bluuebunny/crossref_metadata_2025 huggingface dataset:
Streamwise vortex breakdown in supersonic flows
Authors: Hiejima Toshihiko
Published: May 2017

Transition processes in supersonic streamwise vortices with wake flows are numerically simulated for Mach numbers from 1.5 to 5.0. This paper discusses the effect of an axial velocity deficit on the breakdown for a fixed small swirl number. For the evolution of the linear unstable mode at Mach 2.5, although the linear-growth range is short, the eigenfunction profiles of the mode resolved from a numerical simulation are generally consistent with those obtained from the linear stability analysis. For the discovery of the supersonic vortex breakdown, when the deficits are large within Mach number 2.5, spiral breakdowns occur with the azimuthal wavenumber |m| = 1. This suggests that there might be a correlation between the breakdown and absolute instability not only in subsonic but also in supersonic flows. As a means of determining when this breakdown will occur, this study proves under the condition of compressible flows that such a spiral breakdown occurs where the integrated enstrophy in a plane perpendicular to the axial flow is close to a maximum in the streamwise variation. Ultimately, this study found that the axial velocity on the vortex axis increases in shock-free supersonic vortex breakdowns; thus, there is no stagnation point and the breakdown configuration is only of a spiral type. The features for this breakdown are quite different from those of subsonic breakdowns, as they only depend on the swirl intensity.
Communication: Mean-field theory of water-water correlations in electrolyte solutions
Authors: Wilkins David M. , Manolopoulos David E. , Roke Sylvie , Ceriotti Michele
Published: May 2017

Long-range ion induced water-water correlations were recently observed in femtosecond elastic second harmonic scattering experiments of electrolyte solutions. To further the qualitative understanding of these correlations, we derive an analytical expression that quantifies ion induced dipole-dipole correlations in a non-interacting gas of dipoles. This model is a logical extension of the Debye-Hückel theory that can be used to qualitatively understand how the combined electric field of the ions induces correlations in the orientational distributions of the water molecules in an aqueous solution. The model agrees with the results from molecular dynamics simulations and provides an important starting point for further theoretical work.
Enhanced electrohydrodynamic force generation in a two-stroke cycle dielectric-barrier-discharge plasma actuator
Authors: Sato Shintaro , Takahashi Masayuki , Ohnishi Naofumi
Published: May 2017

An approach for electrohydrodynamic (EHD) force production is proposed with a focus on a charge cycle on a dielectric surface. The cycle, consisting of positive-charging and neutralizing strokes, is completely different from the conventional methodology, which involves a negative-charging stroke, in that the dielectric surface charge is constantly positive. The two-stroke charge cycle is realized by applying a DC voltage combined with repetitive pulses. Simulation results indicate that the negative pulse eliminates the surface charge accumulated during constant voltage phase, resulting in repetitive EHD force generation. The time-averaged EHD force increases almost linearly with increasing repetitive pulse frequency and becomes one order of magnitude larger than that driven by the sinusoidal voltage, which has the same peak-to-peak voltage.
Improved on-state performance of AlGaN/GaN Fin-HEMTs by reducing the length of the nanochannel
Authors: Zhang Meng , Ma Xiao-Hua , Mi Min-Han , He Yun-Long , Hou Bin , Zheng Jia-Xin , Zhu Qing , Chen Li-Xiang , Zhang Peng , Yang Ling
Published: May 2017

In this letter, AlGaN/GaN Fin-HEMTs with different nanochannel geometric parameters were fabricated and characterized. The drain current density, transconductance, and on-resistance were improved by reducing the length of the nanochannel, which was attributed to the modulation of access resistance by changing the length of the nanochannel. The threshold voltage shifted to the positive direction with the decrease in the width of the nanochannel and showed the independence on the length of the nanochannel. With the reduction in the length of the nanochannel, the gate swing was increased by suppressing the increase of source resistance, improving the linearity of transconductance.
THE GEOLOGICAL AND STRUCTURAL FRAMEWORK OF THE OFFSHORE KIMBERLEY BLOCK (BROWSE BASIN) AREA, WESTERN AUSTRALIA
Authors: Halse J. W. , Hayes J. D.
Published: May 2017

The Offshore Kimberley Block area is mainly held under petroleum exploration permit by a group of companies of which B.O.C. of Australia Ltd. is operator. Exploration activities of the Group have shown the area to be a distinctive and separate major sedimentary basin, which it is proposed to term the Browse Basin. The basin is separated from the Bonaparte Gulf Basin in the north by the Londonderry Arch, and from the Offshore Canning Basin to the south by the Leveque Platform. It covers an area of over 60,000 square miles.
The economic value to dairy systems of genetic gains in the nutritive value of perennial ryegrass in grass–clover pastures
Authors: Wims C. M. , Ludemann C. I. , Phillips H. , Chapman D. F.
Published: May 2017

