bluuebunny/crossref_metadata_2025 huggingface dataset:
Ageing behaviour of a polyethylene blend: influence of chemical defects and morphology on charge transport
Authors: Tantipattarakul Somyot , Vaughan Alun S. , Andritsch Thomas
Published: February 2020

The properties of novel cable insulation systems will rely critically upon the morphology of the material. Here, a blend of high and low‐density polyethylene (PE) was processed in order to generate three sets of samples with different morphologies. The influence of thermo‐oxidative ageing at 120°C was then considered. The resulting chemical changes included the introduction of unsaturation and oxygen‐containing groups and were determined by antioxidant consumption and oxygen permeability. Such chemical defects were found to be concentrated in the fraction of each system that was molten at 120°C and, consequently, served to inhibit recrystallisation following ageing. The resulting spatial distribution of charge trapping sites was therefore strongly dependent on morphology. The electrical conductivity of each system varied non‐monotonically with ageing: short times reduced the conductivity; a rapid increase in conductivity over five orders of magnitude occurred beyond a critical ageing threshold. Despite the pronounced structural differences between the morphologically distinct sets of samples, all exhibited comparable conductivity values beyond this threshold, implying that while charge transport is strongly influenced by chemical factors, crystallinity is relatively unimportant. This experimental finding appears at odds with theoretical studies of the electronic states in crystalline and amorphous PE.
Quantifying impacts of automation on resilience of distribution systems
Authors: Hosseini Mohammad Mehdi , Parvania Masood
Published: February 2020

Automating the process of restoring service to customers after a large‐scale outage event have significant impacts on the agility and speed of recovery in distribution systems. This study develops a set of probabilistic metrics to assess the impact of automation in enhancing the resilience of power distribution systems. The proposed metrics capture the features and detailed process of automatically locating and isolating faults and restoring the service to customers in distribution systems. In addition, this study develops a model to evaluate the spatio–temporal impacts of hurricane on power distribution systems, which is used to generate hurricane‐induced outage scenarios to calculate the resilience metrics given different automation schemes. The proposed model is utilised to evaluate the resilience of bus number four of Roy Billinton Test System in the face of a passing hurricane. The metrics are calculated to evaluate the impact of different levels of automation throughout the network, the intensity of the hurricane, and line hardening on the resilience of the system.
Chromospheric evaporation and phase mixing of Alfvén waves in coronal loops
Authors: Van Damme H. J. , De Moortel I. , Pagano P. , Johnston C. D.
Published: February 2020

Context. Phase mixing of Alfvén waves has been studied extensively as a possible coronal heating mechanism but without the full thermodynamic consequences considered self-consistently. It has been argued that in some cases, the thermodynamic feedback of the heating could substantially affect the transverse density gradient and even inhibit the phase mixing process.

Aims. In this paper, for the first time, we use magnetohydrodynamic (MHD) simulations with the appropriate thermodynamical terms included to quantify the evaporation following heating by phase mixing of Alfvén waves in a coronal loop and the effect of this evaporation on the transverse density profile.

Methods. The numerical simulations were performed using the Lagrangian Remap code Lare2D. We set up a 2D loop model consisting of a field-aligned thermodynamic equilibrium and a cross-field (background) heating profile. A continuous, sinusoidal, high-frequency Alfvén wave driver was implemented. As the Alfvén waves propagate along the field, they undergo phase mixing due to the cross-field density gradient in the coronal part of the loop. We investigated the presence of field-aligned flows, heating from the dissipation of the phase-mixed Alfvén waves, and the subsequent evaporation from the lower atmosphere.

Results. We find that phase mixing of Alfvén waves leads to modest heating in the shell regions of the loop and evaporation of chromospheric material into the corona with upflows of the order of only 5–20 m s−1. Although the evaporation leads to a mass increase in the shell regions of the loop, the effect on the density gradient and, hence, on the phase mixing process, is insignificant.

Conclusions. This paper self-consistently investigates the effect of chromospheric evaporation on the cross-field density gradient and the phase mixing process in a coronal loop. We found that the effects in our particular setup (small amplitude, high frequency waves) are too small to significantly change the density gradient.
Evaluation der Sprachaufgaben des sozialpädiatrischen
Entwicklungsscreenings für Schuleingangsuntersuchungen (SOPESS):
Ergebnisse der prospektiven Kindergesundheitsstudie ikidS
Authors: Hoffmann Dorle Ulrike , Diefenbach Christiane , Gräf Christine , König Jochem , Schlecht Jennifer , Schmidt Martina Franziska , Schnick-Vollmer Kathleen , von der Weiden Gabriele , Läßig Anne , Daseking Monika , Urschitz Michael S. , ikidS Projektgruppe
Published: February 2020

Hintergrund Eine frühe Diagnostik und Behandlung von
Entwicklungsstörungen vor der Einschulung ist für den
weiteren Bildungserfolg maßgeblich. Deshalb wurde das
Sozialpädiatrische Entwicklungsscreening für
Schuleingangsuntersuchungen (SOPESS) konzipiert und in mehreren
Bundesländern flächendeckend eingeführt.

Fragestellung Wir untersuchten die Zusammenhänge zwischen den
Screening-Ergebnissen der SOPESS-Sprachaufgaben vor der Einschulung und den
schulischen Sprachkompetenzen am Ende der ersten Klasse als Teil einer
umfassenden Evaluation des SOPESS.

