bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the Interactions of Atomic Oxygen on Silver Clusters with Hydrogen
Authors: Cao Xi-zi , Yin Bao-qi , Wang Ting-ting , Xing Xiao-peng
Published: January 2018

The interactions between AgnO− (n=1−8) and H2 (or D2) were explored by combination of the mass spectroscopy experiments and density function theory (DFT) calculations. The experiments found that all oxygen atoms in AgnO− (n=1−8) are inert in the interactions with H2 or D2 at the low temperature of 150 K, which is in contrast to their high reactivity with CO under the same condition. These observations are parallel with the preferential oxidation (PROX) of CO in excess hydrogen catalyzed by dispersed silver species in the condensed phase. Possible reaction paths between AgnO− (n=1−8) and H2 were explored using DFT calculations. The results indicated that adsorption of H2 on any site of AgnO− (n=1−8) is extremely weak, and oxidation of H2 by any kind of oxygen in AgnO− (n=1−8) has an apparent barrier strongly dependent on the adsorption style of the “O”. These experiments and theoretical results about cluster reactions provided molecule-level insights into the activity of atomic oxygen on real silver catalysts.
The S66 Non-Covalent Interactions Benchmark Reconsidered Using Explicitly Correlated Methods Near the Basis Set Limit
Authors: Kesharwani Manoj K. , Karton Amir , Sylvetsky Nitai , Martin Jan M. L.
Published: January 2018

The S66 benchmark for non-covalent interactions has been re-evaluated using explicitly correlated methods with basis sets near the one-particle basis set limit. It is found that post-MP2 ‘high-level corrections’ are treated adequately well using a combination of CCSD(F12*) with (aug-)cc-pVTZ-F12 basis sets on the one hand, and (T) extrapolated from conventional CCSD(T)/heavy-aug-cc-pV{D,T}Z on the other hand. Implications for earlier benchmarks on the larger S66×8 problem set in particular, and for accurate calculations on non-covalent interactions in general, are discussed. At a slight cost in accuracy, (T) can be considerably accelerated by using sano-V{D,T}Z+ basis sets, whereas half-counterpoise CCSD(F12*)(T)/cc-pVDZ-F12 offers the best compromise between accuracy and computational cost.
Tundra avian community composition during recovery from the Anaktuvuk River Fire
Authors: Pérez Jonathan H. , Chmura Helen E. , Krause Jesse S.
Published: January 2018

In 2007, a fire burned over 100000ha along the Anaktuvuk River in Alaska, causing widespread ecological disturbance. Despite efforts to understand ecosystem recovery, little is known about higher trophic levels. Here, we present qualitative findings from a preliminary bird survey of the burn scar region, conducted in 2014, at three sites representing varying severity of burn damage. We found that abundance and species richness both appear higher at a site that experienced a moderate degree of burn damage than unburned control and severely burned sites. These findings suggest that the impacts of fires on bird communities may be minimal within 7 years post fire. Furthermore, our findings highlight the need for more rigorous efforts to understand the dynamics of tundra bird community fire recovery in a rapidly changing world.
Calculation of ductility from pearlite microstructure
Authors: Das Arpan
Published: January 2018

Ductility in drawn pearlitic steels’ wire is dependent on microstructural features, carbon concentration, transformation temperature and strain. An extensive literature review is performed and investigated that there are conflicting results about the effect of interlamellar spacing, pearlite colony size and prior-austenitic grain size on the toughness of these steels. This may be attributed to the differences in compositions, heat treatment, drawing conditions, the methodology applied for measuring microstructural entities and inaccuracy in measurements. Currently, a neural network model is created to correlate the complex relationship between tensile ductility with its influencing parameters in a variety of cold drawn pearlitic steels. The model has been applied to confirm that the calculations are reasonable in the context of metallurgical theories and other data published in the literature.
Looking in the rear-view mirror as we anticipate another 100 years
Authors: Gordon Sharona E.
Published: January 2018

As JGP approaches its centenary, we consider how physiology has changed over the last 100 years and reflect on the journal's role in the physiology community..
Spectral bounds for singular indefinite Sturm-Liouville operators with 𝐿¹-potentials
Authors: Behrndt Jussi , Schmitz Philipp , Trunk Carsten
Published: January 2018

The spectrum of the singular indefinite Sturm-Liouville operator

A
=
sgn
⁡
(
⋅
)

(

−

d
2

d

x
2

+
q

)

\begin{equation*} A=\operatorname {sgn}(\cdot )\bigl (-\tfrac {d^2}{dx^2}+q\bigr ) \end{equation*}

with a real potential

q
∈

L
1

(

R

)

q\in L^1(\mathbb R)

covers the whole real line, and, in addition, non-real eigenvalues may appear if the potential

q
q

assumes negative values. A quantitative analysis of the non-real eigenvalues is a challenging problem, and so far only partial results in this direction have been obtained. In this paper the bound

|
λ
|
≤
‖
q

‖

L
1

2

\begin{equation*} \vert \lambda \vert \leq \Vert q\Vert _{L^1}^2 \end{equation*}

on the absolute values of the non-real eigenvalues

λ
\lambda

of

A
A

is obtained. Furthermore, separate bounds on the imaginary parts and absolute values of these eigenvalues are proved in terms of the

L
1

L^1

-norm of the negative part of

q
q

.
Signature functions of knots
Authors: Livingston Charles
Published: January 2018