Perennial ryegrass (Lolium perenne L.) breeding efforts have focussed on improving pasture nutritive value by altering flowering behaviour and increasing ploidy. However, the gains in farm profitability that this has delivered are not known. The flowering behaviour, botanical composition and nutritive value of pastures based on 24 perennial ryegrass cultivar–endophyte combinations released in New Zealand since 1970 were compared under grazing for 3 years in the Waikato region of New Zealand. Cultivars were grouped into the following three functional groups for data analysis: mid-season-heading diploids, late- and very late-heading diploids, and late- and very late-heading tetraploids. The first of these groups included older, ‘standard’ cultivars, while the latter two groups were dominated by cultivars released since 2002. The appearance of reproductive tillers in grazed pastures was delayed by 4–8 weeks for the late- and very late-heading cultivars, resulting in pastures that maintained a greater proportion of green leaf and had a greater metabolisable energy (ME) concentration during spring. Tetraploid pastures had a greater ME concentration than did diploid pastures, largely due to the greater ME concentration of the perennial ryegrass component of these pastures. The gains in pasture nutritive value achieved by broadening the range of perennial ryegrass functional types have the potential to deliver economic benefits in the range of NZ$54/ha.year (late-heading diploids compared with mid-heading diploids) to NZ$232/ha.year (tetraploids compared with mid-heading diploids) to New Zealand dairy farmers. Potential economic gains can be diminished by changes in pasture botanical composition both over time and between functional groups.
Functional genomics in
Brugia malayi
reveal diverse muscle nAChRs and differences between cholinergic anthelmintics
Authors: Verma Saurabh , Kashyap Sudhanva Srinivas , Robertson Alan Patrick , Martin Richard John
Published: May 2017

Significance

Methods for studying functional genomics of ion-channel target sites of antinematodal drugs (anthelmintics) have been limited to the model nematode
Caenorhabditis elegans
because many techniques for studying animal parasitic nematodes have been unsuccessful. Here, we develop preparations of the human parasite
Brugia malayi,
which causes elephantiasis, to allow us to combine RNAi, PCR amplification of RNA from single muscle cells, computer analysis of movement, and patch-clamp electrophysiology to study the action of cholinergic anthelmintics. We find that they are not a homogenous class of drugs and that they act selectively on four distinguishable,
M-
,
L-
,
P-
, and
N-
acetylcholine ion-channel receptors. These four receptors are distinct druggable targets with different physiological functions.
Cap-binding protein 4EHP effects translation silencing by microRNAs
Authors: Chapat Clément , Jafarnejad Seyed Mehdi , Matta-Camacho Edna , Hesketh Geoffrey G. , Gelbart Idit A. , Attig Jan , Gkogkas Christos G. , Alain Tommy , Stern-Ginossar Noam , Fabian Marc R. , Gingras Anne-Claude , Duchaine Thomas F. , Sonenberg Nahum
Published: May 2017

Significance

miRNAs are important components of gene regulatory networks and affect all aspects of cell biology by controlling the stability and translation efficiency of their target mRNAs. Here, we identified the mRNA cap-binding eIF4E-related protein 4EHP as an effector of miRNA-mediated translation repression. Through screening for protein interactions in cells via the BioID method, we identified 4EHP as a component of the CCR4–NOT/DDX6/4E-T axis. Direct interaction between 4E-T and 4EHP increases the latter’s cap-binding affinity, suggesting that this interaction potentiates its competition with the eIF4F complex for binding to the mRNA 5′ cap. Our findings suggest that 4EHP facilitates the formation of a closed-loop structure between the 3′ UTR of the mRNA and its 5′ cap, which causes repression of mRNA translation.
Single-crystal
I

h

ice surfaces unveil connection between macroscopic and molecular structure
Authors: Brumberg Alexandra , Hammonds Kevin , Baker Ian , Backus Ellen H. G. , Bisson Patrick J. , Bonn Mischa , Daghlian Charles P. , Mezger Markus , Shultz Mary Jane
Published: May 2017

Significance

Ice surface molecular structures determine reactions and interactions on ice. Observation of macroscopic (etch pit) and microscopic (electron backscatter diffraction orientation density function) images definitively shows the molecular-level termination and the layer structure. Identification of the molecular-level structure enables a statistical model that accounts for observation of contrasting growth from the vapor and growth from the liquid. At the solid–vapor interface, the surface is dominated by primary prism and basal faces. In contrast, the secondary prism face dominates at the solid–liquid interface. A statistical model suggests a basis for this contrast: growth at the liquid–solid interface is enthalpically driven, whereas poor thermal transport in the vapor suppresses growth of the secondary prism face.
Substrate effect on electrodeposited copper morphology and crystal shapes
Authors: Banthia Swastika , Sengupta Srijan , Mallik Manila , Das Siddhartha , Das Karabi
Published: May 2017

Copper has been electrodeposited on copper (FCC) and mild steel (BCC) substrates from acidic sulphate bath with and without cetyl trimethyl ammonium bromide at 0.25, 2, 6 and 9 V. It is found that the surface morphology varies with the change in overpotential, but not with the change in substrate. On the contrary, the crystal shape is found to be independent of the applied overpotential, but varies with the bath chemistry or choice of substrate.
Bilateral comparison of 10 pF and 100 pF standards (ongoing BIPM key comparisons BIPM.EM-K14.a and 14.b) between the NIS (Egypt) and the BIPM
Authors: Gournay Pierre , Helmy M , Raouf A , Hamed Heba A M , Gad A Eliwa
Published: May 2017

This report presents the results of a bilateral comparison of 10 pF and 100 pF capacitance standards between the NIS (Egypt) and the BIPM carried out in 2016. The comparison at 10 pF forms part of the ongoing BIPM key comparison BIPM.EM-K14.a and that at 100 pF of the ongoing BIPM key comparison BIPM.EM-K14.b. The BIPM is the pilot laboratory for both of these comparisons.