Methoden Daten der rheinland-pfälzischen
Schuleingangsuntersuchung und der prospektiven Kindergesundheitsstudie ikidS
wurden zusammengeführt und ausgewertet. Zusammenhänge
zwischen dem Gesamtrisikowert Sprache des SOPESS vor Einschulung
(ordinal-skaliertes Merkmal, 6 Risikostufen) und dem
Gesamtfähigkeitswert Sprache am Ende der ersten Klasse (subjektive
Lehrkrafteinschätzung, intervall-skaliertes Merkmal, Range
−4 bis+4) wurden mittels linearer Regressionsmodelle ohne
und mit Berücksichtigung von weiteren sozio-demografischen und
medizinischen Sprachprädiktoren untersucht (z. B. Alter bei
Einschulung, Geschlecht, Schulbildung der Eltern, Migrationshintergrund,
Hörstörung). Der zusätzliche Nutzen des
Gesamtrisikowertes Sprache des SOPESS wurde durch Varianzanalysen
geprüft.

Ergebnisse In die Auswertung konnten 1357 Kinder einbezogen werden
(48% Mädchen, Alter bei Schuleingangsuntersuchung
4,9–7,2 Jahre). Es zeigte sich ein klarer negativer Zusammenhang
zwischen den Stufen des Gesamtrisikowertes Sprache des SOPESS und den
schulischen Sprachkompetenzen. In der Risikostufe 0 (kein Risiko) lag der
Mittelwert der Sprachkompetenzen bei 0,8 (SD=1,7); in der Stufe 6
(hohes Risiko für Entwicklungsstörung) sank der Wert auf
−3,2 Punkte ab (SD=0,9). Varianzanalysen zeigten zudem, dass
der Gesamtrisikowert Sprache des SOPESS einen signifikanten Zusatznutzen
gegenüber weiteren Sprachprädiktoren hat.

Schlussfolgerungen Es zeigte sich ein klarer Zusammenhang zwischen den
vorschulischen SOPESS-Sprachaufgaben und den schulischen Sprachkompetenzen
am Ende der ersten Klasse. Dieses Sprachscreening könnte daher
– unter Einbezug von weiteren soziodemografischen und medizinischen
Prädiktoren – die Basis für eine passgenaue Auswahl
von weiteren Versorgungs- und/oder Fördermaßnahmen
sein.
The Renal Resistive Index in Allografts: Is Sonographic Assessment Sufficiently Reproducible in a Routine Clinical Setting? – Reproducibility of the Renal Resistive Index
Authors: Theilig Dorothea Cornelia , Münzfeld Hanna , Auer Timo Alexander , Feldhaus Felix , Krüger Anne , Dürr Michael , Geisel Dominik
Published: February 2020

Purpose To assess the reproducibility of the renal resistive index (RRI) in a routine clinical setting.

Materials and Methods 22 patients with a kidney allograft and 19 physicians participated in our prospective study. Within 2 hours each patient was examined by 5 different physicians using 2 out of 3 different, randomly allocated ultrasound machines. Each investigator determined the hilar and parenchymal RRI of the allograft. The reproducibility and reproducibility limit of the RRI were assessed as well as Cronbach’s alpha and the intraclass correlation coefficient (ICC). The deviation of the RRI from the mean RRI over the 5 measurements was used as an indicator of reproducibility. The impact of the ultrasound machine, examiner’s level of experience, and kidney function impairment (GFR < 45 ml/min) was assessed with the Kruskal-Wallis test. The bivariate linear correlation of the minimal transplant distance from the body surface with the variance of the parenchymal RRI was analyzed.

Results A reproducibility of 0.045 with a reproducibility limit of 0.124 was found for the parenchymal RRI. The ICC between RRIs was good with 0.852 for the parenchymal RRI and 0.868 for the hilar RRI. The type of ultrasound machine used was found to have a significant impact on the deviation of the parenchymal RRI (Kruskal-Wallis-Test, p = 0.003). Variance in serial parenchymal RRI measurements correlated significantly with the depth of the kidney transplant (p = 0.001).

Conclusion While the RRI is generally sufficiently reproducible, the type of ultrasound machine used and the depth of the kidney transplant within the recipient’s body have a significant impact on reproducibility.

Key Points: 

Citation Format
Risikofaktoren für Chemotherapie-assoziierte venöse Thrombosen bei gynäkoonkologischen Patientinnen
Authors: Nezi-Cahn Sandra , Sicking Isabel , Almstedt Kathrin , Battista Marco , Heimes Anne-Sophie , Krajnak Slavomir , Steetskamp Joscha , Hasenburg Annette , Schmidt Marcus
Published: February 2020

Einleitung Venöse Thrombosen und deren Folgen zählen zu den Haupttodesursachen bei Patienten mit Tumorerkrankungen. Ziel dieser Studie ist die Analyse von Risikofaktoren sowie die Evaluation der Anwendbarkeit zweier Risikoscores an einem rein gynäkoonkologischen Patientinnenkollektiv. Mit der Identifikation von Hochrisikopatientinnen für das Auftreten von venösen Thrombosen könnte die Durchführung einer gezielten medikamentösen Thromboseprophylaxe mit hohem Nutzen bei gleichzeitig geringem Risiko ermöglicht werden.

Material und Methoden In einer retrospektiven Fallkontrollstudie an 152 Patientinnen, die sich zwischen 2006 und 2013 in onkologischer Behandlung an der Frauenklinik der Universitätsmedizin Mainz befanden, wurden die Daten von 104 Patientinnen mit Mamma-, 26 mit Ovarial- und 22 mit Zervixkarzinom untersucht. 76 Probandinnen der Fallgruppe, die während der Chemotherapie eine venöse Thrombose erlitten hatten, wurde eine Kontrolle zugeordnet, die in den Punkten Tumorlokalisation, Alter, Lymphknotenbefall, Metastasierung und Zeitpunkt der Erstdiagnose übereinstimmte. Mittels χ2-Test, t-Test, Mann-Whitney-U-Test und einer logistischen Regressionsanalyse wurden die Gruppenunterschiede analysiert.