The signature function of a knot is an integer-valued step function on the unit circle in the complex plane. Necessary and sufficient conditions for a function to be the signature function of a knot are presented.
The structure theory of Nilspaces II: Representation as nilmanifolds
Authors: Gutman Yonatan , Manners Freddie , Varjú Péter
Published: January 2018

This paper forms the second part of a series of three papers by the authors concerning the structure of nilspaces of Antolín Camarena and Szegedy. A nilspace is a compact space

X
X

together with closed collections of cubes

C
n

(
X
)
⊆

X

2
n

C_n(X)\subseteq X^{2^n}

,

n
=
1
,
2
,
…

n=1,2,\ldots

satisfying some natural axioms. From these axioms it follows that a nilspace can be built as a finite tower of extensions where each of the successive fibers is a compact abelian group.

Our main result is a new proof of a result due to Antolín Camarena and Szegedy [Nilspaces, nilmanifolds and their morphisms, arXiv:1009.3825v3 (2012)] stating that if each of these groups is a torus, then

X
X

is isomorphic (in a strong sense) to a nilmanifold

G

/

Γ

G/\Gamma

. We also extend the theorem to a setting where the nilspace arises from a dynamical system

(
X
,
T
)

(X,T)

. These theorems are a key stepping stone towards the general structure theorem in [The structure theory of nilspaces III: Inverse limit representations and topological dynamics, arXiv:1605.08950v1 [math.DS] (2016)] (which again closely resembles the main theorem of Antolín Camarena and Szegedy).

The main technical tool, enabling us to deduce algebraic information from topological data, consists of existence and uniqueness results for solutions of certain natural functional equations, again modelled on the theory in Antolín Camarena and Szegedy’s paper.
Relative singular locus and Balmer spectrum of matrix factorizations
Authors: Hirano Yuki
Published: January 2018

For a separated Noetherian scheme

X
X

with an ample family of line bundles and a non-zero-divisor

W
∈
Γ
(
X
,
L
)

W\in \Gamma (X,L)

of a line bundle

L
L

on

X
X

, we classify certain thick subcategories of the derived matrix factorization category

DMF

(
X
,
L
,
W
)

\textrm {DMF}(X,L,W)

of the Landau–Ginzburg model

(
X
,
L
,
W
)

(X,L,W)

. Furthermore, by using the classification result and the theory of Balmer’s tensor triangular geometry, we show that the spectrum of the tensor triangulated category

(

DMF

(
X
,
L
,
W
)
,

⊗

1
2

)

(\textrm {DMF}(X,L,W), \otimes ^{\frac {1}{2}})

is homeomorphic to the relative singular locus

S
i
n
g

(

X
0

/

X
)

\mathrm {Sing}(X_0/X)

, introduced in this paper, of the zero scheme

X
0

⊂
X

X_0\subset X

of

W
W

.
Sieving rational points on varieties
Authors: Browning Tim , Loughran Daniel
Published: January 2018

An upper bound sieve for rational points on suitable varieties is developed, together with applications to counting rational points in thin sets, to local solubility in families, and to the notion of “friable” rational points with respect to divisors. In the special case of quadrics, sharper estimates are obtained by developing a version of the Selberg sieve for rational points.
Management and Outcomes of Childhood Renal Artery Stenosis and Middle Aortic Syndrome
Authors: Rumman Rawan K , Matsuda-Abedini Mina , Langlois Valerie , Radhakrishnan Seetha , Lorenzo Armando J , Amaral Joao , Mertens Luc , Parekh Rulan S
Published: January 2018

BACKGROUND

Renal artery stenosis (RAS) in isolation or in conjunction with middle aortic syndrome (MAS) are important vascular causes of childhood hypertension. Few longitudinal studies have assessed the risk of surgical or endovascular intervention, and outcomes by etiology or extent of vascular disease.

METHODS

In a retrospective study of 93 children seen over 30 years with RAS and/or MAS, data on vascular involvement (isolated RAS vs. RAS with MAS), etiology (unknown, inflammatory, or genetic), and management were collected. Time to first intervention (endovascular or surgical) was assessed by Cox regression. Mixed-effects analysis examined the longitudinal change in blood pressure after intervention compared to antihypertensive medications alone.

RESULTS

Children were 7.0 ± 5.4 years old. Etiology was unknown in 50%, genetic in 26% and inflammatory in 24% of children. Children had isolated RAS (49%) or MAS with or without RAS (51%). Overall, 70% were managed with surgical or endovascular intervention. After adjusting for age, sex, and systolic blood pressure, children with unknown etiology had a higher risk of intervention compared to those with genetic and inflammatory diseases (hazard ratio 3.1, 95% confidence interval [CI] 1.7, 5.6). Children with RAS and MAS were less likely to receive intervention (hazard ratio 0.4, 95% CI 0.2, 0.8) than isolated RAS. Over a median follow-up of 2 years, 65% remained hypertensive. The longitudinal changes in systolic blood pressure did not differ by etiology, or between interventional and medical management.