Two 10 pF and 100 pF travelling standards belonging to the BIPM were used in this comparison carried out with an 'A-B-A' pattern of measurements. The standards were measured first at the BIPM for a period of about one month, then for a similar period at the NIS, and finally again at the BIPM. The measurand was the two terminal-pair capacitance at a frequency of either 1000 Hz or 1592 Hz, for a measuring rms voltage of 15 V at 10 pF and 10 V at 100 pF.

One of the 10 pF travelling standards had to be eliminated from the comparison due to a bistable behaviour, possibly due to transportation.

The results from the NIS and the BIPM at both 1000 Hz and 1592 Hz were found to be in good agreement, with a difference smaller than the relative expanded uncertainty (95 % confidence, k = 2) of about 0.72 × 10-6 at 10 pF and about 0.65 × 10-6 at 100 pF.

Main text

To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.

The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
Bilateral comparison of 100 pF standards (ongoing BIPM key comparison BIPM.EM-K14.b) between the NSAI-NML (Ireland) and the BIPM
Authors: Gournay Pierre , Power Oliver
Published: May 2017

This report presents the results of a bilateral comparison of capacitance at 100 pF between the NSAI-NML (Ireland) and the BIPM carried out in 2016. This comparison forms part of the ongoing BIPM key comparison BIPM.EM-K14.b in which the BIPM is the pilot laboratory.

Two 100 pF travelling standards belonging to the BIPM were used in this comparison carried out with an 'A-B-A' pattern of measurements. The standards were measured first at the BIPM for a period of about one month, then for a similar period at the NSAI-NML, and finally again at the BIPM. The measurand was the two terminal-pair capacitance at a frequency of 1000 Hz, for a measuring rms voltage of 15 V.

The results from the NSAI-NML and the BIPM were found to be in relatively good agreement, with a difference smaller than the relative expanded uncertainty (95 % confidence, k = 2) of 0.85 × 10-6.

Main text

To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.

The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
Bilateral comparison of 10 pF and 100 pF standards (ongoing BIPM key comparisons BIPM.EM-K14.a and 14.b) between the NMISA (South Africa) and the BIPM
Authors: Gournay Pierre , Khoza Michael
Published: May 2017

This report presents the results of a bilateral comparison of 10 pF and 100 pF capacitance standards between the NMISA (South Africa) and the BIPM carried out in 2016. The comparison at 10 pF forms part of the ongoing BIPM key comparison BIPM.EM-K14.a and that at 100 pF of the ongoing BIPM key comparison BIPM.EM-K14.b. The BIPM is the pilot laboratory for both of these comparisons.

Two 10 pF and 100 pF travelling standards belonging to the BIPM were used in this comparison carried out with an 'A-B-A' pattern of measurements. The standards were measured first at the BIPM for a period of about one month, then for a similar period at the NMISA, and finally again at the BIPM. The measurand was the two terminal-pair capacitance at a frequency of either 1000 Hz or 1592 Hz, for a measuring rms voltage of 15 V at 10 pF and 10 V at 100 pF.

One of the 10 pF travelling standards had to be eliminated from the comparison due to a bistable behaviour, possibly due to transportation.

The results from the NMISA and the BIPM at both 1000 Hz and 1592 Hz were found to be in good agreement, with a difference smaller than the relative expanded uncertainty (95 % confidence, k = 2) of maximum value 0.33 × 10-6 at 10 pF and 0.24 × 10-6 at 100 pF (and 1000 Hz in both cases).

Main text

To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.

The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
Recent computational developments on CLIP-seq data analysis and microRNA targeting implications
Authors: Bottini Silvia , Pratella David , Grandjean Valerie , Repetto Emanuela , Trabucchi Michele
Published: May 2017

Cross-Linking Immunoprecipitation associated to high-throughput sequencing (CLIP-seq) is a technique used to identify RNA directly bound to RNA-binding proteins across the entire transcriptome in cell or tissue samples. Recent technological and computational advances permit the analysis of many CLIP-seq samples simultaneously, allowing us to reveal the comprehensive network of RNA–protein interaction and to integrate it to other genome-wide analyses. Therefore, the design and quality management of the CLIP-seq analyses are of critical importance to extract clean and biological meaningful information from CLIP-seq experiments. The application of CLIP-seq technique to Argonaute 2 (Ago2) protein, the main component of the microRNA (miRNA)-induced silencing complex, reveals the direct binding sites of miRNAs, thus providing insightful information about the role played by miRNA(s). In this review, we summarize and discuss the most recent computational methods for CLIP-seq analysis, and discuss their impact on Ago2/miRNA-binding site identification and prediction with a regard toward human pathologies.
POSSUM: a bioinformatics toolkit for generating numerical sequence feature descriptors based on PSSM profiles
Authors: Wang Jiawei , Yang Bingjiao , Revote Jerico , Leier André , Marquez-Lago Tatiana T , Webb Geoffrey , Song Jiangning , Chou Kuo-Chen , Lithgow Trevor
Published: May 2017

Evolutionary information in the form of a Position-Specific Scoring Matrix (PSSM) is a widely used and highly informative representation of protein sequences. Accordingly, PSSM-based feature descriptors have been successfully applied to improve the performance of various predictors of protein attributes. Even though a number of algorithms have been proposed in previous studies, there is currently no universal web server or toolkit available for generating this wide variety of descriptors. Here, we present POSSUM (Position-Specific Scoring matrix-based feature generator for machine learning), a versatile toolkit with an online web server that can generate 21 types of PSSM-based feature descriptors, thereby addressing a crucial need for bioinformaticians and computational biologists. We envisage that this comprehensive toolkit will be widely used as a powerful tool to facilitate feature extraction, selection, and benchmarking of machine learning-based models, thereby contributing to a more effective analysis and modeling pipeline for bioinformatics research.