Ergebnisse Für eine fehlende stationäre Thromboseprophylaxe (p = 0,014), erhöhte Leukozytenzahlen (p = 0,018) vor Beginn der Chemotherapie und Portsysteme (p = 0,032) zeigten sich deutliche Gruppenunterschiede. Operative Eingriffe wurden als unabhängiger Risikofaktor bestätigt (p≤ 0,001). Khorana- und Protecht-Score gingen nicht als unabhängige Prädiktoren für eine Thrombose aus der Analyse hervor. In der Fallgruppe sind mehr Patientinnen verstorben als in der Kontrollgruppe (p = 0,028; OR: 8,1; 95 %-KI: 1,254–52,162).

Fazit Operationen stellen in diesem Patientenkollektiv einen unabhängigen Risikofaktor für venöse Thrombosen dar. Daneben zeigte sich ein Zusammenhang zwischen einer stationären Thromboseprophylaxe, Leukozytose sowie Portsystemen und einem erhöhten Thromboserisiko. Weder Khorana- noch Protecht-Score waren unabhängige Risikofaktoren für venöse Thrombosen. Deutlich mehr Thrombosepatientinnen sind im Beobachtungszeitraum verstorben.
Medical Treatment of Gastrointestinal Neuroendocrine Neoplasms
Authors: Tsoli Marina , Alexandraki Krystallenia , Xanthopoulos Christos , Kassi Eva , Kaltsas Gregory
Published: February 2020

Neuroendocrine neoplasms (NENs) are rare tumours that arise mainly in the gastrointestinal or pulmonary system. Most NENs are well-differentiated and may obtain prolonged survival besides the presence of metastatic disease; however, a subset (poorly differentiated NENs) may display a truly aggressive behaviour exhibiting a poor prognosis. The recently developed classification systems along with advances in functional imaging have helped stratify patients to the administration of appropriate therapeutic options. Surgery is the mainstay of treatment of NENs, but in recent decades there has been a considerable evolution of medical treatments that are used for locally advanced or metastatic disease not amenable to surgical resection. Long acting somatostatin analogues are the main therapeutic modality for patients with functioning and well-differentiated low grade NENs exhibiting symptomatic control and mainly stabilisation of tumour growth. Other systemic treatments include chemotherapy, molecular targeted agents, interferon-α, peptide receptor radionuclide therapy (PRRT), and immunotherapy. In addition, new agents such as telotristat may be used for the control of symptoms of carcinoid syndrome. The choice and/or sequence of therapeutic agents should be individualized according to tumour origin and differentiation, disease burden, presence of clinical symptoms and patients’ performance status in the context of a multidisciplinary approach. Recent advances in the molecular pathogenesis of NENs set the field for a more personalised treatment approach.
Treatment of Recurrent Intracranial Aneurysms: Gore-Tex Interposition Method for Prevention of Galvanic Corrosion at the Clips
Authors: Yokoya Shigeomi , Hino Akihiko , Oka Hideki
Published: February 2020

We describe a new method for preventing galvanic corrosion induced by contact between old and new clips of different materials during clipping for recurrent intracranial aneurysms. After applying a new clip to the aneurysm neck close to the old clip, a Gore-Tex (GORE PRECLUDE; W.L. Gore & Associates, Inc., Newark, Delaware, United States) sheet is interposed to prevent contact between the old and new clip. The procedure was used successfully in three cases. The present technique is beneficial for the treatment of recurrent intracranial aneurysms to prevent galvanic corrosion when encountering difficulty in removing a previously placed clip.
Is the Climb Worth the View? The Savings/Alert Ratio for Reducing Vitamin D Testing
Authors: Hendrickson Chase D. , McLemore Michael F. , Dahir Kathryn M. , Just Shari , Shajani-Yi Zahra , LeGrand Joseph , Lehmann Christoph U. , Weitkamp Asli
Published: February 2020

Background Despite guideline recommendations, vitamin D testing has increased substantially. Clinical decision support (CDS) presents an opportunity to reduce inappropriate laboratory testing.

Objectives and Methods To reduce inappropriate testing of vitamin D at the Vanderbilt University Medical Center, a CDS assigned providers to receive or not receive an electronic alert each time a 25-hydroxyvitamin D assay was ordered for an adult patient unless the order was associated with a diagnosis in the patient's chart for which vitamin D testing is recommended. The CDS ran for 80 days, collecting data on number of tests, provider information, and basic patient demographics.

Results During the 80 days, providers placed 12,368 orders for 25-hydroxyvitamin D. The intervention group ordered a vitamin D assay and received the alert for potentially inappropriate testing 2,181 times and completed the 25-hydroxyvitamin D order in 89.9% of encounters, while the control group ordered a vitamin D assay (without receiving an alert) 2,032 times and completed the order in 98.1% of encounters, for an absolute reduction of testing of 8% (p < 0.001).