CONCLUSIONS

Hypertension persists despite endovascular or surgical management of childhood RAS and MAS highlighting the importance of close monitoring and ongoing medical management.
Professional Values Competency Evaluation: Comparing Student Written Assignments to Literature Findings
Authors: Elliott Annette , Byrne Michelle
Published: January 2018

Nurse educators have had no clear evidence-based method to evaluate student competency related to professional values. This article describes a comparative analysis in which the list of professional values identified in a research study of undergraduate prelicensure nursing student assignments was compared with a list identified in an integrative review of nursing literature. Comparative analysis allowed for a categorization of professional values that were either congruent between student assignments and literature, exclusively evident in literature, or exclusively evident in student assignments. Findings may contribute to curricular process improvements promoting professional values development in undergraduate nursing students.
A Qualitative Study of the Influences on Clinical Academic Physicians’ Postdoctoral Career Decision Making
Authors: Ranieri Veronica F. , Barratt Helen , Rees Geraint , Fulop Naomi J.
Published: January 2018

Purpose

To describe the influences on clinical academic physicians’ postdoctoral career decision making.

Method

Thirty-five doctoral trainee physicians from University College London took part in semistructured interviews in 2015 and 2016. Participants were asked open-ended questions about their career to date, their experiences undertaking a PhD, and their career plans post PhD. The interviews were audio-recorded and transcribed. Thematic analysis was used to generate, review, and define themes from the transcripts. Emerging differences and similarities in participants’ reasons for pursuing a PhD were then grouped to produce typologies to explore how their experiences influenced their career decision making.

Results

Participants described four key reasons for undertaking a PhD, which formed the basis of the four typologies identified. These reasons included the following: to pursue a clinical academic career; to complete an extensive period of research to understand whether a clinical academic career was the desired path forward; to improve clinical career prospects; and to take a break from clinical training.

Conclusions

These findings highlight the need to target efforts at retaining clinical academic physicians according to their reasons for pursuing a PhD and their subsequent experiences with the process. Those responsible for overseeing clinical training must be well informed of the long-term benefits of training academically qualified physicians. In light of current political uncertainty, universities, hospitals, and external agencies alike must increase their efforts to inspire and assuage early-career clinical academic physicians’ fears regarding their academic future.
Home Hearing Test: Within-Subjects Threshold Variability
Authors: Margolis Robert H. , Bratt Gene , Feeney M. Patrick , Killion Mead C. , Saly George L.
Published: January 2018

Background:

The Home Hearing Test (HHT) is an automated pure-tone threshold test that obtains an air conduction audiogram at five test frequencies. It was developed to provide increased access to hearing testing and support home telehealth programs.

Purpose:

Test and retest thresholds for 1000-Hz stimuli were analyzed to determine intrasubject variability from two independent data sets.

Research Design:

Prospective, repeated measures.

Study Sample:

In the Veterans Affairs (VA) study, results from 26 subjects 44 to 88 years of age (mean = 65) recruited from the Nashville VA audiology clinic were analyzed. Subjects were required to have a Windows PC in the home and were self-reported to be comfortable with using computers. Two subjects had normal hearing, and 24 had hearing losses of various severities and configurations. The National Center for Rehabilitative Auditory Research (NCRAR) sample included 100 subjects (68 males; 32 females) with a complaint of hearing difficulty recruited from the local community and Veteran population. Subjects ranged in age from 32 to 87 years (mean = 63.7 years). They were tested in a quiet room at the NCRAR.

Data Collection and Analysis:

Subjects in the VA study were provided kits for installing HHT on their home computers. HHT was installed on a computer at NCRAR to test subjects in the NCRAR study. HHT obtains a five-frequency air conduction audiogram with a retest of 1000 Hz in both ears. Only the 1000-Hz test–retest results are analyzed in this report. Six statistical measures of test–retest variability are reported.

Results:

Test and retest thresholds were highly correlated in both studies (r ≥ 0.96). Test–retest differences were within ±5 dB ≥92% of the time in the two studies. Standard deviations of absolute test–retest difference were ≤3.5 dB in the two studies.

Conclusions:

Intrasubject variability is comparable to that obtained with manual testing by audiologists in sound-treated test rooms.
Clinical Epidemiology of Adults With Moderate Traumatic Brain Injury*
Authors: Watanitanon Arraya , Lyons Vivian H. , Lele Abhijit V. , Krishnamoorthy Vijay , Chaikittisilpa Nophanan , Chandee Theerada , Vavilala Monica S.
Published: January 2018

Objectives:

To characterize admission patterns, treatments, and outcomes among patients with moderate traumatic brain injury.

Design:

Retrospective cohort study.

Setting:

National Trauma Data Bank.

Patients:

Adults (age > 18 yr) with moderate traumatic brain injury (International Classification of Diseases, Ninth revision codes and admission Glasgow Coma Scale score of 9–13) in the National Trauma Data Bank between 2007 and 2014.

Interventions:

None.

Measurement and Main Results:

Demographics, mechanism of injury, hospital course, and facility characteristics were examined. Admission characteristics associated with discharge outcomes were analyzed using multivariable Poisson regression models. Of 114,066 patients, most were white (62%), male (69%), and had median admission Glasgow Coma Scale score of 12 (interquartile range, 10–13). Seventy-seven percent had isolated traumatic brain injury. Concussion, which accounted for 25% of moderate traumatic brain injury, was the most frequent traumatic brain injury diagnosis. Fourteen percent received mechanical ventilation, and 66% were admitted to ICU. Over 50% received care at a community hospital. Seven percent died, and 32% had a poor outcome, including those with Glasgow Coma Scale score of 13. Compared with patients 18–44 years, patients 45–64 years were twice as likely (adjusted relative risk, 1.97; 95% CI, 1.92–2.02) and patients over 80 years were five times as likely (adjusted relative risk, 4.66; 95% CI, 4.55–4.76) to have a poor outcome. Patients with a poor discharge outcome were more likely to have had hypotension at admission (adjusted relative risk, 1.10; 95% CI, 1.06–1.14), lower admission Glasgow Coma Scale (adjusted relative risk, 1.37; 95% CI, 1.34–1.40), higher Injury Severity Score (adjusted relative risk, 2.97; 95% CI, 2.86–3.09), and polytrauma (adjusted relative risk, 1.05; 95% CI, 1.02–1.07), compared with those without poor discharge outcomes.