Availability and implementation

http://possum.erc.monash.edu/.

Supplementary information

Supplementary data are available at Bioinformatics online.
PROXiMATE: a database of mutant protein–protein complex thermodynamics and kinetics
Authors: Jemimah Sherlyn , Yugandhar K , Michael Gromiha M
Published: May 2017

We have developed PROXiMATE, a database of thermodynamic data for more than 6000 missense mutations in 174 heterodimeric protein–protein complexes, supplemented with interaction network data from STRING database, solvent accessibility, sequence, structural and functional information, experimental conditions and literature information. Additional features include complex structure visualization, search and display options, download options and a provision for users to upload their data.

Availability and implementation

The database is freely available at http://www.iitm.ac.in/bioinfo/PROXiMATE/. The website is implemented in Python, and supports recent versions of major browsers such as IE10, Firefox, Chrome and Opera.

Supplementary information

Supplementary data are available at Bioinformatics online.
Mining 100 million notes to find homelessness and adverse childhood experiences: 2 case studies of rare and severe social determinants of health in electronic health records
Authors: Bejan Cosmin A , Angiolillo John , Conway Douglas , Nash Robertson , Shirey-Rice Jana K , Lipworth Loren , Cronin Robert M , Pulley Jill , Kripalani Sunil , Barkin Shari , Johnson Kevin B , Denny Joshua C
Published: May 2017

Objective

Understanding how to identify the social determinants of health from electronic health records (EHRs) could provide important insights to understand health or disease outcomes. We developed a methodology to capture 2 rare and severe social determinants of health, homelessness and adverse childhood experiences (ACEs), from a large EHR repository.

Materials and Methods

We first constructed lexicons to capture homelessness and ACE phenotypic profiles. We employed word2vec and lexical associations to mine homelessness-related words. Next, using relevance feedback, we refined the 2 profiles with iterative searches over 100 million notes from the Vanderbilt EHR. Seven assessors manually reviewed the top-ranked results of 2544 patient visits relevant for homelessness and 1000 patients relevant for ACE.

Results

word2vec yielded better performance (area under the precision-recall curve [AUPRC] of 0.94) than lexical associations (AUPRC = 0.83) for extracting homelessness-related words. A comparative study of searches for the 2 phenotypes revealed a higher performance achieved for homelessness (AUPRC = 0.95) than ACE (AUPRC = 0.79). A temporal analysis of the homeless population showed that the majority experienced chronic homelessness. Most ACE patients suffered sexual (70%) and/or physical (50.6%) abuse, with the top-ranked abuser keywords being “father” (21.8%) and “mother” (15.4%). Top prevalent associated conditions for homeless patients were lack of housing (62.8%) and tobacco use disorder (61.5%), while for ACE patients it was mental disorders (36.6%–47.6%).

Conclusion

We provide an efficient solution for mining homelessness and ACE information from EHRs, which can facilitate large clinical and genetic studies of these social determinants of health.
Basilar Artery Ectasia Causing Trigeminal Neuralgia: An Evolved Technique of Transpositional Suture-Pexy
Authors: Singh Harminder , da Silva Harley Brito , Zeinalizadeh Mehdi , Elarjani Turki , Straus David , Sekhar Laligam N
Published: May 2017

BACKGROUND

Microvascular decompression for patients with trigeminal neuralgia (TGN) is widely accepted as one of the modalities of treatment. The standard approach has been retrosigmoid suboccipital craniotomy with placement of a Teflon pledget to cushion the trigeminal nerve from the offending artery, or cauterize and divide the offending vein(s). However, in cases of severe compression caused by a large artery, the standard decompression technique may not be effective.

OBJECTIVE

To describe a unique technique of vasculopexy of the ectatic basilar artery to the tentorium in a patient with TGN attributed to a severely ectatic and tortuous basilar artery. A case series of patients who underwent this technique of vasculopexy for arterial compression is presented.

METHODS

The patient underwent a subtemporal transtentorial approach and the basilar artery was mobilized away from the trigeminal nerve. A suture was then passed through the wall of the basilar artery (tunica media) and secured to the tentorial edge, to keep the artery away from the nerve.

RESULTS

The neuralgia was promptly relieved after the operation, with no complications. A postoperative magnetic resonance imaging scan showed the basilar artery to be away from the trigeminal root. In a series of 7 patients who underwent this technique of vasculopexy, no arterial complications were noted at short- or long-term follow-up.

CONCLUSION

Repositioning and vasculopexy of an ectatic basilar artery for the treatment of TGN is safe and effective. This technique can also be used for other neuropathies that result from direct arterial compression.
Cannabis for the Treatment of Chronic Pain in the Era of an Opioid Epidemic: A Symposium-Based Review of Sociomedical Science
Authors: Maher Dermot P , Carr Daniel B , Hill Kevin , McGeeney Brian , Weed Valerie , Jackson William C , DiBenedetto David J , Moriarty Edward M , Kulich Ronald J
Published: May 2017

Objective

This manuscript reviews medical literature published pertaining to the management of chronic pain with medical marijuana therapy (MMJ), with an emphasis on the social, medical, and legal aspects of therapy.