Conclusion This CDS reduced vitamin D ordering by utilizing a soft-stop approach. At a charge of $179.00 per test and a cost to the laboratory of $4.20 per test, each display of the alert led to an average reduction of $14.70 in charges and of $0.34 in spending by the laboratory (the savings/alert ratio). By describing the effectiveness of an electronic alert in terms of the savings/alert ratio, the impact of this intervention can be better appreciated and compared with other interventions.
Electrocardiography Findings in Children with Febrile Convulsion
Authors: Noori Noor Mohammad , Khajeh Ali , Teimouri Alireza
Published: February 2020

Febrile convulsion (FC) is a seizure associated with body temperature that leads to electrocardiography changes. This article aimed to study electrocardiographic changes in children with FC as compared with healthy children. In this case–control study, 90 children aged 6 to 60 months were matched with equal healthy ones in “Ali Ebne Abi Talib” hospital in Zahedan, Iran. FC was confirmed by a neurologist based on its definition by the International League Against Epilepsy. Electrocardiogram (ECG) was captured by a pediatric cardiologist. Data were analyzed using SPSS 19. Sex distribution in groups was similar (p = 0.232). QT correction (QTc) was normal in 97.8 and 76.7% of controls and FC children, respectively (p < 0.001). QT dispersion (QTd) was normal in all controls when it was prolonged in 0.6% of children (p< 0.316). Calculated QT (QTcd) prolonged in controls and FC of 4.4 and 27.8% of children, respectively (p < 0.001). RR interval (p = 0.001), heart rate (p< 0.001), S in V1 (p = 0.004), R in aVL (p = 0.007), S in V3(p< 0.001), left ventricular mass (LVM) (p< 0.001), QTd (p< 0.001), QTc max (p< 0.001), and QTcd (p< 0.001) were significant. Means of LVM were 46.00 ± 1.86, 47.22 ± 2.24, and 51.45 ± 2.41 for age groups of <12, 12–24, and >24 months, respectively (p < 0.001). We conclude that QTd, QTc, and QTcd were higher in FC compared with those of healthy children. The rate of FC in children with higher level of QTcd increased compared with controls.
Spin reorientation at (110)-La2/3Sr1/3MnO3/LaCoO3 interfaces by orbital/charge reconstruction
Authors: Han Furong , Chen Xiaobing , Zhang Jine , Zhang Jing , Song Jinghua , Zhang Hui , Zhang Hongrui , Yan Xi , Zhang Qinghua , Gu Lin , Chen Yuansha , Hu Fengxia , Shen Baogen , Sun Jirong
Published: February 2020

The interface reconstruction in perovskite heterostructures caused by interfacial octahedral tilt/rotation and its effects on the spin, charge, and orbital degrees of freedom is a very attractive topic for correlated oxides. Here, we present a systematic investigation on tensely strained (110)-LaCoO3/La2/3Sr1/3MnO3/LaCoO3 trilayers, focusing on orbital reconstruction and accompanied effects. The most remarkable finding is the reordering of the energy levels of Mn-3d orbitals at the interface: the low-lying orbital becomes dx2-y2 for sandwiched La2/3Sr1/3MnO3 rather than d3z2-r2 as expected for a bare La2/3Sr1/3MnO3 film. Interlayer charge transfer via dx2-y2 orbitals is further detected as a driving force of orbital reconstruction. Due to spin–orbit coupling, the charge/orbital reconstruction produces a chain effect on the spin degree of freedom of the La2/3Sr1/3MnO3 layer, resulting in a dramatic spin reorientation by 90° in a film plane. The present work demonstrates how to tune macroscopic properties of correlated oxides via mutual coupling between different degrees of freedom.
Microscale integrated sensor points to cheaper high-throughput displacement sensing
Authors: Liebendorfer Adam
Published: February 2020

Using a double-membrane photonic crystal cavity, the device achieves noise floor levels comparable to bulkier current approaches in atomic force microscopy.
Persistence of remnant patches and genetic loss at the distribution periphery in island and mainland populations of the quokka
Authors: Spencer Peter B. S. , Bain Karlene , Hayward Matthew W. , Hillyer Mia , Friend J. A. Tony
Published: February 2020

Understanding the spatial structure of populations is important in developing effective management options for threatened species, and for managing habitat connectivity for metapopulation function, and for demographic and genetic heterogeneity. We used genetic information to investigate the structure of populations of the quokka, Setonix brachyurus, in south-west Western Australia. We hypothesised that movement between known populations would be relatively rare and result in significant genetic structuring. Genetic analyses from 412 adult individuals at 14 nuclear markers (microsatellite) from 33 sampling locations identified structure, diversity and spatial separation of quokkas across their mainland distribution and on two islands. We identified nine inferred (K = 9) populations of quokka that would be otherwise difficult to define with standard ecological techniques. The highest genetic diversity was evident in a large central population of quokka in the southern forest area and genetic diversity was lower at the peripheries of the distribution. The Rottnest Island population contained 70% of the genetic diversity of the mainland populations but the genetic diversity of animals on Bald Island was markedly lower. Populations of quokka in the northern jarrah forest were the only ones to show evidence of recent or long-term population bottlenecking. Of particular interest was the recently identified population at the Muddy Lakes area (the only remaining locality on the Swan Coastal Plain), which was identified as being genetically associated with the southern forest population. Overall, spatial and population cluster analysis showed small insular populations in the northern jarrah forest area, but in the southern forests there appears to be a large panmictic population.
Null geodesics in conformal gravity
Authors: Turner George E , Horne Keith
Published: February 2020

We present an analysis of the null geodesics of the static, spherically symmetric, vacuum solution to the equations of conformal (Weyl) gravity. We classify the full range of exotic spacetimes arising from the parameter space of the metric. The nature of various notable features of these spacetimes is investigated including light spheres, horizons and physical singularities.
Anti-G250 nanobody-functionalized nanobubbles targeting renal cell carcinoma cells for ultrasound molecular imaging
Authors: Yu Zhiping , Hu Ming , Li Zhouquan , Dan Xu  , Zhu Lianhua , Guo Yanli , Liu Qiuli , Lan Weihua , Jiang Jun , Wang Luofu
Published: February 2020