Conclusions:

Many patients with moderate traumatic brain injury deteriorate, require neurocritical care, and experience poor outcomes. Optimization of care and outcomes for this vulnerable group of patients are urgently needed.
Clinical and radiological response of BRAF inhibition and MEK inhibition in patients with brain metastases from BRAF-mutated melanoma
Authors: Geukes Foppen Marnix H. , Boogerd Willem , Blank Christian U. , van Thienen Johannes V. , Haanen John B. , Brandsma Dieta
Published: January 2018

Patients with brain metastases (BM) from melanoma have an overall survival (OS) of 2–6 months after whole-brain radiotherapy. Targeted therapy (TT) is an effective treatment for BRAF-mutated metastatic melanoma. Moreover, recent studies indicate intracranial responses of TT in patients with BM. We analyzed 146 patients with BM from BRAF-mutated melanoma treated with vemurafenib, dabrafenib, or dabrafenib+trametinib between 2010 and 2016. We determined clinical and radiological response, progression-free survival (PFS), and OS. Median OS of patients treated with dabrafenib+trametinib was 11.2 months [n=30; 95% confidence interval (CI): 6.8–15.7], 8.8 months for dabrafenib alone (n=31; 95% CI: 3.9–13.7), and 5.7 months for vemurafenib (n=85; 95% CI: 4.6–6.8). A significantly longer OS was observed in the dabrafenib+trametinib group than in the vemurafenib group (hazard ratio for death, 0.52; 95% CI: 0.30–0.89; P=0.02). Median intracranial PFS of all patients was 4.1 months. Median intracranial PFS for patients treated with dabrafenib+trametinib was 5.8 months (95% CI: 3.2–8.5), 5.7 months (95% CI: 3.0–8.4) for dabrafenib, and 3.6 months (95% CI: 3.5–3.8) for vemurafenib (P=0.54). A total of 63 (43%) patients had symptomatic BM. Intracranial disease control rate at 8 weeks in these patients was 65 versus 70% extracranially. Neurological symptoms improved in 46% of patients with symptomatic BM, whereas in 21%, they remained stable. Median OS in patients with BM from BRAF-mutated melanoma treated with dabrafenib+trametinib was significantly longer than for vemurafenib. Improvement of neurological symptoms was seen in almost half of the patients with symptomatic BM treated with TT.
Copy number variations and fetal ventriculomegaly
Authors: Wang Yan , Hu Ping , Xu Zhengfeng
Published: January 2018

Purpose of review

Ventriculomegaly is one of the most common abnormal sonographic findings, which is associated with congenital infection, chromosomal and additional structural abnormalities. Currently, karyotype analysis is the primary method to detect chromosomal abnormalities in fetuses with ventriculomegaly. Recently, with the introduction of chromosomal microarray analysis (CMA) in prenatal diagnosis, copy number variations (CNVs) have been identified in cases of ventriculomegaly. The purpose of this review is to summarize the current knowledge about the genetic cause of fetal ventriculomegaly, with particular attention to primary articles regarding the association between CNVs and fetal ventriculomegaly.

Recent findings

Recent studies have disclosed that in addition to numerical chromosomal abnormalities and large chromosomal imbalances, pathogenic CNVs are another important genetic cause of fetal ventriculomegaly, which may be involved in the pathological process of fetal ventriculomegaly as well as postnatal neurodevelopmental disorders. Furthermore, it is reported that the incidences of pathogenic CNVs in fetuses with ventriculomegaly were associated with the presence of other structural anomalies, but were irrelevant to the severity of ventriculomegaly.

CNVs are an important cause of fetal ventriculomegaly and CMA should be offered to all fetuses with ventriculomegaly, regardless of the degree of ventriculomegaly or whether combined with other structural anomalies.
Enhanced Preoperative Deep Inferior Epigastric Artery Perforator Flap Planning with a 3D-Printed Perforasome Template: Technique and Case Report
Authors: Chae Michael P. , Hunter-Smith David J. , Rostek Marie , Smith Julian A. , Rozen Warren Matthew
Published: January 2018