Design

Narrative review of peer-reviewed literature.

Methods

The 3rd Symposium on Controlled Substances and Their Alternatives for the Treatment of Pain was held in Boston on February 27, 2016, with a focus on MMJ for the treatment of chronic pain. Invited speakers had diverse backgrounds, including pain management, addiction psychiatry, neurology, and legal authorities. The purpose of this conference and this subsequent narrative review is to provide a medical, legal, and logistical framework for physicians and other health care providers to refer to when considering the initiation of medical marijuana therapy.

Results

The invited speakers each covered a unique aspect of MMJ therapy for the treatment of chronic pain. These presentations highlighted the current data for and against the use of MMJ as a pain therapy. Optimal patient selection and screening, in addition to policy developments, were discussed.

Conclusions

Increasing interest in MMJ for chronic pain underscores a need for primary care and pain physicians to better understand the indications and evidence for its use free from cultural bias. Given a lack of full conclusive clinical utility, continued research is needed to better understand how to best utilize MMJ therapy for the treatment of chronic pain. Policy initiatives, such as enumerated indications, should follow medical science in order to prevent another abused substance epidemic.
‘Candidatus Liberibacter asiaticus’ Encodes a Functional Salicylic Acid (SA) Hydroxylase That Degrades SA to Suppress Plant Defenses
Authors: Li Jinyun , Pang Zhiqian , Trivedi Pankaj , Zhou Xiaofeng , Ying Xiaobao , Jia Hongge , Wang Nian
Published: May 2017

Pathogens from the fastidious, phloem-restricted ‘Candidatus Liberibacter’ species cause the devastating Huanglongbing (HLB) disease in citrus worldwide and cause diseases on many solanaceous crops and plants in the Apiaceae family. However, little is known about the pathogenic mechanisms due to the difficulty in culturing the corresponding ‘Ca. Liberibacter’ species. Here, we report that the citrus HLB pathogen ‘Ca. L. asiaticus’ uses an active salicylate hydroxylase SahA to degrade salicylic acid (SA) and suppress plant defenses. Purified SahA protein displays strong enzymatic activity to degrade SA and its derivatives. Overexpression of SahA in transgenic tobacco plants abolishes SA accumulation and hypersensitive response (HR) induced by nonhost pathogen infection. By degrading SA, ‘Ca. L. asiaticus’ not only enhances the susceptibility of citrus plants to both nonpathogenic and pathogenic Xanthomonas citri but also attenuates the responses of citrus plants to exogenous SA. In addition, foliar spraying of 2,1,3-benzothiadiazole and 2,6-dichloroisonicotinic acid, SA functional analogs not degradable by SahA, displays comparable (and even better) effectiveness with SA in suppressing ‘Ca. L. asiaticus’ population growth and HLB disease progression in infected citrus trees under field conditions. This study demonstrates one or more pathogens suppress plant defenses by degrading SA and establish clues for developing novel SA derivatives-based management approaches to control the associated plant diseases.
Pediatric Resident Academic Projects While on Global Health Electives: Ten Years of Experience at the University of Minnesota
Authors: Pitt Michael B. , Slusher Tina M. , Howard Cynthia R. , Cole Valerie B. , Gladding Sophia P.
Published: May 2017

Purpose

Many residency programs require residents to complete an academic project as part of a global health (GH) elective. However, there has been little description of the range of projects residents have pursued during GH electives or the extent to which these projects are consistent with proposed best practices.

Method

The authors conducted a document review of 67 written summaries or copies of presentations of academic projects (hereafter, summaries) completed by pediatric and medicine–pediatric residents at the University of Minnesota while on GH electives from 2005 to 2015. Two authors independently coded each summary for the type of project completed; when the project idea was generated; explicit mention of a mentor from the home institution, host institution, or both; whether a needs assessment was conducted; and whether there were plans for sustainability.

Results

Most of the 67 projects were categorized into one of three project types: quality/process improvement (28 [42%]), education (18 [27%]), or clinical research (14 [21%]). Most summaries explicitly mentioned a mentor (45 [67%]), reported conducting a needs assessment (38 [57%]), and indicated sustainability plans (45 [67%]). Of the 42 summaries that indicated the timing of idea generation, 30 (71%) indicated the idea was developed after arriving at the host site.

Conclusions

Residents undertook a wide range of academic projects during GH electives, most commonly quality/process improvement and education projects. The projects were largely aligned with best practices, with most summaries indicating the resident worked with a mentor, conducted a needs assessment, and made plans for sustainability.
General Health Status After Nonoperative Versus Operative Treatment for Acute, Complete Acromioclavicular Joint Dislocation: Results of a Multicenter Randomized Clinical Trial
Authors: Mah Jeffrey M. ,   the Canadian Orthopaedic Trauma Society (COTS)
Published: May 2017

Objective:

To assess the general health status of patients after nonoperative (Non-op) versus operative (OP) treatment for acromioclavicular (AC) joint dislocations.

Design:

Multicenter randomized controlled clinical trial conducted in 11 Canadian trauma centers. A total of 83 patients with acute (≤28 days old), complete (Rockwood grades III, IV, or V) dislocations of the AC joint were included in this study.

Intervention:

Participants were randomized to Non-op treatment or OP treatment with hook plate fixation.