Traditional imaging examinations have difficulty in identifying benign and malignant changes in renal masses. This difficulty may be solved by ultrasound molecular imaging based on targeted nanobubbles, which could specifically enhance the ultrasound imaging of renal cell carcinomas (RCC) so as to discriminate benign and malignant renal masses. In this study, we aimed to prepare anti-G250 nanobody-functionalized targeted nanobubbles (anti-G250 NTNs) by coupling anti-G250 nanobodies to lipid nanobubbles and to verify their target specificity and binding ability to RCC cells that express G250 antigen and their capacity to enhance ultrasound imaging of RCC xenografts. Anti-G250 nanobodies were coupled to the lipid nanobubbles using the biotin-streptavidin bridge method. The average particle diameter of the prepared anti-G250 NTNs was 446 nm. Immunofluorescence confirmed that anti-G250 nanobodies were uniformly distributed on the surfaces of nanobubbles. In vitro experiments showed that the anti-G250 NTNs specifically bound to G250-positive 786-O cells and HeLa cells with affinities of 88.13% ± 4.37% and 71.8% ± 5.7%, respectively, and that they did not bind to G250-negative ACHN cells. The anti-G250 NTNs could significantly enhance the ultrasound imaging of xenograft tumors arising from 786-O cells and HeLa cells compared with blank nanobubbles, while the enhancement was not significant for xenograft tumors arising from ACHN cells. Immunofluorescence of tumor tissue slices confirmed that the anti-G250 NTNs could enter the tissue space through tumor blood vessels and bind to tumor cells specifically. In conclusion, anti-G250 nanobody-functionalized targeted nanobubbles could specifically bind to G250-positive RCC cells and enhance the ultrasound imaging of G250-positive RCC xenografts. This study has high-potential clinical application value for the diagnosis and differential diagnosis of renal tumors.
A phase evolution based constitutive model for shape memory polymer and its application in 4D printing
Authors: Wang Fangfang , Yuan Chao , Wang Dong , Rosen David W , Ge Qi
Published: February 2020

4D printing is a novel concept and multidiscipline research area which integrates advanced manufacturing, material science and mechanics. As an active material with high stiffness and rapid response speed, shape memory polymer (SMP) is widely used in 4D printing structures. Accordingly, a simple but effective theoretical model becomes highly desirable to better assist the 4D printing design. In this paper, a phenomenological model is developed in which the concept of phase evolution is used to describe the glass transition behavior of SMP. Explicit iterative format has been derived where the stress–strain behaviors of phase generation and phase vanishment are distinguished. The model is further employed to predict the shape memory behavior of pure SMP and active bending behavior of SMP-elastomer bilayer composites. With its inherent conciseness and generality, the model is promising to be applicable in modelling other soft active materials with phase evolution behaviors.
Self-reported vision and hallucinations in older adults: results from two longitudinal US health surveys
Authors: Hamedani Ali G , Thibault Dylan P , Shea Judy A , Willis Allison W
Published: February 2020

Background

Vision loss may be a risk factor for hallucinations, but this has not been studied at the population level.

Methods

To determine the association between self-reported vision loss and hallucinations in a large community-based sample of older adults, we performed a cross-sectional and longitudinal analysis of two large, nationally representative US health surveys: the National Health and Aging Trends Study (NHATS) and the Health and Retirement Study (HRS). Visual impairment and hallucinations were self- or proxy-reported. Multivariate single and mixed effects logistic regression models were built to examine whether visual impairment and history of cataract surgery were associated with hallucinations.

Results

In NHATS (n = 1520), hallucinations were more prevalent in those who reported difficulty reading newspaper print (OR 1.77, 95% confidence interval (CI): 1.32–2.39) or recognising someone across the street (OR 2.48, 95% CI: 1.86–3.31) after adjusting for confounders. In HRS (n = 3682), a similar association was observed for overall (OR 1.32, 95% CI: 1.08–1.60), distance (OR 1.61, 95% CI: 1.32–1.96) and near eyesight difficulties (OR 1.52, 95% CI: 1.25–1.85). In neither sample was there a significant association between cataract surgery and hallucinations after adjusting for covariates.

Conclusions

Visual dysfunction is associated with increased odds of hallucinations in the older US adult population. This suggests that the prevention and treatment of vision loss may potentially reduce the prevalence of hallucinations in older adults.
Detection of Falsely Elevated Point-of-Care Potassium Results Due to Hemolysis Using Predictive Analytics
Authors: Benirschke Robert C , Gniadek Thomas J
Published: February 2020

Objectives

Preanalytical factors, such as hemolysis, affect many components of a test panel. Machine learning can be used to recognize these patterns, alerting clinicians and laboratories to potentially erroneous results. In particular, machine learning might identify which cases of elevated potassium from a point-of-care (POC) basic metabolic panel are likely erroneous.

Methods

Plasma potassium concentrations were compared between POC and core laboratory basic metabolic panels to identify falsely elevated POC results. A logistic regression model was created using these labels and the other analytes on the POC panel.

Results

This model has high predictive power in classifying POC potassium as falsely elevated or not (area under the curve of 0.995 when applied to the test data set). A rule-in and rule-out approach further improves the model’s applicability with a positive predictive value of around 90% and a negative predictive value near 100%.

Conclusions

Machine learning has the potential to detect laboratory errors based on the recognition of patterns in commonly requested multianalyte panels. This could be used to alert providers at the POC that a result is suspicious or used to monitor the quality of POC results.
Association Between Inflammatory Bowel Disease and Pruritus
Authors: Iwamoto Shiho , Tominaga Mitsutoshi , Kamata Yayoi , Kawakami Tomohiro , Osada Taro , Takamori Kenji
Published: February 2020

Background

Inflammatory bowel disease (IBD) is often complicated by extraintestinal manifestations. We frequently encounter IBD patients with pruritus; however, clinical evidence for the association of these conditions is lacking. Therefore, the present study investigated the incidence of pruritus in IBD patients.