Optimizing preoperative planning is widely sought in deep inferior epigastric artery perforator (DIEP) flap surgery. One reason for this is that rates of fat necrosis remain relatively high (up to 35%), and that adjusting flap design by an improved understanding of individual perforasomes and perfusion characteristics may be useful in reducing the risk of fat necrosis. Imaging techniques have substantially improved over the past decade, and with recent advances in 3D printing, an improved demonstration of imaged anatomy has become available. We describe a 3D-printed template that can be used preoperatively to mark out a patient’s individualized perforasome for flap planning in DIEP flap surgery. We describe this “perforasome template” technique in a case of a 46-year-old woman undergoing immediate unilateral breast reconstruction with a DIEP flap. Routine preoperative computed tomographic angiography was performed, with open-source software (3D Slicer, Autodesk MeshMixer and Cura) and a desktop 3D printer (Ultimaker 3E) used to create a template used to mark intra-flap, subcutaneous branches of deep inferior epigastric artery (DIEA) perforators on the abdomen. An individualized 3D printed template was used to estimate the size and boundaries of a perforasome and perfusion map. The information was used to aid flap design. We describe a new technique of 3D printing a patient-specific perforasome template that can be used preoperatively to infer perforasomes and aid flap design.
COMPARISON OF VISUAL AND ANATOMICAL OUTCOMES OF EYES UNDERGOING TYPE I BOSTON KERATOPROSTHESIS WITH COMBINATION PARS PLANA VITRECTOMY WITH EYES WITHOUT COMBINATION VITRECTOMY
Authors: Lim Jennifer I. , Machen Lindsay , Arteaga Andrea , Karas Faris I. , Hyde Robert , Cao Dingcai , Niec Marcia , Vajaranant Thasarat S. , Cortina M. Soledad
Published: January 2018

Purpose:

To determine whether 1-year visual and anatomical results after surgery combining pars plana vitrectomy, Boston keratoprosthesis, and a glaucoma drainage device as needed are similar, better, or worse than Boston keratoprosthesis initial implantation alone.

Methods:

We performed a retrospective review of adult patients undergoing Boston keratoprosthesis at our institution. Visual acuity outcomes, anatomical results, and complication rates of patients undergoing combination surgery (including pars plana vitrectomy and a posterior glaucoma drainage device) were compared with those undergoing keratoprosthesis placement alone.

Results:

There were 70 eyes in the keratoprosthesis alone group and 55 eyes in the keratoprosthesis with pars plana vitrectomy group. Mean follow-up durations were 54.67 months in the keratoprosthesis alone group and 48.41 months in the combination group. Baseline mean Snellen equivalent visual acuities were worse for the combination group compared with the keratoprosthesis alone group (P = 0.027). Visual acuities improved postoperatively by 1 month after keratoprosthesis implantation for both groups and improved three or more lines of Snellen acuity in the majority of eyes for both groups (≥72% by 12 months). Eyes undergoing pars plana vitrectomy had lower rates of de novo (P = 0.015) and significantly lower rates of secondary procedures (P = 0.002) at 1 year. One year complications rates for retroprosthetic membrane formation, retinal detachment, hypotony, cystoid macular edema, epiretinal membrane formation, endophthalmitis, and corneal melting were similar for both groups.

Conclusion:

Compared with keratoprosthesis alone, combining keratoprosthesis with pars plana vitrectomy and a glaucoma drainage device as needed, resulted in lower rates of de novo glaucoma, lower rates of additional surgical procedures, similar visual acuity outcomes at 1 year, and did not result in higher complication rates.
OPTICAL COHERENCE TOMOGRAPHY AND OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY EVALUATION OF COMBINED HAMARTOMA OF THE RETINA AND RETINAL PIGMENT EPITHELIUM
Authors: Arrigo Alessandro , Corbelli Eleonora , Aragona Emanuela , Manitto Maria Pia , Martina Elisabetta , Bandello Francesco , Parodi Maurizio Battaglia
Published: January 2018

Purpose:

To study multimodal imaging features of combined hamartoma of the retina and retinal pigment epithelium (CHRRPE).

Methods:

Six patients (3 males, mean age 11 years) and a healthy age-matched control group made up of 15 healthy subjects (8 males, mean age 12.6 years) were included in the analysis. Complete ophthalmologic examination was performed, including best-corrected visual acuity, anterior and posterior segment slit-lamp evaluation, and tonometry. The multimodal imaging protocol included fundus images, structural optical coherence tomography (OCT), and swept-source OCT angiography (OCTA). The main outcome measures included the qualitative evaluation of both OCT and OCTA features of CHRRPE, retinal and choroidal thickness measurements, and the quantitative analysis of superficial capillary plexus, deep capillary plexus, and choriocapillaris vessel densities.

Results:

Optical coherence tomography features of CHRRPE were examined extensively. Multiple little hyperreflective triangular outer retinal alterations were found at the CHRRPE edges in all patients; these were dubbed the “shark-teeth” sign. Optical coherence tomography angiography showed rarefaction and morphologic alterations of all retinal plexa. Moreover, quantitative analysis revealed a statistically significant decrease in superficial capillary plexus, deep capillary plexus, and choriocapillaris vessel densities in patients affected by CHRRPE compared with the control group.

Conclusion:

Optical coherence tomography and OCTA analyses allowed the accurate qualitative and quantitative analyses of CHRRPE features. Further studies are needed to better define OCTA changes of CHRRPE better and to improve our understanding of the possible causes of the shark-teeth sign.
Temporal Improvements in Long-term Outcome in Care Among HIV-infected Children Enrolled in Public Antiretroviral Treatment Care
Authors: Makadzange A. Tariro , Dougherty Leanne , Birri Rutendo , Kupakuwana Gillian , van Dijk Janneke , Bwakura Dangarembizi Mutsa , Mothobi Nomvuyo , Phelps Benjamin , Ojikutu Bisola , Ndhlovu Chiratidzo E.
Published: January 2018

Background:

Increasing numbers of children are requiring long-term HIV care and antiretroviral treatment (ART) in public ART programs in Africa, but temporal trends and long-term outcomes in care remain poorly understood.

