemoral pain (PFP) is a common and recurrent knee condition in young females, characterized by pressure hyperalgesia and reduced pain inhibitory control. This study investigated antinociceptive and pronociceptive profiles in young females with long-standing (>5 years) PFP (current-PFP), those who recovered from adolescent PFP (recovered-PFP), and pain-free controls. This preregistered, assessor-blinded, cross-sectional study included 87 females younger than 25 years: 36 current-PFP, 22 recovered-PFP, and 29 pain-free controls. The primary outcome was conditioned pain modulation (CPM) assessed by increase of cuff pain thresholds during painful cuff conditioning on the contralateral leg. Secondary outcomes included pressure pain thresholds at the knee, shin, and forearm, and temporal summation of pain, assessed by pain intensity recordings on a visual analogue scale during repeated cuff pressure pain stimulations on the leg. Compared with the recovered-PFP, the current-PFP had impaired CPM (mean difference: 11.6%; P = 0.004) and reduced pressure pain thresholds at the knee, shin, and forearm which were also reduced compared to current-PFP (mean difference: 85-225 kPa; P < 0.05). There were no differences between current-PFP and controls in CPM. Current-PFP and recovered-PFP demonstrated facilitated temporal summation of pain, compared to controls (mean difference: 0.7-0.8 visual analogue scale change; P < 0.05). Compared with controls, the recovered-PFP also had reduced pressure pain thresholds at the knee, which were higher than the current-PFP (mean difference: 110-225 kPa; P < 0.05). In conclusion, both current-PFP and recovered-PFP displayed altered pain mechanisms compared to controls with no history of knee pain, despite resolution of symptoms in the recovered-PFP group. The implications of these findings in the recurrent nature of PFP requires further studies.
The Variable Characteristics of Human Papillomavirus in Squamous Cell Carcinoma and Adenocarcinoma of Cervix in China
Authors: Chen Wen , Sun Haikui , Molijn Anco , Zeng Liang , Kang Leni , Jenkins David , Zhang Shaokai , Cui Jianfeng , Wu Zeni , Pirog Edyta , Shen Guihua , Zhang Xun , Qiao Youlin
Published: August 2018

Objective

A hospital-based multicenter, retrospective study was conducted to compare the distribution of human papillomavirus (HPV) in squamous cell carcinoma (SCC) and cervical adenocarcinoma (CADC) in China.

Methods

Paraffin-embedded tissue blocks diagnosed as SCC and CADC across China were collected, as well as the total number of diagnosed invasive cervical cancer of the 9 selected centers. DNA enzyme immunoassay, reverse hybridization, and multiplex type-specific polymerase chain reaction were used for HPV genotyping.

Results

The ratios of CADC to SCC were increasing from 2005 to 2010, in parallel with HPV prevalence in CADC. In 630 patients with SCC (mean ± SD age, 45.40 ± 10.30) and 718 patients with CADC (mean ± SD age, 46.09 ± 10.59) recruited, HPV prevalence rates were 97.6% and 74.5%, respectively. Human papillomavirus viral load for SCC is significantly higher than that for CADC. Most common HPV types distributed in SCC and CADC were HPV-16 (78.5%, 75.1%–81.6%; 47.1%, 42.9%–51.3%), HPV-18 (8.0%, 6.1%–10.4%; 41.1%, 37.0%–45.3%), HPV-52 (2.3%, 1.4%–3.8%; 5.6%, 4.0%–7.9%), and HPV-45 (1.1%, 0.6%–2.3%; 3.9%, 2.6%–5.9%). Different diagnostic mean ± SD age for HPV-16/HPV-18 versus other high-risk HPV types were observed: SCC (44.5 ± 9.94 vs 51.0 ± 10.83, p < .05) and CADC (44.1 ± 9.44 vs 47.4 ± 10.41, p = .006). For HPV-negative cases, mean ± SD age was 46.1 ± 10.73 in SCC and 50.3 ± 11.85 in CADC, which were older than the positive (45.4 ± 10.31, 44.5 ± 9.64). HPV-16 and HPV-18 were the most frequent HPV types in both histological types, and HPV-18 was more frequent in CADC than in SCC.

Conclusions

Human papillomavirus infection was identified more often in SCC than in CADC. Women with HPV-associated cancers, especially HPV-16/HPV-18, were of a younger age at diagnosis when compared with non–HPV-associated cancers.
The role of transjugular intrahepatic portosystemic shunt in the management of portal vein thrombosis: a systematic review and meta-analysis
Authors: Valentin Nelson , Korrapati Praneet , Constantino Joseph , Young Ari , Weisberg Ilan
Published: August 2018

Background

The role of transjugular intrahepatic portosystemic shunt (TIPS) in the management of portal vein thrombosis (PVT) remains controversial. This study aimed to conduct a systematic review and meta-analysis to evaluate the role of TIPS for the management of PVT in adult patients with liver disease.

Patients and methods

Multiple databases were searched through April 2017. Data were gathered to estimate the rates of technical success, portal vein recanalization, portal patency, hepatic encephalopathy, and mean change in portal pressure gradient in patients with PVT who underwent TIPS. Estimates were pooled across studies using the random effects model.

Results

Eighteen studies were included in the analysis. The pooled technical success rate was 86.7% [95% confidence interval (CI)=78.6–92.1%]. Rate of portal vein recanalization was 84.4% (95% CI=78.4–89.0%). The rate of complete recanalization was 73.7% (95% CI=64.3–81.3%). Portal patency was 86.9% (95% CI=79.7–91.8%). Mean change in portal pressure gradient was 14.5 mmHg (95% CI=11.3–17.7 mmHg). Hepatic encephalopathy was 25.3% (95% CI=19.2–32.6%). The number of major adverse events reported across studies was low. The majority of the analyses were not associated with substantial heterogeneity.