Main Outcome Measures:

Physical and mental health were evaluated using the Short Form-36 version 2 survey at baseline, 6 weeks, 3 months, 6 months, 1 year, and 2 years.

Results:

In the Non-op group, 33 patients had grade III injuries, 3 patients had grade IV injuries, 5 patients had grade V injuries, and the injury grade was unknown for 2 patients. In the OP group, 37 patients had grade III injuries and 3 patients had grade V injuries (no difference in Type IV and V Non-op vs. OP, P = 0.12). Fifty-eight percent of patients in the Non-op group and 63% of patients in the OP group completed the 2-year follow-up. The Non-op group had better physical health scores than the OP group at 3 months after treatment (52.13 vs. 45.75, P < 0.001). There were no significant differences between the physical health scores of the 2 groups at any other point (6 weeks, 45.81 vs. 41.21, P = 0.03; 6 months, 54.50 vs. 51.61, P = 0.02; 1 year, 55.10 vs. 53.96, P = 0.37; 2 years, 55.24 vs. 57.13, P = 0.17). Mental health scores were similar between the Non-op and OP groups at each follow-up interval (6 weeks, 49.29 vs. 51.27, P = 0.49; 3 months, 52.24 vs. 55.84, P = 0.13; 6 months, 54.89 vs. 55.05, P = 0.93; 1 year, 55.35 vs. 56.72, P = 0.35; 2 years, 56.41 vs. 55.43, P = 0.56). In both treatment groups, the preinjury physical and mental health scores were better than published population norms before declining to a level equal to or below the norm after dislocation. Physical health recovered to a level above the norm at 6 months in the Non-op group and 2 years in the OP group. Mental health recovered at 3 months in the OP group and 6 months in the Non-op group.

Conclusions:

Hook plate fixation does not lead to improved general health status compared with Non-op treatment. Presently, there is no definitive evidence that hook plate fixation is superior to Non-op treatment for acute complete AC joint dislocations.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Clinical Experience With IV Angiotensin II Administration: A Systematic Review of Safety
Authors: Busse Laurence W. , Wang Xueyuan Shelly , Chalikonda Divya M. , Finkel Kevin W. , Khanna Ashish K. , Szerlip Harold M. , Yoo David , Dana Sharon L. , Chawla Lakhmir S.
Published: May 2017

Objective:

Angiotensin II is an endogenous hormone with vasopressor and endocrine activities. This is a systematic review of the safety of IV angiotensin II.

Data Sources:

PubMed, Medline, Scopus, and Cochrane.

Study Selection:

Studies in which human subjects received IV angiotensin II were selected whether or not safety was discussed.

Data Extraction:

In total, 18,468 studies were screened by two reviewers and one arbiter. One thousand one hundred twenty-four studies, in which 31,281 participants received angiotensin II (0.5–3,780 ng/kg/min), were selected. Data recorded included number of subjects, comorbidities, angiotensin II dose and duration, pressor effects, other physiologic and side effects, and adverse events.

Data Synthesis:

The most common nonpressor effects included changes in plasma aldosterone, renal function, cardiac variables, and electrolytes. Adverse events were infrequent and included headache, chest pressure, and orthostatic symptoms. The most serious side effects were exacerbation of left ventricular failure in patients with congestive heart failure and bronchoconstriction. One patient with congestive heart failure died from refractory left ventricular failure. Refractory hypotensive shock was fatal in 55 of 115 patients treated with angiotensin II in case studies, cohort studies, and one placebo-controlled study. One healthy subject died after a pressor dose of angiotensin II was infused continuously for 6 days. No other serious adverse events attributable to angiotensin II were reported. Heterogeneity in study design prevented meta-analysis.

Conclusion:

Adverse events associated with angiotensin II were infrequent; however, exacerbation of asthma and congestive heart failure and one fatal cerebral hemorrhage were reported. This systematic review supports the notion that angiotensin II has an acceptable safety profile for use in humans.
EFFICACY OF INTRAVITREAL RANIBIZUMAB INJECTIONS IN THE TREATMENT OF VITREOUS HEMORRHAGE RELATED TO PROLIFERATIVE DIABETIC RETINOPATHY
Authors: Chelala Elias , Nehme Joseph , El Rami Hala , Aoun Roni , Dirani Ali , Fadlallah Ali , Jalkh Alex
Published: May 2017

Purpose:

To investigate the efficacy of intravitreal ranibizumab injections in proliferative diabetic retinopathy associated with vitreous hemorrhage (VH).

Methods:

A prospective study including patients with proliferative diabetic retinopathy who presented with persistent VH. Vitreous hemorrhage was graded into mild, moderate, and severe. Patients were randomized into two groups: the ranibizumab group was treated with intravitreal injections of ranibizumab and the control group was assigned to observation alone. Vitrectomy was performed if there was any aggravation of the VH in patients with mild, moderate, and severe VH or in the absence of improvement by 16 weeks in patients with moderate and severe VH.

Results:

The ranibizumab group included 71 patients and the control group included 62 patients. There was a statistically significant difference in the vitrectomy rate in patients with mild-to-moderate VH (5 patients [7.04%] and 12 patients [19.35%], respectively; P = 0.04). However, there was no statistically significant difference in the overall vitrectomy rate, and in the vitrectomy rate in severe VH (17 [23.94%] and 12 [16.90%] patients in the ranibizumab group vs. 22 [35.48%] and 10 [16.13%] patients in the control group, P = 0.14 and P = 0.83, respectively). Recurrence of the VH occurred in 22 patients in the ranibizumab group and 29 patients in the control group (P = 0.06). Better visual acuity measurements were recorded on all follow-up visits in the ranibizumab group (P ≤ 0.04).