Methods:

We analyzed outcomes in a longitudinal cohort of infants (<2 years of age) and children (2–10 years of age) enrolling in a public tertiary ART center in Zimbabwe over an 8-year period (2004–2012).

Results:

The clinic enrolled 1644 infants and children; the median age at enrollment was 39 months (interquartile range: 14–79), with a median CD4% of 17.0 (interquartile range: 11–24) in infants and 15.0 (9%–23%) in children (P = 0.0007). Among those linked to care, 33.5% dropped out of care within the first 3 months of enrollment. After implementation of revised guidelines in 2009, decentralization of care and increased access to prevention of mother to child transmission services, we observed an increase in infants (48.9%–68.3%; P < 0.0001) and children (48.9%–68.3%; P < 0.0001) remaining in care for more than 3 months. Children enrolled from 2009 were younger, had lower World Health Organization clinical stage, improved baseline CD4 counts than those who enrolled in 2004–2008. Long-term retention in care also improved with decreasing risk of loss from care at 36 months for infants enrolled from 2009 (aHR: 0.57; 95% confidence interval: 0.34–0.95; P = 0.031). ART eligibility at enrollment was a significant predictor of long-term retention in care, while delayed ART initiation after 5 years of age resulted in failure to fully reconstitute CD4 counts to age-appropriate levels despite prolonged ART.

Conclusions:

Significant improvements have been made in engaging and retaining children in care in public ART programs in Zimbabwe. Guideline and policy changes that increase access and eligibility will likely to continue to support improvement in pediatric HIV outcomes.
Update on Neonatal Herpes Simplex Epidemiology in the Netherlands
Authors: van Oeffelen Louise , Biekram Manisha , Poeran Jashvant , Hukkelhoven Chantal , Galjaard Sander , van der Meijden Wim , Op de Coul Eline
Published: January 2018

Background:

This article provides an update on the incidence of neonatal herpes, guideline adherence by health care professionals (HCP) and trends in genital herpes simplex virus (HSV) infection during pregnancy in the Netherlands.

Methods:

Questionnaires were sent to all hospitals inquiring about numbers and characteristics of neonatal and maternal HSV infections, and guideline adherence between 2012 and 2015. Longitudinal trends were investigated from 1999 onward using survey data and Perinatal Registry of the Netherlands data (Perined). Trends were smoothed with Poisson regression splines. Risk indicators for neonatal and maternal HSV infections were examined with Poisson regression analyses.

Results:

Neonatal herpes incidence was 4.8/100,000 live births based on survey data (2012–2015) and 3.4/100,000 based on Perined (2012–2014). Mortality rate was 23% (7/30). Neonatal herpes incidence increased slightly over time as did the prevalence of genital HSV infection among pregnant women. Non-Western ethnicity (Rate Ratio: 1.9; 95% confidence interval: 1.5–2.5) and age <20 years (Rate Ratio: 2.3; 95% confidence interval: 1.2–4.7) were associated with genital herpes during pregnancy. In Perined, none of the neonatal herpes cases had a mother diagnosed with an active genital herpes infection during pregnancy. Preventive measures to reduce vertical herpes transmission (such as cesarean section) were less commonly reported by HCP in 2012–2015 compared with 2006–2011.

Conclusions:

Neonatal herpes incidence in the Netherlands slowly increased over the last 15 years. An increased genital HSV prevalence during pregnancy or, to lower extent, the decreased guideline adherence by HCP may be responsible. A rise in asymptomatic maternal HSV shedding is also plausible, emphasizing the challenges in preventing neonatal herpes.
Retrospective Analysis of Physician-based Surveys Published in OPRS
Authors: Prendes Mark A. , Fu Roxana , Lamb Isaac W. , Nunery William R. , Kahana Alon , Lee H.B. Harold
Published: January 2018

Purpose:

To review physician-based clinical surveys published in Ophthalmic Plastic and Reconstructive Surgery.

Methods:

Complementary Ovid and PubMed searches of Ophthalmic Plastic and Reconstructive Surgery journal content were performed for the term “survey.” Results were narrowed to studies that specifically addressed physicians’ clinical practices. This search resulted in 162 articles, and after dual-investigator independent screening, 13 surveys met inclusion criteria.

Results:

Of the 13 surveys published from 2007 to January 2017, 6 were published since 2015, showing an increased trend in survey-based publications. Topics included assessing practice patterns regarding eyelid disorders, thyroid eye disease, optic nerve sheath fenestration, anophthalmic socket, and diagnosing lacrimal disorders. Average response rate was 38.7% (range 17.5–60%), with 201 average number of replies (range 72–310). Nine out of 13 surveys included some form of statistical analysis with the remainder presenting data in percentages.

Conclusions:

There has been an increased rate of survey-type publications in Ophthalmic Plastic and Reconstructive Surgery over the past 10 years. The low response rate and frequent lack of statistical analysis raise concerns regarding the validity and usefulness of such studies. The authors believe that survey studies can be improved through better standardization and the use of author guidelines. They have made specific recommendations to improve the impact of survey papers in the future.
Quality and Cultural Sensitivity of Linguistically Appropriate Cardiovascular Disease Information for Chinese Immigrants
Authors: Li Jialin , Lowres Nicole , Jin Kai , Zhang Ling , Neubeck Lis , Gallagher Robyn
Published: January 2018

Background:

Chinese immigrants are at an increased risk for cardiovascular diseases (CVDs) compared with Chinese nationals partly because of lifestyle changes and knowledge deficits. Translated patient resources are available on the Internet and are often provided by health professionals; however, the quality and cultural sensitivity of these resources have not been reported.