Methods

Seventy-one IBD outpatients, including 55 with ulcerative colitis (UC) and 16 with Crohn disease, and 39 healthy volunteers (HVs) were surveyed about their pruritus symptoms using a visual analogue scale (VAS). Disease activities in UC and Crohn disease patients were classified according to partial Mayo and IOIBD (International Organization for the Study of inflammatory Bowel Disease) scores, respectively. Skin barrier condition was examined by measuring transepidermal water loss and stratum corneum hydration. The distribution of intraepidermal nerve fibers in skin samples from 9 UC patients was examined immunohistochemically using an antiprotein gene product (PGP) 9.5 antibody.

Results

Visual analogue scale scores were higher in IBD patients than in HV (P < 0.001). Active stage IBD patients had more severe pruritus VAS scores than those in the remission stage (P = 0.036). Transepidermal water loss was higher in IBD patients (P < 0.001) and active stage IBD patients (P = 0.004), while stratum corneum hydration was lower in IBD patients (P = 0.019) and active stage IBD patients than in HV (P = 0.019). A relationship was observed between the degree of pruritus and number of PGP9.5-immunoreactive intraepidermal nerve fibers in UC patients.

Conclusions

Inflammatory bowel disease patients, particularly active stage patients, frequently exhibit symptoms of pruritus and dry skin. This result may have predictive and therapeutic implications for the treatment of IBD symptoms.
Evaluation of an Ion-Exchange HPLC Device for HbA1c Measurement
Authors: Altawallbeh Ghaith , Makky Vicky F , Saenger Amy K , Peters Jennifer M , Killeen Anthony A
Published: February 2020

Background

The ADAMS™ HA-8180V is the 8th generation of a fully automated ion-exchange HPLC system from ARKRAY, and the first to be released onto the US market. We evaluated the HA-8180V, for routine hemoglobin A1c measurement in comparison with the Roche Cobas c501, the Tosoh G8 analyzer for normal hemoglobin, and with the Trinity analyzer for hemoglobin variants.

Methods

The analytical performance (linearity, precision, carryover, and sample stability) was assessed based on the Clinical and Laboratory Standards Institute (CLSI) and manufacturer guidelines. A comparison of the HA-8180V against two major analytical methods was performed for 100 whole blood samples. HA-8180V variant mode was also compared against the Trinity ultra2 A1c analyzer for 50 samples containing hemoglobin variants (HbC 14, HbS 14, HbD 12, and HbE 10).

Results

The within-run and total CVs were <0.01 and 0.75% at low HbA1c concentration and 0.46 and 0.63% at high HbA1c concentration, respectively. Linearity was shown in the concentration range 3.4–18.1% HbA1c, carryover was 0.00%, and stability values were excellent. Method comparison demonstrated a high concordance between methods.

Conclusion

The eighth generation ADAMS HA-8180V A1c analyzer demonstrated high analytical performance adequate for routine clinical use.
Characterization of a microSilicon diode detector for small-field photon beam dosimetry
Authors: Akino Yuichi , Fujiwara Masateru , Okamura Keita , Shiomi Hiroya , Mizuno Hirokazu , Isohashi Fumiaki , Suzuki Osamu , Seo Yuji , Tamari Keisuke , Ogawa Kazuhiko
Published: February 2020

This study characterized a new unshielded diode detector, the microSilicon (model 60023), for small-field photon beam dosimetry by evaluating the photon beams generated by a TrueBeam STx and a CyberKnife. Temperature dependence was evaluated by irradiating photons and increasing the water temperature from 11.5 to 31.3°C. For Diode E, microSilicon, microDiamond and EDGE detectors, dose linearity, dose rate dependence, energy dependence, percent-depth-dose (PDD), beam profiles and detector output factor (OFdet) were evaluated. The OFdet of the microSilicon detector was compared to the field output factors of the other detectors. The microSilicon exhibited small temperature dependence within 0.4%, although the Diode E showed a linear variation with a ratio of 0.26%/°C. The Diode E and EDGE detectors showed positive correlations between the detector reading and dose rate, whereas the microSilicon showed a stable response within 0.11%. The Diode E and microSilicon demonstrated negative correlations with the beam energy. The OFdet of microSilicon was the smallest among all the detectors. The maximum differences between the OFdet of microSilicon and the field output factors of microDiamond were 2.3 and 1.6% for 5 × 5 mm2 TrueBeam and 5 mm φ CyberKnife beams, respectively. The PDD data exhibited small variations in the dose fall-off region. The microSilicon and microDiamond detectors yielded similar penumbra widths, whereas the other detectors showed steeper penumbra profiles. The microSilicon demonstrated favorable characteristics including small temperature and dose rate dependence as well as the small spatial resolution and output factors suitable for small field dosimetry.
FXR1 is a novel MRE11-binding partner and participates in oxidative stress responses
Authors: Qi Fei , Meng Qingmei , Hayashi Ikue , Kobayashi Junya
Published: February 2020