Conclusion:

Intravitreal ranibizumab injections could be considered in proliferative diabetic retinopathy patients with mild and moderate VH.
INTRAVITREAL DEXAMETHASONE (OZURDEX) IMPLANT FOR RADIATION MACULOPATHY SECONDARY TO STEREOTACTIC RADIOTHERAPY FOR POSTERIOR UVEAL MELANOMA
Authors: Koc Irem , Kadayifcilar Sibel , Kiratli Hayyam , Eldem Bora
Published: May 2017

Purpose:

To evaluate the efficacy of 0.7 mg intravitreal dexamethasone implant in the treatment of radiation maculopathy after stereotactic radiotherapy for posterior uveal melanoma.

Methods:

Retrospective chart review of seven eyes of seven consecutive patients was performed. Extracted data included age, sex, initial and follow-up visual acuities and central macular thickness values, intraocular pressure, follow-up time, number of implants, and time elapsed from radiotherapy to implantation. Main outcome measures were visual acuity and central macular thickness. Glaucoma, cataract formation, or systemic side effects, if any, were recorded.

Results:

Female to male ratio was 4:3. Mean age was 49.9 ± 17.0 (range: 27–73). Initial mean visual acuity was 20.4 ± 12.5 Early Treatment Diabetic Retinopathy Study letters and initial central macular thickness measured 514.1 ± 135.1 μm on spectral domain optical coherence tomography. All patients except one showed improvement in visual acuity and a mean improvement of 7.4 ± 6.2 letters was observed in the whole group (range: 0–16). The mean reduction in central macular thickness was 226.7 ± 157.0 μm after a mean 9.1 ± 3.4 months of follow-up. On average, implantation of intravitreal dexamethasone was performed 35.2 ± 16.5 months after radiotherapy. Four patients were treatment naive and three had previous intravitreal bevacizumab injections with limited response. Ozurdex reimplantations were performed in four patients and the mean number of injections was 1.7 ± 0.8. Mean time to reimplantation was 5.0 ± 2.12 months. Only one patient developed posterior subcapsular cataract and all patients had intraocular pressures within normal limits. No systemic side effects were observed.

Conclusion:

In our experience, intravitreal implantation of 0.7 mg dexamethasone is an anatomically, and to a lesser extent functionally effective procedure for radiation maculopathy after stereotactic radiotherapy for posterior uveal melanoma.
OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF CONGENITAL SIMPLE HAMARTOMA OF THE RETINAL PIGMENT EPITHELIUM
Authors: Arjmand Parnian , Elimimian Elizabeth B. , Say Emil A. T. , Shields Carol L.
Published: May 2017

Purpose:

To describe the optical coherence tomography angiography features of congenital simple hamartoma of the retinal pigment epithelium.

Methods:

Case report.

Results:

A 14-year-old boy was referred for an asymptomatic fundus tumor in the left eye. Visual acuity was 20/20 in the right eye and 20/40 in the left eye. The right fundus was normal. The left fundus disclosed a gray-white nodular retinal mass of 2-mm diameter in the juxtafoveal region, protruding into the vitreous cavity and causing radial retinal folds. The mass demonstrated echodensity without calcification on ultrasonography, hypoautofluorescence on short-wavelength autofluorescence, and mixed hyporeflective and hyperreflective areas on near-infrared reflectance imaging. By fluorescein angiography, the mass showed absolute hypofluorescence through the arteriovenous phase and diffuse late hyperfluorescence and staining. Optical coherence tomography revealed an optically dense lesion with abrupt posterior shadowing, whereas optical coherence tomography angiography showed an extensive haphazard intratumoral vascular network with fairly large-caliber (100–200 microns) vessels occupying full-thickness tumor, demonstrating more vascular details than visualized on fluorescein angiography. Serial segmental evaluation of the optical coherence tomography angiography en face images confirmed an intratumoral vascular network for full tumor depth down to retinal pigment epithelium, not related to projection artifact. Final diagnosis was congenital simple hamartoma of the retinal pigment epithelium. Considering the benign tumor, observation was recommended.

Conclusion:

Optical coherence tomography angiography of congenital simple hamartoma of the retinal pigment epithelium revealed an extensive intratumoral, haphazard, large-caliber vascular network, more evident than seen on fluorescein angiography. Optical coherence tomography angiography has added new insight into this rare tumor.
Consequences of Traumatic Brain Injury in Professional American Football Players: A Systematic Review of the Literature
Authors: Vos Bodil C. , Nieuwenhuijsen Karen , Sluiter Judith K.
Published: May 2017

Objective:

The purpose of this study was to systematically review the literature for the consequences Traumatic brain injury (TBI) has on cognitive, psychological, physical, and sports-related functioning in professional American Football players.

Data Sources:

We performed a systematic search in 2 databases, PubMed and SPORTDiscus, to obtain literature from January 1990 to January 2015. To be eligible for inclusion, a study had to examine the relationship between TBI and the consequences for several aspects of functioning in professional American football players older than 18 years. Methodological quality was assessed using a 5-item checklist which assessed selection bias, information bias, and correct reporting of the population and exposure characteristics.