Objective:

The aim of this study was to assess the availability, quality, and cultural sensitivity of Chinese-language information available from national “Heart Foundations” (cardiac research bodies, nongovernmental organisations) of the 5 most popular destinations of Chinese immigration.

Methods:

This study is a descriptive research in which national “Heart Foundation” websites were systematically searched for Chinese-language CVD patient education resources. Quality (content, identification, structure) was assessed using the Ensuring Quality Information for Patients instrument. Cultural sensitivity was evaluated using the Cultural Sensitivity Assessment Tool.

Results:

From 107 identified resources, 33 were CVD specific: coronary heart disease (n = 20), arrhythmias (n = 7), and heart failure (n = 6). Quality of resources was adequate (mean Ensuring Quality Information for Patients score, 69%), but scores varied significantly (min, 60%; max, 85%). Although all resources were classified as culturally sensitive (Cultural Sensitivity Assessment Tool score ≥ 2.5), 2 resources scored low (≤2.5) for visual impact, and across all resources, written and visual domains were assessed as least culturally sensitive. Most resources lacked culturally specific references.

Conclusions:

Chinese-language CVD resources were inconsistent in the supply of key information. Quality and level of cultural sensitivity were adequate, but most resources lacked culturally specific references. Comprehensive, high-quality CVD resources powered by Editorial Manager and ProduXion Manager from Aries Systems Corporation tailored for Chinese immigrants are urgently needed for healthcare providers to support CVD education and care of patients belonging to this population.
Effects of Static Stretching Exercise on Lumbar Flexibility and Central Arterial Stiffness
Authors: Logan Jeongok G. , Kim Suk-Sun , Lee Mijung , Byon Ha Do , Yeo SeonAe
Published: January 2018

Background:

Previous studies have demonstrated that arterial stiffness is associated with lumbar flexibility (LF). Stretching exercise targeted to improve LF may have a beneficial effect on reducing arterial stiffness.

Objectives:

We examined the effects of a single bout of a structured, static stretching exercise on arterial stiffness, LF, peripheral and central blood pressure (BP), and heart rate (HR) and tested the association between LF and central arterial stiffness.

Method:

The study had a pretest-posttest design without a control group. Thirty healthy women followed a video demonstration of a 30-minute whole-body stretching exercise. Carotid-femoral pulse wave velocity (cf-PWV), augmentation index, LF, peripheral and central BP, and HR were measured before and after the stretching exercise.

Results:

One bout of a static stretching exercise significantly reduced cf-PWV (t29= 2.708,P= .011) and HR (t29= 7.160,P= .000) and increased LF (t29= 12.248,P< .000). Augmentation index and peripheral and central BP also decreased but did not reach statistical significance. Despite no association found between cf-PWV and LF, the larger increase in LF the subjects had, the larger decrease in cf-PWV they had after exercise (r= 0.500,P= .005).

Conclusions:

Study findings highlight the potential benefit of a static stretching exercise on central arterial stiffness, an independent predictor of cardiovascular morbidity. Static stretching exercise conducted in the sitting position may be used as an effective intervention to reduce cardiovascular risk after a cardiac event or for patients whose sympathetic function should not be overly activated or whose gaits are not stable.
Knowing Your Worth: Salary Expectations and Gender of Matriculating Physician Assistant Students
Authors: Streilein Annamarie , Leach Brandi , Everett Christine , Morgan Perri
Published: January 2018

Purpose

The male-female wage gap is present and persistent in the health care sector, even among physician assistants (PAs). Explanations for the persistent gender earnings gap include differential salary expectations of men and women based, in part, on women's lower pay entitlement. The purpose of this study was to examine differences in salary expectations between male and female matriculating PA students nationwide, adjusting for other factors expected to affect salaries and pay expectations of both male and female matriculants.

Methods

Using data from the Physician Assistant Education Association Matriculating Student Survey of 2013, 2014, and 2015, we investigated the relationship between first-year PA students' gender and their salary expectations after graduation using a multinomial logistic regression analysis. We controlled for possible confounders by including independent variables measuring student demographics, background characteristics, qualifications, future career plans, and financial considerations.

Results

We found that female PA students were less likely than male PA students to expect a salary of $80,000–$89,999 (Odds Ratio [OR] = 0.73), $90,000–$99,999 (OR = 0.58), or $100,000 or greater (OR = 0.42) in comparison to an expected salary of less than $70,000, when controlling for our independent variables.

Conclusions

Our analysis shows that on entry into PA training programs, female PA students' earnings expectations are less than those of male PA students. Our results are consistent with research, suggesting that women typically expect lower pay and systematically undervalue their contributions and skills in comparison to men. Physician assistant programs should consider strategies to promote realistic salary expectations among PA students as one way to promote earnings equity.
Public health impact of androgens
Authors: Kanayama Gen , Kaufman Marc J. , Pope Harrison G.
Published: January 2018

Purpose of review

To summarize recent findings regarding the public health impact of androgen abuse.