Conclusion

The use of TIPS in the management of PVT is feasible and effective in achieving a significant and sustainable reduction in clot burden with a low risk of major complications. TIPS should be considered as a viable treatment option in patients with PVT. Given the limited amount of randomized comparative studies reported, additional trials are warranted to assess the safety and efficacy of TIPS as a treatment modality in PVT, in comparison to other treatment options, such as anticoagulation.
Crohn’s and Colitis Foundation of America Partners Patient-Powered Research Network
Authors: Chung Arlene E. , Vu Maihan B. , Myers Kelly , Burris Jessica , Kappelman Michael D.
Published: August 2018

Background:

To build a Patient-Powered Research Networks (PPRN) that prioritizes the needs of its members who have inflammatory bowel diseases (IBD), we sought to better understand patients’ preferences for what are the essential features that will facilitate and sustain engagement.

Methods:

We conducted a two-phase qualitative study. Seven focus groups involving 62 participants with IBD were conducted (phase 1). Focus group results informed the phase 2 cognitive interviews, which included 13 phone interviews. Topics included experiences with IBD and research, PPRN engagement, patient-generated health data, and resources/tools to facilitate self-management. All focus groups and interviews were digitally recorded, transcribed verbatim, and analyzed in ATLAS.ti 7.5. Thematic categories were derived from the data, and codes were grouped into emergent themes and relationships.

Results:

Four major themes emerged through inductive coding: (1) the impact of knowing; (2) participation barriers and challenges; (3) engagement and collaboration; and (4) customizable patient portal features/functionalities. Participants were motivated to participate in the PPRN because the knowledge gained from research studies would benefit both society and the individual. Main concerns included credibility of online resources, pharmaceutical industry profiting from their data, data security, and participation expectations. Participants wanted a true and equal partnership in every phase of building a PPRN. Participants felt it was important to have access to personal health records and be able to track health status and symptoms.

Conclusion:

Partnering with participants throughout PPRN development was critical to understanding the needs and preferences of patients with IBDs and for shaping engagement strategies and the portal’s design.
MoodNetwork
Authors: Sylvia Louisa G. , Hearing Casey M. , Montana Rebecca E. , Gold Alexandra K. , Walsh Samantha L. , Janos Jessica A. , Tovey Roberta E. , Deckersbach Thilo , Nierenberg Andrew A.
Published: August 2018

Introduction:

Research has often been viewed as a passive process by which participants enroll in studies developed by researchers. It is becoming clearer that to understand the nuances of mood episodes and how to prevent them, we need to conduct large clinical trials that have the power to investigate moderators and mediators, or catalysts and mechanisms of change. MoodNetwork, the first online, patient-centered research community for individuals with mood disorders, aims to change the way that traditional research has been conducted by involving patients, their caregivers, and advocates in the process of research. The aim of this report is to share lessons learned from developing MoodNetwork.

Methods:

Participants enroll by completing a demographic survey and consent form. Once enrolled, participants are encouraged to complete optional surveys about their mood disorders and areas of research priority. Stakeholder and advocacy partners developed the website, web-based surveys, and recruitment materials.

Results:

MoodNetwork has enrolled 4103 participants to date. Of this sample, 96.9% report experiencing depression and 79.7% endorse symptoms of mania or hypomania. Participants rated reducing stigma and alleviating symptoms as their 2 largest research priorities. Recruitment has been slower than expected. Recruiting a diverse sample has been challenging, and this impacts the Network’s ability to conduct comparative effectiveness research studies.

Discussion:

We discuss lessons learned from recruiting individuals with mood disorders to MoodNetwork, an innovative approach to conducting clinical trials. We identify and review 5 strategies for increasing enrollment as well as future directions.
A Novel Stakeholder Engagement Approach for Patient-centered Outcomes Research
Authors: Kim Katherine K. , Khodyakov Dmitry , Marie Kate , Taras Howard , Meeker Daniella , Campos Hugo O. , Ohno-Machado Lucila
Published: August 2018

Introduction/Objectives:

The engagement of patients and other stakeholders is a critical element in the design of patient-centered outcomes research studies. However, methodology for scalable engagement in research management particularly activities such as operationalization of principles and setting of priorities is not well-developed. The objective of this study is to describe a novel approach for scalable stakeholder engagement in research aligned with the Patient-Centered Outcomes Research Institute (PCORI) engagement principles, which was evaluated in a national clinical data research network.

Materials and Methods:

Patient, patient advocate, clinician, and researcher stakeholders were recruited from clinical sites, as well as social media sites related to the 3 conditions of focus, heart failure, obesity, and Kawasaki disease. The engagement strategy was designed, implemented, and mapped to the PCORI engagement principles. Evaluation included internal assessment and quantitative measures of online engagement.

Results:

We operationalized the PCORI principles with 12 stakeholder engagement strategies and convened stakeholder advisory boards and online research prioritization panels to determine research priorities in a rigorous, deliberative process. A total of 46 advisors (20 patients) and 339 panelists (159 patients) actively participated. There were not significant differences between patients and clinicians in level of online engagement. Nonetheless, while patients reported a slightly greater challenge with following online discussion, they overall had a more favorable opinion about use of the online format.

Discussion/Conclusion:

An efficient way to engage large numbers of representative stakeholders in research is a necessary first step to assure the public of trustworthy use of data networks for health research. This paper describes a comprehensive approach to engagement in patient-centered outcomes research management that informs ongoing development of rigorous methodologies in this area.