Main Results:

The search yielded 21 studies that met our inclusion criteria. An evidence synthesis was performed on the extracted data and resulted in 5 levels of evidence. The evidence synthesis revealed that there is strong evidence that concussions are associated with late-life depression and short-term physical dysfunctions. Evidence for the relationship between concussion and impaired sports-related function, prolonged reaction time, memory impairment, and visual-motor speed was inconclusive. Moderate evidence was found for the association between TBI and mild cognitive impairment (MCI), and limited evidence was found for the association between TBI and executive dysfunction.

Conclusions:

There is strong evidence that a history of concussion in American football players is associated with depression later in life and short-term physical dysfunctions. Also cognitive dysfunctions such as MCI are seen in older players with a history of TBI. These results provide input for actions to prevent TBI and their consequences in (retired) American football players.
Motivated Strategies for Learning in Accelerated Second-Degree Nursing Students
Authors: El-Banna Majeda M. , Tebbenhoff Billinda , Whitlow Malinda , Wyche Karen Fraser
Published: May 2017

Students in a second-degree accelerated BSN program experience a rigorous curriculum and fast-paced introduction to the nursing profession. This study examined the relationships among self-esteem, motivation, learning strategies, demographic characteristics, and academic achievement. The results indicated that all of the students had good self-esteem; some demographic characteristics influenced the type of motivation and learning strategies they endorsed but did not influence their current academic performance.
The Yellow Fever Vaccine Misadventure of 1942
Authors: Marr John S. , Cathey John T.
Published: May 2017

In 1942, a hepatitis B outbreak occurred in the US Army after vaccination with contaminated lots of 17D yellow fever vaccine; long-term sequelae were surprisingly limited, and retrospective studies of carrier rates, cirrhosis, and hepatocellular carcinoma were found to be minimal. Later studies identified the contaminant as hepatitis B virus (HBV) in the human serum component of the vaccine. Other than 2 follow-up studies of long-term sequelae and reports within US Military archives, the event has never been fully elucidated in its proper historical context in the medical literature available through MEDLINE (PubMed). The outbreak resulted in nearly 50 000 clinical cases, including 29 000 cases of overt jaundice. More than 300 000 troops may have been infected with HBV. The decision to immunize troops received criticism, but the decision may have been reasonable, given the exigencies of an impending war and the possibility that yellow fever could spread to future theaters of war. The epidemic was the largest and most well-documented vaccine-related epidemic in history. Today, independent of war, globalization has actually increased the likelihood of yellow fever importations to vulnerable areas of the world.
Drivers and Barriers for Adopting Accreditation at Local Health Departments for Their Performance Improvement Effort
Authors: Liu Sandra S. , Meyerson Beth , King Jerry , Yih Yuehwern , Ostovari Mina
Published: May 2017

Context:

A national system of voluntary public health accreditation for state, local, and tribal health departments (local health departments [LHDs]) is part of a movement that aims to improve public health performance with ultimate impact on population health outcomes. Indiana is a good setting for the study of LHD accreditation adoption because several LHDs reported de-adopting accreditation in a recent statewide survey and because 71% of Indiana counties serve populations of 50 000 or less.

Design:

A systematic method of analyzing qualitative data based on the Performance Improvement Model framework to expand our understanding of de-adoption of public health accreditation.

Setting/Participants:

In 2015, we conducted a key informant interview study of the 3 LHDs that decided to delay their engagement in the accreditation based on findings from an Indiana survey on LHD accreditation adoption. The study is an exploration of LHD accreditation de-adoption and of the contributions made to its understanding by the Performance Improvement Model.

Result:

The study found that top management team members are those who champion accreditation adoption, and that organizational structure and culture facilitate the staff's embracing of the change. The Performance Improvement Model was found to enhance the elucidation of the inner domain elements of Consolidated Framework for Implementation Research in the context of de-adoption of public health accreditation.

Conclusion:

Governing entities' policies and priorities appear to mediate whether the LHDs are able to continue accreditation pursuit. Lacking any of these driving forces appears to be associated with decisions to de-adoption of accreditation. Further work is necessary to discern specific elements mediating decisions to pursue accreditation. This study demonstrates the added knowledge of Performance Improvement Model (PIM) to the CFIR framework. A large scale study is called to further clarify and discern supports of specific to the needs of individual LHDs for their performance improvement effort.
The Disease of the Italian Poet Giacomo Leopardi (1798–1837)
Authors: Sganzerla Erik Pietro , Riva Michele Augusto
Published: May 2017

Some authors sustained that the pessimistic thought of the Italian writer and philosopher Giacomo Leopardi (1798–1837) may be attributed to his unhappy life, characterized by several health problems. His philosophical theories appear as the result of depressive and melancholic state, related to his precarious health conditions, so limiting their intrinsic values. Several authors formulated various hypotheses on the diseases that Leopardi suffered from and postulated different theories on the cause of his early death. This article assumed that Leopardi may have been affected by juvenile ankylosing spondylitis, conditioning spinal deformities, relapsing-remitting uveitis, urinary tract and bowel tract problems, and acute arthritis. Chest deformity, as a complication of juvenile ankylosing spondylitis, may have caused progressive cardiorespiratory failure, worsened by recurrent bronchial and pulmonary complications, until his death caused by acute right ventricular heart failure. The acknowledgment of a physical cause of Leopardi’s disease contributes to reevaluate his “cosmic pessimism” as an original expression of his thought, so leading a general revaluation of the figure of one of the most important European thinkers of the 19th century.