Ataxia-telangiectasia (AT) and MRE11-defective Ataxia-telangiectasia-like disorder (ATLD) patients show progressive cerebellar ataxia. ATM, mutated in AT, can be activated in response to oxidative stress as well as DNA damage, which could be linked to disease-related neurodegeneration. However, the role of MRE11 in oxidative stress responses has been elusive. Here, we showed that MRE11 could participate in ATM activation during oxidative stress in an NBS1/RAD50-independent manner. Importantly, MRE11 was indispensable for ATM activation. We identified FXR1 as a novel MRE11-binding partner by mass spectrometry. We confirmed that FXR1 could bind with MRE11 and showed that both localize to the cytoplasm. Notably, MRE11 and FXR1 partly localize to the mitochondria, which are the major source of cytoplasmic reactive oxygen species (ROS). The contribution of FXR1 to DNA double-strand break damage responses seemed minor and limited to HR repair, considering that depletion of FXR1 perturbed chromatin association of homologous recombination repair factors and sensitized cells to camptothecin. During oxidative stress, depletion of FXR1 by siRNA reduced oxidative stress responses and increased the sensitivity to pyocyanin, a mitochondrial ROS inducer. Collectively, our findings suggest that MRE11 and FXR1 might contribute to cellular defense against mitochondrial ROS as a cytoplasmic complex.
Laser Ablation of Abnormal Neurological Tissue Using Robotic NeuroBlate System (LAANTERN): 12-Month Outcomes and Quality of Life After Brain Tumor Ablation
Authors: Kim Albert H , Tatter Steven , Rao Ganesh , Prabhu Sujit , Chen Clark , Fecci Peter , Chiang Veronica , Smith Kris , Williams Brian J , Mohammadi Alireza M , Judy Kevin , Sloan Andrew , Tovar-Spinoza Zulma , Baumgartner James , Hadjipanayis Constantinos , Leuthardt Eric C
Published: February 2020

BACKGROUND

Laser Ablation of Abnormal Neurological Tissue using Robotic NeuroBlate System (LAANTERN) is an ongoing multicenter prospective NeuroBlate (Monteris Medical) LITT (laser interstitial thermal therapy) registry collecting real-world outcomes and quality-of-life (QoL) data.

OBJECTIVE

To compare 12-mo outcomes from all subjects undergoing LITT for intracranial tumors/neoplasms.

METHODS

Demographics, intraprocedural data, adverse events, QoL, hospitalizations, health economics, and survival data are collected; standard data management and monitoring occur.

RESULTS

A total of 14 centers enrolled 223 subjects; the median follow-up was 223 d. There were 119 (53.4%) females and 104 (46.6%) males. The median age was 54.3 yr (range 3-86) and 72.6% had at least 1 baseline comorbidity. The median baseline Karnofsky Performance Score (KPS) was 90. Of the ablated tumors, 131 were primary and 92 were metastatic. Most patients with primary tumors had high-grade gliomas (80.9%). Patients with metastatic cancer had recurrence (50.6%) or radiation necrosis (40%). The median postprocedure hospital stay was 33.4 h (12.7-733.4). The 1-yr estimated survival rate was 73%, and this was not impacted by disease etiology. Patient-reported QoL as assessed by the Functional Assessment of Cancer Therapy-Brain was stabilized postprocedure. KPS declined by an average of 5.7 to 10.5 points postprocedure; however, 50.5% had stabilized/improved KPS at 6 mo. There were no significant differences in KPS or QoL between patients with metastatic vs primary tumors.

CONCLUSION

Results from the ongoing LAANTERN registry demonstrate that LITT stabilizes and improves QoL from baseline levels in a malignant brain tumor patient population with high rates of comorbidities. Overall survival was better than anticipated for a real-world registry and comparative to published literature.
On duality in $\mathcal{N}=2$ supersymmetric Liouville theory
Authors: Nakayama Yu
Published: February 2020

Similarly to the bosonic Liouville theory, the $\mathcal{N}=2$ supersymmetric Liouville theory was conjectured to be equipped with the duality that exchanges the superpotential and the Kähler potential. The conjectured duality, however, seems to suffer from a mismatch of the preserved symmetries. More than fifteen years ago, when I was a student, my supervisor Tohru Eguchi gave a beautiful resolution of the puzzle when the supersymmetry is enhanced to $\mathcal{N}=4$ based on his insight into the underlying geometric structure of the $A_1$ singularity. I will review his unpublished but insightful idea and present our attempts to extend it to more general cases.
Chronic diarrhoea and risk of rheumatoid arthritis: findings from the French E3N-EPIC Cohort Study
Authors: Nguyen Yann , Mariette Xavier , Salliot Carine , Gusto Gaëlle , Boutron-Ruault Marie-Christine , Seror Raphaèle
Published: February 2020

Objectives

To assess the relationship between gastrointestinal disorders and the risk of further development of RA.

Methods

The Etude Epidémiologique auprès des femmes de la Mutuelle générale de l’Education Nationale-European Prospective Investigation into Cancer and Nutrition Study is a French prospective cohort including 98 995 healthy women since 1990. Participants completed mailed questionnaires on their lifestyles and health-related information. Gastrointestinal disorders were assessed in the third questionnaire (sent in 1993). Hazard ratios and 95% CIs for incident RA were estimated using Cox proportional hazards regression models with age as the time scale. Models were age adjusted, and then additionally adjusted for known risk factors of RA such as smoking, and for potential cofounders.

Results

Among 65 424 women, 530 validated incident RA cases were diagnosed after a mean (s.d.) of 11.7 (5.9) years after study baseline. In comparison with no gastrointestinal disorder, chronic diarrhoea was associated with an increased risk of developing RA during follow-up (hazard ratio = 1.70, 95% CI 1.13, 2.58), independently of dysthyroidism or dietary habits. The association was stronger among ever-smokers (hazard ratio = 2.21, 95% CI 1.32, 3.70). There was no association between RA risk and constipation or alternating diarrhoea/constipation.