Recent findings

Abuse of androgens (also called ‘anabolic-androgenic steroids’) has grown into a major worldwide substance abuse problem involving tens of millions of individuals, of whom about 98% are men. Most androgen abusers are still under age 50 today, and thus, the long-term effects of these drugs are only beginning to be understood. Recent studies confirm that long-term supraphysiologic androgen exposure produces cardiovascular toxicity, characterized especially by cardiomyopathy and atherosclerotic disease. Withdrawal from androgens after long-term use may produce prolonged and sometimes irreversible hypogonadism in men. Supraphysiologic androgen levels may sometimes cause irritability, aggressiveness, and violence, whereas androgen withdrawal may cause depression. However, these psychiatric effects are idiosyncratic, affecting only a minority of users. Emerging evidence now also suggests that long-term androgen exposure may cause neurotoxicity, raising the possibility that aging androgen abusers may be at increased risk for dementia. Several recent studies have also described androgen-induced hepatotoxicity, nephrotoxicity, and adverse musculoskeletal effects.

Recent studies have demonstrated marked adverse effects of long-term androgen abuse. As increasing numbers of androgen abusers reach middle age, these effects will likely represent an emerging public health problem.
Nutrition in Pediatric Inflammatory Bowel Disease
Authors: Miele Erasmo , Shamir Raanan , Aloi Marina , Assa Amit , Braegger Christian , Bronsky Jiri , de Ridder Lissy , Escher Johanna C. , Hojsak Iva , Kolaček Sanja , Koletzko Sibylle , Levine Arie , Lionetti Paolo , Martinelli Massimo , Ruemmele Frank , Russell Richard K. , Boneh Rotem Sigall , van Limbergen Johan , Veereman Gigi , Staiano Annamaria
Published: January 2018

Background and Aims:

A growing body of evidence supports the need for detailed attention to nutrition and diet in children with inflammatory bowel disease (IBD). We aimed to define the steps in instituting dietary or nutritional management in light of the current evidence and to offer a useful and practical guide to physicians and dieticians involved in the care of pediatric IBD patients.

Methods:

A group of 20 experts in pediatric IBD participated in an iterative consensus process including 2 face‐to‐face meetings, following an open call to Nutrition Committee of the European Society of Pediatric Gastroenterology, Hepatology and Nutrition Porto, IBD Interest, and Nutrition Committee. A list of 41 predefined questions was addressed by working subgroups based on a systematic review of the literature.

Results:

A total of 53 formal recommendations and 47 practice points were endorsed with a consensus rate of at least 80% on the following topics: nutritional assessment; macronutrients needs; trace elements, minerals, and vitamins; nutrition as a primary therapy of pediatric IBD; probiotics and prebiotics; specific dietary restrictions; and dietary compounds and the risk of IBD.

Conclusions:

This position paper represents a useful guide to help the clinicians in the management of nutrition issues in children with IBD.
BSN Preparation for RNs
Authors: Krugman Mary , Goode Colleen J.
Published: January 2018

Some nurse executives and academic nurse leaders believe that the issue of educational entry into professional nursing practice is an “old” issue. Nursing is the only healthcare profession that still does not require the minimum of a baccalaureate degree (BSN). It is time for nurse leaders to act: eliminate the multiple educational levels and require a minimum BSN degree for professional nurse practice.
2017 National Magnet Nurses of the Year®
Authors: Graystone Rebecca
Published: January 2018

The Magnet Recognition Program® recognizes healthcare organizations for quality patient care, nursing excellence, and innovations in professional nursing practice. Consumers rely on the Magnet designation as the ultimate credential for high-quality nursing. The ANCC National Magnet Nurse of the Year® awards were created in 2010 to recognize the outstanding contributions of clinical nurses for innovation, consultation, leadership, and professional risk taking.
Units of Distinction: Creating a Blueprint for Recognition of High-Performing Medical-Surgical Nursing Units
Authors: Jeffery Alvin D. , Mosier Sammie , Baker Allison , Korwek Kimberly , Borum Cindy , Englebright Jane
Published: January 2018

Background

Hospital medical-surgical (M/S) nursing units are responsible for up to 28 million encounters annually, yet receive little attention from professional organizations and national initiatives targeted to improve quality and performance.

Objective

We sought to develop a framework recognizing high-performing units within our large hospital system.

Methods

This was a retrospective data analysis of M/S units throughout a 168-hospital system. Measures represented patient experience, employee engagement, staff scheduling, nursing-sensitive patient outcomes, professional practices, and clinical process measures.

Results

Four hundred ninety units from 129 hospitals contributed information to test the framework. A manual scoring system identified the top 5% and recognized them as a “Unit of Distinction.” Secondary analyses with machine learning provided validation of the proposed framework.

Conclusions

Similar to external recognition programs, this framework and process provide a holistic evaluation useful for meaningful recognition and lay the groundwork for benchmarking in improvement efforts.
Measuring Care Coordination in the Pediatric Cardiology Ambulatory Setting
Authors: Connor Jean A. , Antonelli Richard C. , O'Connell Cheryl A. , Bishop Kuzdeba Hillary , Porter Courtney , Hickey Patricia A.
Published: January 2018

The role of ambulatory nursing is diverse, and the impact on patient outcomes is difficult to measure. The concept of care coordination is an important focus for the ambulatory nurse. We describe the efforts to implement the Cardiac Care Coordination Measurement Tool to document and quantify care coordination activities in a pediatric cardiac ambulatory setting.