Conclusion

Chronic diarrhoea was associated with an increased risk of subsequent RA development, particularly among ever-smokers. These data fit with the mucosal origin hypothesis of RA, where interaction between intestinal dysbiosis and smoking could occur at an early stage to promote emergence of autoimmunity, followed years later by clinical disease.
The Progression and Ongoing Development of a Research Agenda for Faith Community Nursing
Authors: Solari-Twadell Phyllis Ann , Ziebarth Deborah Jean
Published: February 2020

Research is critical to the growth of professional nursing in every practice area. Faith community nursing research evolved slowly in the years following publication of the first research in 1989. A faith community nursing research agenda was developed in 2008 and research priorities have been reviewed every 2 years since 2012 at a forum held in conjunction with the annual Westberg Symposium. This article reviews the progression and ongoing development of a research agenda for the specialty practice of faith community nursing. Recommendations for the development of future research for faith community nursing are discussed.
Colocated Developmental-Behavioral Pediatrics in Primary Care: Improved Outcome Across Settings
Authors: Martin-Herz Susanne P. , Buysse Christina A. , DeBattista Anne , Feldman Heidi M.
Published: February 2020

Objective:

We developed a colocation “Rapid Developmental Evaluation” (RDE) model for Developmental-Behavioral Pediatrics (DBP) to evaluate young children for developmental concerns raised during routine developmental surveillance and screening in a pediatric primary care Federally Qualified Health Center (FQHC). In this low-income patient population, we anticipated that colocation would improve patient access to DBP and decrease time from referral to first developmental evaluation and therapeutic services.

Methods:

Children were assessed at the FQHC by a DBP pediatrician, who made recommendations for therapeutic services and further diagnostic evaluations. A retrospective chart review over 27 months (N = 151) investigated dates of referral and visit, primary concern, diagnosis, and referral to tertiary DBP center and associated tertiary DBP center dates of service and diagnoses if appropriate. We surveyed primary care clinicians (PCCs) for satisfaction.

Results:

The DBP pediatrician recommended that 51% of children be referred to the tertiary DBP center for further diagnostic evaluation or routine DBP follow-up. Average wait from referral to an RDE visit was 57 days compared with 137.3 days for the tertiary DBP center. Children referred from RDE to the tertiary DBP center completed visits at a higher rate (77%) than those referred from other sites (54%). RDE-recommended therapeutic services were initiated for 73% of children by the tertiary visit. Fidelity of diagnosis between RDE and the tertiary DBP center was high, as was PCC satisfaction.

Conclusion:

Colocation of a DBP pediatrician in an FQHC primary care pediatrics program decreased time to first developmental assessment and referral for early intervention services for an at-risk, low-income patient population.
INTRAPEC Technique Controls Pectoralis Spasm and Pain for Subpectoral Breast Implantation: A Retrospective Study
Authors: Kline Jonathan , Lee Wayne , Wofford Ken
Published: February 2020

Background:

In 2018, a novel approach to reduce pectoralis spasm from sub- pectoral breast implant surgery was published called the INTRAPEC.1 In this study, we more formally examine the effectiveness of the ultrasound-guided INTRAPEC injection to control postoperative pectoralis major spasm and pain following breast surgery with sub-pectoral implantation.

Methods:

We employed a simple postoperative spasm and pain record to collect data on 17 patients, all of whom received INTRAPEC and erector spinae plane blocks as a part of an opioid- free anesthetic. All breast surgeries were completed with LMA general anesthesia, preserving spontaneous ventilation.

Results:

Of the 17 study participants, 13 (76.4%) reported spasm scores less than 3 for the entire 2-day study period and, at most time points, patients reported a median score for pain of 2, with IQRs ranging from 1 to 7.

Conclusions:

The study results suggest that the INTRAPEC injection is a simple, low-cost, low-risk, and effective technique that controls post- operative spasm following breast surgery involving sub-pectoral implantation.
Predictors of Parental Premature Exiting From Early Intervention Services
Authors: Barnard-Brak Lucy , Stevens Tara , Yang Zhanxia
Published: February 2020

The current study examined 2 sets of variables associated with parents prematurely exiting early intervention services for their child. The first set consisted of the variables predictive of premature parent withdrawal, and the second set consisted of variables predictive of a parent and child being dismissed from early intervention services because of failure in being able to contact them. This study represents the first empirical examination of variables associated with parents prematurely exiting early intervention services despite having children who continued to qualify for services.
Role of Oral Tramadol 50 mg in Reducing Pain During Colposcopy-Directed Cervical Biopsy: A Randomized Controlled Trial
Authors: Darweesh Fatma Faisal , Samy Ahmed , Mousa Abdalla Mohamed , Abdelbar Ahmed Tarek , Mahmoud Mostafa , Abdelhakim Ahmed Mohamed , Metwally Ahmed A.
Published: February 2020

Objective

The aim of the study was to assess safety and efficacy of 50-mg tramadol in reducing patient-perceived pain during colposcopy.

Material and Methods

We conducted a randomized double-blind placebo-controlled trial in the colposcopy unit of a tertiary referral hospital, Cairo, Egypt, from April 2018 to October 2018. Our primary outcome was pain during colposcopy-guided ectocervical punch biopsy. Our secondary outcomes were pain during speculum insertion, acetic acid application, Lugol iodine application, endocervical curettage (ECC), endocervical brushing, 10-minute postprocedure, and additional analgesia requirement. Pain was assessed using 10-cm visual analog scale.

Results

One hundred fifty women were randomized into 2 groups: tramadol group (n = 75) received oral 50-mg tramadol tablets, and control group (n = 75) received placebo tablets. Both groups showed no significant difference in anticipated pain score (p = .56), pain scores during speculum insertion (p = .70), application of acetic acid (p = .40), and Lugol iodine (p = .79). However, the mean pain scores were significantly lower in tramadol group compared with placebo at ectocervical biopsy (p = .001), ECC (p = .001), endocervical brushing (p = .001), and 10 minutes after colposcopy (p = .001). Need for additional analgesia was significantly lower in tramadol group (p = .03).

Conclusions

Oral tramadol 50 mg significantly reduces pain perception during colposcopy-guided ectocervical biopsy, ECC, endocervical brushing, and 10 minutes after colposcopy with tolerable adverse effects.